architecture portfolio of duo feng (2015)
DESCRIPTION
University of Florida Architecture Educational Portfolio (Selected Works 2013-2015)TRANSCRIPT
1 2015 ARCHITECTURAL PORTFOLIO
00Contents
SELECTEd wORkS 2013-2015
MIAMI HERALd RESORTS
UF SCHOOL OF MUSIC RECITAL HALL
H21 - HOSPITAL FOR 21ST CEnTURy
03
15
27
2015 ARCHITECTURAL PORTFOLIO 2
01Miami Herald Resorts
DESIGN DISTRICT
WYNWOOD
MIAMI WORLD CENTER
TO AIRPORT
MIAMI HERALD RESORTS
MUSEUM PARK
AMERICAN AIRLINES ARENA
BRICHELL FINANCIAL DISTRICT BRICHELL CITICENTER
PORT MIAMI
ADRIENNE ARSHT CENTER
ONE THOUSANDMUSEUM
MARLINS STADIUM
MIAMI BEACHCONVENTIONCENTER
SOUTH BEACH
VENETIAN CAUSEWAY
JULIA TUTTLE CAUSEWAY
BISCAYNE BAY
MACATHUR CAUSEWAY
1
1
195
395
395
95
95
EXISTING CIRCULATION
PROPOSED CIRCULATION
SITE AREA
CONNECTIONS
VOLUMES
SITE HISTORY
URBAN CONTEXT
HISTORICAL MIAMI HERALD BUILDING
MasterplanThe site is a forgotten land in the heart of traffic routes and the previous light-manufacturing dis-trict. The existing conditions of the site surround the Herald Building are mostly asphalt parking lots. At first stage, our team decided to make a waterfront resort center, the mission is to bring the Miami spirit back to this site – and to imagine an architecture and urban space responsive to the climate and culture of Miami. How we took this idea further is to create an urban fabric of paths and plazas, parks and gardens that forms an urban oasis throughout the site. By doing this, the street-scape will become a walkable urban space with a friendly human scaled environment under the cool shade. With a network of urban life, transportation and undulated green spaces, the 22 acres mixed-use development will accommodate a new cultural center, a market complex, a hotel & residential tower and a fashion school, also will create a new connection across the entire city, and create a new future for Miami city. A green landscape provides an inviting context to the Herald Plaza, connecting it to the Biscayne Bay, Museum Park, and Adrienne Asht Center. In the middle, we introduce a central square to become the pivot of the entire neighborhood. And this pivot is connected to the waterfront by the extension of the arterial road which is already existing in the site. Surrounding this pivot and the central street, these buildings will change the landscape, and enhance the landscape, and encourage new possibilities of economic and social activities throughout the day.
Market Complex The market complex in the north flank of the site is an important component of this urban redevelopment scheme. This corner of the city has great potential for spectacular view as it is located on the transportation node between Miami and Miami Beach. By this advantage, this project brings together a carefully chosen mix of Miami qualities: beach life and big business, cultures and fashion. For this complex, the complexity of the commercial entity breaks down to three green landscape stripes that echo the tropical scenery. The stripes define a sandwiching structure of public and private program which shapes the street-scape into a human scaled environment. This urban form runs east-west to capture the best bay views while also becom-ing an optimal shading system for Miami’s tropical sunlight. Low-angle sunlight of morning and evening is blocked by the stripes, while desirable north-south diffused light is invited into the units. Also, the intensive green roof system reduces heat gain and integrated with the low-energy strategy of the whole master-plan.
The structure gradually rises (ascends) eight levels as it flows through three blocks. Since the park starts at street level, large numbers of people are attracted to the trees and grass land on the roof park. As people travel through, the intensive green roof offers a sloping park, mean-while open-air urban canyons reinforce the connection with nature while forming the primary circulation pattern.
The design strategy of the balustrades is a highly specific response to the climate and beauti-ful South Florida landscape. The resulting scheme resolves multiple orientations situation of the site: it provides shade yet admits light, it is sculptural yet it is environmentally coherent. The balustrades as a louvered shading system intended to reduce the area vulnerable to direct sunlight and ground reflection, also with the services of circulation and occupiable terraces.
Hotel & Residential Tower The 60-story luxury hotel and condominium will mark its program within one gesture. The footprint of the tower articulates different views of the surrounding structures, and intends to equalize the wind pressure which is exerted on the tower. The tower skyline encloses the best quality of Miami as well as the best coherent views of the site. The tower’s program includes hotel rooms and long-stay residential units – ranging from 400 to 1,900 square feet and featuring amenities such as a helipad, an entry foyer, rooftop event spaces, a sky lounge, a restaurant, a fitness center and three fashion runways. The ground floor aims to attach to a multi-height corner that consists of a series of waterfront spaces. Residents will be greeted by a shaded entrance which transitions into an open lobby where exterior and interior is blended by spatial continuity. At lower part, the podium will function as the community space that offers a street-scape intertwined with the market and school. The tower’s elegant facades will form a transforming curtain wall system to complement a series of platforms and balconies. This structure flows over the podium and the top, which grounds itself at the street level while visu-ally recognized as a single object, and articulates the tower’s manifestation within the Biscayne Bay urban image.
Aug 2013 - Dec 2013 Type: Planning & Urban Design, Mixed Use Size: 212,800 m2, 2,290,550 sf Location: 1 Herald Plaza, Miami, FL USA Fall 2013 Advanced Studio 1 Instructor: Lee-Su Huang
3 2015 ARCHITECTURAL PORTFOLIO
DESIGN DISTRICT
WYNWOOD
MIAMI WORLD CENTER
TO AIRPORT
MIAMI HERALD RESORTS
MUSEUM PARK
AMERICAN AIRLINES ARENA
BRICHELL FINANCIAL DISTRICT BRICHELL CITICENTER
PORT MIAMI
ADRIENNE ARSHT CENTER
ONE THOUSANDMUSEUM
MARLINS STADIUM
MIAMI BEACHCONVENTIONCENTER
SOUTH BEACH
VENETIAN CAUSEWAY
JULIA TUTTLE CAUSEWAY
BISCAYNE BAY
MACATHUR CAUSEWAY
1
1
195
395
395
95
95
EXISTING CIRCULATION
PROPOSED CIRCULATION
SITE AREA
CONNECTIONS
VOLUMES
SITE HISTORY
URBAN CONTEXT
HISTORICAL MIAMI HERALD BUILDING
PLOTS ENVELOPE (EXTRUSION)
ORIEnTATIOn HEIGHT PROFILE
URBAN LINK SHAREd PROMEnAdE
BIRD’S VIEW FROM THE WEST 2015 ARCHITECTURAL PORTFOLIO 4
VERTICAL BEACH
SUn ORIEnTATIOn
VERTICAL CIRCULATIOn
FACADE & INTERNAL VIEWS
nATURAL VEnTILATIOn
ACTIVITIES
Loading
Parking
Mechanical
Vehicular Access
Information Desk
Stripe 2 Access
Stripe 3 Access
Press Center
Bay-view Cafe
Loading
Flagship Stores
Lobby
Stripe 1 Access
MARKET STRIPE 1 CIRCULATION DIAGRAM
MARKET STRIPE 2 CIRCULATION DIAGRAM
MARKET STRIPE 3 CIRCULATION DIAGRAM
MARKET SHARED SPACES CIRCULATION DIAGRAM
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VIEw FROM MACARTHUR CAUSEwAy 2015 ARCHITECTURAL PORTFOLIO 6
VIEw OF CEnTRAL STREET
VIEw FROM VEnETIAn CAUSEwAy
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1
2 3
4 56 7
89
GREEN ROOF SPACES DIAGRAM
1 Urban Camping
5 Community Garden
3 Sunbathe Field
4 Rooftop Hiking Path 6 Urban Agriculture
7 Culinary Ward 8 Mini-golf course 9 Afternoon Leisure
2 View Terrace
Parking
Lobby
Fitness Center
Bayside Restaurants
Fashion Runway
Mechanical
Ballroom
Mechanical
Sky Restaurant
Hotel
Mechanical
Residential Units
Loft Open Plan
High Garden
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SITE PLAn
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LOnGITUdInAL SECTIOn
InTERIOR VIEw OF CULTURAL CEnTER
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BIRD’S VIEW OF GREEN ROOF FROM EAST
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PERSPECTIVE CROSS SECTIOn
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VIEW OF URBAN CANYON OF MARKET COMPLEX
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02grams, and circulation); the building form proposes a simple volume as a box. An orthogonal building defines these spaces and appears to sup-port the main body of the building with a clear zoning inside, based on the complexity of the strict requirements.
