Introvert, un-rooted, dominant, mono-functional, inhuman, monolithic and simply ugly are a few of the negative classifications that can well be put on the given hospital site. Our strategy in this proposal is to transform all these negatives into a positively embedded healing environment. The future hospital will be on a human scale, connected to urban life and providing a forum for cultural and social activities. The hospital will be transformed from a “medical factory”, producing as many as possible healthy people, into a link in the network of (healthcare) services, with a strongly customer oriented, personal approach.
Normalisation and full integration of healthcare in the urban and social networks will be achieved by:
- Breaking down the large scale into smaller parts
- Making new connections
- Adding new functions
- Carefully embedding the development, so that roots can start to grow
The traditional hospital is broken down into smaller, more manageable, flexible parts. These parts are ordered and embedded in a larger context than care alone. By adding new parts in the form of complementary functions, connections with the neighbourhood are made. Housing, cafes, a library, office space, a kindergarten, restaurants, wellness, parks and courtyards will bring a new quality of life into the environment. Urban and functional flexibility of all these parts make future expansion and exchange possible.
This exemplary location has a distinct spatial characteristic: On a large plot, there is one main (monumental) hospital building. The later needs of the hospital have been expanded in a pavilion style. The plot itself is a green oasis in a suburban setting.
The existing buildings have to be analyzed on their historic, economical, cultural and architectural merits. We propose to revitalise! By means of relatively simple additions and structural adaptations, the formerly “monoliths” can be durably transformed into a new and positive experience. The cultural perception of these buildings will be turned around completely.
The ground floor of the monumental (u-shaped) building will be opened up and refurbished with public functions. This will generate connections with the existing urban environment as well as with the new developments on site. “Pluggable” additions are made on the courtyard side of this building so that the floors can be made flexible for future use. Sustainability of future possibilities is ensured. The existing monumental architecture is respected and enhanced.
The longer building is fully stripped and divided in two parts. In this case there is no architectural heritage that has to be taken into account and a complete make-over is called for. The remaining structure is reused and the same kind of plug-in additions are made. In this way the floors are suitable for hospital bedding as well as office- or other kind of space. Thus a high level of adaptability over time is gained by a simple intervention.
The functional program of the hospital is categorised into groups that are defined by the type of building that can accommodate them. Four building typologies are distilled:
- The Core Hospital (operating theatres, IC, emergency – a.k.a. “hot-floor”)
- Hotel (nursing)
- Office / Treatment / Administration
- Laboratory / Factory
The program is distributed partly into the existing (modified) buildings and partly into new ones. This approach defines which existing buildings can be (re-) used and what part of the program has to be put in newly built volumes.
The main newly built part of the hospital is the Core. Connecting the existing buildings, this landscaped volume is meant to be an impulse for further development on site or in the neighbourhood. The most in-flexible parts of the program are housed in this spatially and technically specific building. Direct contact with the surrounding park as well as with the inner patio’s is an important theme in the experience of this hospital, enhancing an atmosphere in which patients will feel safe, relaxed and understood: “A Healing Environment”. The provision of such a therapeutic environment does not compromise clinical efficiency but supports it: this will also be a stimulating, inspiring and healthy working place for the hospital staff.
The patient occupies a central position and his needs and desires are the focus of the buildings system and architecture. The logistical routing of patients can become much more flexible: the professionals come to the patient (with laptops and PDA’s) instead of the patient being routed all around the building.
Less beds, more patients, shorter stays, more day-care and outpatient clinical. Extensive use of information technologies: electronic patient files, internet access in each room and specialist consultation through internet. All these future changes will define the new position of the patient.
One of the most important decisions that can be made to provide a healing environment is that of the provision of the single patient bedroom. We propose large communal areas on the bedding floors, containing multi-functional spaces where patients can interact with each other as well as with their family and the hospital staff. Through large sliding doors the choice can be made to participate or rather stay “private”.
Because many differing scenarios seem likely and feasible, flexibility is probably the most mentioned criteria in healthcare design today. The goal of our proposal is to achieve an integration of the development within its surroundings, despite the size, while at the main time providing a high level of adaptability over time on an urban scale and on the scale of the buildings themselves as to be fit to accommodate the unpredictable future. This flexibility is key to the durability of the development. The hospital will become a public building and enhance revitalisation of its surroundings.