There can be confusion about what healthcare flexibility really means. And flexibility can mean different things to different people. For example, for an owner, flexibility is something that allows a system to offer new service lines and generate more revenue; for a nurse, it’s an adjustment in day-to-day care delivery to allow the best patient care; and for facility managers, flexibility is being able to reconfigure a facility to enable the owner, providers, and visitors to do all they need to do.
Healthcare facilities have historically been designed for longevity. Planning for at least 30-50 years of use. Subtle modifications like changing a primary care clinic to a specialty clinic or office spaces to clinical spaces was expected, but foundational change, such as doing complex procedures in outpatient centers that had traditionally been performed only in inpatient hospitals, was not. How can we design for maximum flexibility, across the board, for the needs of today’s healthcare workers?
Flexibility Means Designing for Exponential Change
Medical technology and equipment is constantly improving, demographics and epidemiology evolves, and fluctuations in policy and regulations are a lot more nuanced than they were in the past. The design field is faced with the unenviable task of addressing today’s necessities while also anticipating the effect of iterative transformation going forward. In simpler words, health facilities must be change-ready from the first day they open.
Designing Versatility into Your Facility
Solutions for versatility can be wide and varied, from concourse-style waiting rooms to dual-purpose exam rooms, to demountable walls and multipurpose furniture. Allowing the user to engage in different activities without making changes to the built environment.
Versatility may also take the form of fluid multipurpose zones replacing waiting rooms where people work, interact, self-educate, and (sometimes) shop as they wait for their appointments. Open hall spaces, multipurpose spaces, flexible laboratory spaces, shared spaces, and specialty groupings are also great examples.
Creating a Facility That's Modifiable
Giving users agency to quickly change a space or object without relying on support from the facility or contractors is another facet of flexibility. Multi-functional furnishings for families in the patient room, adjustable workstations, mobile carts, rolling partitions, or patient-controlled shades are all examples of this concept.
Designing a Facility That's Easily Convertible
Transferring agency from the user to facilities and design teams, convertibility is the ability to replace the infill of a building to serve a new purpose. Like shipping containers that can be converted to a tiny home or an emergency shelter, outpatient clinics can convert existing rooms into administrative or exam functions. Other examples include multiple exam rooms that are conjoined to create a procedure room and shell spaces that are ready for conversion to whatever needs exist in the future.
Convertibility isn’t possible unless infrastructure affordances like medical gas availability, ceiling heights, and structural strength have been planned early. This makes it ideal to consider these concepts at the beginning of the process.
Designing for Scalability
Scalability is characterized by the ability to grow or shrink through minor or major renovations. While there are many examples of facility expansion, a physical shrinking of the footprint remains an elusive goal. An International Space Station-like clinic where units get added and removed, as needed would be a truly scalable solution. Mobile clinics might also hold great potential if they gain traction in the industry. Within many multi-specialty clinics, we see operational scalability (growing and shrinking of service lines) by space convertibility or modifiability.
It’s impossible to know what all the future holds. However, designing your healthcare facility for maximum flexibility is a smart way to design for the present and prepare for the future.