This hybrid façade of brick, glass, translucent panels evokes again two rules of composing music – structure and freedom. The building’s west façade is discrete planes that frame the views of the campus along New-ell Drive and towards the Century Tower. It preserves the historic design syntax of southern Gothic, and brings new alphabets. On the facades that face the street, openings illuminate the spaces behind them. The entry space, facing south-west direction, allows exquisite daylight to permeate congregation spaces, creating interior environments condu-cive to enjoy music for the visitors and occupants.
UF School of Music Recital Hall
Newell Drive
Century Tower
Music Building
Maston Science Library
Steinbrenner Band Hall
SITE SCENARIO
Site
Inner Road
Stadium Road
“Structure must be agreed upon, while form wants only freedom to be”. – John Cage
The new recital hall signifies two fundamental constitutions of music – structure (law) and freedom (content), within architectural space. This is the symphony of nothing (tacet) and something (sound), the dialogue between the idea and no idea.
The site is a corner between main road in campus and a tranquil district. The design for the new Recital Hall of School of Music gives promi-nence to the central area of the University of Florida campus at Newell Drive and Inner Road. The new building is adjacent to the historic Music Building, the existing Steinbrenner Band Hall, which houses the univer-sity’s matching band. The new program adds to the public space, and includes a recital hall, supporting areas, recording booths and recording studio, practice rooms, and offices.
The recording booths, recording studios and electronic studios anchor the design. It is an underground volume two stories high that is embed-ded into the ground of the lot. Practice rooms also inhabit the under-ground realm south of the recording studio. Above these submerged spaces, at street level, are located the recital hall and main entrance. One story high offices for faculty and graduate students sit above the recital hall.
To maneuver the possible programs in this tight site, and to follow the parallel trajectories of various design generators (soundscape, site, pro-
SOUND SAMPLING SOUNDSCAPE ANALYSIS
Sound sampling and recordings were made at different locations through the itineraries. At normal week day 4 pm, sound pressure levels were recorded with a length of 1 minute each.
Sound Pressure Level (dB)
Sound Taxonomy
Natural (wind, birds, trees)Transportation (buses, cars, helicopter)Pedestrians (talking, walking)
Itinerary 01
Itinerary 01
60 dB
60 dB
60 dB
Itinerary 02
Itinerary 02
Itinerary 03
Itinerary 03
01 040302 0605 07 08
09 121110 1413 15 16
17 201918 2221 23 24
01
0708
02
06
03
05
04
09
10 11
14
1516 13
12
17
19 20
18 22
232421
Sep 2014 - Dec 2014Type: EducationSize: 3419 m2, 36807 sfLocation: 435 Newell DR, University of Florida, Gainesville, Florida, USAAdvanced Studio 3 Fall 2014Instructor: Gary Siebein
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UF School of Music Recital Hall
SITE PLAn And GROUnd LEVEL PLAn
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SCENARIO
Sound
Program
Recital Hall
Rehearsal
Visiting
Performance
Interdisciplinary
Space
Noise
Topography
Plantation
Classic
Percussion
Vocal
Blues
JazzPop
Country
Originators
Distance
Volume
Loudness
StringVariables
Vibration
Folk
Classrooms
Gallery
Practice
Recording
Electronic
Percussion Studio
Dressing
MusicBirds
Context
Dialogue
TransparencyEntrance
Welcome
Logistics
MaterialRamp
Pavement
Silence
Simplicity
Cars
Piano
ElectroBrass
Wind
Recorder
Bugle
Cello
Tone
Tambourine
Acoustics Reverberation
Clarity
IntelligibilityDiffuse
Brilliance
WarmthBalance
BlendWidth
Envelope
Spaciousness Localization
InstrumentsDead-room
Protection
Circulation
Visual
Performance
Proposal
Design Generators
Activities
Reed Maint
Office
Research
Exhibition
Community
Sale
ShowConference
ConnectionStudents
Storage
Stage Control
Equipments
Library
Repair
RepairTeachingFirst-aid
Piano Lab
Education
Storage
Association
Info
Studio
Restroom
Lighting Booth
Cafe
Green Room
Rack
Soundscape
Site
Amplitude
Frequency
PRINCIPAL FUNCTIONS ZONING
+
Public Activities
Programs Stacking Enbedment Verticality
Intervention
ProfessionalRooms(Sound Isolation)
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PRACTICE ROOMS
ELECTRONIC STUDIOS
RECORDING STUDIOS
CLASSROOMS
GALLERY
BACK-STAGE
PERCUSSION STUDIOS
MUSIC LABS
CONGREGATION
FACULTY & GRADUATE OFFICES
RECITAL HALL
PROGRAM & CIRCULATION DIAGRAM
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VIEw On nEwELL dRIVE
93’-8”
109’-7”
59’-9” 61’-2”
34’-0”
65’-6”
UNIVERSITY AUDITORIUM
AMERICAS PLAZA
MUSIC BUILDING ARCHITECTURE BUILDING
STEINBRENNER BAND HALL
RINKER HALL
Section A-A
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CENTURY TOWER
TURLINGTON HALL
MUSIC BUILDING
SECTION B-B
63’-8”
162’-4”
59’-9”
93’-8”
109’-7”
59’-9” 61’-2”
34’-0”
65’-6”
UNIVERSITY AUDITORIUM
AMERICAS PLAZA
MUSIC BUILDING ARCHITECTURE BUILDING
STEINBRENNER BAND HALL
RINKER HALL
Section A-A
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InTERIOR VIEw OF RECITAL HALL
VIEw On InnER ROAd
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ACOUSTIC QUALITIES
RECITAL HALL TYPOLOGY
ACOUSTIC DIFFUSION
ACOUSTIC DIFFUSERS PERFORMANCE
Ceiling Reflection Paradigms
Shoe-box scheme for room shape to optimize acoustics
>15’
>25’
H
>3’
stage: >20’
fractals
scattering pattern
(absorption coefficient)1
0125 4000
(frequency, Hz)
(diffusion coefficient)
high
lowmedium
1
0125 16000
(frequency, Hz)
L1 L2
audience: >60’
-6 dB
receiver
Loudness– Adequate loudness of soundWall diffusers scheme is to provide early lateral reflection. Shallow room depth < 100-120 ft.Clarity– Early delay time (10, 15, 20 dB of sound decay)Early reflection from ceiling materialsReverberation– Sufficient time of sound decay of -60 dBRelating to volume, materiality, layers of diffusers and ceiling are to control the reverberant energy, and large volume above audience allows reverberant sound energy to build up.RT=0.05V/ƩSa=1.8 sEnvelope– Immersement in the 3 dimensional sound field Narrow width < 80-90 ft.Intimacy– Initial time delay gap[(R1+R2)-D/1120]/1000=12 msBrilliance– Adequate support of high frequencyTreble ratio > 0.70Warmth– Adequate support of low frequencyBass ratio > 1Balance and Blend– Sound from individual instruments blends on stage before progressing to audience
