The Road to Flexibility: Understanding Change

This three-part series will explore the topic of flexibility in architecture. In this first article, we examine the main reason for flexibility: change.

By studying the ways our buildings have evolved, we can begin to understand the demands we will place upon them in the future and the necessity for flexibility.

The second article will present three types of flexibility (convertibility, adaptability, and transformability) and how they can be beneficial to the healthcare field. The third article will study how flexibility is incorporated into the design process, along with specific architectural responses to different flexibility strategies, presented through case studies.

To read part two of the series, please go here: http://www.healthcaredesignmagazine.com/article/road-flexibility-adaptability-transformability-and-convertibility. To read part three of the series, please go here: http://www.healthcaredesignmagazine.com/article/road-flexibility-strategic-interventions.
 

A changing field
Like technology, the medical field experiences rapid progress. Significant advances change how patient care is administered and supported, and oftentimes require new technology, equipment, or spaces. With changes in care delivery technology occurring so rapidly, and in light of economic constraints and environmental concerns, it is not feasible for healthcare institutions to construct new facilities each time technology changes.  

Many drivers exist in the design industry to create innovative, unique, and successful projects, but none is more paramount than flexibility in realizing the full potential of a facility. The ability to accommodate changing standards of care and space requirements reduces service disruptions, medical complications, and the need for capital expenditures to construct new facilities.

As a result, an increasing number of healthcare facilities are emphasizing flexibility when planning their buildings. 

The challenge is twofold: Institutions must prepare and plan for a future they can’t predict; and, historically, efforts toward flexible architecture have focused on building typologies outside of the healthcare sector that tend to be less regulated. 

Healthcare designers and planners are uniquely positioned to implement flexibility strategies; this can extend the life cycle of a structure, reduce future renovation cost, and reduce the impact of construction projects on the organization’s processes and culture.
 

Types of change
In order to understand how flexibility can benefit healthcare facilities, it is important for designers to understand the types of change that hospitals might experience. 

Volume
Although some fluctuation in patient volumes is normal, a sustained change in volume can occur in areas that are growing or decreasing in population, such as a revitalized urban core or a rural town that has just lost a major employer. Greater volume can tax every aspect of a hospital’s facilities, from publicly accessible restrooms to operating rooms and patient rooms.

On the other hand, a decrease in volume means that the facility must provide maintenance for underutilized spaces. 

A hospital can also experience a volume surge after a natural disaster. In the last 10 years, various communities have experienced an increased need for care following hurricanes, tornadoes, earthquakes, and tsunamis that have crippled healthcare systems.

In these circumstances, healthcare systems grapple with diminished or damaged physical environments and limited supplies, in addition to increased volume and acuity of patients.