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Key principles transforming healthcare architecture and design

There’s much more to healthcare architecture than you might initially think. Here, we unpack the fundamental elements that guide the successful design of these highly specialised buildings

26 September 2024
6 minutes read
MRI room in a healthcare facility with modern, clean design emphasising safety and efficiency. The minimalistic white interior features a medical imaging machine, ergonomic layout, and shelves for storage, reflecting principles of infection control, patient comfort, and operational efficiency in healthcare architecture.

There is much more to healthcare architecture and design than meets the eye. 

While you might not think about a hospital’s design as you walk through it or notice the careful design decisions that have been made (in fact, it’s considered a win if you don’t), successful healthcare architecture deserves more praise than almost any other discipline, primarily because of the many complex elements it needs to cater for.

In this article, we’re going to unpack the fundamental design principles of good healthcare architecture, providing insights into what healthcare architects focus on when bringing these facilities to life.

Let's start.

What is healthcare architecture?

Healthcare architecture refers to the design of healthcare facilities, including hospitals, clinics, care homes, medical offices, and long-term care facilities. 

Though it might seem straightforward enough, when you pause to consider what needs to be integrated into the design in terms of preventing the spread of infection, promoting mental wellbeing, and ensuring these spaces can function as efficiently as possible, you quickly realise healthcare architecture can be a complicated art to master.

With this in mind, let’s dive in and review the fundamental principles of healthcare architecture.

A modern hospital patient room featuring a comfortable bed, natural light streaming through large windows with elegant red curtains, and a cosy green armchair. The warm wooden flooring and thoughtful interior design create a serene, healing environment. This design prioritises patient comfort, mental wellbeing, and infection control, reflecting the key principles of healthcare architecture.
Credit: HDR TMK Planungsgesellschaft mbH, Hans Georg Esch

Fundamental principles to consider in healthcare architecture

Healthcare architecture involves a delicate balance of functionality, safety, and patient wellbeing, all within complex regulatory frameworks, making the design process highly specialised.

Every decision, from spatial layouts to material selection, can directly influence patient outcomes and operational efficiency. As such, healthcare architects play a crucial role in shaping environments that foster healing while meeting the stringent demands of modern healthcare delivery.

To create a healthcare space that prioritises the wellbeing of patients and a seamless workflow, healthcare architects use the following principles to guide building design decisions.

Infection control

Given the varied reasons people visit and stay in healthcare facilities like hospitals and clinics, it is crucial infection control is the highest priority when it comes to designing healthcare spaces.

Methods of containing infection from an architectural standpoint include:

  • Ensuring adequate ventilation measures to minimise the spread of harmful microorganisms and airborne pathogens: Strategies include developing negative pressure rooms where highly contagious patients can stay, allowing fresh air into the room but not allowing any contaminated air from escaping. By contrast, positive pressure rooms keep air pressure higher internally, allowing air to flow out of the room and preventing contaminated air from entering. As well as these features, utilising a thoughtful architectural layout can help to create smart zoning, where ventilation strategies can be adjusted accordingly.
  • Hygiene measures and incorporation of easy-to-clean surfaces: Choosing materials such as stainless steel and copper, as well as non-porous materials that are resistant to bacteria for countertops, sinks, and workstations can help to eliminate germs. Plus, carefully considered placement of hand hygiene stations with soaps, sanitisers, and sinks can aid in preventing the spread of infection as patients, staff, and visitors move throughout the space.
  • Designing with enough space to prevent overcrowding: Establishing a smart layout in hospitals is important for so many reasons, not least for the efficient transport of patients and to help staff move with haste when needed. However, it is also a crucial part of stifling the spread of infection. Design choices such as purposefully wide corridors, spacious waiting rooms to avoid overcrowding, and dedicated service corridors to isolate the transport of waste and hazardous materials can help curb the spread of infection.

While supporting the physical health of patients is crucial, so too is the protection of their mental health.

Patient mental wellbeing

What should never be overlooked when it comes to healthcare architecture is how we can design to promote the best possible outcomes for a patient’s mental health and wellbeing. 

Extended stays in hospitals are rarely pleasant experiences, but if we can use the power of design to make the environment as comfortable as possible then, at the very least, we're able to better support recovery and encourage positive mental health.

