Revisiting Hospital Ward Design Basics for Sustainable Family Integration

Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

Abstract:

The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: Caregiving, design basics, family integration, hospital ward, sustainability.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1315533

References:

[1] C. R. Alalouch, ‘Hospital ward design : implications for space and privacy’, Thesis, Heriot-Watt University, 2009.
[2] R. Dixon, H. Goodman, and T. Noakes, Health Service Buildings. The Architects’ Handbook., Q. Pickard.Eds. Great Britain: Blackwell, 2002.
[3] NHS Estates, ‘In-patient care Scottish Health Planning Note 04-01: Adult in-patient facilities’. Health Facilities Scotland property and capital planning, 2010.
[4] IUSS, ‘IUSS Health Facility Guide_ Adult in patient accommodation’. Department of Health, Republic of south Africa, 2013.
[5] A. Cox and P. Groves, Hospital and Healthcare Facilities. A Design and Development Guide. Published by London: Butterworths. Oxford: Butterwoth-Heinaman, 1990.
[6] R. Glanville and A. Howard, Hospitals. Metric Handbook-Planning and Design Data, 2nd ed. Great Britain: Architectural Press, 1999.
[7] K. Gupta, S. K. Gupta, S. Kant, R. Chandrashekhar, and S. Satpathy, Modern Trends in Planning and Designing of Hospitals: Principles and Practice. Jaypee Brothers Publishers, 2007.
[8] NHS Estates, ‘Ward layouts with single rooms and space for flexibility’. TSO, 01-May-2005.
[9] NHS Estates; ‘Hospital Ward Configuration Determinants Influencing Single Room provision’, A Report for NHS Estates, England by the. EU Health Property Network, Nov. 2004.
[10] NHS Estates; Department of Health, ‘Ward layouts with single rooms and space for flexibility’, Jul. 2005.
[11] I. A. Alkali, M. H. H. Ahmad, and I. Said, The challenges of Nigerian hospital ward setting in providing for family participation, vol. 584–586. 2014.
[12] N. E. D. of Health, ‘Ward layouts with single rooms and space for flexibility’, 15-Jul-2005. (Online). Available: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4119152. (Accessed: 30-Oct-2012).
[13] H. Chaudhury, A. Mahmood, and M. Valente, ‘The Use of Single Patient Rooms versus Multiple Occupancy Rooms in Acute Care Environments’, Simon Fraser University, Jan. 2005.
[14] J. D. Thompson and G. Goldin, The Hospital: Social and Architectural History. New Haven and London: Yale University press, 1975.
[15] L. H. Aiken et al., ‘Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States’, BMJ, vol. 344, Mar. 2012.
[16] P. Åstedt-Kurki, M. Paunonen, and K. Lehti, ‘Family members’ experiences of their role in a hospital: a pilot study’, Journal of Advanced Nursing, vol. 25, no. 5, pp. 908–914, 1997.
[17] M. S. Datton, ‘The Therapeutic Benefits of Design’, in Proceedings of the 2ndInternational Conference on Health and Design (DCHP, 2000), Stockholm, Sweden, 2000, pp. 225–238.
[18] H. Li, B. J. Stewart, M. A. Imle, P. G. Archbold, and L. Felver, ‘Families and hospitalized elders: A typology of family care actions’, Research in Nursing & Health, vol. 23, no. 1, pp. 3–16, 2000.
[19] S. Rao, ‘Designing Hospital for better Infection Control : an Experience’, Medical Journal of Armed forced Institute, vol. 60, no. 1, pp. 40–43, 2004.
[20] S. Kirk, ‘Patient preferences for a single or shared room in a hospice’, Nursing Times, vol. 28, no. 5, pp. 39–41, 2002.
[21] M. Phiri, ‘One Patient One Room – Theory & Practice: An evaluation of The Leeds Nuffield Hospital’, School of Archiecture, University of Sheffield, UK, Jul. 2003.
[22] N. J. F. Pease and I. G. Finlay, ‘Do patients and their relatives prefer single cubicles or shared wards?’, Palliat Med, vol. 16, no. 5, pp. 445–446, Sep. 2002.
[23] Scottish Executive, ‘Single Room Provision within Scotland’, Health Department England, Beardmore Hotel Clydebank, Jan. 2005.
[24] Y.-S. Choi and S. J. Bosch, ‘Environmental affordances: designing for family presence and involvement in patient care’, HERD, vol. 6, no. 4, pp. 53–75, 2013.
[25] D. D. Harris, M. M. Shepley, R. D. White, K. J. S. Kolberg, and J. W. Harrell, ‘The impact of single family room design on patients and caregivers: executive summary’, Journal of Perinatology, vol. 26, pp. S38–S48, 2006.
[26] R. Ulrich, Q. Xiaobo, Z. Craig, J. Anjali, and C. Ruchi, ‘Role of the Physical Environment in the Hospital of the 21st Century’. Sep-2004.
[27] U. M. Wali, ‘Sustaining natural ventilation: The design of general hospital Deba.’, Ahmadu Bello University, Zaria, Nigeria, 1999.
[28] N. G. Chosco, R. C. Moor, and M. Z. Islam, ‘Behavior Mapping: A Method for Linking Preschool Physical Activity and Outdoor Design’, Medicine and Science in Sports and Exercise, pp. 513–519, 2010.
[29] I. Said, ‘Garden Restorative Environment for Children in Malaysian Hospitals’, PhD, Universiti Teknologi Malaysia, Skudai, Johor, 2006.
[30] M. M. Shepley, ‘Family Behavior in a Single-Family Room NICU’, American Institute of Architects, AIA Report on University Research 5.
[31] M. Q. Patton, Qualitative Research & Evaluation Methods: Integrating Theory and Practice. SAGE Publications, 2014.
[32] S. Elo, M. Kääriäinen, O. Kanste, T. Pölkki, K. Utriainen, and H. Kyngäs, ‘Qualitative Content Analysis A Focus on Trustworthiness’, SAGE Open, vol. 4, no. 1, p. 2158244014522633, Sep. 2014.