How Do I Size Emergency Rooms?

Form follows function, and nowhere is that saying more true than in a hospital. In a place where time is more valuable than money, clinicians need their environment to support their lifesaving work. That's why someone designing a hospital emergency room must carefully evaluate the hospital's needs so the result will be adequate to the need.

Instructions

• 1

  Consult hospital administrators and managers about their plans for their emergency room. Find out what level of emergency care they intend to provide, the number of beds they are licensed to run, their expected patient flow and plans for growth. Ask if they will have any specialties within their ER as well as any which trauma level they will be operating. A level one trauma center, which handles acute cases -- such as major accidents and serious burns -- needs significantly more space and specialized equipment than a level three center -- which is geared toward less life-threatening problems, such as broken bones.

• 2

  Talk to emergency physicians and nurses about their needs in an emergency room. Find out how they organize themselves, which procedures they perform most frequently and what they need to do their jobs in the best way possible.

• 3

  Observe and shadow people in the hospital's existing emergency room if you're working on an expansion or renovation project. If the emergency room is to be built as part of a new hospital, then visit other emergency rooms of a comparable trauma level and care spectrum. Try to understand the work flow and any special needs.

• 4

  Review the hospital's overall architecture and design -- especially for the floor on which the emergency room will be located. Consider the competing needs for the space when developing space allocation and placement options. Try to come up with at least three choices to present to hospital administration.

• 5

  Share with administrators sketches of the possible space allocations along with a rough design. People need to see how the space accounts for the equipment and work flow of the department. Elicit feedback from key decision makers.

• 6

  Revise your allocation and drawings based on feedback and requests. You may find that it takes several rounds of proposals and revisions before you find a size and layout that receive approval. Hospital renovation and construction costs are formidable. For instance, construction costs of UCLA Ronald Reagan Hospital, which opened in 2008, ran to $921 per square foot. Administrators will be looking for the best value for their money.