Re-thinking space in healthcare estates

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Clean, lean, safe and green are this year’s themes for the Healthcare Estates annual IHEEM conference where Nightingale is presenting a paper.

Richard Mazuch, director of Design Research and Innovation, will be talking about ‘Re-thinking space – Innovative approaches for inpatient accommodation’.

The last 12 months have seen unprecedented changes in our political and economic situation, making the challenges facing healthcare estates bigger than ever before. The paper will describe three innovative approaches developed by Nightingale Associates for the provision of Inpatient accommodation for both existing and new build healthcare settings.

Re-use and refurbishment within the existing estate

BedPod

Developing a lean estate is now more important than ever. Trusts have to find more affordable ways of upgrading their existing accommodation.

Nightingale Associates, with partners SAS International and Billings Jackson Design, have developed the BedPod as part of the Design Council ‘Design for Patient Dignity’ programme funded by the Department of Health. To provide same-sex accommodation, the current solution involves major ward or hospital refurbishment at significant capital cost, downtime and loss of beds. By utilising existing space within wards, the BedPod provides same-sex accommodation at a fraction of the cost.

The BedPod offers a uniquely flexible solution for providing Inpatient bed space. Developed for minor or major works and as a temporary or permanent measure, the BedPod is a prefabricated, modular product that offers simplified procurement, minimal disruption and no loss of beds. Manufactured to the highest quality, its modularity enables choice in initial specification and facilitates replacement and upgrade over time to minimise obsolescence.

Moreover the BedPod aims to create a sense of patient empowerment, offering increased control and improving patient dignity. It is also designed to improve the healing environment by increasing sensory engagement and helping to control the spread of infection.

Providing the right Inpatient accommodation is about understanding the context and applying the right solution. This approach provides the Estate Manager with flexible solutions that respond to reoccurring issues, whilst making the most of any investment.

100% Single room accommodation

Ysbyty Aneurin Bevan, aerial sketch perspective

As the debate continues as to whether single bed accommodation is the future of the NHS, Nightingale Associates (with their Supply Chain Partner, BAM) are about to complete the first purpose designed 100% Single Room hospital in Wales. The 96 bed hospital in Ebbw Vale for The Aneurin Bevan NHS Trust, delivered via the Designed for Life: Building for Wales Framework, will be receiving patients by October 2010. The proposed ward layouts were developed in close consultation with the Trust team, patient groups and stakeholders to ensure cost effectiveness, staff efficiency, optimal observation, patient control, as well as patient privacy and dignity. Best practice, current guidance and full scale mock-ups have been utilised during the design development process.

Multi-bed bay accommodation

Cruciform ward layout

Nightingale Associate’s experience in the healthcare market underlines that providing 100% single room accommodation is often unaffordable or inappropriate for the intended purpose or patient group. To address this problem, Nightingale’s havedeveloped the cruciform ward to provide a cost effective, staff efficient and patient centred alternative to current multi-bed bay models.

The cruciform ward layout is configured to emphasise individual bed heads for each patient, thereby creating a sense of personal space and controlling the spread of infection. The innovative layout provides for the integration of en-suite sanitary accommodation as well as areas for informal seating and/or patient dining. The ward can be deployed with varying percentages of single room accommodation. The cruciform ward has been successfully developed for the recently completed Phase V, Princess Elizabeth Hospital, Guernsey and the new Peterborough City Hospital due for completion in the autumn 2010.

Healthcare Estates is the largest and most influential institution in the UK. The conference is taking place in Manchester Central from 5^th-6^th October 2010.

Arts in health: Choosing art for healing environments

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As the new Peterborough City Hospital approaches practical completion this Summer, the Trust’s art steering group, including Nightingale Associates representatives, has chosen two artists to provide artwork for selected areas of the new-build.

Nightingale Associates discussing the project. Stills taken from the planning film by Living Projects.

Dan Savage and Linda Schwab have been selected to provide wall and glazing treatments throughout Peterborough’s new City Hospital, which has been designed by Nightingale Associates under contractor, Brookfield Construction (UK) Ltd.

