The Patient Path often begins by referral from a specialist or unexpected accident or emergency. The patient will usually arrive with preconceptions and fears, so first impressions should ideally be welcoming and calming, whilst giving security, trust and reassurance in the quality of care provided by the hospital.

Transitional spaces such as corridors, waiting areas, play areas, reception areas and external spaces can have uses beyond their primary function, in that the space can be used to influence the mood of the patient or visitor immediately before or after they enter the treatment zone. Therefore, when designing these environments we have to first understand the spectrum of users passing through the space, so that we can create an environment that is tailored to their likely emotional or psychological state.

The stage of observation, investigation and diagnosis is vital in order to arrive at the appropriate course of treatment and programme of care. Information gathering, tests and scans can be intrusive, painful and frightening because of the physical process, followed by the anxiety of waiting for results.

The form, internal arrangement and construction of the space will primarily reflect the functions and equipment used, whilst consideration also needs to be given to combating the potential stress and anxiety in the patient.

Day-patients will receive direct care in the Consulting, Treatment and Minor Ops Rooms. Inpatients and some emergency patients would be moved to a ward to await or monitor their treatment or to recover from an operation.

The design and arrangement of each ward will vary considerably for patients; for example some will need isolation for infectious diseases, or shared wards for easier monitoring of patients recovering from surgery. Over the years wards have changed in size and gender allocation, but single sex accommodation is now preferred, as are smaller wards or patient bedrooms. In this case it’s essential to have an efficient method of monitoring, whether remotely or direct via strategic Nurse Stations for speed of response.

The associated Sanitary Accommodation will vary from individual en-suites to central shared ward facilities including assist bathrooms.

In any ward there is also the need to protect the patient from contracting or transmitting infections, via physical contact (e.g, patient to visitor), surface transmission (e.g, shared sanitary accommodation), or airbourne transmission (e.g, ventilation systems). Therefore the design standards (HBN’s and HTM’s) for the built environment , hygiene regime and control of access are subject to continual review.

The complexity of the equipment and services systems to each bed space will vary considerably, with top-of-the-range services provided in the Operating Theatre and adjacent Intensive Care and Recovery units.  For example a Laminar-Flow Theatre will provide positive sterile air flows on to the patient on the table and then out to the surrounding support areas, to the point that hanging baffles are now being considered instead of full height wall containment.

For many patients the post-traumatic treatment, therapy, rehabilitation and aftercare will commence in the hospital prior to discharge and then through day-care appointments when back in the local community in liaison with the local GP.

Each hospital department will have a range of therapy facilities to maximise the benefit of the programme of care and to restore the well-being of the patient. Apparatus for physiotherapy as well as sensory equipment are used to improve speech, hearing, mobility, etc.

The aftercare services in the hospital also need to embrace the emotional and spiritual sides to the rehabilitation of a patient.  The visiting relatives and friends may benefit from the use of a Chapel or Multi-Faith Room and Bereavement counselling facility as part of the Hospital’s final duty of care.

When longer term treatment or ongoing care facilities are required this can be continued off-site in the community. This may involve Palliative and Hospice care for the seriously ill and for those with a limited prognosis.