In the bustling corridors of Moorfields Eye Hospital, a silent revolution is underway, one that could reshape how we think about patient flow and clinic design. At the heart of this transformation is a unique blend of architectural innovation and operational research, spearheaded by Kerstin Sailer from the Bartlett School of Architecture at University College London. Her work, published in the journal Buildings & Cities, delves into the intricate dance of patient movement within ophthalmology clinics, offering insights that could ripple through the medical sector and beyond.
The COVID-19 pandemic laid bare the inefficiencies in patient triaging, particularly in ophthalmology, where lengthy waiting times became the norm. Moorfields Eye Hospital NHS Trust responded by opening a new clinic, designed with a linear spatial layout and a patient flow system that prioritizes efficiency and safety. But how does this new design stack up against the existing clinic, and what can other medical specialties learn from these findings?
Sailer’s research integrates direct observations of patient flows, architectural layout analysis using space syntax methods, and queuing simulations from operational research. The results are revealing. The new clinic, with its lane system, supports flows and coordination through sightlines between stations. “The lane system allows for a more structured flow, which can be beneficial in maintaining order and coordination,” Sailer explains. However, when patient load is high, this system can lead to bottlenecks and longer clinic durations.
On the other hand, the existing clinic, with its clusters of stations, allows for a more organic flow. Experienced technicians can navigate this layout more efficiently, especially when the clinic is busy. “The cluster system can be more flexible, allowing technicians to adapt to the flow of patients more organically,” Sailer notes. But this flexibility comes at a cost—it can be less efficient when patient load is low.
So, what does this mean for the future of clinic design? Sailer suggests an ideal allocation of stations to diagnostic activities based on clusters, but with direct sightlines between them. This hybrid approach could offer the best of both worlds—structure and flexibility.
The implications of this research extend far beyond ophthalmology. Other medical specialties with diagnostic procedures, such as orthopaedics, dentistry, or audiology, could benefit from these insights. The growing field of evidence-based design is gaining traction, and this work adds a valuable piece to the puzzle.
For the energy sector, the lessons from this research could be profound. Just as patient flow in a clinic can be optimized, so too can the flow of energy in a building. Understanding how people move through a space can inform the design of energy-efficient systems, from lighting to heating and cooling. The integration of architectural and operational research, as demonstrated in Sailer’s work, could lead to more sustainable and efficient buildings.
As we look to the future, it’s clear that the design of our spaces—whether they’re clinics, offices, or homes—will play a crucial role in shaping our world. Sailer’s research, published in Buildings & Cities, offers a glimpse into how we can use data and observation to create spaces that are not just efficient, but also adaptable and sustainable. The data from this study are openly accessible, inviting clinicians, planners, and academics to build upon these findings and push the boundaries of what’s possible. The future of clinic design—and perhaps even the energy sector—is looking brighter, one sightline at a time.