ARCH 14 - International Conference on Research on Health Care Architecture - November 19-21, 2014, Espoo, Finland - Conference Proceedings

Healthcare Architecture has grown rapidly in recent years. However, there are still many questions remaining. The commission, therefore, is to share the existing research knowledge and latest results and to carry out research projects focusing more specifically on the health care situation in a variety of contexts. The ARCH14 conference was the third conference in the series of ARCH conferences on Research on Health Care Architecture initiated by Chalmers University. It was realized in collaboration with the Nordic Research Network for Healthcare Architecture .It was a joint event between Aalto University, Finnish Institute of Occupational Health (FIOH) and National Institute of Health and Welfare (THL International).The conference gathered together more than 70 researchers and practitioners from across disciplines and countries to discuss the current themes

Administrative workplaces in healthcare: Designing an efficient and patient-focused environment

The article presents an “Evidence-Based Concept Program” for the administrative workplaces in healthcare. Several studies show that Swedish doctors and nurses use about half their working time on administrative work. Despite this, very little attention has been given to the design of administrative workplaces in healthcare. Although healthcare focuses on detailed functional planning of their clinical areas, administrative workplaces are typically designed very traditionally, supporting hierarchical and downpipe organisations. Consequently, they are not always supportive of today’s healthcare needs, which focus on teamwork around the involved and informed patient. This makes provision of healthcare less efficient and patient friendly. However, new technologies and new ways of working means that the conditions for administrative/office work have changed drastically in recent decades. It is therefore time to seek inspiration from other sectors of society so as to rethink healthcare design. Conclusive report findings indicate that a changed approach needs to be introduced to the design of administrative workspaces. Mapping exercises of existing conditions show low utilisation of non-care-related administrative workplaces. These workplaces can be made more efficient by organising the plan according to activity-based usage and thereby reducing the area needed. Included survey also indicate that the degree of utilisation of administrative workplaces close to patients is relatively high. The report concludes that patient-related administrative workplaces need to be developed further through adding new room types and number of functions. Unused space can be redistributed to care located closer to patients, as the need is greater and this will help promote work efficiency. However, the design of new and more activity-based administrative workplaces in healthcare relies heavily on the introduction of new portable and seamless information and communication technology (ICT)-systems

Quality, Innovation and Evidence in Sweden and England – Establishing a Collaborative Roadmap

International healthcare regulators, providers and commissioners are facing severe funding constraints that are putting increased pressures on quality, innovation and performance. Within England, NHS resources have unsustainably grown, and all organisations are launching initiatives to increase quality, innovation, productivity and prevention while decreasing cost. Within the Swedish case the decentralised organisation of health and care into the countries county councils, face similar problems. Many are working together to combine new medical and logistical processes with patient centred approaches. This paper investigates the political and best practice differences between Sweden and England and investigates their similarities and differences according to a number of factors, including e.g. organisational roles, regulator standards, best practices and innovation in quality and organisational learning tools. This work is looking to establish a new international best practice framework that structures the relationship between evidence and design, in its broadest sense. It addresses the international role in improving design quality of mandatory standards and compliance criteria on the one hand and excellence and quality on the other

Mapping a framework for co-design in healthcare buildings - an empirical study

Rapid technological development and changing demands from a changing population call for new ways of working in the healthcare sector. As the working environment should support these new ways of working and be prepared for yet more changes, new strategies for facility planning need to be studied. Architects have a long tradition of working with end user involvement in the early stages of building projects, but over the past ten years, a shift in focus or trend has been noticeable. Over time, the purpose of end user involvement has moved from mere participation to co-designing, making fuller use of user knowledge and experience. This paper revisits seven healthcare building projects, now in various stages of realization but initiated in 2007–2011 using a design-driven co-designing framework, involving end users in the early stages of developing and designing their future environment. The co-designing framework and its outcome are revisited and scrutinized here in light of four factors presumed to influence the quality of the process and its outcome: representativity, continuity, ownership, and innovation. Each case was mapped through archival studies, observations, and interviews with involved architects, project managers, and users. The intention is to deepen our understanding of the planning framework and the consequences of user participation and co-designing by highlighting recurring factors connected to the collaborative planning process and its outcome. The findings indicate that the framework’s basic structure has proven stable and useful in several projects and, although affected by external factors such as timing, politics, and finance, still offers good conditions for involving end users in project development and ownership creation, enabling the development of innovative ideas

Shared-decision making in designing new healthcare environments : ready to take off for improved quality

Background Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. Discussion This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. Summary We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users’ perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments

Quality Innovation & Evidence in Healthcare Physical Environments in England & Sweden - Establishing a Collaborative Roadmap

Regulators, providers and commissioners in healthcare worldwide are facing severe funding constraints that are putting increased pressures on the quality of healthcare delivery. Within England, NHS resources have grown unsustainably, and all organisations are engaged in initiatives to increase quality, innovation, productivity and safety while decreasing cost. Within the Swedish case the decentralised organisation of healthcare into County Councils faces similar problems. This comparison between a centralised English system (looking towards decentralisation) and a decentralised Swedish system (investigating the benefits of centralisation) may provide significant learning. This study investigates the English and Swedish healthcare systems examining their similarities and differences according to various factors - organisational roles, regulator standards, best practices and innovation in quality and organisation learning tools. It also evaluates the role of improving design quality via mandatory standards and compliance criteria on the one hand and others factors which drive excellence on the other. An international best practice framework is proposed that is capable of ensuring evidence based design and informing the balancing of compliance and excellence criteria