BayBuzz recently reported on ten-year health infrastructure plans for Hawke’s Bay announced by the Government, which included a number of specific near-term fixes (e.g., ‘ED and Intensive Care uplift’) and a reference to “hospital redevelopment” in the longer term (2030-2034).

“Hospital redevelopment” could be anything from incremental band-aids to a brand-new fit-for-purpose 21^stCentury hospital.

So, in that context, a recent article in the New Zealand Medical Journal, titled ‘Poor planning: hospital design guidelines fundamentally flawed’, caught my attention. 

To my surprise, the article zeroes in on one very specific issue – the case for single occupancy hospital rooms. As I learned, this is far more important than you might think.

In the ‘modern’ health care world – UK, France, US, Canada, The Netherlands, Norway and others – single occupancy rooms are becoming the norm, mandated for new construction.

But not in New Zealand. Current design guidelines (Australasian Health Facility Guidelines) leave it to local jurisdictions. Consequently, NZ public hospitals have only a small proportion of total beds as single rooms, with the majority provided in multi-bed rooms.

Big deal?

Emphatically ‘Yes!’ says this article.

“Shared rooms compromise clinical standards, breach patients right and privacy law and undermine cultural safety,” say the authors.

Effective infection prevention and control is significantly more challenging with shared rooms, with NZ practitioners frequently unable to meet basic care guidelines for control, for example, of respiratory and gastrointestinal viruses.

You’ve heard some version of: ‘If you don’t want to get sick, stay out of the hospital’. No wonder.

With our ageing population, delirium and dementia conditions managed in hospitals, already high, will rise further. Proper care of these patients, which involves control of light, noise and sleep, is seriously compromised in shared room settings. And managing other risk. The authors comment: “No person should have to share a room with a patient who is agitated, aggressive or sexually inappropriate. Given the high rates of delirium and dementia, this is far from assured in our hospitals.”

The article also debunks the argument that single-room care is cost-prohibitive. The authors give evidence that: “Single occupancy design may cost more initially, but this will be easily recouped over time. US research predicted only a 5.3% increase, with costs expected to be recouped within a year, while United Kingdom (UK) research predicted a similar small 5% increase.”

Here is the article if you’d like to learn more. 

Curiosity aroused, I sent a request to HB Hospital (which of course got routed to Wellington) asking the simple question: What proportion of HB Hospital rooms are single-bed versus multi-bed?

Given the clinical care issues just described, one would think our hospital could readily replay. But no, they can’t. They told me how many total beds (Adult inpatient – 245, Maternity – 12, Mental health – 23), but somehow can know that without knowing their configuration.

Moreover, Health NZ told me they were unlikely to respond further since that would require “substantial manual collation”.

So, who knows how your stay or visit to HB Hospital might at risk because of this issue. Or to what your confined patient friend or relative might be exposed to.

Or even whether these are issues that the HB Hospital takes seriously – either now, or in future planning.

Next week, our May/June BayBuzz magazine hits the streets’, with a major feature on the ‘division of labour’ between HB Hospital and our two private hospitals — Royston and Kaweka. Don’t miss it!