Pediatric hospitals have evolved far beyond the sterile, fluorescently lit institutions of days past. New facilities have child- and family friendly features that create a homelike feel, high-tech efficiencies that enhance treatments and relaxing areas that promote wellness.
Post-pandemic improvements and the rise of security issues, artificial intelligence and immersive technologies have elevated expectations by patients, families and staff. The following are trends to watch in 2024:
Artificial intelligence is the future of healthcare delivery. It’s important to identify where technology can mitigate risk and impact operational efficiency early in the design process so facilities can support future technology needs. A few design elements to consider include allocating space for control rooms, determining monitor locations, visibility and accessibility to dashboards and a shift from desktops to tablets (so some nurse station space can be repurposed).
Increasingly smart, tech-enabled buildings. Instead of architecture being just the repository for technology that healthcare organizations acquire, the future hospital will become the technology framework in which a vast number of platforms can plug and play — truly an integrated, smart infrastructure. At Page, we are including measures like site and building-wide ambient intelligence to help enhance operational efficiencies, heighten security and to help address the impact of staff shortages. Technology-enabled buildings also have the potential for icon-based wayfinding signage, which considers varying levels of language and technology literacy, as well as cultural backgrounds.
Areas for wellness and restoration. Respite rooms, greenery and gardens, large windows and access to natural light are no longer seen as “luxuries,” but necessities. Even if the space is beautiful, if healthcare staff are working in a dysfunctional system, no amount of aesthetics will be enough to influence retention. Operations and design must align in critical adjacencies that minimize staff fatigue and maximize efficiency in workflow, access to colleagues, spaces for collaboration and ability to maintain situational awareness in high-acuity areas.
Private spots such as this covered blue space in Texas Children’s Hospital’s West Campus in Houston allow families and children to reflect, play, make phone calls or just sit quietly. Photo by: Geoffrey Lyon
Inclusivity and privacy issues. Pediatric facilities strive for inclusive environments that accommodate children and families with additional needs, from children on the autism spectrum to teens in the LGBTQ+ population. Built environment features can foster inclusivity and destigmatize illness. For example, private bathrooms instead of stalls, gender-neutral signage and removal of gender icons foster inclusivity. Bathroom changing tables that accommodate varying sizes of patients from infant through adolescents/adulthood provide privacy for all ages. All-ability playgrounds and all-inclusive imagery demonstrates potential for every child and destigmatizes medical conditions.
Flexibility and choice. Seating options in exam rooms and waiting areas can be configured to family preferences and accommodate assistive devices. Choice over the ambient environment through tunable control-capable lighting, or color-changing lighting, provides a sense of choice and control during hospitalization. For behavioral health facilities, open and welcoming entrances that are non-institutionalized and homelike environments promote a sense of normalcy. Patient empowerment, comfort and healing can be supported through intentional art, texture and color.
Partnerships with industry and other brands, such as Seacrest Studios, has brought star power and excitement to children’s hospitals. Innovative retail spaces adjacent to, or within a healthcare facility, encourage application of safe practices often discussed as part of anticipatory guidance in the primary care setting or during hospital discharge planning. For example, a safety store can provide child-proofing supplies such as baby locks, gates, car seats and additional education.
Aesthetics with impact. A pediatric hospital we renovated was, in the words of the director of projects, “outdated, dark and unwelcoming. It didn’t match the level of care staff was providing. The difference after the redesign was night and day. Now the building, itself provides therapy in a lot of ways we weren’t doing previously.” Large windows and natural light replaced exterior paneling with small windows. Families dealing with surgery, or a child in the NICU, could be found in an airy, open concourse. Finishes were updated from the 1970s to modern, and the design team kept in mind elements important to the culture of the city and community surrounding the hospital, such as music and nature.
Palliative care spaces. Pediatric hospitals are creating outdoor spaces and private gardens for patients to have special outside time with their families. Hospitals are also creating bereavement gardens where clinical teams can take patients outside for withdrawal of life support (separate from the public gardens).
Healthcare disparities. Hospital design centered around social determinants of health can impact equity and accessibility, promote community-centered care and preventive care, provide holistic healing environments, encourage patient engagement and empowerment and foster community partnerships. For example, incorporating a lobby concierge desk where social workers, case managers and financial services staff can be easily located and accessible to families. Hospital-based grocery stores and in-house pharmacies increase access to healthy food options and support medication compliance. And proximity of a healthcare facility to public transportation eases access.
Multi-use flexible spaces for community programs, education and events. Teaching kitchens offer families education on healthy eating and wellness, and demonstrations can be tailored to specific patient populations, such as diabetes education. Classrooms on the ground level of the facility improve access to the building after business hours. Hospitals can partner with community leaders to create shared community spaces, birthing or lactation classes, fitness and wellness education.
This patient room at Nemours Children’s Hospital in Orlando, Florida shows the large area around the bed for specialists and medical equipment to be brought to the patient, as well as family space for parents and siblings to work, eat and play. Photo by: Jonathan Hillyer
Spaces that promote socialization. Provision of family space in patient rooms, such as a dining table and chairs for families to eat together, provide socialization and a sense of normalcy especially during prolonged hospitalization. Developmentally appropriate play spaces, with separate entrances, such as playrooms for younger children or gaming and music rooms for adolescents support socialization. By leveraging unused square footage, spaces can be designed to bring families together. Dining amenities, family lounges and waiting rooms provide space for families to seek social support from family members or other patients.
Extra storage. As diagnostic and therapeutic technologies expand, especially tech used at the bedside, more storage space is essential. Some young patients live in the hospital for years, and their room becomes their de facto home. They need a lot of storage space. Family amenities are also essential, including sleep rooms, food storage, laundry facilities, remote work spaces, etc. Child life specialists and other ancillary staff, such as physical therapists and social workers, have become an essential part of the pediatric care team, so spaces must support these specialists as they interact with patients.
Separation and adjacency. Separate paths for sick and well patients, staff and visitors, community and exam/treatment areas, visible and back-of-the-house operations, really took hold during COVID and have remained for infection control and security. But designers are also taking care to relocate service lines and areas that need to be together that previously were in multiple locations throughout the hospital. Now, for example, the ICUs are close to the surgical suites, which enhances patient experience, recovery and infection control. Operation room helipads have been relocated to the top of the patient tower, allowing services directly below for getting children in critical condition into surgery more quickly. New emergency department locations allow for a child in critical condition to get from an ambulance to trauma bay immediately.
Empathetic, person-centered design has led to a new type of children’s hospital where the safety, security and comfort of patient, family and staff are top priorities. Interactivity, choice and flexibility are built into the fabric of the facility, and creative design solutions support operational efficiency at every turn. This keeps the youngest patients happy, secure and protected.
