Delivering open-plan safety with expert balustrade specification

Garth Boyt of Delta Balustrades discusses the considerations for the design and specification of balustrade installations in hospitals

From a design perspective, if there is one thing that stands out about contemporary hospitals it’s the sense of space.

The primary role of a balustrade in a hospital setting is to safeguard against falls on balconies, mezzanines and staircases

Open-plan layouts with multiple-storey atria let natural light pour in. These not only serve a practical purpose, but also create a much-more-relaxing, less-intimidating and easier-to-navigate layout than the old rabbit warrens of darkened corridors, typical of so many legacy hospitals.

Southmead Hospital in Bristol, a £430m ‘super hospital’ that has 800 patient beds and 24 operating theatres, is a stunning example of this new approach.

“Around 75% of patient beds at Southmead are in private rooms to aid infection control while navigating the hospital for patients, visitors and staff is much easier thanks to the design layout and the use of colour.

Balustrades play an important role in delivering all of these benefits, safeguarding health and safety without impacting on line of sight or daylight. However, it is essential to ensure that balustrades are correctly specified to deliver their full design benefits and to ensure that loading capabilities are aligned to the hospital’s fire strategy and evacuation regimes.

Safe loading

The primary role of a balustrade in a hospital setting is to safeguard against falls on balconies, mezzanines and staircases.

Detailed loading calculations need to be carried out to ensure that circulation areas are safe, even in an evacuation scenario. Crush factors from corridors crowded by patients and areas where those with limited mobility will have to be wheeled out of the building, or transferred unconscious from operating theatres or the ICU, must be considered as part of the loading strategy, which often means increasing the specification beyond building regulations requirements.

Balustrades play an important role in safeguarding health and safety without impacting on line of sight or daylight

Infection control

Loading calculations will also affect specification of the handrails, glazing and fixings, but loading is not the only consideration here.

Fixings not only need to provide the required strength and durability, they also need to respond to health and safety best practice.

At Southmead, for example, Delta Balustrades installed a balustrade system that incorporated folded stainless steel pressings that were folded over the fixings, enabling us to position the glass panels flush to the floor for maximum safety and a neat aesthetic.

This approach has also removed any risk of fixings snagging on skin or clothing and contributes to the hospital’s infection control by preventing dust from becoming trapped under the panels.

A clear glass panel not only helps patients and visitors to navigate the hospital more easily, but also ensures that patients are more visible, which can be particularly helpful in environments where patients are vulnerable

Infection control is also a consideration in terms of the finish used, particularly on handrails. A more-highly-polished surface will not only retain its appearance for longer, but will also reduce the risk of bacteria being harboured in the microscopic abrasions on the polished surface and aid effective cleaning as part of the hospital’s infection control regime.

Increased visibility

All glazed panels should be fabricated using toughened safety glass that delivers the loading calculations, but their purpose is aesthetic and functional as well as safety led.

A clear glass panel not only helps patients and visitors to navigate the hospital more easily, but also ensures that patients are more visible, which can be particularly helpful in environments where patients are vulnerable, such as dementia or mental health facilities, or in children’s hospitals where patients’ height may be lower than the handrail.

Clear glass also maximises light, but there is often a balance to strike between the additional visibility and light offered by clear glass and the need to protect privacy and aid wayfinding. At Southmead, for example, the lower section of the glass in patient circulation areas is fritted with a subtle dot matrix pattern that fades as it rises up the panel. This means that each panel is almost opaque at the base and gradually becomes more transparent until it becomes completely clear towards the top.

This is a design feature that has attractive aesthetic impact, but is also successful in keeping the open feel of the interior while providing modesty screening between the lower and upper storeys. In the back-of-house areas, meanwhile, the specification was downgraded to clear glass, offering the same high levels of safety without the cost of a fitted finish.

Bespoke specification

As with any aspect of hospital specification, balustrades must be custom-designed to meet the individual needs of the environment. Early engagement with a specialist as part of the design team will ensure that the end result maximises safety, infection control, durability and aesthetics, all within budgetary constraints.