Hospitals are to healthcare what Gothic cathedrals are to religion. They are constructions of fallible man to inspire and encompass healing by reaching heavenward. And like the Gothic cathedral, what is unseen, the flying buttresses of technology, knowledge, and process, keep the edifice from collapse. Through the rose window the entering patient sees a vision of health and happiness, but the reality is that the window is merely a thin screen, which distorts the reality of life. The reality of life is that human frailty, manifest in the work within the hospital, often leads to unintended events with harmful consequences.


It is a paradox that the safety of patients is both the oldest and most enduring of objectives of medical practitioners and yet at the same time does not receive appropriate attention in the current operation of health care institutions. There is no aspect of healthcare delivery in which this observation is more accurate than in the creation of operating room environments through planning, design and construction. We will briefly describe the process of health facility design. We will continue with a review of the current state of patient safety to show that facility development and design methodologies of the past should be abandoned for new approaches which feature the integration of patient safety into the design and culture of the healthcare setting.