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. 2.! 3.
FINLAND, BACKGROUND DEVELOPMENT OF HOSPITAL BUILDING TYPOLOGY WHAT AFFECTS HOSPITAL PLANNING AND DESIGN? International trends in the early 2000s HEALTH CARE PLANNING OF THE FUTURE
4.
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.
2.!
WHY DO HOSPITALS LOOK LIKE THEY DO TODAY?

- development of hospital building typology in the late 1800s and 1900s
DEVELOPMENT OF THE HOSPITAL BUILDING TYPOLOGY IN THE LATE 1800s AND 1900s
MEDICAL FUNCTIONS IN HOSPITAL IN THE 1850s 1900s
Hpital LARIBOISIRE, PARIS, FRANCE 1845

HELSINKI UNIVERSITY CENTRAL HOSPITAL in 1934
MEDICAL FUNCTIONS IN HOSPITAL IN THE 1930s

MEDICAL FUNCTIONS IN HOSPITALS IN THE 1970s HELSINKI UNIVERSITY CENTRAL HOSPITAL, Finland 1964
MEDICAL FUNCTIONS IN HOSPITALS IN THE 1970s
AACHEN UNIVERSITY HOSPITAL, Germany 1984
HELSINKI UNIVERSITY CENTRAL HOSPITAL, FINLAND 1964

IN THE 2000s
Turku University Central Hospital in 2012

3.!
WHAT AFFECTS HOSPITAL DESIGN?

- international trends in the early 2000s
! SOCIETAL CHANGE ! DEVELOPMENT OF MEDICINE AND MEDICAL TECHNOLOGY ! INCREASING HEALTH CARE COSTS ! DEMAND FOR SUSTAINABILITY
global trends
SOCIETAL CHANGE
! GROWING POPULATION ! AGING POPULATION ! LIFESTYLE CHANGES smoking, fast food, etc. ! DEVELOPMENT OF MEDICINE AND MEDICAL TECHNOLOGY ! INCREASING HEALTH CARE COSTS ! LACK OF WORKFORCE
!!
rising need of health services
!!
new lifestyle diseases rising need of care per patient new treatment methods new types of facilities need for increased efficiency
!!
!!
!!
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
Design
100
Construction
1000 in 25 years 2000 in 50 years

Operating costs
Operating costs are mainly determined at the preliminary design stage Alternative way
12
120
900 in 25 years 1800 in 50 years

increasing health care costs
INCREASING HEALTH CARE COSTS

Annual operating cost breakdown
PERSONNEL
70%
COST SAVINGS BY - IMPROVED FUNCTIONALITY = INCREASED EFFICIENCY
SUPPLIES AND MEDICINES
15%
BUILDING MAINTENANCE AND OPERATING COSTS
10%
OTHER
5%
global trends
SUSTAINABILITY
! SITE
!! !! !!
public transport stormwater management landscape use of portable water wastewater treatment reduction of demand option for green power local construction materials
! WATER
!! !!
! ENERGY
!! !!
! MATERIALS
!!
! ENVIRONMENTAL QUALITY
!! !! !!
thermal control efficient ventilation daylight & views
global trends
copyright Mikael Paatela / Photo Sweco credit: 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

NEW HOSPITAL SITE
EXISTING HOSPITAL SITE
TURKU UNIVERSITY CENTRAL HOSPITAL, site

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

Emerg.
Other . treatm.
Observ. .
Imaging
Cardio unit.
Stroke unit Ward Ultrasound Ward Sur. Intens. . observ.
OP
Paimio hospital
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 - nurses station -.supporting services centralized
ADAPTABLE PATIENT ROOMS
ADAPTED TO OBSERVATION/ ICU UNIT