With this in mind, here are some thoughtful ways that healthcare architects can design to help create the best possible mental health outcomes for patients:

  • Natural light: Working natural light into patient rooms, communal spaces, and corridors via windows and skylights is a simple way to help lift a patient’s spirits. Additionally, designing scenic gardens or courtyards for patients to either relax in when they’re well enough or to look out to from the comfort of the indoors if they’re not, are simple features that can help to reduce stress and support an individual’s mental health. In fact, a seminal 1984 study by Roger Ulrich found that patients recovering from surgery in hospital rooms with views of nature had shorter hospital stays, required fewer pain medications, and had fewer post-surgery complications compared to patients with views of a brick wall, demonstrating that the role of nature in healing cannot be underestimated.
  • Interior design: Though it’s not strictly architecture, clever interior design can be used to help soften the austere environments hospitals can often be. Choices such as incorporating natural materials, soothing colour schemes, warm lighting, and indoor plants can be hugely effective in creating a more relaxed environment.
  • Mitigating noise pollution: Though it might not be immediately obvious, designing in a way that reduces unwanted noise is another vital part of successful design when it comes to healthcare facilities. Given many hospitals and healthcare facilities are quite central, there is a risk of external noise pollution from both car and foot traffic. Plus, these spaces are often buzzing with activity and consequently can be quite noisy internally. Design methods to help turn down the volume include utilising sound-absorbing materials in ceilings, walls, and flooring, as well as integrating quiet rooms or reflection spaces for patients.
  • Comfortable rooms: The benefit of good comfort is obvious, and relates to both physical and mental wellbeing. If rooms in healthcare facilities can create a feeling of spaciousness, privacy, light, comfort, and familiarity, they can work to reduce stress and improve sleep quality, better supporting the recovery of patients.
  • Space for kids to be kids: Sadly, it’s not just adults who get sick. In children’s hospitals, utilising colour and light can help to reduce levels of stress and anxiety, as can clever wayfinding approaches like playful, themed murals to help patients navigate their way through the hospital. Additionally, including dedicated play rooms with toys, playgrounds or computers is also a wonderful touch, allowing children to be children and serving as a positive distraction in their day.
  • Don’t forget loved ones and staff: While patient wellbeing is number one, the mental wellness of staff and family members supporting the patient also cannot be undervalued. From a design perspective, creating spaces for families to stay on the ward as and when needed is a valuable inclusion. Additionally, modern hospitals are increasingly recognising the importance of creating environments that support the wellbeing of healthcare staff. A well-designed hospital can both improve job satisfaction and reduce stress and burnout, which are prevalent in healthcare settings. More on this in our next point.

Operations

Given the important work that goes on in healthcare spaces like hospitals, it’s vital that the building’s design helps to promote the best possible outcomes for the centre’s day-to-day operations. 

Below are a few ways to prioritise effective operations with intelligent healthcare architecture:

  • Optimise the layout and flow of the design to make things as efficient as possible: This involves the strategic placement of critical areas like operating rooms, nurse stations, and supply areas to allow for quick responses in emergency situations, reducing travel time and improving workflow for healthcare staff.
  • Wayfinding: Implementing effective wayfinding strategies via logical and intuitive placement of rooms and clear signage can help patients and visitors better orient themselves in healthcare centres, reducing the need to stop and ask staff for directions and streamlining operational efficiency, as well as decreasing congestion.
  • Ergonomic workstations: Designing ergonomic workspaces is crucial in preventing physical strain for staff who spend long hours on their feet. Adjustable chairs, workstations, and easy-to-access equipment reduce fatigue and improve overall comfort, enabling healthcare workers to perform more efficiently without the risk of injury.
  • Quiet spaces for reflection: Creating quiet zones or small private spaces can help staff step away from the fast-paced, often stressful hospital environment. These areas allow for moments of calm, reducing the psychological strain associated with long hours and high-pressure tasks. For example, hospitals like Shrewsbury and Telford NHS Foundation Trust have revamped staff areas to create restful environments, positively impacting employee wellbeing.

Safety

As you would expect, one of the key principles in healthcare architecture is safety compliance. This is detailed in greater depth in our section on building regulations and compliance in healthcare design, but here are the top-line considerations:

  • Fire safety: Building with fire-resistant materials including fire-rated walls, doors, and floors can help slow the spread of fire should one start. Additionally, the layout of the facility needs to include strategically located exits and fire doors, and corridors should be wide enough to facilitate ease of movement in the case of an emergency. Lastly, fire detection and suppression systems should also be integrated into the design. This includes installing smoke detectors, sprinklers, and fire extinguishers right throughout the facility.
  • Fall prevention and accessibility: An essential element to consider is how healthcare design can help prevent patients, especially those with mobility issues, from slipping or falling. With this in mind, using slip-resistant materials like rubber for floors, particularly in wet areas like bathrooms and operating rooms, can help. Additionally, incorporating handrails around the perimeter of healthcare facilities can be useful, as can providing seating throughout the centre to allow patients to stop and rest as they move around the space.
  • Security checkpoints: Integrating a quality surveillance system and controlled access points via a key card system or something similar is important in keeping patients safe and deterring theft or unwanted visitors into the space.

Adaptability

Adaptability is an important factor in healthcare architecture, as we want to design buildings that can evolve with the changing needs of the times. 

