Looking at the Structure of Hospitals

Civitas, 22 June 2009

The European Observatory on Health Systems and Policies held a seminar last week presenting some recent work of a few of my former London School of Hygiene and Tropical Medicine professors. ‘Investing in Hospitals of the Future’, by Bernd Rechel, Martin McKee et al., presents and compares various case studies of the buildings, costs and capacities of different hospitals around Europe. It’s a fascinating new line of research and something anyone interested in future health policy might want to review.

The Observatory states:

‘This book is one of the first to offer a systematic treatment of the decision to invest in the health care estate (wider than hospitals alone, but this is a useful abbreviation). It is in some senses an interim report, attempting to understand the current state of evidence of what works, and to bring that evidence to bear for decision-makers.’

The study brings up novel questions about the layout of hospital wards and offices, for example, the long-term return on investment for deep (tall) vs. narrow (spread out) building designs. It also highlights certain hospitals that are designing facilities with patient and staff well-being prioritised; St Olav’s Hospital in Trondheim, Norway, has been undergoing reconstruction with aims to promote staff comfort, satisfaction and employment efficiency. The hospital estimates that when renovations are completed, it will require 10% fewer staff members to treat the same number of patients. The authors note the effects that atmosphere and layout (such as lighting, art and space) can have on staff morale is currently an untapped research focus and one that could potentially improve services and health system financing.

The report is definitely worth checking out (pdf).