source
direct sound
lateral reflection
reflection path R1reflection path R2
70’
diffusers
Maneuvering of floor sloping to provide easy access for both performers and audience
Ceiling and diffuser panels to achieve coplanar reflections
spline motif
(coefficient)1
0100 4000
(frequency, Hz)diffusion
absorptionscattering
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NEWELL DR
Turlington Plaza
OUTDOOR GATHERING PERFORMANCE AREA GATHERING EVENT SPACE VISUAL INTERVENTION TRANSPORTATION HUBS
acoustical sourcesacoustical itinerary nodes
Music Building Recital Hall Recital Hall Entrance Rawlings Bus Stop McCarty Parking Garage
PROCESSION
VIEW OF GRAND LOBBY
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VIEw OF SECOnd FLOOR EnTRy 2015 ARCHITECTURAL PORTFOLIO 24
URBAN SOUNDSCAPE, CONTEXT AND ELEVATION
Sound SourceCentury Tower CarillonSelected Music Chapter: “Spring 12”
Notes Beams (Intervals) Cluster Change of Tempo ConcreteBrick
BASEMENT LEVEL PLAN SECOnd LEVEL PLAn
25 2015 ARCHITECTURAL PORTFOLIO
URBAN SOUNDSCAPE, CONTEXT AND ELEVATION
Sound SourceCentury Tower CarillonSelected Music Chapter: “Spring 12”
Notes Beams (Intervals) Cluster Change of Tempo ConcreteBrick
THIRd LEVEL PLAn
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03H21 - Hospital for 21st Century
Hospital is the ultimate housing.
Housing birthplaces, housing souls, housing hopes, housing equality and dignity, housing the opportunities to achieve common welfare; hos-pital is the contemporary temple for physical and mental health. It is of vital importance to a society in both street and global scale. Hospital projects receive only marginal attention in architectural academia, pe-riodicals, websites, practice, architectural awards and in the oeuvre of super star architects. Hence the intention of this project is the “liberating divergence” of an architecture’s insignificant and conspicuously minor realm. Fortunately, innovation always occurs when the preceding mar-ginal is accepted into the discipline, sparking adjustments to the logic within; just like alchemy to chemistry, astrology to astrophysics, folklore to history, Behrens and Gropius’ industrial factories to modern archi-tecture. This project will be an experimental attempt to evoke the new paradigm of hospital, which is the most important atherogenic artifact to maintain the survival. The places of healing can be considered as hospital’s fundamental existence, or in other words, a facility that caters to patients’ well-being. Challenged by the rapid changes of modern so-ciety, a redefinition and an update of very long-established concept of hospital seems needed. When raw birth rate hits 4.3 births/second for the world, hospital reaches the moment of H21.
Hospitals are the oldest type of architecture as well as the newest type of architecture. The hospital or place of care for the sick has certainly its own evolution from ancient times to the modern. Being a descendant of almshouses, poorhouses, correctional facilities, and welfare centers, in many instances run by the church, the administrative line of the hos-pital shifts through eras. As requirements of these crucial facilities have grown, public authorities and companies have taken over the running of these care centers. But the ultimate goal remains, which is the attention to cure ill people as a vital component particularly.
The history of hospitals has stretched over 2500 years. This project has collected, illustrated, examined, criticized many historical examples. On the other hand, with good reason, hospital is new in this time. After a long relation with religion, in the mid 19th century, hospitals and the medical profession became more professionalized, with a reorganiza-tion of hospital management along more bureaucratic and administra-tive lines. That is the reason why in the Lunder Building project of Mas-sachusetts General Hospital, the title was acclaimed as Building for the Third Century (B3C); indeed, modern hospital has existed for no more than two hundred years.
This project consists of four parts, which together aim to evoke a sus-tainable and green design for the next generation hospital, which each part itself has been intrigued by the very basic thought of hospital and hospitalizing in different epochs and aspects.
Part 01 gives a brief historical ichnography of hospitals through ten ca-nonical examples since ancient Greek to present. This part, whose title is inspired by Peter Eisenman’s book - Ten Canonical Buildings. This part intends to open a critical and through view of the way people were thinking about the space for the sick people, and successful findings, and the inspiration it seeks for future in hospitalizing phenomena.
Part 02 reviews contemporary problems of healthcare industry primarily in the United States, intending to combine the research results of man-agement science into healthcare sphere and to provoke how a health-care facilities in future can be managed and constructed.
Asklepieion at Epidauros, in ancient Greece, fifth century BCE, as undeniably places for inpa-tient nursing, including bed rest, treatments, medication, baths. Double hall for dreamer-patient at the Asklepieion, as restored along the lines of a branch building. By the time of Hippocrates, the temples of Asclepios offered a place of worship and shelter for the sick. Healing temples re-sembled spas, emphasizing exposure to fresh air, sunlight, rest, baths, exercise, and reasonable diet. Asklepieia naturally did not lack latrines, or necesaria as they were aptly called in the Middle Ages, which can be considered as the prototype of public bathrooms in Europe.
Part 03 includes a context study page in function and design of the exist-ing University of Florida Shands Complex and a guideline page of the accreditation systems of sustainable healthcare buildings. It also con-siders the possible future application of the concepts discussed, with a practical design project of Cardiovascular Center in UF Health Shands at University of Florida.
Part 04 contains the sustainable healthcare architecture strategem as-sociated with the design proposal of UF Health Cardiovascular Center, which are concerned with hospital design trends of today and particu-larly with the evaluation of a scientifically contemporary standards for green buildings.
