Hospital Planning

INTERNATIONAL APPROACHES TO THE HOSPITAL PLANNING AND DESIGN PROCESS

DESIGN AND HEALTH Malaysia 2010 Kuala Lumpur 27.-30.9.2010 Mikael Paatela Lic.Sc., Architect SAFA SWECO PAATELA Architects

CONTENTS OF THE LECTURES

SESSION 5 ”International Approaches to the Hospital Planning and Design Process” - Design aspects of new hospital buildings, including wards

SESSION 8 ”Global trends in Hospital Planning” - Updating existing hospital sites and buildings

Mikael Paatela Lic.Sc., Architect SAFA SWECO PAATELA Architects

CONTENTS

1.

FINLAND, BACKGROUND

2.!

DEVELOPMENT OF HOSPITAL BUILDING TYPOLOGY

3.

WHAT AFFECTS HOSPITAL PLANNING AND DESIGN? International trends in the early 2000’s

4.

HEALTH CARE PLANNING OF THE FUTURE

copyright © Mikael Paatela / Sweco Paatela Architects Oy

1.

FINLAND,

BACKGROUND

•! Nordic, democratic welfare society, 338 000 km2 •! Four seasons •! •!

light, ”warm” summers dark, cold winters

•! Population of 5.2 million •! 65+ year-olds •!

Life expectancy

800,000 1,400,000 78.5

(15 %) (2007) (27 %) (2030) years (2007)


1 Finland 3 Sweden

6 Norway

10 Denmark

HEALTH CARE IN FINLAND

•! PUBLIC HEALTH CARE SYSTEM: National level Regional level District level -

University hospitals Central and regional hospitals Health centers

•! PUBLIC HEALTH CARE IS FREE TO ALL CITIZENS, FINANCED BY TAXATION •! SMALL PRIVATE SECTOR •! PREVENTIVE HEALTH CARE

-! baby health checks -! mass screenings of population, for eg. breast cancer -! importance of public health education, eg. relating to diet, anti-smoking, physical exercise etc. copyright © Mikael Paatela / Sweco Paatela Architects Oy

2.!

WHY DO HOSPITALS LOOK LIKE THEY DO TODAY? - development of hospital building typology in the late 1800’s and 1900’s


DEVELOPMENT OF THE HOSPITAL BUILDING TYPOLOGY IN THE LATE 1800’s AND 1900’s

MEDICAL FUNCTIONS IN HOSPITAL IN THE 1850’s – 1900’s

Hôpital LARIBOISIÉRE, PARIS, FRANCE 1845 copyright © Mikael Paatela / Sweco Paatela Architects Oy


HELSINKI UNIVERSITY CENTRAL HOSPITAL in 1934

MEDICAL FUNCTIONS IN HOSPITAL IN THE 1930’s copyright © Mikael Paatela / Sweco Paatela Architects Oy


MEDICAL FUNCTIONS IN HOSPITALS IN THE 1970’s HELSINKI UNIVERSITY CENTRAL HOSPITAL, Finland 1964



MEDICAL FUNCTIONS IN HOSPITALS IN THE 1970’s

AACHEN UNIVERSITY HOSPITAL, Germany 1984

HELSINKI UNIVERSITY CENTRAL HOSPITAL, FINLAND 1964 copyright © Mikael Paatela / Sweco Paatela Architects Oy


… IN THE 2000’s

Turku University Central Hospital in 2012 copyright © Mikael Paatela / Sweco Paatela Architects Oy

3.!

WHAT AFFECTS HOSPITAL DESIGN? - international trends in the early 2000’s

•! SOCIETAL CHANGE •! DEVELOPMENT OF MEDICINE AND MEDICAL TECHNOLOGY •! INCREASING HEALTH CARE COSTS •! DEMAND FOR SUSTAINABILITY


global trends…

SOCIETAL CHANGE

•! GROWING POPULATION •! AGING POPULATION

!!

rising need of health services

•! LIFESTYLE CHANGES smoking, fast food, etc.

