Research, institutions, and companies have come together to shape the future hospital model using the JRP Healthcare Infrastructures technology platform. This initiative is led by Professor Stefano Capolongo as the scientific head, who outlines the goals and purposes.

The Next Generation Hospital is a major project aiming to define a future-proof, technologically advanced hospital model that’s resilient to change and demographic challenges.

Recently, at the Politecnico di Milano, researchers, businesses, and institutions gathered to tackle the next development phases of future hospital through the Joint Research Partnership Healthcare Infrastructures (JRP HI) technology platform. This step involves developing a precise and measurable project and criteria to establish an infrastructure model “ready for tomorrow”.

As Stefano Capolongo, a Hospital Design lecturer at the Politecnico di Milano and the scientific head of the initiative, explained, «the hospital today must increasingly integrate with the current socio-cultural context, becoming an urban hub that promotes health and innovation. The hospital entity is a ‘city within a city’where multiple functions find space and relationships in a single complex infrastructure».

Whereas of the future  were previously designed “by beds” or “by activity volume”, today’s challenge is to develop health infrastructure projects based on the health and organizational processes envisioned for the near future. «Through the JRP HI research platform, we’ll contribute to rethinking the accreditation requirements for hospital architectures in these terms, moving beyond the current prescriptive standards by introducing performance indicators for next-generation hospitals».

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TAKEAWAYS

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Professor Capolongo, how should we envision the future hospital, according to the design ideas and concepts outlined by the JRP Healthcare Infrastructures and the Next Generation Hospital project?

The Next Generation Hospital idea that emerges from the JRP HI aims to fast-track the application of already acquired knowledge in the field of hospital construction, which has yet to be implemented with the necessary vigor. Future hospital speeds up processes in terms of social, environmental, epidemiological aspects, and does so mainly from a digitization perspective. Its essential requirement is – or will be – its capacity to adapt over time. Flexibility and resilience are now priority terms capable of accommodating increasingly rapid changes, especially considering that research in the clinical, scientific, and medical fields requires a quicker adjustment of spaces and technologies. The building’s life cycle as a ‘container of people’, equipment, and technological solutions must be able to rapidly adapt to changes.

What does this mean in practice?

Today, we estimate that, to be highly efficient, a hospital’s life cycle should be completed and concluded in 50 years. For this reason, we are working on new functional models capable of embracing the major changes mentioned above, focusing on designing the hospital not just per bed, but for volumes of activity that translate into processes. Therefore, the architectural and construction project of the hospital is essential to synthesize all the components that interact with the hospital world: clinical, technical-scientific, social-health, industrial. I imagine the Next Generation Hospital as a large single volume within which the contents can change very quickly.

What are the main changes anticipated in the design and architecture of future hospital?

In Italy, the hospital building heritage is decidedly outdated. We need to speed up, restarting that relatively recent process of renewing hospitals, which is currently a bit stalled. Given this, I envision a hospital that is primarily accessible, not just physically. It must be a space capable of accommodating expansions to meet continuously evolving needs. Moreover, it should be accessible from a digitization standpoint, a key theme in terms of hospital sustainability. I imagine a compact hospital capable of fulfilling its purpose. It’s important to remember that people access this structure in two ways: in an emergency (via the emergency room) or through planned admission. Having a vision of hospitals increasingly based on criteria of excellence means responding to the demand for choice that citizens make today. They decide to go to a specific facility based on its results in terms of effectiveness and efficiency. Today, we have various tools and requirements capable of supporting the citizen in their choice, based on the success rate from a clinical point of view but also on the infrastructural capacity to provide certain services and assistance. In well-designed and structurally articulated places, the quality of care is better. Therefore, the physical space is very important to ensure both accurate care and a better quality of work for those operating within it. Technical and healthcare staff must work in healing spaces capable of producing health, comfort, and well-being.

Where are we at with the Next Generation Hospital idea?

Well, we’ve already confirmed that for a hospital to be both flexible and resilient, it needs to be designed modularly. This means starting with a big container that holds smaller ones, where you can mix and match different activities as needed. This setup is based on single rooms that can be doubled up if need be. This kind of setup is not just about being flexible; it’s also about paying close attention to care, with sustainability in mind too. I’m also picturing caregivers being there for patients through every step. And I’m thinking about a ward room where most of the care happens.

What’s the deal with digital innovation and its specifics?

Digital innovation is a big goal for us, especially with the JRP HI putting it at the forefront. We believe it’s going to make a huge difference in how we help people and make the healthcare system more sustainable, not just economically, but socially and environmentally too. We’re embracing digital tech, always keeping in mind the importance of ethics, privacy, and cybersecurity. Digital tech is here to help out human activities in hospitals, but also, where possible, to keep people at home instead of in care facilities. Just think, most of the folks who end up in emergency rooms are there for minor issues that could be handled differently.

How will AI be used in the future hospital?

AI’s going to play a big part across the board, from clinical stuff to the building side of things. We need to get on board with the power of AI to sift through massive amounts of data to help us make smart decisions. It’s going to make things easier in hospitals, like moving info straight from a patient’s bed to a digital platform for all sorts of uses, including logistics and therapy. AI will get close to patients to quickly deliver various services accurately but always with a human touch.

With an aging population, including hospital staff, and the ongoing challenge of not having enough doctors and nurses, how important will tech be?

