The current hospital designs that employ segregated specialty approaches create limitations in involving and communicating between clinical disciplines. In addition, these approaches require the movement of patients between places, which impacts the delivered care and increases the cost and stay durations. “Patient Hub,” a creative architecture approach in which all critical functions occur in the same building and on the same floor, focuses on patient-centered care which can improve the quality of the provided care and hospital capacity.
This study aimed to examine the feasibility of the “Patient Hub” architecture approach.
The authors constructed a “Patient Hub” and an exemplary traditional hospital layout using 3D simulation software. The Patient Hub concept is a patient-centered and centralized clinical layout that adapts the built environment to accommodate patient needs and specialties by bringing together associated disciplines instead of distributing them to distant buildings. The aims of the Patient Hub concept include saving space, simplifying patient pathways, and facilitating the implementation and adaptation of new treatment concepts.
Dynamic models were developed using the 3D simulation software FlexSim Healthcare™, which aimed to study and evaluate the flow of patients and other healthcare processes to measure the time spent before and during each treatment. The patient scenario was defined with an accompanying list of healthcare services needed, from entering the hospital all the way through exiting. Staff and equipment scenarios were also defined. The whole process, from entering the hospital to exiting, and monitored key statistics including travel distance, significant milestones, treatment times, waiting times, time proportion, and utilization for both patient and staff were simulated using FlexSim and compared between the Kaiser Permanente model (traditional hospital with similar size) and the Patient Hub model. The parameters studied were 1.) Waiting and transfer times to different buildings and different patient wards, 2.) Travel distance to endo, CT + MRI + cardio, anesthesia + OR + ICU, 3.) Wayfinding the path nodes, path edges, and signage locations, 4.) Number of elevator runs, 5.) Access to respite spaces, nature and quality views for patient rooms, exam rooms, and corridors.
The results showed that the Patient Hub model improved the targeted parameters. For example, the waiting and transfer times became zero minutes, wayfinding complexity was reduced by half, traveling distances decreased by 54%, the number of elevator runs dropped from 9 to 2, and patient and exam room accessibility improved from 0% to 100% and increased from 0% to 38% for corridors.
One limitation of this study is that the size of the Patient Hub was designed for a small system and a single-level building; the application to a larger system and a multilevel building could be challenging and less efficient. Another limitation: the application to existing facilities is not feasible, as the Patient Hub is only applicable to new building designs or significant remodel projects.
And Also...
The authors provided 2D and 3D views of main Patient Hub diagrams.