Nursess workstation
Corridor detail
copyright copyright Mikael Mikael Paatela Paatela / Sweco / Sweco Paatela Paatela Architects Architects Oy Oy
2 patient room
copyright copyright Mikael Mikael Paatela Paatela / Sweco / Sweco Paatela Paatela Architects Architects Oy Oy
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
NATURAL LIGHT
GREENERY
ART
ART
MATERIALS
INTERIOR DETAILING
FURNITURE
EXTERIOR DETAILING
EXTERIOR DETAILING
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
T-HOSPITAL ENLARGEMENT, PHASE III
COMPLETED IN 2012
T-HOSPITAL ENLARGEMENT, PHASE IV
COMPLETED IN 2012
Turku University Central Hospital
Turku University Central Hospital, 2. floor
Turku University Central Hospital, 4. floor
THANK YOU

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INTERNATIONAL APPROACHES TO THE HOSPITAL PLANNING AND DESIGN PROCESS

CONTENTS OF THE LECTURES

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

copyright Mikael Paatela / Sweco Paatela Architects Oy

! Nordic, democratic welfare society, 338 000 km2

! Population of 5.2 million ! 65+ year-olds ! Life expectancy

800,000 1,400,000 78.5

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

copyright Mikael Paatela / Sweco Paatela Architects Oy

HEALTH CARE IN FINLAND

WHY DO HOSPITALS LOOK LIKE THEY DO TODAY?

copyright Mikael Paatela / Sweco Paatela Architects Oy

MEDICAL FUNCTIONS IN HOSPITAL IN THE 1850s 1900s

Hpital LARIBOISIRE, PARIS, FRANCE 1845

HELSINKI UNIVERSITY CENTRAL HOSPITAL in 1934

MEDICAL FUNCTIONS IN HOSPITAL IN THE 1930s

copyright Mikael Paatela / Sweco Paatela Architects Oy

MEDICAL FUNCTIONS IN HOSPITALS IN THE 1970s

AACHEN UNIVERSITY HOSPITAL, Germany 1984

HELSINKI UNIVERSITY CENTRAL HOSPITAL, FINLAND 1964

Turku University Central Hospital in 2012

WHAT AFFECTS HOSPITAL DESIGN?

copyright Mikael Paatela / Sweco Paatela Architects Oy

rising need of health services

competition for skilled employees

copyright Mikael Paatela / Sweco Paatela Architects Oy

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

mini-invasive procedures, day surgery

less need for centralized imaging departments decreases

! MOBILE EXAMINATION EQUIPMENT

copyright Mikael Paatela / Sweco Paatela Architects Oy

INCREASING HEALTH CARE COSTS

1000 in 25 years 2000 in 50 years

900 in 25 years 1800 in 50 years

increasing health care costs

INCREASING HEALTH CARE COSTS

COST SAVINGS BY - IMPROVED FUNCTIONALITY = INCREASED EFFICIENCY

SUPPLIES AND MEDICINES

BUILDING MAINTENANCE AND OPERATING COSTS

copyright Mikael Paatela / Sweco Paatela Architects Oy

thermal control efficient ventilation daylight & views

copyright Mikael Paatela / Sweco Paatela Architects Oy

HEALTH CARE PLANNING

copyright Mikael Paatela / Sweco Paatela Architects Oy

health care planning of the future

SCENARIOS FOR FUTURE ENLARGEMENTS, 10 30 YEARS

FUNCTIONAL CONCEPT OF THE HOSPITAL

TRAFFIC NETWORKS, patients, staff, materials

copyright Mikael Paatela / Sweco Paatela Architects Oy

TURKU UNIVERSITY CENTRAL HOSPITAL, old site

NEW HOSPITAL SITE

EXISTING HOSPITAL SITE

TURKU UNIVERSITY CENTRAL HOSPITAL, site

copyright Mikael Paatela / Sweco Paatela Architects Oy

copyright Mikael Paatela / Sweco Paatela Architects Oy

copyright Mikael Paatela / Sweco Paatela Architects Oy

Turku University Central Hospital, T-Hospital

copyright Mikael Paatela / Sweco Paatela Architects Oy

Turku University Central Hospital, T-Hospital, phase 1

copyright Mikael Paatela / Sweco Paatela Architects Oy

health care planning of the future

EXPANDABLE AND FLEXIBLE BUILDINGS

EXPANDABLE BUILDINGS ADAPTABILITY MODULARITY MULTI-USE OF SPACES

copyright Mikael Paatela / Sweco Paatela Architects Oy