Dense Transparency- Östra Hospital OP building addition

Östra Sjukhuset is part of the public healthcare system
and is managed by Västra Götalands Regionen. In the
regions vision for the Good Life it is stated that all decisions
must take into account the long-term social, environmental
and economic consequences. When working
with social sustainability Östra Sjukhuset have turned to
human rights, being already legally binding rules. As a
hospital and a part of the public sector they are not only
striving towards but are also obligated to create a hospital
and hospital surroundings where the right to the best attainable
health for all are respected, protected, promoted
and implemented.

The common understanding for a Universal Hospital is:
one build upon acceptance of patient’s variety and diversity.
Its definite perception is always colored by the local
characteristics, traditions and enriched with specific social
values. A common principle implemented is “form
follows function”, and quite often the function is weaved
in the complexity of heavily institutionalized system.
Often hospitals should be quite large to be financially
justifiable and preferably small to be human oriented.
They are wanted in the city centers so they can be easily
accessible, but concerns for epidemics and availabilities
of proper building sites push them quite often in the outside
boundaries. Hospitals should be quite flexible and
accessible to all; as well as create the sense of security and
privacy. All these contradicting to each other factors create
complicated decision making processes which directly
affect the final architectural outcome.

In many cases the health care building stocks we see today
is part of an era of massive building production which has
occurred 30-40 years ago. Quite common past practice is
that little or non attention was given to a hospitals social
aspects and influential factors such as rapidly aging population,
higher lobar professional expectation, demand
of multi- tasking, flexible designed spaces, and changing
social communication demands. Today these become the
hospital design ruling factors.

dense transparency

dense transparency2

Growing old- senior house proposal

The Senior Citizens Green House is a representation of human-nature interaction. One of the initial idea is to explore the relationship between design science and architecture. The Senior Green Home is created with the mind of allowing healing property of nature to take over physical and psychological state of senior citizens.

Essential to underline is reviling the opportunities of alternative holistic life and self awareness for the elderly.

The Senior Green house was strategically positioned on a lot in the main campus of University of Illinois in Chicago. Close enough for a short walk it will give an opportunity for its residents to sign for free classes attend some activities at the university fitness centre and use the library.

Being part of the campus life the senior home will present a perfect opportunity for volunteers, as well as study and research. The project is a representation of newer alternative care for the growing elderly population.

Reinventing the traditional nursing care, implementing humanity along with familiar home base living conditions resulted in a social cultural changed design.

Growing old

The Healthcare Social Dilemma, continue

All-Childrens-Hospital, st petersburg, florida
All Children Hospital, St Petersburg, Florida, USA

Triangle Hospital, Helsinki, Finland

University of Washington Medical Centre, USA

Innovation such as the artificial ventilation, air conditioning systems, and the X-ray machine allowed to concentrate the medical knowledge entirely in the hands of the hospital employees. Educator and cultural critic Neil Postman noted “Technology was to be the weapon with which disease and illness would be vanquished…….1. Medicine is about the disease, not the patient, 2. What the patient knows is untrustworthy; what the machine knows is reliable.”

In the current of these thoughts tragically but true is pointed the state of todays’ hospital operating standards. Architecture of hospitals has become merely a dress up for institutionalized systematical procedures, addressing biological problematic matter in our humanity. The separation of the human from what is viewed as a patient could not be more accented. Current hospital designs are praised to accommodate rapid and chaotic changes in urbanization and suburbanization, medical improvements, technological demands, and in this process vital principles as healing environment, wholeness of mind body and spirit, connection to nature and human communication were relegated to the past. 

By now it is well acknowledged among professionals and architects that hospitals’ building typology has profound application over the essence of provided healthcare. Stephen Verderber concludes ” The Hospital as a machine for healing has become an anachronism. As a building type, the hospital remains a curious amalgam, with medical technology often pitted against human concerns…..There is little doubt that architecture can, and should, play a crucial role in humanizing the hospital.”    The road map to successful social sustainable healthcare practice begins to unfold when specific goals within the contexts of people centered cooperative practices, and humanized architecture are identified. Thus what are the primary aspects of the medical delivery system which are shaping the current design archetype? What are the new trends of physical and psychological healthcare; understandings of medicine, technology, and patient and how are they profiling the hospital building stereotype? ( Gail Vittori and Robin Guenther, 2008)

