This study evaluates 171 hospital bed tower designs from the past decade. The Floor-building gross square feet (BGSF)/Bed, patient care area, ratio between them, and the bed count per unit were analyzed. The findings suggest that the average patient care area has decreased 5%–10% to a 305 departmental gross square feet (DGSF)/Bed average. The patient care area, support, circulation, and area grossing on floor were found to average 908 Floor-BGSF/Bed, and were impacted by the total beds/unit. It was determined that larger bed count per unit designs with 32–36 beds/unit average 21.9% less Floor-BGSF/Bed than designs with 24 beds/unit. The research evaluates design solutions impacted by a shifting environment of regulatory change and escalating costs. The hospital bed towers represent new facilities, horizontal/vertical expansions, and 25+ design teams. Design and/or construction took place during a 10-year period (2008–2018). The acute patient unit designs were reviewed and electronically quantified. The area measurement methodology aligns with the guidelines set forth in the “Area Calculation Method for Health Care” guidelines. Each project team was faced with a unique but similar set of circumstances. The balance between core values, guiding principles, budget, and quality of care was always present and included a diverse combination of owners, designers, construction delivery methods, profit models, and clinical approaches. In today’s world, common solutions are grounded in providing the best value. Project teams face a number of challenges during design. The lack of information should never be one.

This article shares the results of a quantitative analysis of the space use and physical attributes of 140 acute care units (ACU) completed since 2007. Objective: To fill a gap in the literature with respect to the state of practice for ACU design over the study period by investigating relationships among the physical characteristics and density of completed ACUs. Background: Robust industry interest about the topic—further agitated by the dearth of large-scale quantitative research regarding ACU space use—motivated completion of the study. Method: Through extraordinary collaboration by participating firms, floor plans of 140 new ACUs from the study period were gathered, systematically measured, and then analyzed. Results: Structural bay size, nurse station location, and the number of beds per unit were found to have significant relationships to ACU floor-gross area per bed. Additionally, nine significant associations among the explanatory variables were found, including moderate relationships among bay size, nurse station location, room handedness, and toilet room placement. Conclusion: The results suggest that project design teams tend to bundle key physical attributes together when planning ACUs. Moreover, density increases resulting from bay size reduction diminish as the bay size drops below 31′. Any impacts resulting from the major external events demarking the last decade were not sufficient to appreciably affect ACU density. Lastly, those concerned with increasing density and controlling ACU floor gross area are alerted to explore design options featuring bay sizes of approximately 30′ in conjunction with a centralized nursing model containing more than 32 beds per unit.