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UNDERSTANDING HEALTHCARE FACILITIES & TYPOLOGIES
The quality that is closely related to health, can be achieved by focusing the human needs to understand their interaction with the environment, a matter which always was neglected. Pellitteri & Belvedere, Humanization and Architecture in Contemporary Hospital Building, 2011.
This is obvious that in an institute as complex as hospital the patients and visitors are more sensitive to the quality of design so they are more affected by the humanization of those dedicated space than staff. So perceived hospital environment quality will be improved when a degree of humanization increases in space. -Fornara, Bonaiuto, & Bonnes, 2006. Hospitals are places in which solidarity, equity, and participation must be found as the conditions of effective enjoyment of right in the space.
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Hence, a good architecture can promote effective enjoyment of social rights by emphasizing the right to health in the hospital space. Humanization of hospital spaces is not only called to reduce and remove the disease but on one hand, they have to be the provider of health rights services for community in order to answer the new social needs for citizens. It is clear that simply designing a functional and therapeutic set is not enough, and other factors are involved in achieving the goals set.
Elements that may be seemingly intangible but directly affect the quality of spaces and the patient's mood; Items such as harmony, variety, sense of control over space, etc., which are often less considered in the design of hospitals.
Figure 25: Healing through architecture Source:http://waterlooarchitecture.com/bridge/blog/2015/07/30/the sis-healing-through-architecture/ Figure 26: Figure 20: Lucina Women and Children’s Hospital Source:https://awards.rethinkingthefuture.com/rtfawards-2020-winners/lucina-women-and-childrenshospital-bh-architects/
A health facility is, in general, any location where healthcare is provided. Health facilities range from small clinics and doctor's offices to urgent care centers and large hospitals with
elaborate emergency rooms and trauma centers. The number and quality of health facilities in a country or region is one common measure of that area's prosperity and quality of life. Healthcare facilities are not only limited to a hospital or a clinic, a brief look at the healthcare industry shows a lot of different types of facilities which help in easing the burden on large hospitals.
A) Types of Healthcare facilities
Healthcare facilities can be differentiated based on a variety of factors that includes functionality, size, location, ownership and specialization.
1. Functionality Functionality refers to whether the hospitals are general-purpose, teaching hospitals, acute care facilities, long-term hospitals, community hospitals, research hospitals or if they provide trauma care for patients. It refers to how the hospitals themselves function within the communities they serve.
2. Size There are three primary classifications when it comes to size: Small hospitals: Fewer than 100 beds Medium hospitals: 100 to 499 beds Large hospitals: 500 or more beds Typically, these sizes are classified by the number of beds they have although there can be some variation within these groups of hospitals and medical centers.
3. Location They can also be classified by their locations. Rural hospitals aid smaller communities and often have limited access to advanced equipment or specialized procedures and techniques. Since they also face competition, urban hospitals serve larger metropolitan areas and must often offer a wide degree of versatility when it comes to treatment options and patient experience.
4. Ownership Ownership of the hospital also tells a lot about how the hospital will operate.
Figure 27: Types of healthcare facilities Source: by Author
Some hospitals are a part of larger networks that offer a streamlined approach to management. While some physicians feel this improves efficiency and patient experience, some feel it removes the emphasis from the patient and makes treatment less personal.
Private hospitals often offer access to the latest technologies and equipment, but may underserve community members who need healthcare the most.
Government-supported facilities operate via grants and other public funds. They have greater restrictions but also reach out to members of the community who may not otherwise receive healthcare and medical treatment.
5. Specializations Specialized hospitals appeal to physicians who entered the medical field with plans to treat people with a specific condition. Most physicians choose specializations due to personal reasons, an area of intense interest or a desire to provide a comfortable life for themselves and their families.
Figure 28: Categories of specialization in healthcare Source: by Author
B) Healthcare facilities with a large requirement of
Holistic approach
In an ideal scenario all patients suffering from all kinds of illnesses whether severe, long term, minor or temporary require a holistic approach in their treatment. But since it is not a very common practice it is important to understand that chronic diseases affect a patients wellbeing in various ways patients experience low self-esteem, social isolation, body image issues and even severe depression as a result of their conditions. It’s important that patients and their caretakers don’t ignore these issues or view them as unimportant next to the physical disease process. Many of these emotional needs are beyond the reach of modern medicine and doctors, but holistic care
can help to fill that gap.
