Evaluation of factors and approaches affecting emergency department space planning

This paper aims to evaluate emergency department (ED) design space planning approaches and draw lessons for developing more resilient and integrated ED guidelines. Two key objectives have been set; these include: exploring potential factors affecting the ED performance, and investigate how ED space planning is addressed internationally through the evaluation of international case studies and design guidelines.

A robust research method has been adopted including comprehensive literature review in addition to 76 case studies from Italy and the USA.

Findings show that the important factors in defining ED space requirements are attendance variability, vulnerable groups and mass casualty events. The study concludes that current design guidelines and approaches need to be updated to meet with the current and future demand by taking into account design performance: effectiveness, efficiency and resilience, to avoid underestimating ED space; and that the US EDs are in a better position, than Italian EDs, to increase capacity when needed.

The contribution of this study is in providing a tangible “understanding” of factors influencing ED design and prepares a firm ground to develop more resilient and integrated design guidelines, able to meet current, exceptional and long-term needs of EDs. The study also shows that research can provide a valuable contribution to improve ED design which needs to feed more in practice to improve design process and guidelines.