The Sustainable Schedule of Hospital Spaces: Investigating the ‘Duffle Coat’ Theory

Hospitals experience constant change of use, so flexibility for activity change is an accepted objective in hospital design. By extending the useful life, flexibility enhances the sustainability of investment in hospital buildings. A widely accepted strategy for flexibility is to design hospitals with a small number of distinct space types, repeating these types as often as possible. By analogy with Royal Navy duffle coats, which were loosely tailored and supplied in a limited variety of sizes, this is called the ‘duffle coat’ theory of room sizing. Standardisation of sizes may be desirable for the design, construction and maintenance of hospitals, but this study focuses on flexibility for activity change. In two mathematical simulations, the duffle coat theory of hospital flexibility is not validated.