We’re feeling the pinch with not enough medical and nursing staff, a problem that’s not new. Despite the current challenges, things could get better in the future with the right policies to encourage medical and healthcare professionals. For now, technology is lending a hand by taking over some tasks that people do.Imagine having tech (like robots) by a patient’s bed, ready to offer basic help, especially in emergencies.

How’s the patient care process going to get better in hospitals, including how things are managed?

Well, it’s going to get better the moment we’ve got a top-notch setup: the better it works, the faster we can take care of patients and the shorter their hospital stays will be, meaning we can offer high-quality care and more answers to their needs. A big headache today is waiting lists: cutting them down needs smart organization and facilities that can really look after patients’ needs and keep the whole operation smooth. Here’s where stepping up automation in logistics and getting more digital can help cut down on unnecessary movement of people and stuff, make things more traceable, and keep everything clean and safe.

What’s the designer’s job when it comes to creating future hospital?

They’ve got to really listen to what professionals, patients, and decision-makers are saying and then bring all those insights into the design in a collaborative way. It’s crucial that the designer pulls it all together in the end to avoid ending up with a hospital that only works well for now but won’t adapt to future changes. That’s why being able to incorporate flexibility into the design is key.

Where are we at with the whole Next Generation Hospital and JRP HI project?

In its first year, JRP HI was all about gathering data and figuring out what areas to focus on to sketch out the future hospital model. By the second year, it started laying the groundwork for a big collaborative project (embraced by research, institutions, businesses, and professionals) packed with standards that could turn into guidelines for Regions, strategy bosses, ministries, and the folks who make big decisions. They could use these guidelines to think differently about tomorrow’s health facilities. The next steps are about setting up and slotting KPIs into the tech platform to really measure how well we’re hitting our goals. Being able to measure stuff is super important because we need to know if a hospital’s design is actually doing its job in being effective and efficient. So, the plan is to come up with a bunch of measurable performance indicators to give us a clear picture, in numbers and quality, of how well the hospital structure we’re building will work. This whole methodical approach, just like what’s happening with the Next Generation Hospital, is already a thing in places like the UK’s National Health System or Denmark’s National Clinical Guidelines. JRP HI’s got the backing of UNI (the Italian Standards Organisation), which is helping roll out the first set of standards for designing new hospitals. This starts with a terminology standard laying out the overall structure and specialist terms for 410 words, agreed upon by everyone in the health ecosystem, followed by performance standards.

Glimpses of Futures

The path to figuring out what future hospital in Italy will look like is starting to get clearer, thanks to the teamwork of the JRP Healthcare Infrastructures and their project, Next Generation Hospital. 

It kicks off with a pretty stark realization from JRP HI: half of Italy’s hospital setups aren’t cut out for the new ways of doing things that today’s social, economic, and environmental challenges demand. What we really need are some solid guidelines to help design efforts keep up with these changes and respond the right way.

A big step on this journey is pinpointing KPIs, which are these clear, measurable standards that’ll help us build healthcare facilities that are not just efficient and robust but also safe and sustainable for the long haul.

Using the STEPS matrix, we now attempt to anticipate future scenarios, analyzing what future hospital might mean for us.

S – SOCIAL: the future hospital is all about making patient care more focused and considerate. The ward room is stepping up as a key spot where a lot of care happens. We’re aiming for spaces that are smartly designed and structurally savvy, knowing that it already leads to better care. It’s a shift towards something better from the overcrowding many Italian hospitals are dealing with now, where every day about three thousand people are stuck in emergency rooms waiting for a bed elsewhere [source: SIMEU – Italian Society of Emergency Medicine].

T – TECHNOLOGICAL: digital innovation is set to make services better for everyone and even help the national healthcare system be more economically, socially, and environmentally sustainable. Capolongo points out that bringing in artificial intelligence into hospitals could make caring for patients easier and better.

E – ECONOMIC: shaping a hospital model like the Next Generation Hospital, ready for what’s coming, means having a system that’s streamlined, adaptable, and enhances the care experience by cutting down on how long people need to stay in the hospital. This not only saves money but is a big deal for Italy, which in 2020 saw its public health spending hit 7.1% of its GDP, making it one of the top spenders in Europe [source: Ufficio Valutazione Impatto del Senato – Senate Impact Assessment Office]. In the Italian healthcare system, hospitals are where most of the money goes, taking up 45.5% of the total health spending, Istat says.

P – POLITICAL: building hospitals that are ready for the future definitely needs focused political effort towards big investments. It’s worth noting that in the WHO’s European region, hospital costs suck up between 35 and 70% of national health care budgets over the next few decades. The Italian National Institute of Health highlights that Europe is planning to bump up its spending on healthcare facilities, mentioning that EU Structural Funds are a big chance for all European countries. Every decision to put money into healthcare facilities is going to shape the healthcare system for the next 30-50 years.

S – SUSTAINABILITY: when designing the hospital of the future, thinking about sustainability (be it social, environmental, or economic) is crucial. It’s also a major topic of discussion in the JRP HI’s Next Generation Hospital project as they look at building and managing health infrastructures. Having hospitals that stick to sustainable practices can lead to big savings, not just in money but also energy and emissions. Plus, it can help shorten waiting lists and make the whole care process smoother, in spaces that really fit what people need.