The clearest illustration of the importance of adaptability in a healthcare setting would be the Covid-19 pandemic, which forced centres to bend themselves to meet the demands of a huge influx of highly contagious patients. As we saw, some facilities were more prepared and better able to adjust than others.

To make healthcare architecture as adaptable as it can be, the following considerations can help:

  • Utilising modular designs: Using modular designs that can be reconfigured easily to cater to changing requirements, like converting a general ward into an intensive care unit. Elements like movable partitions can help to do this too, flexibly changing the function of a space as needed.
  • Integrating demountable ceilings and raised floors: This design feature can allow easy access to infrastructure including wiring, plumbing, and HVAC systems to simplify future upgrades or repairs without disrupting healthcare services.
  • Opting for expandable corridors and entry points: Designing wide corridors and access points that can be adjusted based on changing demand.

The more adaptable a healthcare space, the lesser the need for costly (and disruptive) renovations or updates down the line. Of course, it’s also better for the environment, which brings me neatly to my next point.

Sustainability

Sustainability is becoming a vital consideration in healthcare architecture, particularly in the UK, where stringent environmental targets like the NHS Net Zero initiative are pushing the industry towards more eco-friendly solutions. The aim is to reduce the carbon footprint of healthcare facilities while maintaining high standards of care and efficiency.

To meet these goals, healthcare architects are increasingly turning to energy-efficient building materials and systems that lower a facility's environmental impact. 

Fortunately, there are a number of ways we can minimise waste and our impact on the environment. 

  • Energy efficiency: Healthcare centres are hives of activity and designing in a way that makes energy use as efficient as possible should be at the top of every architect’s list of priorities. Firstly, obvious choices like the use of solar panels to generate clean, renewable energy on-site can help reduce dependence on the grid and lower energy costs. Plus, using demand-controlled ventilation and installing HVAC systems that adjust airflow based on the number of occupants in a room or area can significantly reduce energy use. These systems only provide fresh air when needed, lowering energy consumption. Similarly, zoned temperature control can allow different areas of the hospital to be controlled separately, avoiding over-conditioning of unoccupied or low-use spaces like administrative offices after-hours.

    Lastly, utilising natural light is not just great for a patient’s mental health. If we can use design to maximise natural daylight throughout the centre, we are both reducing the need for artificial lighting and increasing the building’s internal temperature, minimising energy use. Large windows, skylights, and light wells are all great options to naturally illuminate a space.
  • Construction materials: A strategic choice of construction materials can also support sustainability efforts in healthcare centres. Using eco-friendly, low-carbon materials such as recycled steel, locally sourced wood that hasn’t had to travel too far to get to the site, or materials with a high thermal mass helps reduce the environmental impact of construction and lowers ongoing energy use.
  • Green roofs and insulation: Green roofs not only provide insulation, reducing heating and cooling needs but also contribute to stormwater management and improved air quality, enhancing overall sustainability.
  • Water conservation: Design decisions like incorporating low-flow faucets, toilets, and showers can serve to reduce water consumption, which in turn reduces the energy required for water heating and wastewater treatment. Additionally, greywater recycling for non-potable uses, such as irrigation or toilet flushing, can also lower the demand on water supply systems and decrease overall energy consumption.
  • Adaptable design: As mentioned above, the more adaptable our design, the greater its longevity. As new technologies are introduced into the healthcare sector and processes change, it’s important our healthcare buildings can evolve without requiring significant structural overhauls.
     
  • BREEAM: The UK’s BREEAM certification is also a key factor in sustainable healthcare design. This widely recognised building assessment method ensures that new builds and refurbishments meet sustainability standards, which is increasingly important for healthcare facilities aiming to reduce energy consumption and improve overall environmental performance.

Meeting UK building regulations and compliance in healthcare design

In the UK, healthcare architecture must adhere to both building regulations and specific guidance provided through Approved Documents, which cover a wide range of technical and safety requirements for construction. 

Approved Documents offer healthcare architects practical examples and solutions to meet building regulations. They provide detailed guidance for ensuring compliance in key areas such as fire safety, ventilation, drainage, and accessibility. Healthcare architects ensure their designs align with regulatory standards by incorporating building regulations drawings that cater to the specific needs of healthcare facilities.

For example, Approved Document B focuses on fire safety, requiring healthcare architects to design spaces with fire-resistant materials and enough fire exits to accommodate the safe evacuation of patients. Approved Document M is another critical regulation, making sure healthcare buildings are accessible to people with disabilities, incorporating elements like wheelchair-friendly doorways and accessible bathrooms.

Key guidelines also come from the Health Technical Memoranda (HTMs), which details technical specifications on everything from water safety to electrical systems, and the Health Building Notes (HBNs), which focus on the spatial and functional aspects of healthcare environments.

