The document discusses an integrated approach to health facility planning that considers the entire life cycle of a facility. It emphasizes incorporating flexibility into designs to accommodate changing needs over time through an approach called "long-life, loose-fit". The planning process involves bringing together all stakeholders from the beginning to develop a detailed design brief that outlines objectives, constraints, and functional and architectural requirements. The goal is to design facilities that provide high quality care for patients and good working conditions for staff while optimizing whole-life costs.

1. Integrated Approach to Health Facility Planning Richard L Jones - Chief Director

2. Introduction Health facilities must respond to changing expectations & to new opportunities offered by innovations in technology & configurations of care A new approach involving the whole integrated team, from strategic planning, through occupation, to demolition Incorporate flexibility into designs that will meet the requirements of tomorrow

3. Quality and Life-Cycle Cost Client focus to be on optimum balance of required quality whole life costs of the facility Whole-life cost = costs of acquiring it, costs of maintaining it costs of operating it ...over the whole life of the asset to its disposal

4. Designing hospitals of tomorrow Hospitals of tomorrow will be a combination of features for the well-being not only of patients & their relatives, but also doctors, nurses and all staff Design costs less than 1% of life-cycle costs Capital costs scarcely more than 5% of life-cycle costs Often cost effective to make changes to configuration of a facility midway through its life, rather than rigidly accepting initial structure. Source: Radical improvements in hospital design. CABA (Commission for Architecture & the Built Environment – London)

5. Optimal design allows for continuous change “Long-life, loose-fit” “Agile Space”

6. Design qualityA combination of... How well does the facility achieve its purpose? How well does the facility create a sense of place? How well does the facility perform?

7. Value management maximises project value Improving whole-life project value sometimes requires extra initial capital expenditure. It is not about cost cutting

8. Design process involves four sequential steps

9. To achieve this we need An Integrated Project Team Client Supplier, Users (clinical, managerial, technical) Patient/community Design, Construction, Operation and Maintenance should not be considered in isolation from one another

10. The Design Brief.... The design brief marks the beginning of design process Describes in detail what the Client wants from the design Anchors the project, serving as an essential point of reference throughout project Importantly, it does not dictate how the architect & engineers will actually execute the design

11. Design Brief Consultants will... Work with individuals & groups to devise the critical aspects of the Design Brief: Ensure Design Brief produced at start of project Keep record of who was met with & what was discussed Document Client’s requirements Make copies for Client, architects & engineers, & anyone else involved project Change Design Brief as project progresses, but only by agreement

12. Design Brief: Principal audiences

13. Design Brief: Visited and re-visited by all kinds of people

14. Contents of the Design Brief Background and objectives Design constraints and creative direction Functional descriptions Architectural descriptions

15. 1. Background & objectives The Design Brief will contain all the information about the services to be provided, catchment population, objectives and rationale Extracted from Business Case may require supplementing with statistical information and descriptions from the Client

16. 2. Design constraints & creative direction Design Brief will describe what is inside and outside the scope of the project It will describe any design constraints e.g. requirements to fit with existing designs or buildings; specific technical or legal requirements; specific environmental issues.

17. 3. Functional descriptions A thorough Design Brief provides a definition of services or functions to be accommodated, decomposing these into specific sub-functions and then to activities (processes and flows) From the Business Case, statistical information sources and detailed discussions with service providers

18. 4. Architectural descriptions Sets out the accommodation specifics for design options Includes a schedule that lists all parameters and performance needs Occupancy levels Wall, ceiling & floor finishes Floor loading Light & acoustic needs Engineering services e.g. power, lighting, gases, HVAC, water, communications, back-up systems Environmental issues e.g. temperature, noise, extraction, waste Security & physical access to site, departments and rooms Furniture, fittings and equipment Cleaning, infection control, health & safety

19. Service re-design Services re-designed to meet legitimate expectations of patients and improve clinical outcomes Strategic rethink of the way care is delivered, leading to fundamental changes in hospital systems Redefinition of the principles underlying provision of care Placing more value on patients’ time Increased emphasis on a smooth flow Minimal waiting times.

20. “Agile space”“Long-life, loose-fit” “Soft space” next to complex areas make it possible to adapt the building to changing needs Standardise hospital space & facilities, separate logistical flows Facilitate long-term management of change in demand (elasticity), change in need (functionality) and sustainability (life-cycle of building)

21. In Conclusion Hospitals should provide a therapeutic environment, contribute to the process of healing and reduce risk of hospital-acquired infections Growing body of evidence which identifies issues such as: daylight noise reduction privacy safety opportunities for family participation, ease of finding one’s way around the hospital imaginative use of nature and arts Hospitals must meet the needs of staff: Good working conditions can in part ameliorate the growing challenges of recruitment and retention. Good design reduces the risk injuries to staff of and occupational diseases

22. Thank you Richard L Jones “Incorporate flexibility into designs that will meet the requirements of tomorrow”