Incorporating art into the healing environments is more than hanging aesthetic pictures on the walls; for Peterborough & Stamford Hospitals NHS Foundation Trust it’s been a two-year long programme, providing the opportunity to create an appealing healthcare environment as well as building identity for individual departments and aiding wayfinding.

The artist selection process has come to fruition following two years of planning. Dan Savage will provide wall and glazing treatments in the children’s out-patient department, adolescent in-patient, emergency centre, bereavement suite centre and NICU.

Dan Savage will provide wall and glazing treatments in the children’s out-patient department, adolescent in-patient, emergency centre, bereavement suite centre and NICU.

Linda Schwab will provide artwork for haematology and oncology unit, waiting area, children’s waiting day treatment unit, children’s waiting area in the head and neck unit and glazing in the faith centre. 

Linda Schwab will provide artwork for haematology and oncology unit, waiting area, children’s waiting day treatment unit.

The locations identified by Nightingale Associates’ architects and the Trust as priority areas for artistic embellishment were chosen according to the service they provide – or particular needs for patients, staff and visitors.

Nightingale Associates’ Interior Design Lead, Elizabeth Petrovitch, believes the effect of artwork upon children’s recovery cannot be underestimated.

Nightingale Associates’ Interior Design Lead, Elizabeth Petrovitch, said: “The children’s departments feature high in the priority art areas as the effect of artwork and bright colour themes upon children’s recovery cannot be underestimated.”

Freelance arts consultant, Emma Larkinson, has been employed by the Trust. She has helped put together a longlist of artists. She is also a member of the arts steering group including Trust representatives, Nightingale Associates, contractor representatives and user groups members. But it wasn’t as simple as picking the best three artists by a demographic vote; other factors had to be considered.

“There are always challenges for artists working in public contexts,” says Emma, “Within healthcare there are limitations that come with restricted use of materials.  In addition there are often strongly held identities for wards and groups of staff and patients, which means there is often a directional design brief. The best artists are those that are able to identify the opportunity for a creative response that results in a unique environment that people can relate to.’

The art needed to respond to the building’s natural lighting and design features. It needed to be engaging, potentially educational, flexible and able to respond to different environments within the hospital – as well as meeting the relevant technical specifications and infection control methods.

The new hospital offers new facilities but also a refreshed visual language for the healthcare environment.  Wayfinding and orientation are a key area of the patient experience and this has been addressed by the wayfinding and interior design strategy.  A positive contribution to a locally relevant design language has been made by Nightingale Associates in their design of wayfinding symbols.

Wayfinding symbols designed by Nightingale Associates.

Not only do these art projects contribute to the patient experience, they have also provided the opportunity for staff to engage with arts practitioners in order to express and explore key areas of interest through art commissions – resulting in more unique work environments. 

Wayfinding symbols designed by Nightingale Associates reflect buildings of local importance.

While visual arts form the backbone of the arts strategy, the new hospital’s relationship with the community it serves through the building’s art and other activities has been explored.  Students from a local school  are creating paintings for particularly areas, temporary exhibitions and installations will be incorporated through partnerships with the local museum and art gallery and even hospital staff are creating artwork for the staff spaces.

There will also be a local photography competition based around wayfinding themes and an arts film by Richard Mullane at ‘Living Projects’  using local landscapes and communities. 

“A well considered piece of art can instill feelings of hope, comfort, reflection and joy. It is a window out of the highly functional world of the hospital, a break from the thoughts and feelings associated with a hospital visit,” adds Elizabeth.

The art is planned to be installed by the end of the year but the art programme will continue through the Trust after the handover in Autumn.

From the top, images show Nightingale ’s Matthias Peretz, Elizabeth Petrovitch and Emma White discussing the project. Stills taken from the planning film by Living Projects; Dan Savage’s artwork; Linda Schwab’s artwork; wayfinding symbols designed by Nightingale Associates 

Coalition Government brings uncertainty for architects

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The coalition Government has created uncertainty for architects. UK chancellor George Osborne has announced that £1.7bn of contracts across all sectors will be delayed or stopped to achieve £6.2bn of savings. Even the role of architecture minister is changeable with Ed Vaizey only being in office for four days before John Penrose took over.