For instance, HTM 03-01 covers heating and ventilation systems to prevent the spread of infection, a critical concern in hospitals, as we touched on earlier. This includes standards for airflow rates in operating theatres and negative pressure rooms to control contamination. Similarly, HTM 08-03 focuses on medical gases, ensuring that supply systems are safe and reliable, which is vital for surgical and emergency care. Architects must incorporate adequate space for gas cylinder storage and ensure pipelines meet the rigorous safety standards outlined in this document.

For fire safety, HTM 05-02 mandates fire-resistant materials, such as doors and walls, and details the minimum width for corridors to allow for the safe evacuation of patients. These regulations must be built into the design from the outset, influencing layout choices and material specifications.

Understanding and applying these standards not only ensures legal compliance but also positions architects and planners to deliver cutting-edge, safe, and sustainable healthcare environments.

A modern healthcare facility corridor designed for efficiency and patient care. The space features wide hallways with handrails for accessibility and safety, an ergonomic nurse station with bright orange seating for staff comfort, and natural light streaming through large windows. This healthcare architecture focuses on infection control, staff operations, and patient wellbeing through thoughtful spatial design and evidence-based practices.
Credit: HDR TMK Planungsgesellschaft mbH, Hans Georg Esch

The role of evidence-based design in healthcare architecture

Evidence-based design (EBD) plays a crucial role in healthcare architecture, utilising data and research to inform decisions that directly impact patient care and operational efficiency. EBD focuses on integrating proven strategies into the design of healthcare facilities to enhance both patient outcomes and the working conditions of healthcare staff.

For instance, careful consideration of factors such as room layout, lighting, and material choice can lead to improved recovery times for patients, while simultaneously increasing staff productivity. As we’ve discussed, research has shown that access to natural light, quieter environments, and thoughtfully placed patient areas all contribute to reducing stress and promoting faster healing. 

The benefits of EBD are well-documented through various studies, showcasing tangible improvements such as shorter hospital stays and fewer complications after surgery. By embracing these research-driven design decisions, healthcare architecture can foster environments that not only meet functional needs but also significantly enhance the quality of care provided.

Smart healthcare buildings

As the healthcare sector in the UK continues to evolve, the adoption of smart technologies is transforming hospitals into highly efficient and patient-centric environments. Smart hospitals leverage automation and the Internet of Things (IoT) to improve patient outcomes, streamline operations, and enhance sustainability. These buildings integrate systems such as automated lighting, HVAC, and security, all controlled through centralised platforms designed to optimise both patient comfort and staff efficiency.

One of the most innovative aspects of smart hospitals is the use of IoT devices that enable real-time monitoring and management of patient care. For example, smart rooms can adjust lighting, temperature, and air quality based on patient needs, while wearable health monitors transmit real-time data to medical staff. These systems not only improve the patient experience but also enable more efficient use of hospital resources, such as minimising energy consumption through adaptive HVAC controls.

Another significant feature is digital wayfinding systems, which help patients and visitors navigate complex hospital layouts. These systems can integrate with mobile apps, allowing hospitals to provide step-by-step guidance or even pre-book parking spaces for patients attending appointments​.

The benefits of smart hospitals extend beyond patient care. By integrating digital twin technology, hospitals can monitor building occupancy, energy use, and equipment status in real time, making it easier to reduce operational costs and improve sustainability. Hospitals such as Milton Keynes University Hospital are already leading the way with pilot programs that use digital twins to manage facility efficiency.

Architects and planners collaborating in a modern office, discussing healthcare architecture design plans. The team is reviewing project blueprints with a digital layout of a healthcare facility on the screen behind them. This image highlights teamwork, innovative planning, and expertise in healthcare architecture, ensuring functional and patient-centered design solutions.

How Urbanist Architecture can help you

That concludes our review of the seven key principles that guide thoughtful healthcare architecture. To recap, those principles are sustainability, adaptability, safety, infection control, safety, patient wellbeing, and operations. The best examples of healthcare architecture will focus on each of these elements, bringing to life spaces that have been designed with a holistic, patient-centred approach.

If you need help with your next project, whether it’s a commercial healthcare project or something smaller, we’d love to chat.

Urbanist Architecture is an experienced and multidisciplinary team of architects and town planners who are deeply passionate about our craft and achieve consistent results to prove it. With a success rate of 97% when it comes to gaining planning permission, we know how to yield the best results for our clients. 

Don’t hesitate to get in touch.

Robin Callister, Creative Director and Senior Architect at Urbanist Architecture
AUTHOR

Robin Callister

Robin is our creative director, guiding our architectural team with the wisdom of more than 20 years of experience. All architectural projects at our practice are overseen by Robin, so you know you’re in the safest of hands.

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