Rembrandt van Rijn: The Anatomy Lesson of Dr. Nicolaes Tulp, 1632, Oil on canvas, 216.5 x 169.5 em, Mauritshuis (Hague, Netherlands). In the 17th century anatomy was not considered as an precise science and sometimes even served as a means of entertainment - the forerun-ner of modern television programs like Grey’s Anatomy and CSI. The painting presents the public dissection of an executed criminal; the only event of its kind to take place in those years in Amsterdam.
Nov 2014 - Apr 2015Type: HealthcareSize: 30000 m2, 322000 sfLocation: 1600 SW Archer Road, Gainesville, Florida, USAMaster’s Research Project (Degree Project) 2015Instructor: Bradley Walters & Nawari Nawari
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ALMANAC OF HEALTHCARE BUILDINGS
Temple Valetudinaria Sanctuary MonasteryOrigin Asclepieion Bimaristan
350 B.C.E.: Temples dedicated to the healer-god Asclepius, known as Asclepieia in ancient Greece 625: Hôtel-Dieu de Paris was founded
1043: Monastery and Infirmary in Cluny, France
400 B.C.E.: The record in his travelogue by Fa Xian is one of the earliest accounts of a civic hospital system anywhere in the world
1154: Bimaristan (Islamic hospital) of Nur al-Din, Damascus, Dimashq, Syria820: The plan of St. Gall
monastery, Switzerland55: Roman Valetudinarium (Military Hospital) in England (first century CE), as a part of Hadrian’s Wall
1150: The leprosarium of Perigueux in France
100: First public restroom - latrines, or necessaria, appeared in Asklepieion in now Turkey
325: Earliest hospitals in theRoman Empire were built by Saint Sampson the Hospitable
707: First prominent Islamic hospital was founded in Damascus, Syria in around 707 with assistance from Christians
400 C.E.: First description of a civic hospital system anywhere in the world
Classical Medieval
0 500 800 1200300 B.C.E.500 B.C.E.
Open Hall Wards PavilionHôtel-Dieu Voluntary Center
1772: Hôtel-Dieu de Paris fire
1801: Hôtel-Dieu de Paris rebuilding project
1889: Johns Hopkins Hospital founded
1721: St Thomas' and Guy's hospitals founded 1865: Mower General Hospital, Philadelphia, Pennsylvania
1824: Eugène Delacroix ‘s drawing of Military Hospital1721: St Thomas' and Guy's hospitals was founded
by Thomas Guy, a publisher of unlicensed Bibles
1500: Episodes from the Life of a Bishop-Saint, by the Master of Saint Giles, showing the Gothic buildings of the Hotel Dieu at right.
1155: Kirkstall Abbey, England. Drain of the dormitory necessarium were built near water
1815: The Apothecaries Act made it compulsory for medical students to practice for at least half a year at a hospital as part of their training
1502: First hospital founded in the Americas - Hospital San Nicolás de Bari, in Dominican Republic
1842: First air-conditioned hospital, John Gorrie used to cool air for his patients in his hospital in Apalachicola, Florida
1803: First medical textbook ‘Medical Ethics, or a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons’ was written
Renaissance Enlightenment Industrial Revolution
1700 1800 1830 185015001300
Radiology EscalationAntibioticsSkyscraper Modernism
1889: Johns Hopkins Hospital was founded, now it is regarded as one of the world's greatest hospitals
1932: Paimio Sanatorium designed by Finnish architect Alvar Aalto was completed
1944: USS Mercy (AH-8) was a Comfort-class hospital ship laid down under Maritime Commission
1884: Civil and Military Hospital, Montpellier, France, the transverse section shows the intake of fresh air
1950: Veterans Hospital in Brooklyn opened, which is designed by Skid-more, Owings & Merrill 1935: Beaujon Hospital located in Clichy, Paris opened
1931: Sanatorium Zonnestraal, was designed by Jan Duiker and is an example of the Nieuwe Bouwenit, it was built as a tuberculosis sanatorium
1895: First X-Ray Image, Wilhelm Conrad Röntgen accidentally discovered an image cast from his cathode ray generator
1945: First country to make the penicillin available for civilian use was Australia after World War II
1860: First official nurses’ training programme, theNightingale School for Nurses was opened
WWIIWWIModern Post-war
1920 1940 1945 19501900
Information Energy DirectionEfficiency Sustainable Evidence
1965: Yale–New Haven Hospital was named as the result of a more formal agreement with the Yale School of Medicine
1951: Massachusetts General Hospital Research Laboratory constructed, and linked by corridor to the 1821 Bulfinch Building
2008: B3C - Building for the Third Century, of Massa-chusetts General Hospital commenced, marking a sustainable and green design for the future
2011: Pacific coast of Tōhoku earthquake near Japan opens a new challenge of mas-sive healthcare by information technology
1993: Hospital for Sick Children in Toronto of Canada, designed by Zeidler Roberts Partnership
1990: Shanghai's Number 1 Maternity hospi-tal, China, the intense population increase questions the existing hospital management
1979: Hospital: House of Hope, Houses of Birth, Houses of No Return drawn by Raimund Abraham
1978: First test tube baby were conceived by IVF, and born in Oldham General Hospital, Greater Manchester, UK
1996: First mammal, Dolly, cloned from an adult somatic cell using the process of nuclear transfer
1953: The structure of the DNA molecule was described by James Watson and Francis Crick at Cambridge University
Cold War GlobalizationSecond Industrial Revolution
1970 1990 2000 20111960
Though the institutions of healthcare have been happening for less than two hundred years, this artifact has its own history, its own traditions, and its own dogmas. As what has been discussed in the previous page, the disruptive model in healthcare will result in the moving down-market of general hospitals and moving up-market of clinic and doctor’s offices. Therefore, a large group of ambulatory clinics can begin doing in that setting the simplest of the procedures that can only be done in hospitals today. And small groups and individual doctors’ offices can begin do-ing the simplest of things that today require a large ambulatory clinic. Business model innovation, in the form of disruption, is the propelling mechanism by which substantial improvements in the quality and cost of healthcare can be achieved. Thus, the economic division of healthcare industry can be based on three methods solution shops (fee for service), value-adding process business (fee for outcome), facilitated user net-works (fee for membership, advertising).
01
03 02
Hospital ls become focused solution shops, practicing intuitive medicine. Focused value-adding
process hospitals & clinics provide procedures after definitive diagnosis.
Facilitated networks take dominant role in the care of many chronic diseases.
SOLUTION SHOPS(Fee for service)- Consulting firms- High-end law firms- R&D organizations- Diagnostic activities of hospitals
VALUE-ADDING PROCESS BUSINESSES(Fee for outcome)- Retailing- Manufacturing- Food Services- Medical Procedures
FACILITATED USER NETWORKS(Fee for Membership, Advertising)- eBay- Insurance- Education- Telecommunications- D-Life (for diabetes patients & families)
THREE TYPES OF BUSINESS MODELS OF FUTURE HEALTHCARE FACILITIES
Data
Finance
Contracting DISRUPTIVE VALUE NETWORKEXISTING VALUE NETWORK
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GREEK ASKLEPIEIA (350 B.C.E.)
