Analysis of Functional Layout in Emergency Departments (ED). Shedding Light on the Free Standing Emergency Department (FSED) Model

Abstract

The ever-increasing number of hospital Emergency Department (ED) visits pose a challenge to the effective running of health systems in many countries globally and multiple strategies have been adopted over the years to tackle the plight. According to a systematic review of the available literature, of the numerous models of healthcare systems used to address the issue in western countries, the FSED Model has the greatest potential for reducing hospital ED overcrowding as it can reduce the additional load by diverting minor cases, freeing up space for more urgent cases. The aim of the study is to shed light on the Free Standing Emergency Department (FSED) model and compare it with the traditional Hospital Based Emergency Department (HBED) in international contexts. In this study, 23 papers have been collected in a literature review and the main features have been highlighted; 12 case studies have been analyzed from a layout point of view and data have been collected in terms of surfaces, functions, and flow patterns. The percentages of floor areas devoted to each function have been compared to define evolution strategies in the development of emergency healthcare models and analyses. The use of FSED models is an interesting way to face the overcrowding problem and a specific range for functional area layout has been identified. Further studies on its application in different contexts are encouraged.

Congruence Mapping of the Activity Flows Allocated in Built Environments: A Pilot Application of Under-Development Software in an Emergency-Care Service

“…Recent studies have reviewed the evidence demonstrating the impact of healthcare facilities on patient outcomes [1,17]. Others have pointed out that healthcare workers exhibited reduced efficiency when they were performing their tasks in unsuitable working environments [15,16].…”

“…Others have pointed out that healthcare workers exhibited reduced efficiency when they were performing their tasks in unsuitable working environments [15,16]. In particular, a problematic ED design can have a potentially detrimental effect on patient and staff health, safety, and satisfaction, leading to contamination, and crowding issues [1,5,18,19]. Unfortunately, reports of EDs with long waiting times, busy staff, and crowded and uncomfortable rooms are recurrent [1].…”

“…The planning, design, and facilities management processes in large, dynamic, and complex installation facilities, such as healthcare facilities, are continually evolving [1][2][3]. The emergency department (ED) is the most vital and complex sector of any healthcare facility [1,4], representing a "front door" for primary care hospitals, through which most inpatients enter the hospital [1,2]. Inadequacy in the flow within the ED has the potential to impact the hospital system's functions and hamper the overall delivery of the health services [1,2,4].…”

“…The emergency department (ED) is the most vital and complex sector of any healthcare facility [1,4], representing a "front door" for primary care hospitals, through which most inpatients enter the hospital [1,2]. Inadequacy in the flow within the ED has the potential to impact the hospital system's functions and hamper the overall delivery of the health services [1,2,4]. Thus, it is important to have the means to carry out building performance evaluations and interventions based on evidence and inventiveness.…”

Rethinking the Healthcare Facilities: The Role of the Buffer Space

“…In this context, a “BS”—sometimes referred to as a “lung space” in technical jargon—is a hospital area designed to host a variety of healthcare functions and meet variable facility use and spatial needs (Rodríguez et al, 2021). These areas are typically found in the context of critical hospital areas, such as emergency departments (EDs) and intensive care units (ICUs), which must be able to host large influxes of users when required (Adamy, 2021; Brambilla et al, 2022). Conceptualizations and designs of BSs vary, ranging from fully operational and furnished, to incomplete and empty but ready to be easily completed and fully operational (Capolongo, 2012; Gola et al, 2021).…”