Space to care and treat safely in acute hospitals: recommendations from 1866 to 2008

This paper will explore and discuss the spatial recommendations, and the supporting research evidence, for in-patient bed spaces. The bed space is defined as the area around an individual bed that offers privacy either as a single room or a cubicle. A document review from 1866 to 2008 found that the recommendations for bed space width had increased by 1.1m over 44 years, from 2.4m (1961) to 3.6m (2005). However, a small scoping project in the United Kingdom revealed that the bed space areas in recently built hospitals (medical and surgical wards) were less than the recommendations. These data are discussed in the context of healthcare Evidence-Based Design to consider three patient safety issues (falls, noise and infection transmission). A role for ergonomics is proposed in the design, planning and evaluation stages as a methodology bridge between clinicians and architects (participatory ergonomics) and as an expert adviser to address design issues of patient safety and environmental functionality.