As architects await a government decision on the Building Schools for the Future £1.2bn second phase, as reported in BD, Building deputy editor, Sarah Richardson, commented, “The coalition has stated that it will review spending commitments made since January using its own value for money criteria, and it’s obvious that the £55bn earmarked for schools renewal is not going to survive this process unscathed.”

Head of the British Council for School Environments, Ty Goddard, considers the newly launched coalition programme for government that shares some more detail about schools policy and the rumoured cuts to the Building Schools for the Future budget in the video below.

As part of chancellor George Osbourne’s £6.25bn savings plan, the Department for Business, Innovation and Skills has been ordered to save £836m by reviewing several projects including investment into science facilities. This contrasts US president, Barack Obama,  who committed to investing in research and development upon his inauguration last year. Concern has also arisen about targets for zero-carbon homes by 2016, which have not been included in the new Coalition government deal. While the healthcare sector has been spared in the first round of spending cuts, it’s unclear how Tories and the Lib Dems could change the NHS, as questioned by the BBC. 

Beyond spending cuts, RIBA has outlined their new priorities for the new government:

• Construction sector and architecture in the new economy – the construction sector forms 10% of GDP and is the second largest in the European Union. The RIBA believes that construction, and in particular architecture, should form a principal plank of a new economy. The Government needs to ensure that we maintain the skills and expertise that make us a respected world leader and capitalise on the opportunities for growth, both at home and abroad.
• More and better homes – delivery of new homes where they are needed and a concerted effort to improve the standard of new homes to address the current market failure in housing.
• Sustainability - A major retrofit programme for both domestic and non-domestic buildings in order that the UK can meet its carbon targets. We need stringent new-build performance standards and improved post-occupancy evaluation.
• Positive localism – strengthened local government backed by the resources and skills required to deliver the great places and spaces we need. Any implementation of a more local system needs to guarantee that communities have the opportunity to help create a positive vision for their area and ensure that NIMBY-ism is not the default option

What do you think are the priorities for the new government? How will spending cuts affect the architectural industry? Tell us what you think.

 

Downing Street image used via Flickr courtesy of cornfed1975 under Creative Commons licensing.

BedPod unveiled at Design Council ‘Design for Patient Dignity’ exhibition

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Created for the ‘Open Brief’ category of the Design Council’s ‘Design for Patient Dignity Challenge’ and for the Department of Health, the BedPod was unveiled last week.

The aim of the Design Council scheme is to improve patient experience in hospital with particular emphasis on the separation of male and female patients through innovative product and service design. If you missed the Design Council’s exhibition from 23-25 March 2010 of the resulting designs, here is a collection of images and video of the event and the design process.

Sustainability, the Copenhagen Accord and the built environment: A green-wash out?

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Issues of climate change and sustainability are at the forefront of international concern. The recent Copenhagen Climate Summit failed to secure a binding, legislative agreement, but the Copenhagen Accord did recognise scientific evidence showing carbon emissions need to be reduced and rising temperatures limited to an increase of 2^oC. While the failure to secure a legally binding treaty was criticised by some, progress is being made towards making our world more sustainable – especially with regard to building design.

“There is  a lot being done at a national level to help improve new buildings, not only to provide statutory requirements but also to educate and raise awareness of the issue, for example, the recent Eco-Build conference in London, the WRAP (Waste & Resources Action Programme) initiative, the introduction of non-domestic zero-carbon building targets from 2016 to 2019, depending on building type and the increases in building regulation requirements,” says Nightingale Associates’ architect and director of design, research and innovation, David Rowley.

How can building design improve dementia care provisions?

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It causes changes in mood, judgement, personality, and makes it difficult to communicate or cope with day to day tasks. And it usually gets worse over time. By 2020, it is estimated over a million of us will suffer from such symptoms – caused by dementia.  

Dementia can start as early as 40. With about one in every 20 people over-65 suffering from it, by the age of 80 about one in five are affected. Yet care provisions and older adult facilities have been identified in the Draft of the Health Building Notes as largely unfit for purpose. Clearly, building design must respond to the demand for quality dementia provisions and care facilities.  

