Why hospital design matters: A narrative review of built environments research relevant to stroke care

Abstract

Healthcare facilities are among the most expensive buildings to construct, maintain, and operate. How building design can best support healthcare services, staff, and patients is important to consider. In this narrative review, we outline why the healthcare environment matters and describe areas of research focus and current built environment evidence that supports healthcare in general and stroke care in particular. Ward configuration, corridor design, and staff station placements can all impact care provision, staff and patient behavior. Contrary to many new ward design approaches, single-bed rooms are neither uniformly favored, nor strongly evidence-based, for people with stroke. Green spaces are important both for staff (helping to reduce stress and errors), patients and relatives, although access to, and awareness of, these and other communal spaces is often poor. Built environment research specific to stroke is limited but increasing, and we highlight emerging collaborative multistakeholder partnerships (Living Labs) contributing to this evidence base. We believe that involving engaged and informed clinicians in design and research will help shape better hospitals of the future.

Keywords: Stroke; evidence-based design; hospital design and construction; stroke rehabilitation.

Figure 1.

The volume of built environment research conducted in different healthcare settings. Circle size indicates the number of published research articles based on systematic literature review in preparation and articles listed in the Centre for Healthcare Design research repository. Pink circles represent all built environment research, and the dark gray circles indicate stroke-specific research. (The aerial sketch in this image has been adapted with permission from Architectus + HDR.)

Figure 2.

A summary of the evidence specific to stroke care environments. Dotted lines = a hypothesis, garnered from research in other populations; thin lines = limited evidence, < 3 studies; thick lines = moderate evidence, ≥ 3 studies, based on systematic literature review.