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New Pembury Hospital, Tunbridge, Wells, Kent, United Kingdom

September 2011
EDAC Advocate Firm Project
Anshen+Allen, a part of Stantec Architecture

ANSHEN+ALLEN
a part of STANTEC ARCHITECTURE



Firm's role on the project:  Planning, Programming, Architecture, Design, Interiors 
 



EBD Goal

To evaluate the impact of single bedrooms in the UK health economy, reduction of infection, improvement in patient recovery time and wellbeing from impact of nature views, natural ventilation, and reduced staff travel time. Pembury is the first Pebble Project in the UK, and the first NHS hospital, with 100% single bed wards. Affordable patient safety was the core guiding principle.


Challenge

EBD research suggests that single rooms improve patient experience and well being. The team hypothesized that standardized patient rooms and “single-handed” design is better for reducing staff errors. EBD studies regarding 100% single-bed facilities reducing nosocomial infection were reviewed. Finding conclusive evidence on therapeutic/social value of single-bed versus multi-bedded wards was challenging, as the studies are affected by clinical specialties and cultural contexts variability. It was also challenging to extract clinical evidence measured on cumulative impact of multiple factors (patient’s clinical conditions, mental/physical behavior) compared to measurable clinical individual factors. Several 100% single-room ward designs were tested with Intelligence Space Consultants using surveys on work patterns in Leeds Nuffield Hospital, as well as Space Syntax Consultants’ research on the Bevan Pilot Ward in Hillingdon hospital. This led to an optimized acute ward template, maximizing staff efficiency of travel and visibility.


Solution 

Pembury’s standardized single-room has the following design characteristics:
 

  • Bed-head placed in direct sight line from door with large vision panels
  • Clinical basin at entrance
  • Staff zone kept at entrance with bed-head unit on “clinical side”
  • Large windows provide natural daylight and woodland views from patient bed
  • Naturally ventilated rooms provide the patient control
  • Bed-head on same side as en-suite bathroom door to reduce risk of falls
  • En-suite door design allows ease of maneuvering and emergency access

 
The ward design is efficient, creating smaller sub-clustering of rooms, thus reducing nurse travel and maximizing patient visibility. All rooms have natural ventilation and external views (81 percent overlook woodlands).
 
The design reduced walking distances by 7.5km (/ward/12 hours) compared to generic single-bed wards and by 16.3km compared to Nuffield Hospital’s 29 percent single-rooms L-shaped ward. Nurse-patient contact time increased by 2.8 hours (/12 hours) compared to generic wards and by six hours compared to Nuffield Hospital.