Can Gerry Robinson Fix Dementia Care Homes? - asked BBC One recently.

Care and treatment for sufferers of dementia should be at the heart of the general election campaign, the Alzheimer’s Society charity told the BBC. As the press continues to reveal the flaws in elderly care – specifically in relation to dementia care – how is building design working to improve provisions and facilitate a better healthcare service for older people? 

Building Better Healthcare Awards 2009: Winners announced

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Nightingale Associates scooped the Patient Environment Class Award for Best Interior Design of the Centre of Neuromuscular Diseases at UCLH at this year’s Building Better Healthcare (BBH) Awards.

The annual BBH Awards celebrate excellence, innovation and professionalism in the healthcare built environment, looking specifically at building design, the patient environment, people, products and estates and facilities management.

The winning project, the Centre for Neuromuscular Diseases at UCLH, was extensively refurbished earlier this year to provide a stimulating and modern environment in which to conduct specialist scientific research. The centre, which is located in an early twentieth-century central London building, has a ‘contemporary fitting in the classical shell’ design theme, displaying a unique mix of modern architectural design concepts with many carefully-restored original features.

Women’s International Centre for Economic Development in 3D

A 3D fly-through presentation has been released of Nightingale Associates’ design of the Women’s International Centre for Economic Development (WICED) in Liverpool.

Train 2000 Ltd, supported by its partners Liverpool City Council and Liverpool Vision, are developing the centre, with design by Nightingale Associates.

The 2,000sqm centre is the first of its kind in the UK and will be located in the heart of Liverpool and is expected to help 3,000 women set up businesses, creating 4,500 new jobs over the next ten years.

The new-build project, to be completed in late 2010, will contain a range of offices, training & conference facilities and incubator space for new businesses. It is being jointly-funded by WICED, the North West Development Agency, Future Builders, Train 2000, Liverpool Vision, and Liverpool Council.

Sensory design in schools | Primary Capital Action Conference 2009

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Oranges were given out at the Primary Capital Action 09 event to demonstrate the power of the senses. Image used courtesy of OrangeSmell via Flickr CC.

We know that children are best prepared to learn when they are active and alert. The challenge for teachers and designers is to create school environments that enhance this emotional and intellectual receptiveness. While a new building may offer the opportunity to design up-to-date learning environments, this is not always an option; the Government’s cash injection of £3bn will not help all the UK’s primary schools. So how do you transform life-expired buildings into inspiring spaces on modest budgets?

The recent Cambridge Primary Review final report has suggested that school building design should provide better facilities for specialist teaching, outdoor learning and libraries. But there are other ways of revolutionising primary school learning through building design. At this year’s Primary Capital Action event, Nightingale Associates took centre stage to explain the theory of sensory learning and introduce a potentially ground-breaking primary school experiment.

Private view | Reflecting Wales 09:09 at the Cardiff Design Festival

“Whether it’s Only Men Aloud, brass bands or Welsh slate,” chirped Lord Dafydd Elis Thomas as he officially opened the Reflecting Wales 09:09 exhibition; he was in celebration of all things Welsh – and in particular tonight – Welsh design of the built environment by nine selected designers.

Lord Dafydd Elis Thomas chats to exhibition artists.

These nine designers all have a connection to Wales, and have been selected to exhibit their work as part of the Cardiff Design Festival at the Reflecting Wales 09:09 exhibition. Lord Dafydd Elis Thomas, the Presiding Officer for the National Welsh Assembly, praised the designers for more than “throwing a few Welsh slates on” but for designing Welsh buildings that secured a sustainable future for Wales as well as considering tradition, community and democracy in their designs.

The exhibition aims to ‘highlight nine young / emerging architectural designers who exhibit the potential to make a significant impact on design standards in our homes, working environments and the quality of places – cities, towns, villages and rural areas – in the decades to come’.

“No pressure,” quipped one of the organisers – which got a laugh from the vast audience crammed into Cardiff’s Howard Gardens gallery for the private view and opening speeches.