Inpatient unit flexibility: design characteristics of a successful flexible unit

Flexibility in health care design is typically addressed from an architectural perspective without a systematic understanding of its meaning from the end-user's viewpoint. Moreover, the architectural perspectives have been generally focused on expandability and convertibility. This study explored flexibility needs in adult medical-surgical inpatient care with the objective to understand its meaning from an end-user perspective and identify characteristics of the physical environment that promote or impede stakeholder' requirements. Semistructured interviews were conducted using a qualitative design with 48 stakeholders in nursing and nursing-support services at 6 hospitals across the United States. Data were collected during September-November 2006. Findings suggest that adaptability influences more aspects of unit operations than convertibility or expandability. Furthermore, physical design characteristics affect 9 critical operational issues where flexibility is required, spanning nursing, environmental services, materials management, dietary services, pharmacy, and respiratory therapy. Keywords: adaptability; convertibility; efficiency; expandability; flexibility; inpatient unit