KARMIN research team designs infection-proof patient room for hospitals KARMIN research team designs infection-proof patient room for hospitals
The KARMIN research project

Healing Architecture: Infection prevention by design

Poignant new study sets new standard for patient rooms in the hospital

Fighting pathogens begins in the patient’s hospital room

Patients are hospitalised to get better, not worse. Contracting an infection during their stay, however, can significantly imperil their health and healing process. An increasing number of multi-resistant pathogens put patients at risk in a place, where hygiene should be at home. The fight against viruses and germs begins in the patient’s room. Now, the research project KARMIN (the acronym stands for hospital architecture, microbiome and infections in the hospital) is setting a new standard for the optimal patient room, designed to prevent infections.

Blueprint for infection prevention

M:IP should not be left to medical professionals alone. Disciplines such as architects, designers or biologists, must take on the challenge, too.

The precedent-setting research project unquestionably demonstrates that infection prevention in the hospital cannot solely rest on the shoulders of medical professionals: „Finding solutions for better controlling and fighting infections should not be left to one isolated group of experts,“ agrees the KARMIN project’s principal investigator and architect, Wolfgang Sunder, PhD, from the Institute of Construction Design, Industrial and Health Care Building (IKE) at Technische Universität Braunschweig (TU Braunschweig). „Rather, such undertaking requires the insight and expertise of an interdisciplinary team of experts from various professions and fields of study.“

Interdisciplinary team of experts designs prototype

Indeed, a team of architects, designers, medical professionals and molecular biologists from TU Braunschweig and Charité Berlin was the first to identify risk factors of infection transmission in a hospital room across disciplines. Together, they designed the optimal floor plan and outfitted the room with the best-possible equipment to all but eliminate contamination with dangerous pathogens.

In particular, hygiene hinges on people’s activities in the hospital room: patients’ behaviour, how workflows guide staff around the room, where and how visitors stay in the room and how the room is cleaned and disinfected. Consequently, any object in the KARMIN prototype room that touches the ground is movable so it can easily be moved during cleaning, to name one example.

Designing staff’s workflows around the room
The design of the room intents to guide staff’s movement around the room and promote hand disinfection.

Workflows and hand disinfection

KARMIN dispensers are strategically placed to promote hand disinfection

The disinfectant dispensers specifically developed for the KARMIN project are strategically placed along staff’s routes around the room, at the counter of the nurse’s work station, at the foot of each bed and in the patient bathrooms. Thus, movement about the room is minimised and the dispensers are in nurses’ view at all times to encourage hand disinfection.

The patient room’s wholesome design

„Healing Architecture“ — designed with wellbeing in mind

Not just the COVID-19 pandemic brought to light what has long been evident: A future-proof hospital room must protect people in close proximity to one another against pathogens and has to be adaptable to the situation at hand. „A modern patient room,“ Sunder says, „is subject to quickly and constantly changing circumstances, which depend on medical advancements, societal demands, and progress in the fields of architecture and construction.“ One of the biggest challenges were the rise of infections and multi-resistant germs, demographic changes, innovations in medical technology, new treatments and the change in patients expectations.

Floor plan and interior design support physical and mental health

Healing architecture considers the needs and conditions of patients during illness, the stresses of hospitalisation, as well as the recovery and healing process. Floor plan and interior design support the physical and emotional wellbeing of patients and their families. The flow of the room as well as furniture and equipment are designed to optimise staff’s workflows, make them simpler, easier.

The KARMIN hospital room represents an indicatory example of healing architecture. Goal of the project was to design a room that effectively eliminates cross-contamination with pathogens between doctors, nurses, patients and cleaning staff.

KARMIN two-bed patient room
Leading infection prevention by example: The design of the new KARMIN two-bed hospital room

Infection-proof design must be adaptable

KARMIN project leader Wolfgang Sunder, PhD.
KARMIN project leader architect Wolfgang Sunder, PhD
"A modern patient room is subject to quickly and constantly changing circumstances, which depend on medical advancements, societal demands, and progress in the fields of architecture and construction."

The ideal two-bed patient room

KARMIN researchers interviewed experts as well as the various types of users of a hospital room. The team took sample swabs of surfaces and objects, such as door knobs and sinks. Even swabs of the patients’ body were taken. At the same time, the interdisciplinary team analysed workflows and routes of nurses, doctors and cleaning staff in the room. One conclusion, for instance, was that pathogens are most often transmitted between the cohabiting patients when doctors and nurses interact with one patient while treating the other, for instance, if that patient calls a nurse over to his or her bed for help.

Based on the new insights and analysis, the team developed requirements for an infection-proof patient room, including the bathroom. „The KARMIN patient room represents the first prototype of a two-bed room with two bathrooms, designed, furnished and equipped to adequately prevent infections. It was also the first prototype an interdisciplinary team of researchers was able to plan, realise and analyse,“ project leader Sunder says.

Specifically, the solution includes a thoroughly considered, specially zoned room layout, innovative furnishings and features, such as BODE/HARTMANN’s disinfectant dispenser Eurospender 3 flex at the foot of the beds, the nightstand, the bedside terminal displaying innovative content with targeted informational campaigns for the patient, plus, last but not least, a well-thought-out lighting concept.

Infection-proof KARMIN two-bed patient room

The floor plan

Floor plan KARMIN two-bed patient room
KARMIN two-bed patient room in detail

Vision: The infection-proof patient room as positive place to heal and unbend

New insights inspire advancements

HARTMANN was part of the network of industry partners supporting the KARMIN project, which took several months to complete. In late 2020, a prototype was installed on the campus of Charité Berlin, giving experts and the public the opportunity to explore the KARMIN hospital room and provide constructive feedback. Moving forward with the project, the researchers are set on continually expanding and optimising the concept.

The current pandemic will provide researchers additional new insights, allowing them to approach healing architecture from yet another new perspective. At this point, the KARMIN project has revealed evidence and set a new standard for sensibly planning hospital rooms of the future — far from a scary place where the invisible risk of infection lures in every corner but rather a highly functional and comfortable place of wellbeing and coming together.

Das Patientenzimmer — Planung und Gestaltung

Accompanying book on the KARMIN research project [in German]

In November 2020, KARMIN project leader Wolfgang Sunder, PhD, et al. released the book about planning and designing the exemplary KARMIN hospital room (in German language): Das Patientenzimmer – Planung und Gestaltung.

The publication for medical professionals and architects presents the planning parameters and introduces 25 examples. What’s more, the book includes scientific floor plan analyses of 25 hospital rooms around the world, based on infection research.

Sunder, W. et al. (2020). Das Patientenzimmer — Planung und Gestaltung. DeGruyter.

Buchtipp: Das Patientenzimmer - Planung und Gestaltung
Dr.-Ing. Architekt Wolfgang Sunder et al.: Das Patientenzimmer — Planung und Gestaltung

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