A critical analysis of accident and emergency (A&E) units’ design. A Case Study of Mulago National Referral Hospital.

Abstract

The design of Accident and Emergency units significantly influences the quality of patient care and the overall efficiency of any health facility. More so than often, these act as the first point of call for patients that come in a very critical state. The purpose of the study was to examine the critical architectural design issues that affect the provision of emergency care services at the facility. Data was collected through observation, literature and interviewing the users which included the medical staff, patients and their attendants at the facility. A descriptive and exploratory approach using qualitative data collection methods was adopted, involving an extensive review of existing literature and in-depth case studies with the leading case study being the biggest and oldest national referral hospital in Uganda. The study affirmed that one of the critical factors for the functionality of these facilities is accessibility - site placement, egress, wayfinding and signages, entrances and the spatial layout of the facility. Furthermore, factors like privacy, security, safety and comfort were also of primary importance for the users’ wellbeing. Factors related to spatial quality such as lighting, ventilation, acoustics and temperature greatly impacted the quality of emergency care. The caretakers revealed their dissatisfaction with the wait times at the facility highlighting a need to reinvigorate the facility’s waiting areas design. Staff members also underscored the need for their privacy. The research concluded that there are immense gaps in the design of the facility which negatively impacts the quality of emergency care.