A National Look at Hospital Bed Tower Design

Abstract

This study evaluates 171 hospital bed tower designs from the past decade. The Floor-building gross square feet (BGSF)/Bed, patient care area, ratio between them, and the bed count per unit were analyzed. The findings suggest that the average patient care area has decreased 5%–10% to a 305 departmental gross square feet (DGSF)/Bed average. The patient care area, support, circulation, and area grossing on floor were found to average 908 Floor-BGSF/Bed, and were impacted by the total beds/unit. It was determined that larger bed count per unit designs with 32–36 beds/unit average 21.9% less Floor-BGSF/Bed than designs with 24 beds/unit. The research evaluates design solutions impacted by a shifting environment of regulatory change and escalating costs. The hospital bed towers represent new facilities, horizontal/vertical expansions, and 25+ design teams. Design and/or construction took place during a 10-year period (2008–2018). The acute patient unit designs were reviewed and electronically quantified. The area measurement methodology aligns with the guidelines set forth in the “Area Calculation Method for Health Care” guidelines. Each project team was faced with a unique but similar set of circumstances. The balance between core values, guiding principles, budget, and quality of care was always present and included a diverse combination of owners, designers, construction delivery methods, profit models, and clinical approaches. In today’s world, common solutions are grounded in providing the best value. Project teams face a number of challenges during design. The lack of information should never be one.

Space Use and the Physical Attributes of Acute Care Units: A Quantitative Study

“…Conversely, Ritchey and Pati (2008) reported that larger ACUs (i.e., >32 beds) often need less DGSF per bed than smaller ACUs (i.e., <22). Similarly, Pingel (2021) found a 21% reduction in floor-BGSF per bed-with a 4% increase in net patient care area-in larger ACUs (32-36 beds) when compared to smaller (24 bed) units with similar 30 0 bays. These conflicting findings, among others, support the need for this research.…”

“…Some variables are variants of those previously cited. For example, many of the prior works summarized in Table 1 reported the DGSF per bed; however, this study, following Pingel (2021), uses floor-BGSF per bed as a design density indicator to more plainly capture the total scope of built spaces supporting direct patient care in the ACU. Similarly, and also in accordance with Lavy et al’s (2019) findings, areas devoted to on-floor air handling unit (AHU) equipment were deducted from the floor-BGSF values before analysis to normalize between projects where AHUs were located on the roof (or penthouse) and those projects where AHUs were positioned indoors on the patient floor.…”

“…Building upon prior work by Allison and Hamilton (2008), Hamilton and Lavy (2017), Latimer et al (2008), Lavy et al (2019), and Pingel (2021) regarding healthcare space use measurement and allocation, the purpose of this study is to fill a gap in the literature with respect to the physical attributes and space characteristics of ACUs completed in the United States since 2007-after the industry's shift to single-patient rooms (SPR) compliant with the requirements of the Facilities Guidelines Institute (FGI, 2006), during the passage and effectuation of the Patient Protection and Affordable Care Act (PPACA; 2010), and coinciding with the Great Recession and subsequent economic expansion.…”

“…Larger rooms were found in units with over 35 beds, and smaller rooms were found in the units with about 20 beds. Similarly, Pingel (2021) found larger patient rooms in units with 32 or more beds, but an inverse relationship between floor-building gross square foot (BGSF) per bed and unit size: As the bed count increased, the floor-BGSF per bed decreased. Interestingly, Pingel (2021) also found a median floor-BGSF per bed of 880 ( n = 157); after factoring down this finding to approximate DGSF per bed, over half of that sample would be classified as small (or perhaps even “super-small”) following Durham’s (2011) sorting.…”

A Comparison of Hospital Area Measurement in Germany, Canada, Australia, and the United States: Part 1

“…In response to these challenges, several countries have created hospital area measurement standards. These standards enable organizations to facilitate accurate and reliable benchmarking to support their hospital planning and management endeavors ( Kelly & Pingel, 2021 ; Lavy et al, 2019 ; Pingel, 2021 ). However, many organizations work in international contexts and lack clarity in how to measure and analyze hospital areas across countries.…”