Experts in healthcare architecture and infection prevention have called for safer hospital designs, stronger healthcare systems and improved infrastructure to reduce avoidable harm to patients.
They made the call at the Federal Teaching Hospital, Gombe, on Thursday, during the commemoration of the 2026 World Patient Safety Day organised by the Federal Ministry of Health and Social Welfare in collaboration with the hospital’s Infection Prevention and Control Committee.
The event, which brought together healthcare workers from various departments, was held with the theme, “Safe Care for Non-Communicable Diseases.”
Speaking on “Architectural Considerations in Patient Safety in Non-Communicable Diseases,” the Guest Speaker, Prof. (Arc.) Abubakar-Ibrahim Alkali, said hospital architecture could either reduce or create opportunities for patient harm.
Alkali said poor accessibility, confusing movement patterns, overcrowded waiting areas and inadequate privacy could expose patients to avoidable risks.
He said, “If there is no ramp or the lift is not sufficient for a patient who needs assistance, it becomes a problem. If circulation within a healthcare facility is confusing, the patient may become disoriented or delayed.
“If the patient does not know where to go while trying to locate a clinic, he or she may eventually miss the appointment.
“When patients get to the registration or booking counter, they may be directed from one place to another. If the waiting areas are overcrowded, the environment creates additional stress. Body heat, noise and congestion build up, and the harm has already begun.”
The architect also identified poor acoustic privacy as a potential threat to safe healthcare delivery, particularly during consultations.
“If consultation spaces have poor acoustic privacy, communication suffers. While the doctor is trying to communicate with the patient, background noise can make communication difficult.
“Even when the patient is explaining himself or herself, comprehension can be significantly affected,” he said.
Alkali said poor spatial relationships between laboratories, imaging units and consultation rooms could also increase unnecessary movement and delay care.
“If laboratory, imaging and consultation areas are poorly related, unnecessary movement and delays increase.
“At times, you find the X-ray unit in one axis and the laboratory in a completely different area, while other investigation units are located elsewhere. These arrangements increase unnecessary movement and stress for patients who may already be vulnerable,” he said.
He further warned that failure of essential services such as electricity and water could become a patient-safety incident rather than simply an operational inconvenience.
“Imagine that you are in the middle of an active prescription, diagnostic procedure or another clinical activity and suddenly one of the essential services fails.
“The entire service may be interrupted, creating consequential problems and adding to the risks faced by the patient,” Alkali stated.
According to him, patient safety should be considered from the design stage of healthcare projects because the physical environment determines the conditions under which care is delivered.
“Architecture can therefore either introduce or reduce opportunities for harm. It cannot prevent all medical errors, but it can either contribute to or reduce patient-safety problems.
“The physical environment is one of the conditions under which safe or unsafe care takes place.
“The architect’s responsibility is to ask: where can the design either support or compromise patient safety?” he said.
Alkali identified accessibility and movement, visibility and privacy, spatial relationships, clinical workflow, environmental conditions, infrastructure resilience and emergency preparedness as key considerations in hospital design.
He called for step-free access, appropriate ramps, non-slip flooring, adequate corridor widths, rest points, accessible toilets and clear wayfinding, particularly for elderly patients and people with mobility limitations.
“Every unnecessary step, change in floor level or obstacle is a potential safety risk,” he said.
On environmental conditions, Alkali said poor lighting, excessive noise, inadequate ventilation and uncomfortable temperatures could compromise patient safety.
“If there is poor lighting and an area is dark, vulnerability increases. If there is excessive noise, stress can build up and communication can suffer.
“Poor ventilation may contribute to the spread of hospital-acquired infections. Therefore, whenever architects design healthcare facilities, these factors must be treated as key and critical aspects of the design,” he said.
He urged healthcare planners to incorporate reliable water supply, power, cooling, medical gases and alternative systems into hospital designs.
“In Nigeria, we know that infrastructure can be unreliable. Therefore, architects need to consider passive and alternative strategies for addressing these challenges,” Alkali said.