!!

new ”lifestyle” diseases rising need of care per patient

•! DEVELOPMENT OF MEDICINE AND MEDICAL TECHNOLOGY

!!

new treatment methods new types of facilities

•! INCREASING HEALTH CARE COSTS

!!

need for increased efficiency

•! LACK OF WORKFORCE

!!

competition for skilled employees


global trends…

DEVELOPMENT OF MEDICINE AND MEDICAL TECHNOLOGY …to name just a few examples

•! ENDOSCOPY

!!

mini-invasive procedures, day surgery

•! DIGITAL IMAGING

!!

less need for centralized imaging departments decreases

•! MOBILE EXAMINATION EQUIPMENT

!!

bedside care


global trends…

INCREASING HEALTH CARE COSTS Cost structure of an acute care hospital project

1 Preliminary design

10

100

Design

Construction

1000 in 25 years 2000 in 50 years Operating costs

Operating costs are mainly determined at the preliminary design stage Alternative way

2

12

120

900 in 25 years 1800 in 50 years copyright © Mikael Paatela / Sweco Paatela Architects Oy

increasing health care costs…

INCREASING HEALTH CARE COSTS Annual operating cost breakdown

PERSONNEL

70%

COST SAVINGS BY - IMPROVED FUNCTIONALITY

SUPPLIES AND MEDICINES

15%

BUILDING MAINTENANCE AND OPERATING COSTS

10%

OTHER

5%

= INCREASED EFFICIENCY


global trends…

SUSTAINABILITY •! SITE

!! !! !!

•! WATER

!! !!

public transport stormwater management landscape use of portable water wastewater treatment

!!

reduction of demand option for green power

•! MATERIALS

!!

local construction materials

•! ENVIRONMENTAL QUALITY

!!

thermal control efficient ventilation daylight & views

•! ENERGY

!!

!! !!


global trends…

copyright © Mikael Paatela / Photo Swecocredit: Paatela Frode Architects Birk Nielsen Oy

4.

HEALTH CARE PLANNING of the future Case study: Turku University Central Hospital, T-Hospital Building, completed in 2003, enlargement, completed in 2012

•!

MASTER PLANNING

•!

EXPANDABLE AND FLEXIBLE BUILDINGS

•!

FUNCTIONALITY

•!

WARD DESIGN

•!

HUMAN-CENTERED HOSPITAL ENVIRONMENT


health care planning of the future…

MASTER PLANNING

•!

SCENARIOS FOR FUTURE ENLARGEMENTS, 10 – 30 YEARS

•!

FUNCTIONAL CONCEPT OF THE HOSPITAL

•!

TRAFFIC NETWORKS, patients, staff, materials

•!

SERVICE BUILDINGS


TURKU UNIVERSITY CENTRAL HOSPITAL, old site copyright © Mikael Paatela / Sweco Paatela Architects Oy

NEW HOSPITAL SITE

EXISTING HOSPITAL SITE

TURKU UNIVERSITY CENTRAL HOSPITAL, site copyright © Mikael Paatela / Sweco Paatela Architects Oy

TUCH T-HOSPITAL


MASTER PLANNING


TRAFFIC PLAN MASTER PLANNING


Turku University Central Hospital, T-Hospital


Turku University Central Hospital, T-Hospital, phase 1



EXPANDABLE AND FLEXIBLE BUILDINGS

•!

EXPANDABLE BUILDINGS

•!

ADAPTABILITY

•!

MODULARITY

•!

MULTI-USE OF SPACES


EXPANDABLE BUILDINGS expansion possibilities of Turku University Central Hospital, T-Hospital


TUCH T-HOSPITAL

ward building

atrium

examination and treatment building


ADAPTABILITY

TECHNICAL ROOM

TECHNICAL ROOM


ADAPTABILITY




FUNCTIONALITY

•!

CLEAR AND EFFICIENT PATIENT FLOW

•!

