Background: In 2029, the Ghent university hospital aspires to start using a new hospital building for all nursing wards. However, it was unclear what the lay-out and size of these nursing wards should be. In order to determine the optimal ward design, several aspects should be taken into account, such as the future nursing care model, future evolutions and developments, legal and environmental boundaries, etc. Aim(s): The aim of this study was to identify how architecture can help the nursing department to stimulate the core qualities of a university hospital: care, research and education. Methods: A Five-Phased study was used to determine the ward design. Amongst others, an extensive literature review of 12226 papers about nursing models, the challenges for nursing and nursing architecture was conducted. Through an iterative process of expert consultation, focus groups and brainstorm sessions, different elements were combined in order to determine the guidelines for a new nursing ward. Results: The new nursing ward has 12 beds (per unit), with a partial radial structure. This lay-out was the most optimal choice in supporting the possible nursing care model of primary or modular nursing. Furthermore, this small, standardized type of unit also provides the possibility to scale up if needed, or change the care trajectories of patients in a fast and fluent matter (i.e. in case of pandemic). Discussion: There is no clear-cut answer on which design fits best for the nursing ward of the future. Each hospital should take into account their vision and strategic choices concerning nursing care in the design of a new hospital with the use of stakeholders. Implications and future perspectives: Before designing a nursing ward, main principles and care values need to be determined in order to facilitate decision-making.

The COVID-19 pandemic placed healthcare design at the heart of the crisis. Hospitals faced challenges such as increasing their ICU-capacity and enabling physical-distancing measures to prevent infectious spread. They also needed to co-house (suspected) COVID patients and non-COVID patients with different requirements enforced separate entrances and routes to keep staff and patients safe. It is suspected that even in a fully vaccinated world other pandem-ics are waiting in the wings. In a design brief, flexibility is typically mentioned as an important target, and single occupancy in-patient accommodation may be considered as a way to enhance flexibility. To gain insight in and to inform future hospital design, this study evaluated what oper-ational coping strategies and design solutions were considered important enablers to increase ICU capacity and to support different patient flows and what design solutions enabled physical distancing. We have collected data from 30 Dutch hospital organizations, including from some recently opened hospitals, with 100% single occupancy in-patient accommodation. Using a practice-based approach, in-depth interviewing was combined with document and multimedia analyses to analyze and compare successful operational strategies and design elements that helped provide the flexibility needed in this recent crisis. As we looked at existing facilities and alterations made to allow hospitals to operate in ‘crisis mode’ during the COVID-19 pandemic, we present emerging design considerations for future healthcare facilities that, preferable, can also be implemented in renovations of refurbishments. We add the perspective of staff as a limiting factor to a hospital’s pandemic preparedness.

Research highlights 1) This paper explains how EBD principles in the design of an academic hospital were inte-grated in the design 2) Design solutions, based on EBD principles, were integrated on different scale levels.

The current COVID 19 pandemic has highlighted the need for flexibility in the provision of nursing care of extremely ill patients. A new proposition for a clinical adaptability suite of rooms is presented which can be multi-functional to accommodate surgery, intensive care or isolation. A literature review of medical and nursing practice and requirements and a case study analysis are presented. We explore the physical changes to the built environment which have taken place during the pandemic and undertake an analysis of the environmental and infrastructure requirements of a clinically adaptable room. Finally, we present the initial ideas for an innovative case study which considers how we design, manufacture and assemble advanced, versatile and multi-functional hospital settings. The resulting proposed clinically adaptable room reflects new models of clinical care. We explore the common denominators which show similar requirements in terms of medical equipment infrastructure, ventilation requirements and sterile conditions. A more sustainable alternative scenario shows the potential for reorganization and alteration to existing facilities.