Building the hospitals of tomorrow
By World Healthcare Journal-
As we examine the healthcare needs of the present day, hospitals are facing a growing need to be more fit for the future. With the cost of care rising, populations expanding, larger patient need for specialist care, and the delivery of care systems through personal solutions such as eHealth, how can we begin to build modern hospitals that can meet the challenges of the 21st century? Richard Cantlay shares his vision of how we can best develop the hospitals of tomorrow and provide better levels of care with higher efficiency, moving towards the ultimate goal of improving patient experience.
Over the coming editions of WHJ, experts in healthcare systems and infrastructure from Mott MacDonald will offer world-leading analysis and perspective on how we can prepare hospitals for the future, the best strategy for achieving this, and how we can improve not just our hospitals but our workplaces and homes to cultivate health.
Providing the vision of the future hospital
Richard Cantlay has been involved within the development of healthcare facilities for more than 15 years. A chartered civil engineer, Richard has extensively worked as a technical advisor to the NHS, leading teams to deliver healthcare system planning, architectural expertise, engineering cost consultancy and advisory on healthcare systems and facilities that are built within the UK.
Richard also supports work in multiple regions around the world. He develops and implements a global healthcare development strategy supported by regional strategies, and secures the appropriate delivery teams to deliver this goal.
In February this year Richard was appointed to Healthcare UK’s advisory board, promoting UK healthcare services abroad as well as supporting overseas organisations with healthcare systems development, and assisting with the development of the strategic direction of HCUK.
As a result, Richard has an unparalleled perspective on the issues that are currently faced in building the next hospitals for the world. Through witnessing first-hand the approaches of different geographies, cultures, and governments towards healthcare and hospital building, Richard can see what needs to be changed, and how we can begin to change it.
“We’re all at different places in terms of healthcare systems,” he says. “If you take the UK for instance, it is more advanced in terms of integrated healthcare, albeit we haven’t quite cracked it just yet. However, at the other end, for instance, is China where they recognise that they have a huge healthcare need but often their approach is to build huge hospitals without really looking at integrated systems. ”
The process of designing, planning, procuring and building a hospital itself is a time-consuming and lengthy process. As the growing need for hospitals and specialist care increases around the world, and clinical teams begin to recognise this, time is precious when it comes to developing new healthcare facilities to meet current needs. However, it is important that in doing so, hospitals aren’t just built for current requirements, but also ready for what the future may hold.
“Clinical teams are often only thinking about how they operate now and then design a facility, rather than how they might operate in five or ten years’ time,” says Richard. “And it’s very hard to predict the requirements for ten years’ time. So, the question is, how do you make facilities that are more adaptable for the long term? ”
Four key strands
Richard proposes that the best way to begin is with a dedicated plan incorporating key areas of development that are currently either neglected or not even considered during current hospital development. While there are many aspects to this, four key strands are as follows:
• Efficient models of integrated care
• Adaptable hospitals
• Healthy buildings
• Digital Infrastructure
These can be achieved in any project, so long as the correct direction and guidance sits behind it.
“These strands are all relatively easy to implement,” says Richard. “It’s all about doing so at the right time and knowing when this is, which will ultimately result in cost savings, better clinical efficiency, and better patient outcomes. ”
Efficient models of care Keeping integrated models of care in mind when planning hospitals is the first stage. Within the UK, hospitals and clinics are part of more integrated models, and these continue to evolve with new developments in fields such as the digital front door.
“The first component of efficient models is building the hospital as part of an integrated care system. The second is getting clinical teams to think about how they might be working in 5, 10 or 15 years’ time. In this way, they achieve a more streamlined, efficient clinical model for their hospital,” Richard says.
However, in other parts of the world integrated healthcare systems aren’t seen as a priority as the demand for care is so great. Building large capacity hospitals as centres for the majority of care is a common approach across the globe. Yet, this may not be the best way to develop new care systems, according to Richard.
“For instance, in China, they often consider building big hospitals. But, instead of building a 2000-bed hospital, they could build a 200-bed hospital and surround it with community facilities, which are surrounded by home services and e-health facilities, so that people can “step-up” through the healthcare system as and when they need to, meaning the clinical services are more accessible, delivered in the most appropriate setting and more efficient. ”
The hospital of the future needs to be able to face any challenges that the future may throw at it. For this reason, a vital part of building the hospitals of the future is to give them the capability to utilise their space, technology and staff in different ways to ensure that, in any situation, hospitals are always working as efficiently as possible.
“The outcome from building more adaptable facilities is to embrace the changes that come along in terms of clinical equipment and technology so you are able to keep up to date more easily, as carrying out a construction project in a live hospital is never good. It also becomes more cost effective to implement those changes, all leading to a better patient experience and better patient outcomes,” says Richard.
Hospitals as buildings should cultivate and restore health, not damage it. If the hospital of the future can curate an environment which is healthy and comfortable, patient recovery times will improve; diseases transmitted in hospitals will decrease; and workload will be reduced across services, as the amount of time patients spend in the hospital will go down.
In addition, healthcare workers who operate within hospitals reported more indoor and workplace related symptoms than any other types of workers, according to Motts. Working for long, continuous hours, being surrounded by sick patients, no designated rest areas – all of these factors contribute to poor concentration levels, work ethic, mood, and physical health as well.
Some of the most innovative and commercial organisations in the world are putting huge effort into designing their working environments to be healthier, more comfortable, and better places to work in. Having a good working environment is a key consideration for people when looking for work nowadays. If hospitals can do this, their capability to attract and retain staff will increase massively. If organisations which aren’t involved in healthcare are designing their workspaces to be as healthy as possible, then why aren’t hospitals doing so?
“Hospitals that put health and wellbeing at the heart of the design process will have positive outcomes,” says Richard. “Better recovery of patients; less risk of hospital-acquired infections; the ability to attract and retain staff; more productive and effective workforce; better visitor experience – an ultimately better patient experience. ”
The impact that digital technology and smart solutions bring to healthcare infrastructure cannot be understated. Monitoring and tracking software can give live, real-time data on how buildings are being used, this allows for predictive building maintenance and the utilisation of equipment in the best way possible. Richard refers to a “digital twin” which provides a digital, live model of a building, which can then be used to monitor the building’s performance.
“Real-time data is sent back to the ‘digital twin’ at all times, giving an up-to-date representation of the asset and how it’s performing which allows you to make better decisions surrounding your building. ”
Building the hospital of the future is a process that won’t happen overnight and won’t be easy. It will require the integration and cooperation of clinical teams, patients, procurers, contractors, engineers, and architects to develop the hospital of the next 5, 10, or 15 years.
The ultimate goal of Mott MacDonald isn’t just to improve hospitals for better efficiency and cheaper running costs, but also to improve the patient experience throughout the entire process. Mott’s experts see these four key strands as essential in moving forward with ever-improving digital solutions and making hospitals more able to face the new and unique problems that the future might hold. Motts plan for the hospital of the future - if implemented - will provide a better quality of care for all.
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