HÔTEL-DIEU DE PARIS (651)
ST THOMAS’S HOSPITAL (1721)
INFIRMARY OF MONASTERY IN CLUNY (1050)
JOHNS HOPKINS HOSPITAL (1889)
PAIMIO SANATORIUM (1932)
Orientation(Direct Sunlight)
Treatment(Spatial Division of patients and resources)
Beds(Inpatient Placing)
Latrines or Necesaria(Sanitation Facilitating)
Supporting(Storage and Mandatum-Kitchen)
Wards(Male and Female inpatient units separated)
Pavilion(Longitudinal arrangement on behalf of natural air)
Corridor(Rational connection between pavilions)
Pharmacies(Pharmaceutic Supporting)
Control(Visiting group are guided by main entrance)
Lobby(Supporting and welcoming)
Zoning(Walled organization for the sicks)
Division(Dividing of a great hall)
Galleries(Basic circulation spaces)
Hall(An integrated program in infirmary)
Temple(Modular System established by the temple)
Ventilation(Shaft excluded for air and heating)
Height(Volumetric Increase)
Street(Clear circulation like a main street)
Department(New zoning strategy for contagion)
Lighting(Orientation of patient tower)
Skyscraper(Stacking configuration for inpatient program)
Administrative(Enlarged supporting volume attached to inpatient part)
Lean(Shorten distance to access to patients)
29 2015 ARCHITECTURAL PORTFOLIO
BEAUJON HOSPITAL AT CLICHY (1935)
USS MERCY AH-8 (1943)
YALE-NEW HAVEN HOSPITAL (1965)
H3C MASSACHUSETTS GENERAL HOSPITAL (2011)
Logistics(Multiples transportation cores to achieve efficiency)
Dynamics(Convenience of services of each inpatient tower)
Rehabilitation(The space on roof deck for rehabilitation)
Density(Most compact layout of beds)
Functionality(Food and water treatment on lower deck)
Mobility(Maximum consideration of circulation in compact space)
Complexity(One integrated testing and supporting tower connected to all inpatient towers)
Escalation(Juxtaposed inpatient tower with pavilion layout)
Core(Rearranged tower core for mechanical, ventilation, and services)
Opportunities(Massing reflects the five-story bed tower is separated from the procedural floors below)
Convenience(Maximizing the number of patient beds per floor)
Efficiency(Minimizing travel distances for medical staff)
Greenness(Atrium garden is visible from many of the building's lounges and consultation rooms)
Accessibility(Modernized wings are connected to the consolidated core)
Incorporation(Old pavilions incorporated in longer and wider towers)
Technology(Laboratories and medical facilities are located in the heart of the X-shape)
The ten hospitals chosen for discussion were important, or in some means, making it better. Each hospital examined in general or in some details does represent the way people were thinking about the Space for the sick at that time and that place. The method of “cutting history” applied in this part were developed from Peter Eisenman’s didactic and unorthodox notion in the book of Ten Canonical Buildings. In many in-stances beyond the ten, other examples from different regions might serve as well but the ten are chosen because reliable information about them was relatively easy to come by, because they could intrigue the design of next generation hospital by certain aspects, because they place the positive attention closer to Michel Foucault’s idea of “effective history”, “bias”, “misinterpretation” than to the eternal value of the art of canonical edifices.
These cross-era hospitals exhibited in this part demonstrate a diverse understanding of the places of healing. Through instances, this observa-tion therefore facilitates a panoramic comparison between the various
ELEMEnTS OF TEn CAnOnICAL HOSPITALS In HISTORy
projects: How will the ideologies steer the shifts of hospital architecture? What positions did or does hospital architecture occupy in past and to-day? What factors that enable architects to tackle the challenges facing influential aspects? How did hospital planning satisfy the growing needs and demands of the users? Those questions make an attempt to trace the canonical moments in the development of hospitals.
Hospital spaces have developed through the track of ten basic elements as shown in former chapters: Temple, Sanctuary, Ward, Pavilion, Sky-scraper, Modernism, Complexity, Mobility, Efficiency, Sustainability. Each case represents a core aspect of healthcare space. These buildings not only construct the conceptual thread, but also explain what constitutes the space of any healthcare institution, whole-to-part, macro-to-micro, subject-to-object, coordinates-to-patterns, abstractions-to-meanings.
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BIRD’S VIEW FROM THE NORTHEAST CORNER OF SOUTH CAMPUS
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Located on the south campus of University of Florida, the new Cardiovascular Center is potentially connected with other facilities of UF Health system including UF Health Shands Hospital, UF Health Shands Cancer Hospital and UF Health Shands Children’s Hospital. The adjacency are
mostly open landscape, however for the future expandability of the entire complex, the useful space is relatively constraint.
SITE CONDITIONS
The Cardiovascular Center provides a series entrances to improve the connectivity of the other parts of the campus. At the west side close to the Cancer Hospital, an accessible bridge is added to the Cardiovascular Hospital. The east end as the extension of the main spine of the value-adding
process wing opens to the main garages. At the central garden of the Cardiovascular Hospital, the passage is preserved for the purpose of the expansion of other facilities in the site.
CONNECTIVITY AND EXPANDABILITY
UF Health Shands Cancer Hospital
Medical Clinics Tower
Specialty Hospital
Parking Structure
Daylighting of the interior spaces are applied based on whether it is needed for that type of room. More than eighty percent of the rooms are proposed to have natural lighting through the means of orientation and openings on facade. The Cardiovascular Hospital will enhance daylight and
views to green areas and plants that has a healing effect on bed lying patients.
DAYLIGHTING AND VISIBILITY
The building program consists of two wings that houses a bifurcated array of the solution shop program and the value-adding program. All programs are organized as the combination of linear and the traditional grid through the buildings. The linear array of programs gives clarity of
circulation and efficient logistics. The grid-matrix provides the intimacy of the complex functions.
FUNCTIONALITY
UF Health Shands Cancer Hospital
Wing of Solution Shop Wing of Value-Adding ProcessUF Health Shands Children’s Hospital
UF Health Shands Hospital
VIEW OF THE PUBLIC ENTRANCE FROM THE MAJOR PARKING STRUCTURE
VIEw FROM THE wEST SIdE THROUGH ARCHER ROAd
In different business models, there are three types: solution shops, val-ue-adding process (VAP) businesses, and facilitated networks. As how the healthcare institutions started, the two dominant provider institutions in health care-general hospitals and physicians’ practices-emerged au-thentically as solution shops. But over a century they have mixed in val-ue-adding process and facilitated network activities in the spectrum of services as well. Nowadays, the health-care system has trapped many disruption-enabling technologies in high-cost institutions that have con-flated three business models in the same building. The first step of inno-vation must separate different business models into separate institutions whose processes, resources, and profit models are corresponded to the
level of precision by which the disease is understood. Solution shops are supposed to become focused so they could deliver and price the services of intuitive medicine accurately. Focused value-adding process hospitals need to absorb those procedures that general hospitals have presently performed after definitive diagnosis. And facilitated networks need to be fostered to manage the care of many behavior-dependent chronic diseases. Solution shops and VAP hospitals can be created as hospitals-within-hospitals if done correctly. The reason why this segre-gation of business models must happen from the outset of disruption is that it will enable accurate assessments of value, costs, pricing, and profit for each type of business.
