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Trends in hospital planning

Despite coming under increasing cost pressure, hospitals are expected to deliver ever more impressive results. This is reflected in hospital renovation projects. So what will hospitals look like in the future?

Text: Katharina Rilling, photos: Per Kasch

Light parquet floors, high ceilings, large panorama windows with a great view. Ideal conditions to relax – in a 4-star holiday resort. However, when it comes to our health we’ve usually had to put up with inconspicuous high-rise buildings with labyrinthine corridors, neon lights and an outdoor area that tempts only smokers and tired nursing staff outside.

Adaptable thanks to modular design

What will hospitals look like in 20, 30, 50 years? “Medicine is in a state of flux, so it’s hard to make long-term predictions,” says Eugen Schröder, Executive Director Corporate Real Estate Management at Zurich University Hospital. “But one thing is clear: hospital design must respond as flexibly as possible to new requirements. Standardisation and modularity play an important role here”. One example of an adaptable hospital are rooms with standard grids, which can be extended and adapted without conversion work.

More privacy in a single room

In the new Cantonal Hospital Aarau and in the new building planned for Zurich University Hospital there will only be single rooms. Another trend? “Patients today want state-of-the-art medical care and the latest technologies,” says Schröder. Bernhard Güntert, Professor of Health Economics at the curafutura health insurance association, added: “More single rooms are being offered in response to patient requirements.”Sylvia Blezinger, Managing Director of the Blezinger Healthcare Academy, who designs and organises conferences, seminars and study trips on the topic of “Hospitals of the Future”, mentions another critical point: “Resistance to antibiotics will increase. In the Netherlands and Scandinavia, where the most modern hospitals in Europe are located, single rooms are therefore the preferred choice, because patients can be isolated more quickly and infections kept in check more easily.”

Güntert doesn’t accept the criticism that single rooms lead to higher costs and thus higher premiums and agrees with  Blezinger: “Studies show that the duration of treatment in single rooms is shorter and the risk of infections by hospital germs is massively reduced. This eliminates follow-up costs.”

Healing: How rooms can help

The Cantonal Hospital Baden relies on the concept of “healing architecture”, which is based on the idea that careful building planning contributes to recovery. What sounds esoteric at first glance is scientifically sound: It has been proven that nature has a positive influence on the healing process. For instance, when you go into hospital, green courtyards help alleviate fears. Long-term studies have shown that patients in a pleasant, relaxing environment need fewer painkillers, experience fewer post-operative complications and therefore leave hospital faster.

Digitalisation: networked hospitals in the countryside

Bernhard Güntert of curafutura is sure: “Hospitals will also be increasingly digitalised, which means staff will have access to targeted patient information. Sensors in beds and rooms, cameras and communication tools will support nursing care and care management”. Patients today may not like the idea of cameras next to their hospital bed, but Güntert knows: “Scepticism will decrease, because digitization is on trend in other areas of life, too.”He also believes that hospitals will be increasingly networked with associated outpatient medical, nursing and therapeutic care systems in order to be able to provide patients with seamless, customised aftercare.

Shift from inpatient to outpatient care

As a further consequence of the ongoing shift from inpatient to outpatient care, more and more procedures will be performed on an outpatient basis. The Director of Real Estate at Zurich University Hospital sees direct building-related consequences: “The two areas will be separated, with the outpatient sector growing to create more space for outpatient operating theatres and intervention rooms, while the number of inpatient beds drops.”

The vision: competence centres and patient hotels

Güntert assumes that not only individual hospitals, but the entire hospital landscape will change greatly in the future: "Smaller hospitals with fewer than 200 beds will give way to five to seven larger, highly specialised competence centres. Where possible, these will be located outside of cities where there is more room for development.”This would make it possible to reduce vertical infrastructures in high-rise buildings, which are expensive and prone to problems. Schröder of Zurich University Hospital has a similar prediction: “Our traditional hospitals will only be needed for complex, interdisciplinary and extensive procedures.” A large proportion of today’s hospitals will then be converted into outpatient health centres. And patient hotels can relieve hospitals of the burden of care.