What goes into designing floors for healthcare environments?

by Madelein
What goes into designing floors for healthcare environments?

In hospitals, clinics and other healthcare environments, flooring plays a particularly important role. FLOORS in Africa magazine spoke to Andrew Mills head of interior department at Geyser Hahn Architects and Rudolf Roos, Senior Architect at Hospital Design Group, to learn about the key considerations, expectations and requirements of architects when it comes to choosing the perfect floors for a hospital.

“When you walk into a building, the first thing you see is the floor. It’s more important than many other interior aspects in a hospital,” says Rudolf.

Andrew says that during the initial planning stages of a hospital, interior designers and architects look at how the floor should perform and what is required of the floor.

Biggest deciding factor
“We also take the client’s budget into consideration, which is usually a key factor on the flooring system that is specified. The intended maintenance regime of the facility How the client plans to look after the floor is also a major consideration when specifying floor types,” says Andrew.

He adds that while architects expect floors to perform according to specification and intended purpose, the responsibility of product selection and maintenance needs to be considered.

“We expect floors to perform for the function intended. One cannot put a vinyl plank in a theatre and expect it to contribute to a sterile environment. We also expect a vinyl floor, for example, to last 30 years if well looked after, but is very much the responsibility of the hospital or tenant to look after their floor. It is important as professionals with knowledge of the specified product to inform the end user about manufacturer recommended cleaning strategies,” says Andrew.

From terrazzo to vinyl sheeting in hospitals
Rudolf says that while anti-static flooring is only used in special circumstances, i.e. specialised theatres where doctors could be at risk of electrical shocks, the majority of healthcare environments receive normal vinyl sheeting.

“Traditionally, many hospitals had terrazzo flooring, which is beautiful but can be costly. Many of the old hospitals in Italy as well as Little Company of Mary in Pretoria and the Kernridge Hospital in Johannesburg originally had terrazzo floors. Today, hospitals still opt for a seamless floor for hygienic reasons and vinyl sheeting is commonly used. The joints need to be welded so that no dirt or water can penetrate into the floor. The advantage of these floors is that they are attractive, offer acoustic benefits, are easy to clean and promote ‘a-septic’ principles,” says Rudolf.

Image courtesy of Hospital Design Group

Specific preferences for different clinical environments
He adds that slip-free flooring products are used in bathrooms and that floors with a studded texture are often installed in front of lifts. Psychiatric hospitals have specific preferences when it comes to the colours that they want for their floors, and physiotherapy areas may also specify soft textured floors. While porcelain tiles with special jointing, such as epoxy joints, and carpet tiles may be chosen for reception and administrative areas, designers need to make sure that the floors in healthcare environments are easy to clean.

“After installation, the floor will be dressed, so the only maintenance that is left is the cleaning. There are new systems that consist of pads used in conjunction with prepared solutions that make vinyl floors easy to clean in hospitals. There’s no mopping involved. If a quality flooring system has been installed, it can last thirty years,” says Rudolf.

Andrew says that the protective layers produced for vinyl is improving the way floors are maintained and the longevity of the product.

“The old school ward matron’s idea of ‘if a floor doesn’t shine, it is not clean’ is slowly being changed by continuous improvements in the flooring sector. We are particularly excited about new products from the vinyl industry that are specifically geared towards healthcare facilities. A hospital that can invest in proper maintenance and cleaning will have a different set of options to a healthcare clinic where there is only weekly deep cleaning. A lot of time is spent understanding the hospital’s activities and needs during the planning stage,” says Andrew.

A hospital’s floor must be practical
Practicality when designing floors is important and interior designers as well as architects need to know what to put and where within a hospital environment.

“You need to know what is available on the market and understand your client very well. We mostly receive information about new products from magazines, flooring manufacturers, books that are geared towards architects and even hospital staff who work with us on projects,” says Andrew.

He says that flooring patterns should be implemented in innovative way to improve the user experience within hospitals.

Image courtesy of Geyser Hahn Architects

“Floor patterns can be implemented in many ways – for direction, to define a space or to facilitate therapy. At a recently completed project at Rehab Matters, which is located on 200 Rivonia road, we used flooring inlays to accent, create wayfinding and marking on a walking track to facilitate therapy for amputees,” says Andrew.

Getting your specification 100% correct
Rudolf says that a hospital floor’s specification needs to be 100% correct if the floor is intended to work perfectly for three decades. “There are many things that must be specified in a hospital floor project. The screed must be completely level and smooth, and it needs to adhere to minimum moisture requirements. The floor also needs a 3mm self-levelling screed to remove any irregularities and ensure that the floor is completely flat. If you are unable to comply with the moisture requirements and you are on a tight deadline, then the contractor would need to install a vapour barrier before the self-levelling screed is poured. Avoid laying the floor when a lot of sun is coming through the windows, otherwise the vinyl will heat up and expand. When it cools down, the joints will tear open,” advises Rudolf.

He concludes by saying that the detailing around the doors, the direction of the tiles, and patterns on floors are also key considerations.

“Vinyl flooring needs to be brought up to meet doorways for a seamless system as there should be no wooden skirtings in a healthcare environment. We have started to move away from too many patterns as they can be perceived as disruptive, except in paediatric wards, for example. A directional print vinyl sheet may be less economical as you can’t always use the cut-offs. In our experience, non-directional flooring is a more cost-effective solution,” concludes Rudolf.

Specialised tip: Many items must be specified in a hospital flooring system. The screed must be completely level and smooth, and it needs to adhere to minimum moisture requirements.

Full thanks and acknowledgement are given to www.hdg-pretoria.co.za, www.gharchitects.co.za and www.sans10400.co.za for some of the information contained in this article.

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