We recently looked at six hospital design trends that chart a path to responsive healthcare in the 21st century. Our dissection of complex constructs like lean design healthcare, UX design and evidence based design, informed us that consumer focus punctuated every one of the six trends. It is about time industry players placed shaping of hospital construction standards in Kenya, top of the list of their priorities. This could be the path to patient centered care, responsive health systems, cost reduction and improvement of efficiency in provision of health services.
Inasmuch as responsiveness in health demands a certain agility from health systems, insufficient consideration of the six trends in hospital design is unethical. No less different to offering patients a lower standard of care, oblivious of prevailing demands of evidence based healthcare.
We picked the heated conversation on this building said to be constructed on a road reserve from the ever vigilant #KOT. The concerns of these Kenyans involved in twitter activism centered on the supposed ownership of the building. They called on high powers in Kenya’s executive to end impunity in corruption as manifest by the building.
What caught our eye however, was an advertisement by a leading Kenyan private hospital chain. With a large banner, defaced here to protect the hospital’s identity, it announced its occupancy of a section of the building.
Disclaimer: We have no way of telling the private hospital chain’s implicit role. Neither can we verify the claims surrounding the building. Chances are, in the oft unforgiving world of social media, the private hospital chain is a victim, caught in the eye of the storm. Therefore, this synopsis on hospital construction standards in Kenya will be in general terms.
The Role of the Private Sector in Shaping Hospital Construction Standards in Kenya
The trend in Nairobi and most major cities in Kenya has seen proximity as a strategy employed by private healthcare providers. Though proximity does not equate healthcare access, private hospitals angling for a slice Kenya’s mass market for healthcare continue to set up branches in suburbs and Nairobi’s satellite cities.
The next 33 million, this lucrative market has been labelled. Moreover, the global trend towards ambulatory care as a strategy to cut costs and improve efficiency in healthcare often results in utilization of healthcare spaces initially not designed for this purpose. Combined, In the absence of stringent legislation, this private sector designed healthcare delivery model is at risk of perpetuating unethical practice.
Nairobi’s family of mushrooming malls have offered refuge for these ambitions by players in Kenya’s private health sector. The proximity to the masses and declining rents thanks to oversupply have proved to be an irresistible attractant. Only that some of these shopping malls aren’t even designed to be disability friendly. On the other end of the scale, some of the new buildings in Nairobi stand proud as relics of unethical practice. Corporate Kenya as good citizens have a duty to fight corruption by denying blood-letting corrupt enterprises business.
Limited Role of The Kenya Medical Practitioners and Dentists Board
Kenyan laws that govern licensing of new health facilities lack in being explicit on begetting an ideal regulatory environment. They fail to nurture best practice in hospital construction standards in Kenya. At the very best, requirements form the regulatory body, The Kenya Medical Practitioners and Dentists Board, only imply desired standards.
First, the board comes in late in the process : when the investor in healthcare is seeking license to operate a medical facility in Kenya. The requirement then is for the investor in healthcare to self declare if their health facility has this number of rooms or beds. This information enables the board classify the as a dispensary, clinic, health center, nursing home or hospital. A physical inspection of the facility by the county government then follows. The role of the various departments of health in the county governments is largely limited to confirmation of what the investor self-reported. And that’s pretty much it.
Public’s Abdication of Duty in Shaping Hospital Construction Standards in Kenya
Secondly, the wider public, potential users of the health installation hardly take interest or participate in ratifying new hospital constructions in their neighborhoods. This denies the already weak hospital construction standards in Kenya the impetus for quality and responsiveness. These two qualities that are desirable in health systems are dividends of aptly designed pubic participation. Sadly, at best, news of new hospital construction in Kenya focuses on the cost of the project. Cost being used here as a surrogate indicator of the quality of healthcare expected once the hospital is completed.
The Role of Hospital Management Integrity in Shaping Hospital Construction Standards in Kenya: How Investors In Health are Left to Their Own Designs
Thirdly, the investor often has to only contend with local requirements on general building construction. These often archaic, non-standardized regulations wrongly assume the role of hospital construction standards. They at best address only some aspects of environmental assessment such as: noise pollution, disposal of waste and protection of the natural environment.
Fourth, given the likelihood of anarchy — especially in a weak regulatory environment fraught with never ending reports of grand corruption — the onus lies with hospital management and investors in healthcare. Integrity, enforced individually or collectively through self-policing units like the Kenya Association of Private Hospitals, should be the indelible standard.
An investor who knowingly supports a criminal enterprise through rents or other paying contractual engagements are as culpable. At blame not any less than the financial sector is in layering loot from corruption and other unethical practices. Due diligence can never be stressed enough. Conversely, self regulation may downstream yield acceptable hospital construction standards in Kenya.
Self-directed, peer appraised accreditation is just one of the options available. Developing a culture of continuous quality improvement, bench-marking and sharing of best practices could help foster sustainability. Collaborative work with other professional organization such as The Architectural Association of Kenya. Third sector players involved in patient rights are a crucial partners in the journey to acceptable hospital construction standards in Kenya. They can’t be left out.
Conclusion
The government through it’s various arms remains the equivalent of the sino-atrial node and purkinje fibers. Meaning that government (in)action will set the tone of hospital construction standards in Kenya. Policy and regulation are the obvious sticks in hand to kills the snake. Lets get on with that. While at it, constructs of the Kenyan constitution regarding health rights and public participation should be ingrained in the DNA of the process.
However, government serving as an example to be emulated should be the long term goal. Never again should public funds be spent building dispensaries, health centers and hospital wards with such obvious design flaws. Stupid flaws actually, likes too narrow passages that can’t allow a patient to be wheeled.