CLAHRC BITE

Brokering Innovation Through Evidence Collaboration for Leadership in Applied Health Research and Care

BITE 13 September 2013

A bite-sized summary of a project within CLAHRC for South Yorkshire Does the design of hospitals meet the needs of older people? Growing numbers of emergency admissions for older people create an imperative for hospitals to develop facilities to meet their needs. This research aimed to identify design criteria that can improve the processes, quality and outcomes of acute services for older patients. Three acute care settings were recruited into the study, representing: • the acute-care pathway for older people • different building types • different building ages. They comprised a middle-sized NHS Foundation Trust hospital, an in-patient rehabilitation hospital and an intermediate care site. The Built environment is an adopted project of the CLAHRC SY Reducing Health Inequalities theme.

The building evaluation assessed the design quality of the building; evaluated the performance of the building in supporting the specific needs of older people; and provided feedback to inform changes made to enhance the built environment in relation to use by older people. Findings showed that, largely, hospital designs do not meet the needs of older people. The main issues are found in the basic design layout and can be improved by: • establishing a clear intuitive wayfinding strategy • providing windows giving views, daylight and ventilation to spaces where people spend time • providing level or gently ramped routes inside and outside • ensuring travel routes do not compromise a patient’s dignity and privacy • limiting walking distances and providing handrails and resting areas along routes • providing appropriate signage in large print with nonreflective surfaces

• using colour, contrasting tone and textures to identify different zones of the building. Small, relatively inexpensive changes can be made to existing buildings which can improve the environment for older people such as: • including art/plants/flowers in waiting and bed areas • avoiding a proliferation of notices • ensuring there are no obstacles or tripping hazards on routes below eye level • avoiding using high gloss cleaning products on floor and wall surfaces. For more information on the project please visit the CLAHRC SY website www.clahrc-sy. nihr.ac.uk/theme-inequalitiesresearch-evaluation-acutecare-older-people.html You can also download the ‘Design Guide: Meeting the needs of older people in hospital settings’ and key findings from the project on the CLAHRC SY Website www.clahrc-sy.nihr. ac.uk/resources-projectreports.html

About CLAHRC for South Yorkshire There are nine CLAHRCs in England. Our remit is to undertake applied research and implementation activities, and to build capacity within our partner organisations. CLAHRC for South Yorkshire is a partnership between universities, the NHS, other NIHR initiatives, patients, charities and industries.

Our website www.clahrc-sy.nihr.ac.uk This is a summary of independent research. The Built Environment project (grant number R/130190) is funded by the NIHR Physical Environment Research programme. The project is an adopted project within CLAHRC for South Yorkshire. CLAHRC for South Yorkshire acknowledges funding from the NIHR. The views and opinions expressed in this document are those of the authors, and not necessarily those of the NHS, the NIHR or the Department of Health. CLAHRC SY would also like to acknowledge the participation and resources of our partner organisations. Partner details can be found on our website.