Designing these structures requires a delicate balance of technical requirements with the needs of doctors and patients, but when done right, these designs can save lives. Studies conducted within the last decade have found the link between facility design and patient safety and staff outcomes. These include; patient and staff satisfaction; a patient’s stress experience, and organization performance metrics. Health care providers and design firms have taken the opportunity to target clinical latent conditions and active failures by using evidence-based designs in order to decrease distractions, standardize locations of equipment and supplies, and ensure adequate space for documentation and work areas.  

KEY TERMS: As defined by the Ministry of Health, latent conditions are physical conditions on, underlying or adjacent to the site that could not be identified by the contractor by reasonable observations or investigations. Latent failures are attributed to people who influence the system; for example, housekeeping, maintenance, information systems and management. Active failures are errors made by the operators performing the processes; for example, actions by a doctor, nurse or any other direct caregiver.

Staff / Patient Perspective and Priorities

Universal access, simple way-finding, safety, privacy and confidentiality are high priorities for both staff and patients. Lighting, low noise levels, comfortable temperatures and welcoming interiors are also valued by both groups.

Patient Needs

• Prefer an environment that offers quality and comfortable personal space, rather than an environment that addressed only medical needs.
• Easy access to public transport, a safe entrance, and proximity to other facilities such as a pharmacy
• The provision of a welcoming reception, comfortable temperature, good lighting, a quiet waiting space and attention to privacy and confidentiality throughout.
• Consulting room layout that facilitated good doctor-patient communication
• Access to music and views of nature; patients can benefit from the skillful utilization of music and artwork.

Staff Needs

• For staff the importance of access, safety and local facilities resonated with the patient views presented above.
• Privacy, confidentiality and patient safety through careful design of waiting room, reception and consulting room.
• A design that facilitated communication between team members.
• Infection control measures: air filtration and room pressure relationships, cleaning and housekeeping, and waste management and disposal.

Other Facility Management Considerations Preventing adverse effects though design i.e.; falls can result from slippery floors, poor placement of handrails, inappropriate door openings, and furniture heights. Infection rates have been found to be higher in patients, particularly critically ill patients, in overcrowded facilities that have few private rooms, lacked individual bathrooms and toilets, had no isolation facilities, and had deficient ventilation systems.