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Vertical Circulation: Stairs

In this article, we assess stairs as a familiar and easily understood way of travelling from one building floor to another in the hospital setting.
Southmead Hospital, Bristol, United Kingdom
Photo Design Features
  • Vertical circulation shaft clearly identifiable and easily located within hospital atrium.
  • Good balance of artificial and natural light throughout atrium space.

Stair Design Considerations and Awareness
Most people will use stairs on a daily basis, whether this is at home or out and about in the community. Therefore, they offer a familiar and easily understood way of travelling from one building floor to another in the hospital setting for a mobile person. Walking up and down stairs also provides exercise, represents an activity of daily living, and preserves skills that may be required when they depart the hospital.

In many hospitals many internal stairs are designed as a fire escape and are therefore enclosed and can only be accessed through fire doors that must remain closed when not in use. Consequently, while they will be clearly identified with fire exit signs, the stairs themselves may be hidden from direct view and out of easy reach for those who are unfamiliar with the building.

In this context it would be helpful to provide more open and publicly used stairs in addition to the primary fire stairs. To make these stairs accessible and easily understood, they should be in a logical location and clearly visible from the main public area within the hospital. In some cases, it may be possible to provide glazing to the stairs and therefore make them visible from the main circulation space.

While stairs may be beneficial, their use may represent difficulties for people living with dementia, especially those with mobility difficulties. Contrasting colours between the steps of the stairs, the stringer, and the walls can help a person with dementia to identify steps and changes in level or gradient, thereby simplifying the visual environment. This is also beneficial for older caregivers with age-related vision difficulties. Lighting is also very important on internal stairs so that they can be used safely at all times.

Where stairs are enclosed, access doors must be easy and intuitive to use while lighting and signage will make these entrances easy to locate and use.

UD Dementia Friendly Design Guidance

  • Stairs should be considered a good opportunity to provide mobility, exercise and activities of daily living for mobile patients who are capable of using them.
  • Stairs should be in obvious locations and clearly visible from the main public space.
  • Access doors to stairs should be well lit and clearly distinguishable from their background by using a different colour or tone.
  • Provide a continuous floor finish and colour from the corridor into the stairs. Where there is a change in material make sure there is minimum colour contrast, particularly at door thresholds.
  • Use colour or tonal contrast to help a person identify the stairs.
  • Provide colour contrasting nosing strips to the top and bottom of the flight of stairs to highlight the changes in level.
  • In addition to the above, providing colour contrasting nosing strips to all steps will provide greater legibility for the user.
  • Use a handrail design that will be familiar to most people and will be consistent with their expectations.
  • For the stairs use a contrasting colour or tone so that the handrail stands out clearly from the background.
  • Where possible, use some feature to clearly indicate where a handrail ends, as this will help provide a better signal to the user that the handrail is ending and thus give them a chance to adjust accordingly.
  • Ensure high levels of even, natural and artificial lighting within circulation areas to help those with visual difficulties
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Dementia Inclusive Hospitals from a Universal Design Approach

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