Rethinking Circular Hospital Design: A Systematic Review
Abstract
Why are most hospitals or buildings of a rectangular design only? Compared to the standard rectangular Nightingale nursing unit design, why has a circular/elliptical nursing unit or hospital design not been developed to date? This study reexamines the concept of circular hospital building design. It aims to understand the reasons behind the limited existence of circular hospitals/buildings and compare circular with shaped buildings and their pros and cons. The study proposes a design concept based on further investigation to make economical, structurally stable, and efficient circular hospitals with modern technologies to improve patient safety, quality, and proper space utilization. The literature search was conducted using the MeSH terms "Circular Hospital", "Round Hospital", "Hospital Design", "Doughnut design", "Circular Building", "Round Building" from Web of Science, PubMed, Scopus, and Google Scholar databases, last accessed October 27, 2025. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guideline but was not registered. The inclusion criteria were strictly assigned as circular building or hospital design only. Only 19 records were screened out of 96,210 records analyzing the pros and cons of circular design hospitals. The results show that the concept of circular hospital design is old enough, with the most significant advancements in the 1960s, 1988s, and 2015. Advantages of circular hospitals include wider…
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Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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