At some point, healthcare has to be delivered to the patient. Ok, preventative healthcare and a healthy lifestyle do not require you to physically meet with your physician, but e.g. surgery still does. So we still need hospital buildings. Hence, buildings themselves are an integral part of the healthcare ecosystem and as such, contribute just as much to patient outcome as does the procedure performed on the patient. Welcome to the great world of healthcare architecture.
It is a recognized fact that a patient’s overall wellbeing significantly contributes to his/her faster recovery. Hence patient-centric designs for hospitals, making them look and feel more like hotels than the traditional neon-light, bleach-white cubic edifice. This is not a new idea, as exemplified by the Architecture of an Asylum exhibition at Washington’s National Building Museum. But healthcare architecture is much more than just nice designs. It addresses many of the challenges that healthcare faces. Evidence-based design is now used by architects and engineers, helping them take into account even the smallest details such as replacing metal handles by wooden ones, the former oftentimes aggravating the neuropathic hands of patients undergoing chemotherapy
Infection control and prevention in hospital settings is a major concern, especially given the increase in multidrug-resistant organisms. The fight against infectious pathogens in hospitals from the architectural angle is precisely what Wolfgang Sunder, in charge of the KARMIN project at InfectControl2020, is doing: “When it comes to the structural level, one specific issue is what a room needs to look like to counteract the spread of pathogens: what size should it be? Does it require specific building equipment and ventilation technology? What materials do we need to use? How can surfaces be cleaned and disinfected? These are some of the questions we need to ask, which is also why we see an urgent need for research in this area.”
Achieving a patient-centric environment is one thing. This must however not be done at the expense of caregivers’ workplace ergonomy. In other words, a hospital needs to remain functional for the nursing staff. Far from being a balancing act only achievable through compromises on both sides, innovative solutions can be implemented that will answer to everyone’s needs and even go beyond. Mehrdad Yazdani, design director of CannonDesign’s Yazdani Studio, created sculptural headwalls for patients’ rooms, behind which medical equipment can be hidden from the patient. As a bonus, these removable panels allow hospitals to easily upgrade their equipment as technology evolves.
Another such many-problem-solving-at-once example is AIA COTE Top Ten award winning NTFGH hospital, in Singapore. Through its use of natural ventilation and passive cooling, patients have their own operable window, providing them with sunlight and a view. In addition of being more energy efficient than mechanical air conditioning, it saves water, since no cooling towers are required, making the hospital a greener corporate citizen who abides by many of the seven elements of a climate friendly hospital, as edicted by the WHO.
Healthcare architecture extends well beyond the science and technology required to achieve better patient outcome. It also takes into account the social fabric of the community in which the hospital is established and to which healthcare services are dispensed. Karratha Healthcare Center, in Australia, was designed from the start with these considerations in mind : “Our briefing and design responded to the cultural values of Indigenous clients [and] the understanding of cultural traditions for privacy” says Coda, the firm commissioned as the project lead, in a design statement. Neighbourcare Health, in Seattle, WA, which won an AIA Healthcare Design Award, offers spaces to neighbourghood groups after hours. Its patios can double as consulting spaces for mental health homeless patients and the driveway is wide enough to provide space for farmers markets.
This brief account all but scratches the surface of what architecture can contribute to healthcare. For one, we focused on hospitals. Healthcare architectural concepts obviously apply to medical clinics, retirement homes, research labs and even private homes as well. And if we were to ask health authorities, they would certainly say everything we build should be designed with healthcare in mind, since everything we build has an impact on public health e.g. air quality in buildings, fire hazards in high-rises, etc.
The integration of architecture and healthcare begins way before the groundbreaking ceremony and even before the first sketches of the design firm. It is a way of thinking that starts with education. This is the philosophy driving the merger between Thomas Jefferson University, with its roots in medicine, and Philadelphia University, with its roots in arts, business and engineering, from which graduates will emerge with a symbiotic knowledge between healthcare and architecture.
To get an idea of some of the best healthcare architecture projects, take a look at Contract magazine’s Healthcare Environment Awards, AIA/AAH Healthcare Design Awards, or World Interior of the Year Awards shortlist, which is this year dominated by China, including the Health&Education category.
As always, comments, questions, feedback are welcome.