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To achieve to deconstruction of health care institutions into the two dif-ferent business models: solution shops and value-adding process ac-tivities. This can be done by creating hospitals-within-a hospital, or by building distinct facilities. In either case, the work done within each busi-ness model must be organized distinctly, and their cost accounting and pricing systems must be separated and assembled in ways appropriate to each. The biggest and best medical centers will be able to bifurcate themselves. Smaller hospitals, nonetheless, will need to focus on be-coming solution shops or value-adding process hospitals, or simply ex-pect to be integrated through disruption. The reason why this division is such a essential first step of this innovation is that there are two different jobs-to-be-done. To visualize how this process happens in the next gen-eration healthcare institutions, two different diagrams of value networks can indicate the attempt.
All the study which has been done through the path of this master’s research project did not show a clear vision of the how it will look like for a “hospital for twenty-first century”, but even revealed a number of new question marks. One guiding principle which has been discovered is that healthcare building follows the medical technology and medical situa-tions of that time. This proposal for the new cardiovascular center in UF Health South Campus, serving as an integrated component in the entire complex, seeks to preserve the good of existing medical architectural features while opening the future of hospital machine.
According to a World Bank analysis, cardiovascular diseases are the leading cause of deaths on the globally. To accommodate anticipated growth of need in thus area, this project intends to propose to build a new specialty hospital that will house cardiovascular services of UF Health Shands Hospital, by taking the preemptive step of the next gen-eration hospital paradigm further.
The design for the new Cardiovascular Center employs the thoughts which has been discussed in previous chapters regarding the H21 (hos-pital for twenty-first century). Through use of new, more contemporary design methodology of Building Information Modeling, the designer is able to manage programmatically-dense building with a high level of precision in the design and delivery of the project.
The new specialty center is to consolidate and align their cardiac ser-vices in an integrated facility that will improve physician collaboration, efficiency, and patient therapy. It will be located on the hospital’s south campus on Archer Road and connect to the existing UF Health Shands Cancer Hospital, providing inpatient and outpatient care to patients with heart and vascular conditions. The program includes private patient beds, state-of-the-art operating rooms, intensive care unit beds, clinic exam procedure rooms, diagnostic testing and imaging, preoperative and postoperative and PACU (post-anesthesia care unit) areas, mul-
tidisciplinary outpatient clinics, catheterization lab facilities, cardiac re-habilitation, hybrid operating rooms, and intraoperative MRI (magnetic resonance imaging).
The center will also contain amenities and resources with a convenient parking garage with 600 spaces to accommodate patients and families. When entering by road or walkway, the central circular park welcomes all to the tranquil environment within the building. Spaces for families such as family zones in the patient room, sleep couches, and technol-ogy access will allow extended stays. To engage families with patient care and recovery actively, educational center with study resources for family care and welcoming wait spaces with views to the scenic land-scape will also be included in the center.
Connection link the existing Cancer Hospital to the new center at the second level and frame an inviting gateway to the main campus across the main road of this region. Those connections play a critical role for ease of facility and logistical access, patient transport to services else-where on campus and materials flow. Site landscape facilities will in-clude natural water features and gardens which can be viewed from a number of rooms, retreat spaces for patients and families, and gathering and event space for community health fairs and public wellness events.
The Cardiovascular Center will include an indoor atrium and abundant natural light. Located on the building’s fourth floor, the atrium garden which will include 15-foot hanging plants, trees and a variety of ground-cover vegetation that will be visible from many of the units and staff lounges and consultation rooms. A green garden will cover the roofs, and those plants will be drought-tolerant and require no irrigation; all of the necessary water for the plantings will come from rain harvesting and condensation collected from the building’s cooling towers.
Due to being open 24 hours a day and meeting strict interior environ-mental requirements, hospitals are notorious in energy conservation, making LEED certification or other green building criteria very difficult. One preliminary task to sustainable practices is the recycling of most construction waste during the building’s construction schedule, as well as the use of renewable materials such as recycled rubber flooring and wood walls; rubber floors will help to cushion footsteps and reduce noise, and the wood panels, which are sustainably recollected locally in Florida neighbors, will promote a natural and warm connection to nature. Elec-tricity conservation stratagem include sun shading, high-efficiency air handlers, low-E windows, low-energy light fixtures, and cascading day-lighting; the project is targeting on that more than 80 percent of interior spaces receive natural light. Use of low-emitting adhesives, sealants, carpets, and paints throughout the facility preserves air quality, while low-flow plumbing fixtures reduce water consumption.
VIEw FROM THE nORTHEAST CORnER On wALdO ROAd GREEnwAy-dEPOT AVEnUE RAIL-TRAIL
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The institution program consists of four parts: solution shops, value-adding process, supporting, community connection. The question emerge of how to allow for maximum flexibility and efficiency while still preserving the functionality and autonomy of individual artifacts.
PROGRAMS
Café1450 SF
Conference Center
2025 SF
Gift Shop1360 SF
Patient Management
Center3000 SF
Sterile Processing
Receiving Dock3600 SF Vestibule
2000 SF
Locker Room3000 SF
Locker Room3600 SF
Kitchen3000 SF
Bed Support3000 SF
Administrative Offices
4200 SF
Roof Garden3000 SF
Mechanical21000 SF
Mechanical21000 SF
Central Processing Department15000 SF
SOLUTION SHOP
VALUE-ADDING PROCESS
SUPPORTING COMMUNITY CONNECTION
Family Center3500 SF
Outpatient Echocardiography
6000 SF
Outpatient Clinics Center
6000 SF
Shands Pavilion6000 SF
Emergency Department10000 SF
Cardiovascular Clinics
11000 SF
Operation Theaters8000 SF
Intermediate Beds15000 SF
CDU2000 SF
SpecimenCollection3000 SF
MRI OR3000 SF
OR Supports3000 SF
PACUs5000 SF
CCUs5000 SF
ICUs5000 SF
Imaging CT3925 SF
Electro-physiology Rooms
2750 SF
Advanced Molecular Diagnostics Center
3000 SF
Diagnostic Units12000 SF
CDSS center6000 SF
UF Precision Medicine Hub
23000 SF
Cardiac Stress Test
2100 SF
SPECT1250 SF
PET1250 SF
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It is proposed of “hospitals in a hospital” in the Cardiovascular Center that will allow this advanced medical center to bifurcate itself rather than to stick on the existing commingling model of solution shop and value-adding process. Two identities composed of two services - fee for service and fee for outcome.