The Healthcare Social Dilemma

University Medical Center, Boston
University Medical Center, Boston, USA

Case- Medical Cancer Centre, unknown

Childrens Hospital, Atlanta
Children Hospital, Atlanta, USA

Radium Hospital research departmen, Norway
Radium Hospital Research Department, Norway


Abbotsford Regional Hospital and Cencer Centre

The simplicity of the word health holds in its essence the complexity of our lives capsulated and protected, with all its individual meanings. We wish our self of being healthy, we do the same for others, and we write it on cards, balloons, and say prayers of it. Health as a value has long ago passed through the personal boundaries of physical and mental well being; it has acquired a new social and community values. Major part of such are combined and stated in policies, dedicated to describe and regulate the healthcare professional sector. The EU Article 152 of the EC Treaty states that a“high level of human health protection shall be ensured in the definition and implementation of all community policies and activities”2, simultaneously ensuring the excellence in general level of healthcare provided to the expending earth population. Countries around the globe invest enormous capital in social and communal policies to promote the health state of their citizens. When all the efforts fail and humans become unhealthy the responsibility of bringing one to its well being state is assigned to the hospitals and healing centers as they are viewed by society as primary specialized care providing units.(Wagenaar Cor, 2006)

Here is where the dilemma of our compound society emerges. Common understanding for Universal Hospital design is: one which is build upon the principle of patient’s multiplicity and diversity acceptance. Such will strive to provide equal rights of treatment and health advises for all seeking a professional help. Its definite perception of architectural aesthetics is always colored by the specifics of local characteristics, traditions, believes and enriched with unambiguous social values. Unfortunately it is often that political debates, financial dependency, and the need to achieve maximum technical-economical performance are factors which rule the architectural execution of healthcare buildings. Principle repeatedly implemented in the past is form follows function, and quite often the function is weaved in the complexity of institutionalized systems’ web. In such practices, elements needed to support the person healing process, and necessary employee work conditions by default are left with less consideration that probably should have had.(Wagenaar Cor, 2006; Kjisik Hennu, 2009)

Patient verses Person Centered care

Architectural GIGA map-01

It is a practice today to address the one being treated
by a room number, when the staff discusses his/hers conditions. Such practice
implemented in an order to protect ones’ privacy is the smallest example of a
chain hospital institutionalized culture by which the human is leveled to the
state of patient. Thus the hospital stresses the absolute importance of their
actions directed towards physical healing processes. According to Cambridge
dictionary patient is “someone who is being treated by a doctor, nurse,
etc”. What is missing in the definition is clarification of what has been
treated, and it seems that majority of hospitals are operating under the presumption
of healing the body. Without accounting for the whole body mind spirit the health
practice will continue to stumble upon simple questions such as where the
person perspective is, what is the individual side of the health process and
how am I responsible for my own health. Patient Centered Care in that matter is
still only directed towards healing the biological problem, and looks in the
one in need as human matter buried down in sick body. The responsibility acquired
in that case is for the body material, while the human side is often
disregarded. What Person Centered care is aiming for is simple: switch the
perceptions, understand and focus on the human who in its complexity is carrying
certain unhealthy conditions.

2012 ICU Design Citation Awards

Architectural interventions in hospital environment are structurally classified by their purpose in achieving certain sustainable aspect. In the last years popular discussion topic has been the green design of hospitals in relation to their overall footprint. Main focuses – questions such as energy efficiency, water consumption, waste treatment, surrounding lands locking and so on. The core of the presented architectural possibilities is however driven from combining already emphasized EBD research outcomes related to healing environment principles, and PCC philosophy implemented in development of more human hospital practices. Intertwining physical and social factors allows the advancement of new cooperative ideas structured around goals such as: deliver a hospital ward design which will allow the architectural elements and design aesthetics to become active part of the healing environment; supporting and promoting patient centered care; reducing stress factors; enhance safety for patient and staff; and improve the overall vision of hospitalization.

Person Centered Care and Evidence Based Design

Person Centered Care Philosophy and Evidence Based Design Principles are two complimenting each other sides of the same desired outcome- healing environment. For an architect to accent on elements in the design supporting one without implementing the other will result in less than the intended outcome. Implementation of PCC and EBD could bring Healthcare Practice a new professional culture, improve patient experience and support better overall healing results in a long term perspective.