The answer is yes, and I'm not talking about roads, parking, or shuttle busses. It is amazing how much "transportation" goes on inside a hospital every day. Patients, supplies, and food come in. Trash, dirty laundry, and visitors go out. Biomedical equipment goes from unit to unit. Samples and specimens go in and out of the lab. The pharmacy staff takes medication all over the hospital. The loading dock and ambulance bays are easy to identify, but what happens to the supplies or the patient after they enter the door? You get the idea.

I have seen various transportation-friendly features incorporated into my hospital projects. Some have to be addressed in design and others are typically worked out with vendors during the construction and activation processes. One of my favorites is having a dual network of corridors—back of house for materials and equipment and front of house for patients and visitors. When we do this, we can beef up the wall protection in the back of house corridors and prevent the patients and visitors from seeing some of the less attractive sights. We also help the staff to move more efficiently as they transport needed items. For long hauls, some of my clients have gone to "tug" systems of mechanized carts. When adding on to an existing facility, sometimes the elevations don't match so we need to be sure that ramps with gradual slopes are used in high traffic areas. And, of course, match the door widths to the maximum loads likely to pass through them. Automatic door openers can speed up transport in many cases.

Elevators are also key in the "transportation plan.” Talk to your client about designating elevators for patients, visitors, staff, or materials as needed. Have they planned for a dedicated elevator for moving items from sterile processing directly to the operating room support areas? How about a trauma elevator from rooftop helipad to trauma area of the ED, or possibly straight on to an area accessing the operating rooms?

Security issues have to be considered in planning how everything and everybody gets around. Should certain doors, elevators, or stairs only be accessible to certain groups of people or during certain hours? All of these scenarios are easy to make happen with most access control systems, as long as you communicate the requirements to the vendor as the system is being set up.

Last but not least: I urge healthcare clients to think about wayfinding in a global way—can we use colored tiles or paint treatments to help people know where they are and how to get to the next place? Where and how do we feature signage? Patient, staff, and material flows have been incorporated into the design, but what cues will people need to follow them? These are all relatively easy issues to address in design and construction and they pay long-term benefits in operational efficiency.