Reactivating Hospital, Active Patients Through Special Design
Authors: Feenstra Femke 
Published: November 2020

Objective: With the reactivating hospital concept, it is our goal to provide a more active stay in a hospital for patients by diverting the focus away from “lying in bed.” We want to achieve this by changing the spatial environment of the nursing ward. These new spatial interventions are aimed toward helping the patients to be healthier during and after their admission to the hospital. Background: When it comes to hospitals, we tend to have a mindset that is basically focused on disease, not on health. The whole hospital is geared toward illness, waiting, lying in bed: a passive attitude of the patient in this medical stronghold. Staying in a hospital has a negative influence on the body, especially for vulnerable patients. However, when patients remain active during their hospital stay, fewer negative effects occur. The risk of complications reduces, and patients recover better and faster. Research shows that only 15% of patients actually need to stay in bed. In order to enable hospitals and their patients to benefit from these insights, Gortemaker Algra Feenstra Architects introduces the reactivating hospital concept: a set of scientifically based practical interventions intended for a change in organization and spatial design of hospitals. Design hypothesis: How can spatial interventions to a geriatric department contribute positively to activating elderly patients during their stay in the hospital? Research question: What impact does providing areas for activation away from a patient’s bed have on the quality of the patient’s experience? Method: The reactivating hospital concept no longer revolves around “lying in bed,” but around the notion of “making patients stronger.” We are introducing a new rhythm of 8 hr of activation, 8 hr of relaxation, and 8 hr of sleep. This requires a different mindset of patients and personnel and involves a totally different interpretation of space. To tackle the problem at its roots, the bed will be solely reserved for sleeping and all other activities will take place elsewhere in the nursing ward. To encourage patients to remain active, we soften the transition from bed to room, from room to corridor, from corridor to department, and from department to the rest of the hospital. These subtle transitions invite patients to move around, thus remaining active. To test these methods, we use qualitative and quantitative research methods such as observation, conversations with focus groups, and questionnaires during the research. Results: Reactivating hospital concept is a concept and a design research in progress in collaboration with the existing Diakonessenhuis hospital and the Netherlands Organisation for Applied Scientific Research (TNO). In this setting, there are different scales of innovation. In the first phase, we have been working on a completely new bed department with a new typology. In the second phase, we are currently testing significant changes in a room, corridor, and department level, within the context of the existing department, and we are measuring and monitoring the results. The first research results show a positive effect on the state of mind of patients as well as the nurses. At this moment, we are researching the positive effect on the exercise and health of patients, and we are expecting the first concrete results to come in at the end of the year. Conclusion: The initial feedback we have received from the Diakonessenhuis hospital has been positive. Furthermore, we have noticed that the reactivating hospital concept is receiving more and more support. Lying in bed has a negative effect on patients, and a lot of hospitals are aware of this and are therefore looking for alternatives.