MEDICAL SPECIALITY FLOORS ”mini-hospitals” within the hospital

•!

HOT-FUNCTIONS CONCEPT (at the enlargement phase)

•!

The staff moves – not the patient


functionality

CLEAR AND EFFICIENT PATIENT FLOWS Home

patient flow analysis of the whole hospital

Other . treatm. Emerg.

Observ. .

Imaging

Stroke unit

Cardio unit.

OP Ward Intens. . observ.

Ultrasound

Paimio hospital

Ward Sur. A- or Uhospital Home


functionality

MEDICIAL SPECIALITY FLOORS ”mini-hospitals” within the hospital

One medicial speciality on one floor level


WARD DESIGN

•!

”CARE CELLS” WITHIN THE WARDS

•!

SINGLE ROOMS / MULTI-BED ROOMS - ISOLATION ROOMS - BATHROOMS

•!

BED-SIDE PROSEDURES - FAMILY SUPPORT


ward design

”CARE CELLS” WITHIN THE WARD

One cell for 8 to 10 patients with - patient rooms - nurse’s station -.supporting services centralized


ADAPTABLE PATIENT ROOMS

ADAPTED TO OBSERVATION/ ICU UNIT copyright © Mikael Paatela / Sweco Paatela Architects Oy

Nurses’s workstation

Corridor detail

copyright copyright © Mikael © Mikael Paatela Paatela / Sweco / Sweco Paatela Paatela Architects Architects OyOy

2 patient room

copyright copyright © Mikael © Mikael Paatela Paatela / Sweco / Sweco Paatela Paatela Architects Architects OyOy

Bed head

Electricity and gas outlets


Sluice to isolation room


Isolation room


Patient bathroom


BED - SIDE PROCEDURES

PATIENT ROOM



HUMAN – CENTERED HOSPITAL ENVIRONMENTS

•!

NATURAL LIGHT

•!

GREENERY

•!

ART

•!

SOUNDS

•!

MATERIALS

•!

INTERIOR DETAILING

•!

FURNITURE

•!

EXTERIOR DETAILING


NATURAL LIGHT copyright © Mikael Paatela / Sweco Paatela Architects Oy

NATURAL LIGHT copyright © Mikael Paatela / Sweco Paatela Architects Oy

GREENERY copyright © Mikael Paatela / Sweco Paatela Architects Oy

ART copyright © Mikael Paatela / Sweco Paatela Architects Oy

ART copyright © Mikael Paatela / Sweco Paatela Architects Oy

MATERIALS copyright © Mikael Paatela / Sweco Paatela Architects Oy

INTERIOR DETAILING copyright © Mikael Paatela / Sweco Paatela Architects Oy

FURNITURE copyright © Mikael Paatela / Sweco Paatela Architects Oy

EXTERIOR DETAILING copyright © Mikael Paatela / Sweco Paatela Architects Oy

EXTERIOR DETAILING copyright © Mikael Paatela / Sweco Paatela Architects Oy

TUCH T-HOSPITAL, Enlargement in 2007 - 2012


PROJECT GOALS

•! TO FACILITATE ALL ”HOT FUNCTIONS” IN A SINGLE BUILDING, e.g. -! -! -! -! -!

EMERGENCY OPERATING THEATRES INTENSIVE CARE UNIT IMAGING OBSERVATION

•! TO MINIMIZE OPERATING COSTS •! TO IMPROVE THE QUALITY OF CARE


TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL, PHASE I

COMPLETED IN 2003


T-HOSPITAL ENLARGEMENT, PHASE II

COMPLETED IN 2010 copyright © Mikael Paatela / Sweco Paatela Architects Oy



T-HOSPITAL ENLARGEMENT, PHASE III


T-HOSPITAL ENLARGEMENT, PHASE IV


Turku University Central Hospital


Turku University Central Hospital, 2. floor


Turku University Central Hospital, 4. floor










THANK YOU copyright © Mikael Paatela / Sweco Paatela Architects Oy

Hospital Planning

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