This informal CPD article on ‘A Concept Ward for Single In-Patient Rooms’ was provided by Health Spaces, healthcare estates and design consultants with integrated project delivery capabilities. An award-winning team of best-in-class healthcare consultants and designers creating and delivering world-class NHS estates and facilities.
A Concept Ward for Single In-Patient Rooms
Remedial work at a Norfolk hospital has proved the perfect launchpad for an exciting pilot project – a “Concept Ward” trialling single in-patient rooms. Faced with the need to decant patients into a new space while the renovations were underway, the team at James Paget University Hospital and Health Spaces have seized the opportunity to go further and carry out ground-breaking research.
In a pioneering move in healthcare design, together with James Paget, they have created a 28-bed modular ward that will test out the principle of single rooms, which are due to become the norm under the NHS New Hospital Programme. Moving to 100% single in-patient rooms will be a major transition, therefore the Concept Ward is a vital testbed to evaluate the considerations around practical implementation of the policy.
The ward showcases innovation in healthcare design, but just as important will be recording the impact on patients and staff in terms of experience, length of stay, infection control and the development of complications, for example.
Listening to staff
Design was informed by deep discovery through workshops with staff – who shared the frustrations they currently have when caring for patients and what could be improved – as well as detailed investigation with clinicians, patients’ feedback, national and international research, and best practice. Co-design after listening to staff was critical to address fears such as patients feeling isolated in single rooms, and challenges around observation of patients in closed spaces.
“The richness of our engagement with staff will pay dividends in understanding how they might use the space and how models of care might change,” Jaime Bishop, healthcare architect and co-chair of Architects for Health.
While important research has already been undertaken into single-in patient rooms, what makes the concept ward unique is that it will be used in turn by many different types of patients – from maternity to orthopaedics – as they are moved in from other wards undergoing renovation.
Game changing for clinical strategy
The opportunity this offers can be game changing for clinical strategy. “We needed to avoid ticking the box but missing the point,” said Paul Morris, Chief Nurse at James Paget University Hospital. “It’s not just about lifting and shifting design and practices but really making sure we embrace all the benefits this new world brings.”
He added: “This is an amazing opportunity where we have co-designed modern-day healthcare architecture with patient and staff views to work in collaboration for a really usable space that helps with wellbeing – physical and psychological needs – and has all the added benefits including enhancements to infection control, rest, mobility, the ability to have a shower with ensuite facilities, improvements in privacy and dignity, the ability to use outside space, and improvements to technology in medicine management, education and training.”
Constraints of cost and practicality mean the concept ward has 71% single in-patient rooms with two four-bed bays, but all will be tested with innovative developments in healthcare. These include:
1. Technology
As well as piloting single rooms, the Concept Ward is also pioneering associated technology such as lighting to suit the patient, enabling individuals to change the colour and intensity for comfort while the nursing team can return it to clinical setting when required. The space will be also be a silent ward to encourage active listening. Patients can press a button and alert the nursing team without the noise of bells, and nurses have the essential ability in turn to communicate with patients when they are not in the room. Rooms have also been future-proofed to be ready as technology evolves. “Tech plays a really important role as an enabler with single beds, allowing staff to travel less yet still be in touch with patients,” Jaime said.
2. Observation
The design process has prioritised observation with curved windows that give nursing staff maximum visibility while minimising the need to disrupt a patient while they’re resting. From their touchdown bases nurses can turn 360 degrees to observe at least five patients. Touchdown bases have also been integrated into each single room so nursing and caring is dispersed around the ward with only a small centralised nursing station.
3. Wellbeing
Rooms have been designed to create a healing environment, maximising the use of natural light, each with a bay window and window seat. Half the rooms look out onto grass, half onto the garden. This is also a good example of the need for compromise, however. While beds have been positioned so every patient can see out of the window, nurses’ visibility has also been taken into consideration: they want to see their patients’ torso and face, not just their feet! “It is the art of the possible,” Paul said.
The ward will also feature a new garden area with piped oxygen, covered areas for sitting in the shade or avoiding the rain and a variety of surfaces. The garden and a day room help manage the potential psychological impact of isolation, and the need for socialisation has been in-built in the healthcare design priorities.