Types of specialty hospitals that treat chronic diseases with a requirement of holistic needs are:
1) Multi- specialty hospitals 2) Cardiac hospitals 3) Pediatric hospitals 4) Geriatric hospitals 5) Cancer treatment hospitals 6) Trauma center 7) Neurology hospitals (brain) 8) Bariatric hospital (obesity) 9) Oncology hospitals (tumor) 10) Psychiatric hospitals
Out of these specialty hospitals or healthcare centers cancer treatment hospitals, oncology hospitals and trauma centers are comparatively most likely to have holistic approach incorporated at least in the working system of the facility if not the design.
Most probably Psychiatric hospitals also have mental health programs included in the working systems. Cardiac, Pediatric, Geriatric, Neurology and Bariatric hospitals have an essential need for humanized designs and holistic working systems but are more commonly ignored.
Figure 29: Types of specialty hospitals Source: by Author
C) Areas/departments in
facilities with requirement of Holistic approach
When it comes to the healthcare industry, it includes a lot of spaces or rooms that are designed in a certain way so as to fulfill the required function which cannot be changed or to be precise should not be redesigned for aesthetic purposes. For example, departments like:
1. ICU, ICCU, NICU 2. Operation theatres 3. Special wards 4. Recovery room 5. Radiology/ECG or 2D echo 6. Pathology 7. Areas that don’t give access to patients like sterilization, server, storage rooms and HR office. Such rooms or spaces cannot incorporate a holistic approach architecturally hence they shall not be considered for this particular aspect.
On the other hand, spaces where patients spend most time recovering and getting treated should incorporate a holistic environment. For example:
1. General wards – Male and female 2. Physiotherapy and stress test rooms 3. Rehabilitation wards 4. Isolation wards 5. Consultation rooms 6. Common rooms or spaces like; Registration/ billing, waiting room, canteens, auditoriums, doctor/staff rooms, etc.
In order to create a holistic environment, it is not only necessary to create calm areas for patients but also for other users like doctors, nurses and family members to keep a less stressful environment for all.
Figure 30: Types of users and areas in a healthcare facility Source: by Author
D) Differences and common factors between Holistic healthcare and
normal healthcare facilities
Focuses on the diagnosis or physical treatment
Using most effective medicines and treatments to speed up the healing process Focuses on overall healing of the body, mind and soul
Includes exercises and remedies to develop a stable mindset and increase self-healing process
Makes use of latest technology and equipment
Increase in expenditure and expenses Encourages natural methods and remedies
Cost effective methods
The comparison is not to indicate which is better than the other. It only shows what are the pros and cons in each to get better clarification.
The need of today’s healthcare industry is dependent on the latest technology, equipment and modern medicine development but at the same time it also has a requirement to fulfil psychological needs.
An ideal healthcare facility would be a facility that is very well equipped and provides all services with the latest technology and machinery while also inducing a holistic approach in the working as well as the design of the facility.
E) Analysis of the Healthcare industry for Holistic needs in India
The healthcare industry is indispensable to the holistic needs of every patient in any sector. For example, Cancer and trauma patients require a lot of emotional support for recovery. However, besides these facilities there is a particular sector which is often bypassed in the healthcare industry which is the Geriatric healthcare sector. It is not an unknown fact that very few geriatric care facilities exist in India. “The concept of geriatric care has drawn a black in our country.”- Consultant physician, Dr. Rohit Barman at Breach Candy Hospital. It is unfortunate that Indian Medical Science does not even offer geriatrics as a branch of study. There is only one university in India that offers the degree. How aware and sensitive are we about geriatric care in our country and are there enough geriatricians to cater to the ageing population?
India has about 112 million elderly population that deal with multiple physical, social psychological, and economic problems with unmet needs in all domains of health. Over the years, as the average longevity of humans increased, so has the need for specialized care in older age.
