How to design a healing hospital environment
As part of our series of articles on Buro Happold’s Hospital of the Future project, we examine how future hospital designs must consider how to create an environment that provides people with an environment in which to heal
The modernist movement of the last century was driven by a fascination with machines; Saw factories for mass production become real industrial machines; Homes were viewed as “living machines,” universities and colleges became “learning machines,” and hospitals were “healing machines.” Hospital planning united the four promises of medical environments in the machine age: rationality, efficiency, flexibility and sterility. Somewhere along the way, the human experience of healing was lost in this rationalist healthcare revolution.
Buro Happold collaborated with OMA and other collaborators on its groundbreaking conceptual project, Hospital of the Future, after being commissioned to study how hospitals could look in the 21st centurySt Century.
We worked on this extensive research project in parallel with a health district master plan for a Middle East site. Executing these workstreams together has given us a rare opportunity to examine a step in the evolution of hospital design.
Our multidisciplinary team of experts studied hospitals from the ground up to prototype effective hospitals of the future. In previous articles we’ve looked at how the prototype reinterprets the structure of hospitals – with a horizontal orientation that offers a number of advantages over the traditional stacked tower design. We also looked at the importance of “walking the earth lightly” and creating a resilient hospital that can withstand shock and stress.
Our research has also identified the importance of creating an environment conducive to healing rather than just clinically facilitating medical treatment.
Creating a calm hospital environment
The report finds that a healing environment involves psychological aspects for patients such as control, privacy and quiet. By realizing a more enjoyable patient and staff experience, hospitals can more effectively achieve their ultimate goal of healing.
This feeling of “quiet surroundings” needs to start upon arrival – which puts a well thought-out integrated mobility strategy at the forefront. In the hospital of the future, queues, confusion and fear will be replaced by automated, fast and direct journeys. This in turn will change the arrival experience for everyone who has to physically enter the hospital.
Christopher Rizk, Transport and Mobility Engineer at Buro Happold says: “We don’t see transport as roads, we focus on people and always take a user-centric approach to everything we do. Here it was important to identify all the different types of users that will be using the hospital.
“Of course you want a stress-free arrival at a hospital, especially when you have such a large medical complex.”
The horizontal orientation of the building creates the possibility for multiple entrances, eliminating the heavily frequented “main entrance” of existing hospitals and allowing for the separation of staff and patient entrances. This innovation also ensures that patients arrive as close as possible to the desired ward within the hospital building.
With AVs (autonomous vehicles), the interface between delivery and parking is changing. The drop-off becomes the main connection hub and parking becomes a side issue as private vehicles are able to “self park”. This means parking spaces do not need to be placed in close proximity to the building, allowing more space for nature near the hospital windows. Eventually, it’s envisioned that we could see the rise of shared AVs and the move away from private car ownership. This would allow parking spaces to be reserved for other uses of space.
moving around the hospital
The repeated modular design of the hospital layout easily allows for an internal loop that provides a comfortable horizontal flow in the facility for both staff and the public. Our experts have carefully analyzed the walking distance limits to ensure that users do not need to cross the comfortable limits to get around.
Two forms of AVs were conceived within the prototype – Group Rapid Transit (GRT) is a new form of collective public transport using small, automated electric “cyberbuses” to provide scheduled and/or on-demand feeder and shuttle services. The system is more like a lift or elevator, where the passenger presses a button at the stop to call the vehicle and then another on the vehicle to select the destination.
The second form of AV is the smaller Autonomous Network Transport (ANT). These are autonomous pods that move freely around the complex without following a specific set route. ANT is a travel option for shorter trips and a more private environment for users. The main benefit is the flexibility and modularity of these pods. They can also be used as a “doorman” solution to move patients around the facilities.
Closer to nature
A growing body of evidence shows that a healthy environment is about more than offering patients a view from their bedside. Since the 1990s, research has shown that “tree-facing patients require fewer pain medications and have shorter hospital stays.” Creating the best possible environment for patient recovery has many physical aspects and they can be applied in spatial arrangements, the integration of natural elements, lighting, scents, acoustics, environmental conditions and places for art and religion.
Tree-view patients require less pain medication and have shorter hospital stays
The prototype hospital returns to the traditional 20th centuryth century hospital. It places the bed stations on the ground floor. A major advantage of the low, horizontal hospital is that each ward has a direct connection to ground-level, natural courtyards. Courtyards emerge naturally through the combination of crosses, which facilitates the modular structure. It brings Hospital the Future back to the monastic aesthetic, where hospitals first emerged in a monastic setting.
Courtyards have been carefully considered in the prototype to maximize year-round thermal comfort. A concept of “seasonal retreat” has led to a microclimate strategy that balances potentially competing demands to reduce water and energy use while maximizing healing benefits.
Fergus Anderson, Sustainable Design Specialist at Buro Happold says: “One of the questions in the original brief was ‘What is a healing environment in Qatari culture?’ These types of plants and landscapes that we attribute healing properties to [in the UK] could be very different from the plant species to which the Qataris attribute healing.”
Given the desert location of the prototype, this cultural consideration for planting needed to be coupled with the implementation of a sustainable planting strategy.
Neil Harvey from Buro Happold, who provided the infrastructure know-how for the project, adds: “All of our plants had to have a function. One end of our study was xeriscaping, a form of planting that doesn’t require watering at all in hot climates. In some courtyards we focus on this type of landscape. In other areas we have plantings that have more of a clear function, such as patient shade.”
Ultimately, the focus on both transportation and courtyard gardens work together to create a tranquil hospital for end users and customers – one where healing is given a natural edge.
Read more about the Hospital of the Future project: How to make the most of automation to improve the patient and staff experience.