[Talk-GB] Hospital Departments (was Re: Reception desks)

SK53 sk53.osm at gmail.com
Wed Nov 15 14:29:07 UTC 2017

In general health facility tagging on OSM is very poor. About the best you
can say that amenity=hospital actual means is that there is some kind of
health facitlity at the location rather than a hospital. Worldwide there
are far more amenity=hospital than amenity=doctors. This has also been true
in parts of the UK (there was a particular batch around Wrythe Green in S
London which I think now has been resolved).

The various schemes on the wiki have not had much uptake, almost certainly
because they are too complex and also fail to account for common scenarios.

The current main things we need to get generally right & consistent are:

   - *GP practices*: these will normally be amenity=doctors
   - *Health Centres*. Many larger GP practices will be called XXXX Health
   Centre (or more rarely YYYY Medical Centre). Again in general I think most
   of these will be amenity=doctors. The ones which need to be mapped as
   distinct entities are where a single health centre is shared between
   several GP practices, and in addition there may be other services offered
   in the same building. amenity=health_centre is fine for this, although
   there is a significant usage of healthcare=centre as well. I think the
   latter tag should be avoided: it is hopelessly ambiguous as a wide range of
   different healthcare facilities will have names ending in Centre (such as
   my local daycase hospital which is called the NHS Treatment Centre, or NHS
   drop-in centres).
   - *Clinics*. clinic is probably really a term to be avoided because it
   tends to have multiple meanings: a) a session
   where a doctor, nurse or other healthcare worker sees patients (Dr Y's
   Clinic); b) dedicated areas in hospitals which are used for various kinds
   of out-patient appointments, these may be completely general (Out Patients
   Clinics 1-4 in Birmingham QEH), general but specific (Rare Diseases clinic
   in the same hospital), or specific (ENT Clinic, Eye Clinic). I certainly
   use amenity=clinic for these; c) standalone places, often called XXX Clinic
   (or Centre) which offer a broader range of primary care services than a
   typical health centre. (these used to be common in Portugal where they were
   known as polyclincs, which may be a useful term for our purposes; d) small
   places offering healthcare related services such as single-handed
   physiotherapy practices (one added in Hickling recently). I suggest that we
   accept amenity=clinic for b) & c), but add something like clinic:type which
   could be hospital, polyclinic etc. Broadly I don't see good reasons for
   trying to map (a) as the location of these will change (and many primary
   healthcare clinics move around the local area to limit patient
   - *Multiservice Centres*. These seem to emerging as a recent trend. We
   have at least 3 in Nottingham (Clifton, St Ann's, and Bulwell). They
   include social housing, healthcare and social services on a single site
   (building). The 3 know include multiple GP practices. I'm not aware of a
   good tag for them, but amenity=social_facility is a good start.
   - *Single site Multiple Hospitals*. Not as uncommon as one might think.
   The main QEH has at least 2 other hospitals on site: the Birmingham Women's
   Hospital and the MoD facility within the main building. The NHS Treatment
   Centre at QMC Nottingham is a separate institution run by Circle (and I
   think they have others). In both these cases the main campus has got the
   names and tags of the principle hospital on site, and the other hospitals
   are mapped individually.
   - *Hospital Types*. Apart from emergency=yes to indicate hospitals with
   an A&E department, I'm not aware of any tags to separate out different
   hospitals by role. If we assume the standard hospital is a district
   hospital with the typical mix of main specialties then it is the other
   hospitals which need to be noted, and particularly those with a) limited
   facilities (GP hospitals, cottage hospitals); and b) totally specialised
   such as the National Hospital, the Marsden etc. It's certainly also useful
   to know which hospitals are regional centres. A complication here is that
   in larger cities all the local hospitals may be managed together, so that
   certain illnesses and conditions will only be treated at one location.
   Psychiatric facilities and other places were patients are in for a longer
   time (almost all will not take patients referred from a GP, but from a
   hospital) also should be distinguished.
   - *Departments
   Department seems too vague a term (at least from looking at the NHS Data
   Dictionary) for our purposes. Specialties (not spelling, please dont call
   them Specialities) will often have a 1:1 with a Department (e.g.,
   Radiologists will work in the X-ray Department), but there are plenty of
   other things which are departments. There are also places which call
   themselves Units which belong here. Basically we want to identify, tag and
   name places with direction signs within a hospital site: MRI Scanning,
   Clinical Genetics etc. I don't have a good idea about tagging these.
   - *Wards*. healthcare=ward with specialty should work for most.
   - *Rehab Centres*. Not sure if we have any tags for these at all. A
   friend was one in Rugby over the summer after 3 weeks in hospital.

There's a lot more to think about, not least that virtually all of this
requires indoor mapping.

Back to the original question about reception desks. If mapped as nodes the
location of clinics etc should be at the reception desk, but if mapped as
areas, which indoor mapping will require, then we need a distinct way of
showing that. Note that many out-patient clinics (or at least one's I've
attended recently) actually have 2 reception desks. For instance at QEH
there is a desk in the main atrium/corridor for each of the clinics with
screens telling patients when they are called. However, once called you
still need to register at another desk and there is an additional waiting
room. This was something I for one was unprepared for. It also doesn't help
that desks side by side will be signing-in different groups of patients.

For mapping hospitals the things which I think can be done (in some sort of
order of easiness). These all based on recent experience.

   - Principle entrances (some only have a few, others have many)
   - Shops, cafes, toilets (in main public spaces)
   - Parking, and pedestrian routes from these to the hospital. Disabled
   parking and access worth special attention
   - Drop-off and pick-up zones
   - Main corridor network (generally accessible areas) at entrance level
   - Principle out-patient facilities: X-ray, Out-patient Clinics, ENT,
   Eye, Maternity, Childrens
   - Discrete in-patent facilities (see for example Nottingham City
   Hospital, where new buildings often house such things)
   - Some special facilities: MRI (which may not be co-located with other
   X-ray facilities), day-case unit (front desk staff at QMC dont really know
   where it is).
   - Wards on a case-by-case basis.

Vespucci now has an indoor mode which ought to assist in editing for this
level of detail.

Sorry for being so long-winded, but I've been thinking a little about this
since Andy first posed the question about clinics.


On 15 November 2017 at 10:54, Andy Townsend <ajt1047 at gmail.com> wrote:

> Actually, prompted by Will's question below, I've always wondered about
> the best way to map hospital departments.  There's plenty of examples of
> mapping of "clinics", which would work for the more standalone departments,
> but there are also those that don't deal with external patients but only
> with those referred internally.
> Obviously the people on the "tagging" list https://lists.openstreetmap.
> org/listinfo/tagging may have a view too, but it struck me as worth
> asking here first.
> Best Regards,
> Andy
> On 15/11/2017 10:43, Will Bailey wrote:
> Hi
> I’m doing some internal mapping of hospitals in North Wales with the
> objective of allowing people to navigate from their front doors to the
> front desk of a relevant hospital department in our accessible journey
> planner. I haven’t been able to find a definitive way to tag a reception
> desk – can anyone help me with this please? Is their agreed approach to
> doing this?
> Thanks!
> Will
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