All About The Children - Queen Silvia's Childrens Hospital

With her experience as a paediatric intensive care nurse and university lecturer, Monica was instrumental in ensuring that the 35,000m² extension, with operating theatres, an intensive care unit and three floors of single-bed patient rooms, would provide the best possible environment for the care of sick children.  

What were your aims in designing the new hospital? How is it different from other, more traditional children’s hospitals?

Monica Johansson (MJ): We are fortunate in that we were already one of the leading children’s hospitals in Sweden, but the original 1960s building of the existing hospital was lacking space for new and more advanced nical equipment, space for involving parents in their children’s care and we had a really dull looking building.  This new facility is for sick children either on short visits  after surgery or for long-stay patients with serious or life-threatening illnesses, who require 24/7 care. We wanted to create a homely atmosphere for the children and their families, as well as to provide the best possible working environment for our staff. 

From surveys I conducted with children and their parents I found out that the children wanted more colour, and their own ward rooms where they could be with their parents and where friends could visit, equipped with TV, internet and computer games. Parents wanted to be at their child’s side with all the facilities needed for a comfortable stay; a bed, a shower and somewhere to relax and make phone calls.

The staff wanted to work in smaller, self-contained units, each with a nurses’ station, team room and documentation located close to the patients, rather than the large, central administration room they had previously occupied. This would allow them closer, more immediate contact with the children and their parents. They also requested a large staffroom, a kitchen to prepare lunch and relaxation areas.

Of course, the overall driver in the design of this hospital was for the child to be at the centre. To lessen the anxiety of children as they arrive, we have the play therapy area at the entrance, to immediately create a fun atmosphere. We also have an arts area, a music room and for the teenagers a room with a pool table and cosy areas for computer games and where they can meet their friends. There are classrooms for those well enough to leave their beds, and there is a central indoor garden which provides a calm and relaxing area for children and their parents. New for us is the swimming pool in the physiotherapy unit for children with rheumatic diseases, pain problems, anxiety and obesity.  

WSP provided building services engineering design for this project. How supportive was our team of your approach? 

MJ: They were extremely supportive. We held workshops and I gave talks about how we work and what is required for our patients and staff, always focusing on our mantra that everything we do is for the sake of the children. WSP also attended workshops with the medical staff and hospital technicians to get their thoughts on details such as the internet, lighting themes and colours and acoustics. They listened to our staff and were very keen to understand exactly what we needed. 

In terms of our technical delivery, what are the stand-out features that are helping the hospital to function in the way you envisaged?

MJ: We have seven, large, high-tech operating theatres containing a large amount of equipment. The ventilation here is top notch, from the purity of the air to practical details such as a pressurised space between double doors at the entrance to the sterile areas so staff can easily step out for a coffee. Special lighting schemes of red and green have been installed to assist surgeons during complex operations such as open-heart surgery.  Some of our operating theatres are hybrid rooms where we can combine modern imaging and X-ray technology with surgery to avoid moving patients between rooms. The technical support we received from WSP in providing the infrastructure we need for all this machinery has been greatly appreciated by the surgeons and technical staff.

WSP were also very helpful in resolving contradictory requirements of meeting government energy-saving regulations while providing a warm enough environment for our patients. If you are examining a small child, they must be kept warm. The solution was to place heaters in the ceilings for extra warmth when we need it. 

WSP also supported us in ensuring a high level of flexibility in order to re-purpose rooms or add new machinery. The wards are mainly single rooms and very well equipped, but the technology is all hidden to maintain the homely atmosphere. It means we can transfer a patient room from bedroom to treatment room with ventilators, machines for blood cleaning and so on. This allows their parents to stay with them and we can teach them, for example, how to deal with a tracheotomy or with blood lines. And by learning to care for their children, they can take them home earlier, which is of course the best place for them. 

The hospital has been operational since March. Are you happy with the way it is working out and will it improve outcomes for patients?

MJ: We are seeing many benefits for children, parents and staff. The design of the wards to enable our way of working in small units, where the nurses are in close proximity to the children and their parents, with all the documentation at their fingertips, is really optimising the care of our patients. 

The single rooms reduce the risk of infection, whilst enabling the children’s family and friends to visit them without disturbing other patients. And having parents’ rooms on each ward, where they can cook – some of the children find it very hard to eat - a little home cooking can make all the difference. 

I am also delighted with the whole layout of the hospital. The garden in the centre provides such a pleasant and relaxing area for the children and their families; the educational facilities; the way we cater for children of all ages; the play therapy; and the importance of involving the children’s parents; all these combine to create the best possible environment for children and help their recovery. 

What for you has been most rewarding about this project?

MJ: The fact that everyone involved in the proje listened and was totally committed to its success. The head of one of the construction companies said that it has been magical to build this hospital for the children. We are the envy of medical staff everywhere for the exceptional working environment we have created. Most of all, we are so proud that we involved the children in the design process and in doing so delivered this fantastic project which we see as a model for children’s hospitals in the future.