Suzanne MacCormick: What if we can… Design Adaptable ‘Outpatients’ Rooms?

Previous Associate Director Healthcare Advisory, WSP in the UK

Artificial Intelligence and smart technologies may seem unlikely to influence the future of ‘outpatients’ at your local hospital. Yet as digital technologies and demographics combine with changing patterns of healthcare, the need for outpatient buildings on hospital sites is set to decline faster than any of us might have expected.

The familiar concept of a daytime visit to the hospital for routine monitoring, or minor surgery, could soon be a thing of the past. Here’s why…

The drivers for change

AI is paving the way for home-management of many chronic conditions, making it entirely plausible that patients who regularly visit outpatients at the moment will rarely – or never – have to go there in the future.

Smart technology is already replacing one-off visits for minor surgical procedures. Consider endoscopy, for example, which is already redundant in some instances because swallowing a tiny camera can provide the necessary insight instead.

Trends such as these are radically and rapidly changing the options for delivering outpatient services, but patients are so familiar with existing models that expectations have yet to align with technological capability. This makes it difficult to predict the pace at which the switch away from traditional hospital-based outpatient services to community-based provision will happen.

We still need outpatient rooms in our hospitals at the moment, but they must be designed and built to adapt to alternative uses in the near and medium-term future, probably on more than one occasion.

Healthcare timebombs

Age and lifestyle are the two words that crop up most regularly in any conversation about the future of outpatient provision. We are living longer and suffering from the degenerative diseases that old age brings. The United Nations estimates that the proportion of the world’s population aged over 60 will triple by the end of this century, to make up more than a third of all people1.

At the same time, we are sitting down more – at work, and in the home – and exercising less, and this is contributing to the rise in obesity. According to recent research published in The Lancet2 one-fifth of all people are predicted to be obese by 2025,

Multiple conditions suffered by one individual is on the increase. In the UK, for example, the number of older people with four illnesses or more is expected to more than double in less than 20 years3.

These age and lifestyle conditions mean that more people than ever before are in need of outpatient-type support. We are at an interesting intersection of demand and opportunity that will be governed to a very large extent by patient expectations and behaviours, and the likely outcome is community-based care enabled by technology.

So, with demographics, healthcare needs, and the technological backdrop all changing at the same time, can we design outpatient facilities that will be adaptable to meet future needs?

Thanks to digital building design technologies, including BIM and precision-engineered off-site construction methods, we know that we can. Technological capabilities are providing future-ready solutions.

Flexible buildings

Healthcare clients often ask us to design new outpatient facilities to meet changing demands and make the most of funding which may be hard-won against competing priorities.  They want buildings that will last and remain relevant for many years into the future.

We can design outpatient space with this longevity by building in adaptability from the outset. By designing robust structures, using a steel grid and lightweight panels, it is possible to enable walls to be taken out and spaces repurposed very cost-effectively.

This means that in the coming years, as the requirement for outpatient treatment areas on hospital sites declines, the space can be converted to meet alternative medical needs, or replaced with facilities such as extra-care housing for people who may benefit from living close to healthcare services.

Taking ‘out’ out of the equation

It is clear that in the future the patient will be the point at which we provide healthcare services. By approaching the design of healthcare buildings from this perspective – because it is certainly how the future is shaping up – our options become clearer.

Flexible, adaptable design, and off-site construction of precision-engineered buildings, will help to consign the notion of ‘outpatients as a place’ to history – and make the provision of the services that we need community-focused, patient-centric and future-ready.

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