Who’s who, Part 1: The Needs of Hospital End-users

How does one start designing a healthcare facility? As architects, we don’t need to learn the ropes of being a medical professional. What we need to know is how the end-users of the building or facility (whether it is a tertiary level hospital, a dialysis center, a clinic, or a lab) move in the space. An architect’s work is to create the space that helps make the end-users feel at ease (when they are the patients) and work with ease (when they are the medical professionals). Their needs and concerns are what we look at when designing the care space.

Who’s who

So, who’s who? Here’s a rundown of the different end-users of a healthcare facility.

1. Patients. They are generally the in-patients, those who are admitted in the facility. They occupy a bed and are there for more than one night. They receive the facility’s services to make them well again. The needs of a patient differ depending on the culture or attitude of people towards health, wellness, and recovery. For instance, a hospital for Filipinos would need to consider putting additional space in the private rooms because Filipinos prefer to have somebody—a family member, a companion—to stay with the patient in the room 24/7. In other countries, this may not be true, so the patient rooms can be made smaller.

2. Out-patients. They are the people who have something done (say, an eye surgery) but don’t stay overnight. Their needs are different from the in-patients who would need board, lodging, and monitoring. Some of the conveniences that they require are entertainment, rest areas, commercial areas, waiting areas, and clear signs to indicate where to go and what to do next to minimize having a stressful experience.

3. Companions of patients. More common in the Philippines, they come to the healthcare facility to accompany the patient. They stay for as long as the patient is admitted; they buy their own food and use the room amenities as needed. We must consider what options can be given to these people in terms of creating public spaces that can cater to their needs.

4. Visitors. They are the ones who do not need care but pass through the healthcare facility to, say, visit a patient, buy medicine in the pharmacy, join a class at the gym, enjoy a coffee at the café, or lounge at the lobby (to cool off, perhaps). Visitors are usually welcome and encouraged to be there as they help the hospital find other sources of income; they use the commercial spaces (other than the usual gift shop) that are becoming a more common addition to the building’s amenities. The general direction of health facilities nowadays is to be more of a community center.

5. Doctors who do rounds or hold clinic in the healthcare facility. What do their clinics need? How do they prefer to do their rounds? How do they use the operating room? Do they need a place to rest? Resident doctors tend hold shifts and work in the 24/7 operating areas. Their needs differ from specialist doctors and docs who simply hold clinic in the facility’s Medical Arts Building. Not to mention the visiting doctors and other doctor consultants—do they need temporary offices? Bed and board? Teaching venues? Remember that some healthcare facilities, such as the Philippine General Hospital, double as teaching institutions. The needs of medical students, then, can also be considered in this case.

6. Nurses. The work of nurses is different from that of doctors. They’re the frontliners in the care for in-patients, so they are the ones working in the nurse stations in shifts; their needs include proper desk space in the nurse stations, resting spaces, changing rooms, etc. As a round-the-clock job, nurses tend to work within those spaces that are operating 24/7 and/or require constant observation and care (such as out-patient dialysis or eye centers).

7. Other medical workers who are the experts in terms of the operational needs and other activities in the healthcare facility. They’re the ones who know the logistics behind running a healthcare facility, and they range from people who work in the admissions offices to those who work in the cafeteria and those who care for the maintenance of the building(s). They are also end-users because the facility is their workplace.

Knowing the end-users’ needs is just one factor in designing a healthcare facility. But it is a big help in finding solutions that will lead to better health outcomes, which is our final goal.

"[A] hospital for Filipinos would need to consider putting additional space in the private rooms because Filipinos prefer to have somebody—a family member, a companion—to stay with the patient in the room 24/7. In other countries, this may not be true, so the patient rooms can be made smaller."