Care pathways and the built environment: Conceptual framework for understanding

The 'Care Pathways' is a relatively recent health care management concept that seeks to make explicit the process of caring for patients. Care pathways appear central to the UK government's National Healthcare Service reforms. However, published reports of care pathways do not adequately incorporate the nature of the built environment infrastructure within and through which most care is delivered. Aligning care pathways issues with buildings' spatial system elements, we realised that the information embedded in care pathways can and arguably should be able to inform architects thinking when considering a building's spatial system. Briefing is identified as the interface where care pathways issues are discussed, and their consequences in the infrastructure tested and formulated. To understand how design requirements to encapsulate care pathways concepts is captured and assessed during the briefing process, scoping study designed with the aim to investigate the mechanisms of specification and evaluation of care pathways in current briefing practices. The study showed that Care Pathways as a term does not exist in current briefing documents. Also it revealed that delivery architects are not involved in the health care planning process furthermore they are not well informed of the outcomes of the health care planning process. As we recognised that care pathways have the potential to inform briefing if represented innovatively and in an understandable way to both health care clients and designers, we are proposing modelling as an approach to understand care pathways to capture the spatial requirements of health care facilities.