(BUILDING WING A) (BUILDING WING B)
PROGRAMMING RELATIONS
Café1450 SF
Conference Center
2025 SFGift Shop1360 SF
Patient Management
Center3000 SF
Sterile Processing
Receiving Dock3600 SFVestibule
2000 SF
Locker Room3000 SF
Locker Room3600 SF
Kitchen3000 SF
Bed Support3000 SF
Administrative Offices
4200 SFRoof Garden3000 SF
Mechanical21000 SF
Mechanical21000 SF
Central Processing Department15000 SF
SOLUTION SHOPS VALUE-ADDING PROCESS
Family Center3500 SF
Outpatient Echocardiography
6000 SF
Outpatient Clinics Center
6000 SF
Shands Pavilion6000 SF
Emergency Department10000 SF
Cardiovascular Clinics
11000 SF
Operation Theaters8000 SF
Intermediate Beds15000 SF
CDU2000 SF
SpecimenCollection3000 SF
MRI OR3000 SF
OR Supports3000 SF
PACUs5000 SF
CCUs5000 SF
ICU5000 SF
Imaging CT3925 SF
Electrophysiology Rooms
2750 SF
Advanced Molecular Diagnostics Center
3000 SF
Diagnostic Units12000 SF
CDSS Center6000 SF
UF Precision Medicine Hub
23000 SF
Cardiac Stress Test
2100 SF
SPECT1250 SF
PET1250 SF
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(Building Wing of Solution Shop)
(Public Access from the Central Garden)
(Imaging Programs Support the Value-Adding Process)
(Advanced Medical Programs Fused Together)
(Sky Lit Space Organizes the Framework)
(Hanging Extrusions Enhancing the Interior)
(Interchangeable Spaces for Future Technology)
(Bridges across Two Wing Provide Connections)
INCORPORATION
ACCESSIBILITY
SUPPORT
CONSOLIDATION
LIGHTING
FLEXIBILITY
DYNAMICS
INTER-BRIDGING
(Reunited Value-Adding Process Wing in Paradigm)
(Main Street Providing Clear Logistics and Circulation)
(Efficient Division Strategy through a Matrical Grid)
(Sub-divisions with Matrical Relations Spatially)
(Outpatient Programs Linked to Parking Facility)
(Service Floor Accommodation Located in Middle)
(Facing Green Areas and Daylighting for Nursing Units)
(Shortest Distance to ORs and Support Programs)
OPPORTUNITIES
CLARITY
DIVISION
MATRIX
CONVENIENCE
SERVICE
ORIENTATION
PROXIMITY
SPATIAL STRATAGEM OF SOLUTIOn SHOP wInG SPATIAL STRATAGEM OF VALUE-AddInG PROCESS wInG
SITE PLAn
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Café
Conference Center
Gift Shop
Patient Management Center
Sterile Processing Receiving Dock
Vestibule
Kitchen
Bed Support
Administrative Offices
Roof Garden
Mechanical
Mechanical
Mechanical
Central Processing Department
Family Center
Outpatient Echocardiography
Outpatient Clinics Center
Shands Pavilion
Mechanical
PACUs
Operation Theaters
Operation Theaters
MRI OR
Emergency Department
Cardiovascular Clinics
Intermediate Beds
Intermediate Beds
Intermediate Beds
CDU
Specimen Collection
OR Supports
CCUs
ICUs
Operation Theaters
PET
SPECT
Cardiac Stress Test
Electrophysiology Rooms
Imaging CT
Imaging CT
Advanced Molecular Diagnostics Center
CDSS Center
UF Precision Medicine Hub
Diagnostic Units
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VIEw FROM THE nORTHEAST CORnER On ARCHER ROAd
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VIEw FROM THE SOUTHwEST CORnER nEAR CAnCER HOSPITAL
EARLy SkETCHES
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VIEW OF THE GARDEN IN BETWEEN TWO WINGS
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VIEW OF THE PUBLIC ENTRANCE OF THE CARDIOVASCULAR HOSPITAL43 2015 ARCHITECTURAL PORTFOLIO
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VIEw FROM THE dIAGnOSTIC UnITS
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LOnGITUdInAL SECTIOn OF SOLUTIOn SHOP wInG
VIEw FROM THE CEnTRAL PATH OF SOLUTIOn SHOP wInGVIEW OF THE INTER-BRIDGES FROM THIRD LEVEL
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VIEw FROM THE SOUTHwEST CORnER nEAR CAnCER HOSPITAL
VIEW FROM THE LOBBY OF VALUE-ADDING WINGAXONOMETRIC SECTION OF SOLUTION SHOP WING And VALUE-AddInG PROCESS wInG
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GROUnd LEVEL PLAn
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SECOnd LEVEL PLAn
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SIXTH LEVEL PLAN
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Just as what Toyo Ito said in the article of The fragile state of things, “I think our task now is to rethink how we ‘assume’ design conditions, rather than reviewing the conditions, we need to start by questioning the way we relate to nature.” When it comes to healthcare, any writing regarding the paradigms can be a tricky task, particularly in an arena where the politics are unstable, the solutions are difficult, and the eco-nomics is dispiriting. In the healthcare field, changes have been occur-ring so fast for so long that what seem a dramatic change often appear in days to set new game rules. All of these changes signify the needs to regulate the designs of healthcare facilities to stay fluid and flexible and include paradigms for future use, paradigms that differ from the way we think our designs today.
Many of the changes that occurred in the past rose to the profound level of what we call paradigms as we discussed in the first part of ten ca-nonical hospitals. And for the same reason, this project has been led to produce this part to assume or anticipate paradigms that are essential to seeing ahead and getting beyond. In the wider social and technological landscape of which healthcare industry, a number of profound and inter-related paradigm changes which are active and governing the building design extensively should be observed: From Youth to Longevity; From Healing to Health; From Speciality to Universalness; From Responding to Preventing; From Categorization to Mutuality; From Congregation to Integration; From Management to Relationship; From Passive Receiver to Active Receiver; From Institutional to Residential; From Inpatient to Ambulatory Care; From Freestanding to Regional; From Urgent Care to Primary Care; From Nursing Center to Subacute Center.
Not just in terms of an era’s zeitgeist, but in terms of changing para-digms: models, patterns, tool-sets of assumptions about a field, profes-sion, or society that explain and guide our thinking and behavior, several needs influence or promise to impact hospital and healthcare design. The quality and the safety of healthcare facilities have always been the paramount of what design concerns, but these days heightened con-sideration is being taken to measuring the caliber of needs and to pro-mote the results. The landscape of all aspects of healthcare is chang-ing. Hospital and other healthcare facility design is now moving toward evidenced-based and green design to make hospitals more sustainable businesses as well as buildings, healthier places to visit. Following items consider the new design directions shaped by the changes in the needs of this time for healthcare.
FlexibilityAbove all, flexible. Because of its size, multimillion-dollar building pro-gram and complexity, healthcare design is needed for flexibility is further intensification by the technological nature of the healthcare industry. Not only should facilities adapt to changing patient populations and chang-ing patient needs, but they should also anticipate the physical demands new technologies would make. Hospitals and healthcare facilities make more strict demands on electrical/mechanical systems, thus, present harder challenges to achieving flexible design.
