Lecture: Hospital of the Future

Photo linked to Canadian Architect

The University of Toronto John H. Daniels Faculty of Architecture, Landscape and Design has a lecture series every year and I attended Wednesday night’s lecture on the Hospital of the Future, by Dr. Ernesto Morales, a researcher from L’Insitut Universitaire de Geriatrie de Montreal (IUGM).

Dr. Morales was recently invited to participate in a project with the Research Centre for Innovation in Health Care (or Hogeschool Utrecht – HU) in Utretch, Netherlands for the Hospital of the Future. In his lecture he presented an initial design scheme, limited to the patient suite. He uses information gathered from literature and performed a Cochrane Review to determine what the primary needs of hospital users were, and combined with some Evidence-Based Design (EBD) proposals, synthesized it into a network of Values, Peformance and Building System requirements.

His preliminary design based on the EBD proposed by the Cochrane Review was interesting, and provoked a lot of sudden questions from the audience. Some of the design features may not necessarily work with Canadian codes, such as sink accessibility, but I think it was a really great start in the design phase. He’s taking it back to former patients, and doctor and nursing staff for further review.

Ernesto Morales’ lecture also featured some of his interventions in facilities housing seniors with severe Alzheimer’s related dementia. In one location he proposed neutralizing the colour scheme in the corridor (instead of every door being a different colour) and providing tactile areas on the wall to enliven the journey down the corridor. It seems a bit odd, and someone did ask about window boxes instead, but I believe his point is to engage the seniors’ other senses, such as tactility.

In another location for similar seniors, he is testing out the use of light transitions to aid in sleep circadian rhythms, and therefore decrease the use of medications. From 9am to 6pm blue-white light panels light the wing. From 6pm to 9pm it transitions to yellow light. The rest of the night the lights are orange. The lights transition over 30 minutes, and the theory is that the lower intensity light makes it easier to sleep through the night, but still makes it easy enough for staff to check on patients. An architect who attended the lecture is currently designing an NICU with red lights to help newborn prenatal infants sleep while in the hospital. It’s also a light similar to what they’re used to in the womb, which makes it feel familiar.

I have two major thoughts about Wednesday’s lecture. Having worked in a hospital briefly I think there are two other groups he should expand his research to include: maintenance workers and housekeeping staff. While nurses get the brunt end of most patient issues, housekeeping staff are the ones who clean up the hallways of blood, urine, etc. They are the ones who have to reach into pocket doors to get rid of buildup that can cause health problems. Maintenance staff members are the people who make sure the doors, air systems, operating rooms create perfect working conditions for physicians. They even make sure the roads get plowed in snow storms. Their design feedback should be included in his research.

Second, in 2010 I attended a Cascadia workshop on designing and building energy-efficient hospitals in BC. Some of their ideas were along the lines of Ernesto Morales’ lecture. During Wednesday’s lecture, I remembered one of the Cascadia presenters talking about allowing natural light into ORs to help doctors feel the passing of time. I still wonder what physicians prefer. What is good for the patient isn’t always good for the practitioners or staff. (You can download any of the presentations or the audio clips from the workshop by clicking on the link above.)

I found the presentation re-energizing; though the ideas weren’t all new, it renewed my passion for healthcare architecture. I left a card with my email, as UofT lecture organizers promised to send the presentation over; hopefully I’m allowed to post what I receive. If I find a link to the recorded session, I’ll post it as well.

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