Designing the flooring system

Flooring in healthcare facilities must not only fulfil a practical role but also aesthetic and sustainable one, says Manu Malhotra

The reception lobby at Apollomedics Super Specialty Hospital in Lucknow.
The reception lobby at Apollomedics Super Specialty Hospital in Lucknow.

Healthcare in India is an evolving infrastructure, where the patients are considered as healthcare consumers and therefore beside treatment, the hospitals tend to provide a healthcare experience. From cleanliness and accessibility to heavy wear, way finding and promoting a healing environment — hospitals face many daily demands. The flooring is a crucial part of creating a quality care setting and satisfying such demands.

A patient room at Apollomedics Super Specialty Hospital.

Today where the healthcare systems of all types and sizes are constantly competing to offer consumers a top-notch patient experience, I believe that flooring in healthcare facilities must not only fulfill a practical role but also aesthetic and sustainable one.  The design of the flooring system of a healthcare facility should be driven by multiple factors such as:

• Making care environments more homely

• Incorporating  state-of-the-art, safer slip-resistant solutions

• Focusing on green building and sustainability

Today flooring for healthcare facilities has a multi-faceted job to improve safety, reduce stress, facilitate patient satisfaction, and provide a robust return on investment (ROI). While designing the flooring system of a healthcare facility one needs to ensure that the system excels in all required parameters such as: slip resistance, sanitisation, noise absorption, cushioning, aesthetic, fall within a certain installation and maintenance budget, and shall last by enduring heavy foot traffic, as well as equipment carts and patient transport rolling across it regularly.

Thoughtful design

Varying requirements of a given space within the hospital ultimately dictates which type of flooring is the right choice, and that no single flooring is ideal throughout most facilities. And, therefore, unlike 30 years ago where one would see the same type of flooring throughout an entire hospital, now, a mixture of products is being used that addresses the varying traffic and design needs from area to area. The design should act as a differentiator to attract both patients and skilled staff and thus contribute in improving patient outcomes and reducing medical errors.

Entrance areas

Entrances are the first area patients, families and visitors see in a hospital and therefore the area is subjected to the heaviest foot traffic and rolling loads. One should have a durable, welcoming floor for the area that promotes the design vision and makes a strong first impression. Therefore, the design of the flooring system should be with durable and premium products such as Italian marbles, engineered stone, luxury vinyl tile (LVT) which offers a diverse range of looks and can easily emulate natural wood, stone, and tile which can go a long way toward defining the atmosphere of an entrance area, so that it’s reassuring and professional.

The corridor at RGCIRC in New Delhi.

Corridors and clinical areas

The corridors are the main arteries of a hospital which are subject to heavy use 24x7, including foot traffic and heavy rolling loads, such as equipment carts, stretchers, med carts and wheelchairs.  The design of the flooring systems in corridors should be on evidence-based design scheme using themes and patterns with lively colour to create clear paths that identify care areas and reduces stress and promote healing.  For such areas products which are highly durable to minimise maintenance (vitrified tiles), and with a good sound absorbing properties (vinyl with additional cushioning) should be used.

Emergency and operating rooms

Emergency and operating rooms in a hospital meet the most strict infection control requirements and remain usable 24x7. For such areas we use easy-to-clean materials that promote cleanliness such as LVT, sheet and linoleum which enable the use of heat welding and flash coving during installation, making it possible to create a fully aseptic space and at the same time resist chemical staining from medical products and bodily fluids and promote indoor air quality with low emissions of volatile organic compounds (low VOC).


Following the  evidence-based design scheme , the design of the flooring system for cafeterias should use vitrified tiles and Italian marbles that comes with diverse patterns, vibrant colours and natural textures and  not only creates a comfortable environments that promote relaxation but  also  ensures the floors to be  stain-resistant, easy to clean and slip-retardant.

Nurse’s stations and treatment areas

Apart from being patient oriented, a healthcare system also comprises staff, doctors and nurses who also spend most of their time in these environments- which can sometime be stressful. Nurse station is such an area which never shuts down.

The design of the flooring systems of nurse stsation should be by using products such as vinyl sheets, vitrified tiles, Bio-Based Tile (BBT) etc to match with the surrounding area whether it’s OPD, ICU or wards that not only promotes stress reduction but also visually blends the space, creating balance and harmony in design.

Patient rooms

Patient rooms should be designed to emulate home-like environments. One should use vitrified tiles, Italian marbles and vinyl sheets to create warm, inviting flooring with natural textures allowing the patients, families and visitors to feel safer and more focused on recovery.


While designing the flooring of toilets, one needs to ensure minimal accumulation of water on the surface and use antiskid ceramic/ vitrified tiles with roughness properties of R10-R11 in order to prevent falls and injuries.\

Shift from evidence based design to biophilic design

With flooring being an integrated part of a healing environment, one is constantly researching and using systems of innovative solutions that can be used to encourage optimum health and wellness. Besides working on evidence-based design one is now focusing more on biophillic design as an act to connect the inherent need for nature to the modern built environment.

The healthcare industry is moving away from its long-employed institutional look and feel to warm, home-like trends.  Therefore, one must use products which  feature warm designs that do not feel institutional, offer coordinating colours and patterns, and facilitate way finding—all the while matching specific facility aesthetics.  These products using evidence-based and biophillic design principles are found to contribute to the patients healing process by reducing their stress level during inpatient stays.

Manu Malhotra is founder partner with RSMS Architects.