He also advocated the use of solar power, adequate water storage and other backup systems to minimise disruption when essential services fail.
The architect urged Nigerian professionals to develop hospital designs suited to local realities rather than simply importing models from other countries.
“We should not simply import hospital design models from other countries. Instead, patient-safety principles should be translated into architectural priorities that respond to the realities of the Nigerian healthcare system,” he said.
Alkali said durability and maintainability should be prioritised when selecting hospital infrastructure and equipment.
“The issue is not simply whether the technology is advanced, but whether it is appropriate, sustainable and maintainable within the local context.
“The objective is not necessarily low-cost design. It is high-value design—achieving the greatest safety benefit from available resources,” he stated.
He also called for hospital designs that accommodate family members who assist patients with care.
“When properly accommodated, they can become an asset to patient safety. This calls for appropriate waiting and family spaces, sleeping or resting provisions where necessary, clear and visible circulation, hand-hygiene facilities, communication spaces and spatial separation between family activities and clinical functions,” Alkali said.
He added that safety should continue beyond construction, warning that poor maintenance could render even a well-designed hospital unsafe.
“A beautiful hospital can become unsafe if finishes deteriorate, lighting fails, ventilation becomes blocked, air-conditioning systems stop functioning or other safety features become defective.
“Architects must therefore think beyond design and construction to operation and maintenance,” he said.
Also speaking, a Professor of Medical Microbiology and Infection Prevention and Control at Gombe State University and the Federal Teaching Hospital, Gombe, Prof. Mohammed Manga, identified resource shortages, environmental factors and unsafe healthcare practices as major threats to patient safety.
Speaking on “Basic Concepts and Contexts about Patient Safety for Communicable and Non-Communicable Diseases,” Manga said safe healthcare required systems capable of identifying risks before they resulted in harm.
“Safe care depends on systems that anticipate, detect and learn. Patient safety is the organised work of lowering risk, reducing avoidable harm, making error less likely and limiting its impact when it occurs,” he said.
Manga called for standardised procedures, reliable safeguards and an environment where healthcare workers could report safety concerns without fear.
He said, “Standardise work and build reliable controls. Respond fairly so staff can speak up and report. Engage patients and families in safer decisions.”
According to him, shortages of healthcare workers, essential supplies, functional equipment and basic infrastructure could magnify everyday safety risks.
“Resource gaps magnify everyday safety risks. Harm increases when scarcity combines with fragile processes and little capacity to recover,” Manga said.
He listed workforce shortages, inadequate supervision, lack of essential supplies and diagnostic equipment, poor water, sanitation and hygiene facilities, unreliable electricity, oxygen shortages and weak maintenance systems among the challenges.
He added that overcrowding, long queues and difficult referral pathways could further increase risks to patients.
Manga said the consequences could include missed or delayed diagnoses, unsafe procedures, healthcare-associated infections, delayed response to deteriorating patients, injuries, distress, fatigue among healthcare workers and loss of public trust.
He stressed that healthcare facilities must prevent infections while treating patients.
“Health facilities must treat infection without transmitting it to patients, health workers or the wider community,” he said.
Manga called for continuous staff training, occupational health support, safe water, proper cleaning, effective waste management and appropriate reprocessing of medical equipment.
He urged healthcare institutions to design systems around the realities of patients, healthcare workers, families and communities.
“Build reliable processes, environments and safeguards around real work. Put patients, health workers, families and communities within the safety boundary.
“Detect risk early, respond fairly and turn every signal into safer care,” he said.
Manga said improving patient safety required sustained attention to the challenges confronting both healthcare workers and patients within the health system.
Lauding the organisers, the Vice-Chancellor of Gombe State University, Prof. Sani Yauta, described the programme as commendable, saying it would strengthen awareness and encourage the adoption of global best practices in patient safety and healthcare delivery.
Yauta said initiatives that brought healthcare professionals together to examine patient safety were important in improving the quality of care available to Nigerians.
The World Patient Safety Day is observed annually to raise awareness of patient safety and encourage stakeholders to take practical steps to prevent avoidable harm in healthcare.