by Janet Faulkner, AIA

Acute-care units in U.S. hospitals face challenges: low satisfaction levels for patients and caregivers, ineffective materials flow, lack of storage, inefficient use of beds, and a shortage of nurses, technicians, and other health workers.

Reduced reimbursements don't help, nor does a diminishing supply of operational capital. To top things off, design has often magnified these problems, when it should be helping to alleviate them. But how? What should the acute-care unit of the future look like?

Where We've Been

A brief review of the evolution of the configuration of patient floors shows a variety of shapes as each iteration attempted to solve a different problem.

For one configuration, visibility of the patient was the focus. For another, decreasing the caregiver's daily hike was paramount. Yet each solution invariably compromised other needs — materials flow, storage, patient needs, caregiver requirements — sometimes to the point where the concessions outweighed the intended solution.

Years of incremental tinkering have resulted in today's typical acute-care unit, which forces inefficiencies in a world where efficiency is the only way to succeed. The most important lesson from the past? Let it go. To design the acute-care unit of the future, let's start with current needs, not those of the last century.   >>>

Room-side charting stations decrease travel distances for nurses. Photo: Chris Eden "Care-ports," or nurse stations outfitted to serve as many as three nursing teams, help caregivers maintain critical contact with colleagues. Photo: Chris Eden   Click on thumbnail images to view full-size pictures.