It might seem only too obvious, but good design is all about designing for what goes on in a building. Which is not the same as designing a building where things just happen to go on. Or as Briony Smith, director of research at the Serco Institute, puts it: “It’s about designing with the service in mind.” Smith is the author of a recent report from the Institute, ‘Built to Serve: the benefits of service-led PPPs’. The report makes the point that the building should reflect the activities that go on within it, not vice versa.“ Physical infrastructure should not be the starting point in a PPP that is concerned with the delivery of effective services. The infrastructure is merely part of the service solution,” she says. “By thinking about the service requirements of a particular project – be it a hospital or a prison or a training establishment, for example, you get ideas to help you think about ways to design the building itself, to achieve certain ends,” she says. Those ends might include building it in such a way as to cost less to run over the long term, say, or (and these are not mutually exclusive attributes) making things better for the service user.
The example Smith gives for prisons is doing away with the often infamous shower blocks, providing prisoners with showers in their own cells.“ That way you create a more normalised environment.” Seems obvious, doesn’t it? Think of the users first. But then you’re into the second problem, namely – I know what is best for the users now: what about in the future? How should my design think about that? Smith agrees with the findings of my Birmingham charette: anticipation of change is key.“
“There is a discussion around the issue of change. In a long-term contract such as Public Finance Initiative (PFI) certain things are defined upfront. From a service point of view, you like to have as much flexibility as you can so as to meet changing needs.” The solution is to have enough big, flexible spaces that can be divided up in all kinds of ways for uses nobody might have thought of yet; or conversely smaller spaces that can be opened out.
Future focused
The team redeveloping St Olav’s hospital in Norway, due to be completed in 2015, is using IT in a bid to future proof the design and make it the most technologically advanced hospital in Europe.
The aim is to use technology to enable the organisation to deliver better patient care through improved communication between patients and health professionals and to cut costs. For example, the hospital will use mobile and wireless technology so medical staff communicate with one another and check patient records using mobile devices, wherever they are in the hospital. Verbal updates will become a thing of the past in this high-tech environment.
For patients, the technology will bring the ability to easily contact medical staff as well as access the internet, control lighting and room temperature.
St Olav’s also tackled a problem faced by many hospitals: patients admitted to wards who are too well to be in hospital but too ill to be at home. To answer this conumdrum, a patient hotel was opened in September 2004. Boasting 150 rooms, the hotel allows patients to be self-sufficient with access to 24-hour professional care. All the clinical centres can be accessed via a heated walkway or underground corridor and there is also a unit dedicated to new mothers.
Attention is also being paid to maximise the therapeutic role of the surroundings including the grounds. To further enhance this, art will be displayed inside and outside the hospital. Several art installations have been commissioned, including Kare Groven’s five boulders. However, only time will tell whether the design is sufficiently future-focused.
