Hospitals are complex environments formed from a diverse population and services. By definition, hospital sub-populations have different abilities and very different needs – depending on their purpose at the hospital and their status (e.g. whether they are immunosuppressed, contagious, a nurse, a porter, etc.). It is critical that hospitals meet their functional needs – that their design and resources enable patients to receive their intended treatment in a timely manner, that staff are able to fulfil their responsibilities and also, as with any occupied building, that it provides the required level of life safety for the entire population under emergency scenarios.
Hospital pose particular challenges in this regard:
- They represent critical infrastructure and so need to function – especially in times of crisis;
- They have transient and varied populations, many of whom will be unfamiliar with the space and the procedures;
- They have complex operational needs that involve frequent local emergencies (e.g. an individual having a life-threatening ailment);
- They are also subject to traditional emergency scenarios (fire emergencies, security concerns, etc.), host functionality that deals with sub-populations who are potentially a threat (e.g. isolation wards) and will be hubs during regional/national for large-scale incident management (e.g. a pandemic).
It is apparent that the design and management of the physical space, the human/technological resources and the management of people movement throughout a hospital given these considerations poses an enormous task. The impact of design changes on the safety and comfort of patients and staff may not be intuitive or accessible to direct analysis. This impact may therefore require simulation – to identify influential factors, when and where they have an influence, and the local/global impact of this influence. This is to assess performance and support recommendations for improvement. This article outlines the use of engineering and computational models to assess the effectiveness of hospital design and management procedures across a range of emergency and non-emergency scenarios. This use is intended to identify influential factors, enable comparison of key performance indicators, and to map these outcomes to communicate these results in an intuitive manner.