This article looks at the important role lifts play in ensuring patients, staff and visitors can move around often very complex hospital estates safely
Lifts must cater for patients with a wide range of disabilities and injuries, as well as cognitive impairments
Visiting a hospital can be daunting, particularly for the elderly, infirm, injured or disabled, who have to navigate the monolithic tower blocks and endless corridors of imposing and often-confusing buildings.
Modern products are designed to make patients feel comfortable and safe, and they make building managers happy by operating with maximum efficiency and low power consumption
Key to ensuring ease of movement is to make it simpler to move vertically through a building. However, stairs, while abundant in healthcare settings, are useless to patients who are seriously ill or need to be moved in a wheelchair or on a bed or stretcher.
This is where lifts come in - and most hospitals will have a large number of them, whether they are for visitors, bed-bound patients, or facilities management use. “When designing mobility solutions for healthcare facilities reliability is paramount,” said a spokesman for manufacturer, Schindler.
“Modern products are designed to make patients feel comfortable and safe, and they make building managers happy by operating with maximum efficiency and low power consumption.”
These priorities steer procurement of lift technologies across the NHS and private sector.
Specification is guided by Health Building Note 00-04: Circulation and Communication Spaces; the BS 8300 code of practice; and BS EN 81-70 and BS EN-81-80 standards.
Health Building Note 00-04 states that: “Lifts should be versatile to accommodate as many types of load as possible. Number, type, size and speed should be determined by traffic analysis specific to the proposed development and should allow adequate flexibility of the solution to accommodate future changes.”
It adds: “At least one wheelchair-accessible lift should be in operation between each floor of a healthcare facility and, where planning allows, there should be doors on opposing sides to allow wheelchairs to exit without reversing.”
For general traffic, lifts should have internal minimum dimensions of 1600mm wide by 1400mm deep and handrails should be provided on both sides and rear walls. Trolley and stretcher lifts should be a minimum size of 1400mm×2400mm to accommodate trolleys up to 800mm×2375 mm.
Maintenance planned in accordance with operational requirements of the hospital is crucial in maintaining the lifts remain in service for as long as possible and minimising disruption
Where trolley-stretcher lifts are to be used for general traffic, lift cars will require handrails and the internal dimensions 1400x2400 will need to be clear of these. Where provided, handrails should be limited to one side wall of the lift car to minimise potential risk to patients on trolleys.
Lifts for moving bed-bound patients should be a minimum of 1800x2700. In order to segregate traffic for operational and infection control it is not anticipated these lifts will be used for general traffic. Where they are to be they will require handrails. Once inside the lift, the guidance offers advice on the design of lobbies and landings, lift finishes and lighting.
It states: “Each lift should open onto a landing of adequate depth in order not to restrict traffic flow in front of the lift entrance or onto a protected lobby. Lifts should not open directly into corridors.”
It adds: “Lift landings and lobby walls and lift doors should contrast visually, as should the landing floor and lift floor.”
Stannah has installed modern lift solutions at a number of UK hospitals, including Scunthorpe General Hospital and the Princess of Wales Hospital in Grimsby
Finishes should include slip-resistant, high-luminance flooring with uplighting or perimeter lighting rather than direct downlighting, which could dazzle patients being transported on beds.
Steve Hull, technical sales engineer at Stannah, said: “Durability and reliability are key factors when specifying lifts for healthcare environments.
“Consideration needs to be given to the selection of lift capacity, door opening sizes, and speed, ensuring that staff, patients and visitors all have reasonable access and availability. This means that input with architects and consultants at the earliest stage of a building design process is essential.”
Flexibility is also important, with modern lift solutions using swipecards to manage usage. For example, during the day they may be set aside for patients, while at night their use could be switched.
To meet infection control standards, high-quality stainless steel is often utilised within lift cars, making them easier to clean. This protection is further enhanced with sealed joints and jointless floor coverings.
In particular, handrails, control buttons and their surrounds are of concern, with a number of suppliers and manufacturers opting to use materials that have natural antibacterial properties that can withstand rigorous and regular cleaning.
In particular, recent research carried out in Canada found that lift call buttons often harbour more germs that toilet seats, with bacteria colonisation at 61% and 43% respectively.
To combat the problem, the study, published in the journal, Open Medicine, recommends placing more alcohol-based hand sanitisers outside lifts. It also puts forward the idea of enlarging elevator buttons to allow for elbow activation or installing touchless proximity sensors.
The design and layout of internal controls needs to take into account all types of disability, with a clear and precise layout, large indication, and high-quality voice annunciation with induction loop. Ligature attachment points should also be avoided, so any surface-mounted equipment must be smooth and angled downwards.
Hull said: “Modern lifts offer a lot in terms of technology, with controls allowing remote access via PCs, with automatic signals of any malfunction.
“In terms of potential problems, doors are the most-likely cause of a lift breakdown due to being hit by a trolley or similar, or being held open for extended periods of time. Full-height safe edges which change colour as the doors begin to close assist in preventing this sort of damage and, if doors are to be held open, door nudging can be triggered to slowly close them before pacing the lift back into service automatically.”
Other recent enhancements include voice communication, CCTV coverage, and the introduction of back-up power supplies, which mean lifts will keep working in the event of a total power failure.
“Maintenance planned in accordance with operational requirements of the hospital is crucial in maintaining the lifts remain in service for as long as possible and minimising disruption,” said Hull.
Stannah has worked on a number of hospital projects, including installing lifts at Scunthorpe General Hospital and the Princess of Wales Hospital in Grimsby.
Hull said: “All existing lifts were beyond their life expectancy and although previous part improvements had been carried out, they were proving unreliable. We were contracted to carry out major improvement works to bring the lifts up to current regulations, which included incorporating new landing doors and frames with formal fire certification.”
Modern solutions must also be environmentally-friendly, with many new systems becoming gearless to improve efficiency and power consumption.
Contrasting, easy-clean flooring, handrails, and good lighting are crucial