By Tysen Gannon
Flexible design is a building trend that is here for the long-term. In general, buildings that can adapt to changes in users’ needs, whether sudden or foreseen, or can be repurposed often enjoy a longer lifespan than more stagnant architecture because they can shift in response to occupant need. While these modifications can happen years after a project is completed, they can also happen during the planning or construction stages. Further, adaptable buildings can support more sustainable construction practices by providing built environments that can be reimagined through the years. This reduces the ecological impact associated with demolition and a subsequent construction since the building can be modified easily to fit a new purpose.
Although flexible design can provide long-lasting solutions for most architectural projects, it provides several unique benefits for a health care facility. As the past few years have shown, a health care centre’s ability to quickly respond to shifts in patient and staff needs can have a substantial impact on patient outcomes as well as the general public’s health and well-being. In addition, as advances in technology change what type of health care is possible and where that health care can occur throughout a facility, flexible design can support the integration of said advances without having to drastically renovate an entire wing, floor, or building.
Given the number of codes and guidelines governing specifications within health care settings, it can be difficult to know how to mesh flexible design goals with code compliance. Though difficult, designing flexible health care facilities is possible—especially when architects look to specific elements that can support these goals, such as doors. Since doors occur repeatedly throughout a built environment and set a limit on what can be feasibly moved into or out of a room, they can be integral to flexible design in the health care sector and others.
How doors contribute to flexible design goals
One of the most common hindrances to flexible design in health care facilities is the width of their doors. How wide a door opens sets the parameters on what equipment (and which patients) can be moved into or out of a room. For instance, the minimum clear opening width for door openings in a Treatment Occupancy (Group B, Division 2) is 850 mm (33.5 in.) (NBC 3.3.3.4); for doors that must allow the passage of patient beds, the minimal width is 1,050 mm (41.3 in.). The discrepancy between these dimensions can limit how a room can be used in the future, since rooms with doors that are below the latter threshold cannot be repurposed for inpatient care.
Further, these minimum widths could also entirely prohibit the use of some mobile computerized tomography (CT) scanners or provide such a small tolerance that wheeling this medical equipment through the door opening would risk unintentional damage. In an ideal situation, door opening widths could be enlarged to accommodate a plethora of uses without consequence. However, spatial constraints and the efficient use thereof can directly impact the size of an opening. For example, large openings that use swing doors will need more generous clearance to account for swing arc trajectories. Not only might this be unfeasible in dense areas, but it might also make operation difficult for those mobility assistive devices.
All these considerations complicate specifying doors that can accommodate larger equipment and patient beds. In these instances, doors that support wider openings without sacrificing useable space to swing arc trajectories create a flexible space and ensure those rooms can be used for multiple purposes throughout the facility’s lifetime. This is especially true when the doors repeat throughout a building.
