What will Canadian hospitals look like in the future?

The Globe and Mail

St. Michael's staff in Toronto, Ontario Canada take part in a simulation of a surgery in a pandemic situation with standards set by the CSA Standards following the introduction of a new national standard to help hospitals and other health care facilities reduce infections, plan for pandemics. (Deborah Baic/The Globe and Mail)

The Canadian hospital of the future will have mostly private rooms and a better layout to avoid the confusion and bottlenecks common in many facilities today, and it will be built using sustainable design principles so it can be adapted to meet subsequent needs.

The details of this vision were sketched on Wednesday at the unveiling of Canada’s first national design guidelines for health-care facilities. They are contained in a 400-page document that will attempt to usher hospitals from an era of grey walls, multiple patients sharing sleeping areas and bathrooms and generally inefficient systems to an era defined by preventing illness, reducing the spread of hospital-acquired infections and building facilities designed around the needs of patients instead of doctors.

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“Ultimately, bad hospital design can kill,” said Bonnie Rose, president of CSA Standards, the organization that created and published the guidelines. “Hospitals and other health-care facilities that meet this standard will help our health-care practitioners do what they do best: save lives.”

Although the guidelines aren’t mandatory, they were developed in collaboration with numerous provinces, Ms. Rose said. CSA Standards, formerly known as the Canadian Standards Association, has long provided standards that have become part of common practice.

But there are questions about how many hospitals will fully embrace the guidelines and what impact they could have. For instance, while they recommend that all patient rooms be private, a major infection-control measure, they allow hospitals to continue to built multi-bed rooms.

“I don’t think it holds water” to allow shared-patient rooms, said Michael Gardam, medical director of infection prevention and control at the University Health Network in Toronto.

But he said he thinks that the guidelines are “critically important” because, for the first time, they provide a national resource to help hospitals build better facilities.

The guidelines reflect a growing recognition in the medical community that the design of health-care facilities is in need of major overhaul to meet the changing needs of patients. It’s a field called evidence-based design, and reflects the notion that hospitals should provide pleasant environments that promote healing, prevent illness and adapt to patients.

Some of the components of evidence-based design include single-patient rooms; ample natural lighting in rooms, as research suggests this promotes healing; noise-reducing walls and decreased use of overhead paging to help patients sleep.

Decades ago, facilities were built to treat patients suffering from single ailments that would require only a short stay. But medical advances and longer life expectancies mean that hospitals are expected to care for patients with chronic illnesses, which isn’t ideal in the traditional hospital.

For instance, elderly patients admitted to hospital for even a few days may have difficulty becoming mobile and independent again after being confined to a bed for a long time. Similarly, a lack of handrails in patient rooms and hallways and intense lighting can raise their risk of falling, a preventable problem that could lead to injury or death.

Follow on Twitter: @carlyweeks

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