As far back as 2008, we at Healthcare Design were reporting on the growing popularity of standalone emergency departments (EDs), a solution to both the rising demand for services and the declining stock of hospital-based EDs.

Five years later, little has changed. Except you can now add on the effects of healthcare reform and the age of accountable care to reasons why the facility type remains an attractive way to provide affordable care that’s accessible to patients and in a setting that's more flexible than a hospital-based ED might be.

In the white paper “Smart Healthcare Infrastructure: How Stand-Alone Emergency Departments Improve Patient Accessibility and Care” from the McGraw Hill Financial Global Institute, authors Timothy Spence, Julie Zook, Nicholas Watkins, and Esperanza Harper, all of BBH Design (Raleigh, N.C.), and Carolyn Knaup, of WakeMed Health & Hospitals (Raleigh, N.C.), explore the concept and highlight what knowledge exists today on best practices for design.

While there’s a ton of information packed into the paper’s 24 pages, for the sake of this blog, I’ll share highlights of the design suggestions the team makes for standalone EDS:

  1. Easy navigation—The space should be easily traversed by new patients, even if an escort is generally provided. “A legible plan is likely to be more welcoming and satisfying than a confusing plan,” it says.

  2. Create a visual hierarchy—Corridors and other interior spaces where patients will travel should be clearly differentiated from other less important areas, something that likely won’t be achieved simply through color-coding or signage, “which can reflect the failure of the spatial layout to ‘read’ clearly,” the paper states.

  3. Create a line of sight—Clinicians should be able to see patient beds from where they work, with nurses’ stations located in a place where anyone in a corridor can easily see if a nurse is available.

  4. Go beyond the floor plan—When it comes to issues like visibility, spatial depth, and wayfinding, floor plans don’t tell the full story. Apply space syntax analysis during design to better understand the configuration and achieve a more realistic view of the end result. “Every design concept is unique,” it says.

For more on standalone EDs, see this coverage from Healthcare Design: