Conceptual Design of Future Children's Hospitals in Europe: Planning, Building, Merging, and Closing Hospitals.

Designing children’s hospitals requires new solutions for the re-organization of services, and renovating, merging, or closing old hospitals, as well as building new children’s hospitals. This article is the first of a 3-report series opening the debate on the future of children’s hospitals in Europe. Children’s hospitals should be child friendly and safe, thus creating a “small world in itself.” They must communicate with the outside world and offer a comprehensive expertise to the regional territory. Large children’s hospital should provide specialist tertiary and quaternary services for children, including highly specialized equipment and access to rare procedures and clinical trials that may involve experimental treatments and procedures. Furthermore, each specialist unit should provide outreach clinics in regional centers, bringing their expertise closer to the patient, and also should be able to engage in shared care arrangements with local pediatricians working in regional pediatric units. It is conceivable that such hospital model, proposing high quality standards of safe and reliable care for all children, would become progressively the preferred alternative to standalone children’s hospitals and mother and child centers. These centers may become less relevant to the population and therefore less likely to maintain any political support that may have favored their survival throughout the years, despite a likely substantial inefficiency