Empirical review of NHS Estates ergonomic drawings

In the late 1970s and the early 1980s the Department of Health developed an ergonomic database, in the form of ergonomic drawings, to act as guidance for the design of new hospitals and the adaptation of old buildings. But there is very little peer-reviewed empirical evidence published to support the recommended drawings. The project used ergonomic methodologies to review the ergonomic drawings of single bed spaces and toilet / shower facilities on adult acute wards and intensive care units (ICUs) in terms of nursing staff carrying out specific clinical tasks. The objectives were to (1) review the complex interfaces using ergonomic task analysis methods from other industries, (2) to provide up-to-date ergonomic information to designers (architects) and planners on spatial requirements for the above units, and (3) provide recommendations for the development of future guidance on functional space requirements. Five PFI hospitals were visited to capture a range of `actual' space dimensions in the forms of coded AutoCAD drawings and relevant photos for the application of building the mock-ups for the Functional Space Experiments (FSEs). The field observations were conducted over 5 weeks at two local hospitals. A total of 100 nursing tasks with 74 nurses were recorded and analysed by using Hierarchical Task Analysis (HTA) and Link Analysis (LA). FSEs were conducted with 36 nurses for the ICU, adult acute ward and toilet/shower mock-ups resulting in 190 composite link analysis diagrams. The results from the FSEs were described as an `ergonomic envelope', the incompressible functional, space required for clinical tasks in these areas. The average spatial requirement of ward bed space envelope was 11.14m2 (average width of 3.21 m, length of 3.47m). The average spatial requirement of toilet / shower envelope was 5.43mz (average width 2.08m, length of 2.61m). The average spatial requirement of ICU bed space envelope was 23.47m2 (average width of 4.96m, length of 4.80m). It was recommended that both the width and the length should be given together with the area for an envelope, and hospital planners and architects should regard ergonomic envelope as a "core space" in the hospital development. Finally a 4-step protocol for future development, revision and testing of ergonomic drawings were presented, and the potential further study areas were suggested.