Pachilova, R; Sailer, K; (2019) Ward layout, communication and care quality: Spatial intelligibility as a key component of hospital design. In: Proceedings of the 12th International Space Syntax Symposium (12 SSS). International Space Syntax Symposium: Beijing, China.

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Abstract

This study is an empirical investigation of the ways in which the spatial configuration of inpatient wards influences work processes and communication networks of caregivers and the effect on patient care quality. Space syntax research argues that the spatial configuration of hospitals has an effect on social behaviours. However, how this relationship influences care quality is poorly investigated. Therefore, this study researches the link between these three components. In particular, this study looks at at six hospital wards focusing on how various spatial metrics - connectivity, integration, mean depth and intelligibility, influence observed work activities, paths of movement and interactions between caregivers and how this affects team work and consecutively patient care. Three NHS hospitals situated in London are included as case studies in this research and two corresponding wards from each hospital – one intensive care unit and one nursing ward, are selected for a comparison. Space syntax was used to calculate various spatial metrics and investigate how spaces in the six wards are interconnected in a spatial network. Social network analysis was used to describe the network of relations of caregivers. Data was collected with wearable devices that provided information about communication patterns and network partners. The workflow of caregivers was captured by shadowing members of staff and recording digitally type and durations of activities and locations. Finally, a staff survey to assess teamwork and communication was used to evaluate healthcare quality. The study affords new insights into the relationships of spatial configuration, social networks and care processes with the aim to improve quality of care. Results suggest that certain generic patterns and relations between spatial metrics, work processes, communication patterns and care quality can be established. Layouts with high intelligibility tend to have shorter duration of activities and conversations, more democratic work culture, higher rated teamwork and communication and consequently better quality of care. However, more case studies are required to fully investigate the relationship between the three components and establish concrete patterns.

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