Health Building Notes
MAAP has been engaged in the development of design guidance in the UK for over 20 years, and has continued to contribute to international discourse on the design of healthcare facilities through ongoing research and practice.
Views from the bed and four locations for ensuites.
A pilot ward project that informed HBN 04
HBN 04 (2nd Ed) – Acute Inpatient Accommodation
Between 1995 and 2010, MAAP were commissioned for a dozen significant research projects on behalf of NHS Estates on and around Health Building Note 04 - Inpatient Accommodation. Not only did we undertake the research and help write the guidelines, but MAAP have also tested this work in our live projects. An initial report; “Ward Layouts with Single Room and Space for Flexibility” was published by NHS in 2005.
The result of our work on inpatient accommodation has been:
An increase in the proportions of single rooms in hospitals around the world: in the UK, USA, Canada and Australia in particular.
Larger spaces around the bed and single-bedded rooms. These are a key element of patient-centred models of care. These spaces have been found to improve staff and patient satisfaction, lessen mistakes and hospital acquired infections, improve hand-washing behaviours and shorten hospital stays.
New models of staff spaces to enable leaner, more flexible and more responsive care.
More detailed and highly rational ensuite bathroom concepts to make them safer: preventing falls and reducing hospital-acquired infection.
Smaller patient groupings – frequently in pods of 4, 6 or 8 beds.
NHS Estates / Department of Health
HBN 04 1997, HBN 04 2005
HBN 35 Part 3 – Accommodation for People with Mental Illness
The period of deinstitutionalization in the UK left a lot of uncertainty about what replacement facilities would look like and how they would suit the first generation of deinstitutionalized models of care. This building note was intended to illustrate the variety of approaches that NHS Estates took and assess how the services are affected by the various design approaches.
The analysed schemes ranged from small community-based support through to 76 bed campus facilities that offer a wide range of in-patient and out-patient services. These were selected to provide a mix of scale and size in urban and rural locations.
Each case study describes the background to the scheme, including the local strategy for mental health services, a description of the building design, including key briefing principles and comments on the suitability of the design for service users. Each scheme is supported by photographs and floor plans.
The document highlights a number of common issues in planning mental health facilities, including the size and scale of buildings, the creation of domestic environments and external constraints. It also reveals that the most successful schemes are those that translate service philosophies into detailed design briefs: well-planned facilities rely on highly articulated and strategic design principles.
HBN 27 – Intensive Therapy Unit
The 1980’s and 1990’s saw changes in models of care and in technology that made the old Nightingale model of intensive therapy largely redundant and the HBN 27 was researched and written to reflect an increasing demand for modern services.
The changes outlined in HBN 27 were diverse, ranging from the impact of computers to handle medical records, to minimum standards of lighting, ergonomics, predictability and views and right through to optimal layouts for staff observation and patient privacy.