The next generation of healthcare buildings will be very different from the hospitals, clinics and general practitioner (GP) surgeries we are familiar with today. A revolution in building design is already underway, which has largely been prompted by an acceleration of technological innovation, changing population demographics, shifts in expectations of how healthcare should be provided and environmental considerations.
Laura Swanepoel, head of healthcare, building services, WSP in Africa
In the pursuit of a prosperous future of inclusive and sustainable growth, where all African people have a high standard of living, quality of life, sound health and well-being, learning from global trends and adapting these to suit African conditions may be the key to building successful networks of healthcare infrastructure and medical facilities across the continent.
Designing for flexibility and future adaptability
A hospital commonly takes 10 years from inception to delivery, and has an average 60-year lifespan. To remain effective through as many as three generations of change, a future ready hospital is therefore one that is technologically advanced, resilient and – above all – flexible and adaptable to changing healthcare needs.
For instance, a new hospital will need to respond to the rapidly rising trend towards prevention and wellness, as opposed to solely providing treatment once conditions arise. Thus, we are likely to see more adoption of the ‘healthcare campus’ approach in major African cities and urban nodes aimed at keeping people well in the first place. This approach will likely reduce the need to house outpatient provision while in-patients will spend less time in hospitals, so that future hospitals may become smaller. As the focus of services shifts from reactively curing illness and disease, to proactively promoting health and fitness, African hospitals will have to become more adaptable.
There are ways to build in the flexibility and adaptability required to deal with changing healthcare needs. For instance, modular construction systems can allow walls to be taken out and spaces repurposed at far greater ease and lower costs. This approach means that when the requirement for large outpatient treatment areas declines, rooms can be converted or replaced quickly with other facilities, such as extra care housing for people who may benefit from being close to healthcare services. Alternatively, these spaces could be converted into technological hubs for telemedicine as technology continues to develop.
Hospitals will certainly continue to treat the most complex cases, and provide for the most vulnerable patients. Facilities will need to be based on robust, reliable and resilient infrastructure that can accommodate the most technologically advanced procedures. We expect to see core clinical services, such as surgical suites, becoming more centralised. Additionally, there is scope for new ‘hybrid operating theatres’ – where both surgery and diagnostics can be carried out – to be constructed from the outset of a hospital’s development, with the space to accommodate robotic assistants, augmented reality devices and radiology equipment that monitors the patient during procedures.
Smart and connected hospitals
Technological advances and the digitalisation of the healthcare industry are changing hospital design and planning. Healthcare industries are already being disrupted by widespread adoption of digital technologies including, increased connectivity, cloud computing, internet of things (IoT), big data and analytics driven insights, collaboration tools and continued advancements in robotics and artificial intelligence (AI). And, increasingly, hospitals of the future will rely on smart systems that automate procedures and administration to improve overall patient care and staff experience.
With rising adoption of the ‘healthcare campus’ approach, while retaining all core and critical clinical services, we will also see hospitals making increasing use of technology to deliver outpatient services straight to the patient’s home. These services will be supported by networks of decentralised, community-based day clinics, to provide hands on nursing care and social support, as needed.
The new breed of smart and connected hospitals will have super-fast communications technology embedded, with thousands of sensors monitoring their rooms, the building systems, and the patients’ conditions. The sensors will feed patient data into big data and analytics systems, backed by AI, that will sift for any irregularities and alert medical professionals when attention is needed. This opens new conversations around telemedicine, in that machines can now be used to screen all symptoms and provide preliminary diagnosis, or continual or on-demand monitoring of conditions.
Powerful computer systems will be at the heart of these smart and connected hospitals of the future. The technological hubs will also require the capacity to manage huge amounts of data supporting diagnostics feedback from a range of real-time sources, including wearables or digestible sensors. Additionally, leveraging this capacity, the data, along with using delivery mechanisms such as telecare and video conference – even at community-based day clinics – immensely increases opportunities to provide one-stop, remote diagnosis and outpatient care.
Building for resilience
Resilience takes many forms. Globally, there is a continuous drive for – though not exclusive to – efficiency and cost reduction, increasing bacterial resistance, and the need for resilience to climate change and future energy and water scarcity. There is also a growing understanding that the environment in which patients are treated and cared for is a significant contributing factor to the healing process. And, if we look at global healthcare centres being built, there are a number of innovative architectural elements and sustainable design principles being incorporated and aligned to these drivers.
In the African context, these drivers are just as important, yet often compounded by aging and over-subscribed healthcare infrastructure and strained budgets for new builds or refurbishments. And, while there are some phenomenal, forward-thinking government-led and private hospital group projects that are adopting these principles to create world class hospitals and medical centres, largely we still seem to be falling behind this modern global trend. Often, this can be attributed to concerns over delivering a project within budget. However, we need to break free of this way of thinking.
To put this into context, in the commercial property space building for efficiency, sustainability and climate change resistance have already been proven to boast significant return on investment. Added to this, in many parts of Africa there are infrastructure concerns that constrain access to basic services such as water and power. This makes the case in Africa much stronger for hospitals and healthcare facilities to implement green building best practices and renewable energy solutions to provide their own power and heat efficiently, making them self-sufficient in the event of outages and, at the same time, countering the effects of climate change, rising energy costs and water scarcity.
Similarly, resilience to remain operational during natural disasters will be important in some parts of Africa, as will resilience to disease and infections given trends towards antibiotic resistance. Interiors fitted out with bacterial resistant materials and ‘self-healing’ surfaces will help infection control, as will rooms designed to be cleaned by robots. Added to this, a resilient hospital will increasingly enhance the working environment, improving staff retention and engagement rates, making the facility extremely competitive in attracting the very best clinicians.
High performance smart hospitals and medical facilities may be rated and attain excellence across multiple measures of performance; from energy-efficient building systems to improved clinical outcomes, and enhanced patient and staff wellbeing. Leveraging global trends to design and build African healthcare facilities based on the patient-centric approach, will allow public and private sector providers to ensure a better experience and deliver value and return-on-investment across the board. In particular, we must move away from the principle of big concrete blocks that have a surgical and clinical feel and towards creating well-designed, functional spaces that are future ready as well as economically and sustainably sound.