A Historical Study of Chinese Nursing Unit Design Evolution Since 1989

Objectives: To provide a historical review on the evolution of contemporary Chinese nursing unit design and contextual factors that drive the design and changes. Background: China is undergoing a major healthcare construction boom. A systematic investigation of the characteristics and development of Chinese nursing unit design is warranted to help U.S. healthcare designers to provide design that fits the local context. Methods: The investigation is developed in two phases. The first phase is a large-scale spatial analysis of 176 Chinese acute care unit layouts from three periods: 1989–1999, 1999–2004, and 2005–2015. In addition to qualitative descriptions of the nursing unit typologies, the percentage of various typologies, patient room (PR) types, the number of beds, visibility from nurse station (NS) to PRs, and access to natural light during each period were evaluated quantitatively. The second phase defined key factors that shape Chinese nursing unit design through expert interviews. Results: Significant differences were found between design in these three periods. Chinese nursing unit size has continuously grown in the number of beds. Most PRs have shifted from three-bed to double-bed rooms. Most Chinese hospitals use single corridor, racetrack, and mutated racetrack layouts. Mutated racetrack has taken over single corridor as the dominant configuration. The access to southern sunlight remains important. The average visibility from NS to some PRs is restricted by the preferences of allocating most PRs on the south side of a unit. Conclusions: Chinese nursing unit design has undergone transformations to fit the local cultural, socioeconomic context and staffing model.