The challenge
The Leeds Teaching Hospitals NHS Trust (LTHT) plans to build a new state-of the art hospital, including a new home for Leeds Children’s Hospital, one of the largest single-site maternity centres and new facilities for adult services at the historic Leeds General Infirmary. This is one of the largest healthcare infrastructure projects in the UK Government’s New Hospitals Programme.
Movement Strategies was commissioned by the LTHT to assess a range of clinical and spatial plans, providing a patient (and staff) centric review of the developing design.
A key challenge at RIBA stage 2 was to ensure that critical elements of the design were right-sized for all user groups so that the facility can deliver high quality healthcare services, and reduce capital expenditure by maximising the use of space.
It was also important to the Trust that the design was rooted in an effective vertical circulation strategy for patients and staff, to ensure a smooth transition of operations to a building with a greater reliance on vertical movement.
Our response
We began by developing a detailed understanding of the current operational approach of key clinical facilities through visits to the existing departments, staff interviews and analysis of clinical data. First-hand data was collected to gain estimates of patient group sizes and arrival patterns. This provided a foundation for subsequent analysis so that the Trust had confidence that findings reflected the current and future practices of the hospital.
We used patient appointment data from the busiest day in the previous six months to predict usage of facilities, such as the waiting areas and consultation rooms, by patients and their families. This assessment considered the full patient journey through several clinical departments such as the outpatient departments, imaging, and the emergency department. This helped identify provisions that may be surplus to requirement and supported the clinical design concepts of each department.
We conducted a spatial assessment of the proposed patient waiting areas to ensure they were right-sized to accommodate the number of patients and families expected to use the space at busy times. We also provided operational advice on how to improve seating layouts to create functional spaces that can comfortably accommodate people using different mobility equipment, such as wheelchairs and prams.
The atrium is expected to be a multi-functional hub of activity. We reviewed the design of this area to help ensure that the space can comfortably accommodate the range of circulation, dwelling and queuing activities expected to occur. This provided design recommendations to improve the welcome experience of visitors, patients and staff when they first arrive at the hospital.
We collected data to build a complete picture of expected patient, staff and visitor movement patterns around the new hospital across a typical day. This helped identify risks and informed potential routing strategies to maintain ease of circulation, minimise the need for hospital beds to pass in corridors and manage lift lobby queues during peak staff arrival times.
Finally, we assessed the latest proposed lift specification against industry-standard performance criteria given by CIBSE (Chartered Institution of Building Services Engineers) guidance for lift systems in non-residential buildings. A more detailed assessment of the lift capacity requirements was then undertaken to further refine the vertical circulation strategy to offer the required transport capacity and help minimise staff and patient journey times. This provided evidence to support decision making in terms of the number of lifts required and operational transformation to improve flow of people around the new building.
"Working with GHD over the past couple of years has been transformative. Their expertise ensured our ‘Hospitals of the Future’ design is efficient, patient-centric, and cost-effective."
- Alec Musson, Senior Project Manager, Building the Leeds Way Programme Team
The impact
The assessment helped understand how some waiting areas space and consultation rooms could be re-purposed to accommodate additional functions. This helped ensure the hospital can deliver more services more efficiently at less cost.
Our analysis of patient flow within the emergency department provided insight into the impact that adding different facilities would have on the patient experience. This prompted the Trust to plan for a revised layout of the department during the next design stage to improve the efficiency of patient flow to and from the main waiting area.
Our spatial and lift capacity assessment helped provide confidence that the design will deliver sufficient capacity in corridors, lifts and waiting areas. Routing strategies were also given to reduce the expected congestion during the busiest times in the hospital. These outcomes supported the Trust in responding to staff concerns related to journey time in the new hospital building.
The people movement expertise provided by our team helped support the Trust develop a user-centric design with a clinical brief support by an evidence-based approach. This helped right-sizing clinical and waiting area facilities to ensure that the hospital has the infrastructure and the clinical capacity to serve the expected demand with a high quality of service.