The traditional “racetrack” corridor pattern does have a certain flexibility, in that it can often be added to and modified with some purposes. How-ever, it is an often inefficient and uncomfortable layout. As the decedent, circular plan alternatives to the racetrack recognized in popularity in the 1970s and were often welcomed by providing nursing service, who shortened distance and could more effectively attend to patients’ needs. In real use, the circular plan is less flexible than even the racetrack plan, due to the requirement of double nursing stations and staffing needs.
Beyond this obtaining in productivity and efficiency, flexibility is not only important for patient well-being but also crucial to any industry operating in a competitive market. To offer a great flexibility, in the design proposal of this project, the various modules that can be configured and reconfig-ured as needed allows a potential flexibility. But still, the solution to keep both functionality and dynamics is under exploration.
ExpandabilityExpandability consideration should begin at the planning stage, howev-er it usually does not end at that point, nor even after construction phase is complete. In a global vision, most healthcare facilities are built based on a certain masterplan, but by essence, hospitals are always engaged in a dynamic change, a process that is part of what medical conditions may ask for. The strategy which is the most relevant to ensuring the
ongoing expandability of the design is the participation of the users. For example, in the practical scenario of this project, the cardiovascular hos-pital is merely a step in the expansion of the whole system. We may say “growth”, since in an environment as dynamic as that of the hospital or healthcare facilities, the constructing is never really complete. In today’s healthcare environment, a completed project is, truly, an expandable project designed for, and considered for, the expansion of the whole system. In sum, a project in which the expanding possibility built-in rep-resents the greatest chance of enduring.
Vertical IntegrationAssociated with the flexibility, vertical integration (redesign and rethink-ing the traditional departmental zoning of the hospital) is primarily to maximize caregiver contact with patients and to promote continuity of different kinds of services for each patient from admission to discharge. Like the experiment which is initiated in the design proposal of this proj-ect, in vertically integrated hospitals, the multiplicity of departments is reduced to only a few integrated areas of services/responsibility, like supporting, services for fee, and services for outcome (patient care).
What is outlined down there suggests some design implications of verti-cal integration for programs grouping and indicates how facilities, equip-ment, and staff may be effectively shared across what once were the isolated of traditional departments: Supporting (entry area, registration processes, medical records, office, information services, administration, staff lounge, human resources); Services for Fee (pharmacy, laboratory, support center, materials management, education, diagnostic services); Services for Outcome (emergency services and combined ICU/CCU, recovery, obstetrics, surgery, physical therapy, inpatient medical, physi-cians’ offices).
At the beginning of this project, it has been mentioned that it was an devastating earthquake that made me decide to establish architecture as my life’s career. One lesson that I learned from that tragedy is that when all the people find themselves faced with a great threat that may take their lives, the appeal about making buildings from everyone is relevantly unitary —to make something, or anything, to protect lives in tranquility. For me, this concept drives all the decisions as an architec-tural designer, especially in the designing of public buildings—and it has driven me to research into healthcare field in this book.
To protect the health of humanity and civilization in tranquility is the mis-sion of both the physicians and architects. It is in reality that both of those professions are facing the changes in how to shape the future by design of the whole thing. Throughout this project, it have strived to balance on the delineating future and a practical design proposal for those ideas concerning with hospitals and healthcare facilities which are currently building or currently planning. In this final page, it will take an extended view and attempt to profile the trends and developments likely to shape healthcare and, therefore, the practice of healthcare architec-ture. The discussion naturally boils down to three broad areas: (1) pos-sibilities of trends of medical technology, (2) how architecture practice will facilitate the healthcare developments, (3) further thoughts from the design proposal in H21.
Through the reading for this project, it is noticed that numerous histo-rians who study medical history regard all the healthcare prior to the 1930s as the Dark Ages. Until the emergency of antibiotic drugs, doctors could really seize a little chance to win the combat against diseases. Although the counterattack of HIV, Ebola, Marburg virus, Lassa fever, Legionnaire’s disease, hantavirus, hepatitis C, anthrax, West Nile virus place a great pressure on the defense line, new technology and new dis-coveries at least are advancing. Two megatrends will continue to shape the future of medicine: biology medicine now addresses the causes of disease, and noninvasive treatments and minimally invasive procedures will continue to extensively replace surgery. They are happening in the form of Genomics, Nanotechnology, Pharmacology, Treatment Mo-dalities, Robotic Surgery, Decentralized Care and Self-Care, A Caveat. These trends of technology has freed healthcare from the bed-centered hospital and they may embody certain extensions into future. In this project, based on the bifurcation of the solution shop and value-adding process, those implications above are represented in some programs like precision medicine hub and CDSS center.
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FURTHER THOUGHTS FROM THE H21. SKETCHED BY THE AUTHOR.
As a vision cast into the future, the cardiovascular hospital ought to be perceived as the total solution machine for cardiovascular diseases. On north side of the site located the solution shop wing, this building is to provide all the components concerning diagnosis. In this wing, the structure is designed for advanced information storage and processing. For the other part, the value-adding process wing is designed for achieving the checking-in and treatment in seconds. Upon entering the registration area, patients can check-in based on their own digital record. Clinics and ORs are built for maximum flexibility. Patient rooms occupy the prime orientation of the building for daylighting. The back part houses shafts for the transport of supplies. Mechani-cal, electrical, plumbing lines, and staff circulation are structured at the concentrated cores for convenience. The zoning in both vertically and horizontally embodies the needs for the new era of medical practice.
Designers of future healthcare facilities will probably be quested to cre-ate a total healthcare solutions for the whole community, especially as a larger percentage of the elder population. Such facilities as solution machines for communities may become as pervasive in this century as the sprawling of planned suburban communities was in post-World War II period. The key concept in this process is flexibility. The concept of flexibility extends beyond what the architect designs to provide a range of services, or a template. This change may make architects be active during the entire lifespan of the facility. In this sense, architects will serve as caregivers, practitioners of medicine, and members of the patient-care team. But there is more profound dimensions of this new role. The future of healthcare architecture are being driven by three traditional antagonists: technology, economics and humanity. They may lead all things to paradox. But there is always a belief that is instilled in this whole project, that the heart of the future of hospital and healthcare facil-ity design will remain as simple as before. Just as what we went through in the ten canonical hospitals in Greek, India, medieval Europe, after the technology has run through a long and meandering path, the healthcare may back to the very concept similar to those temples.
The hope of this book, especially with its emphasis on chronological cases, current situations, business models, a practical design propos-al, and observations of trends and changing needs is to demonstrate that these aspects can not be exclusive in our study. Instead, the basic principles of good healthcare design are synonymous, thus, to use the ideas of the origin, the future, the solution for now as a basis for design in our projects-from benchmark placement to the interior elements-will lead the process forward. In sum, whatever directions or paradigms the healthcare facilities design of the future may take, it will include an ulti-mate hope of what we have been long preserving—we are capable to make it better of the environment around us. By that meaning, H21 has been a gripping experience to visualize the assumptions.
REFERENCES:AIA Academy of Architecture for Health, and Facilities Guidelines Institute. 2006. Guidelines for design and construction of health care facilities. Washington, DC: American Institute of Ar-chitects.
Bowers, Barbara S. 2007. The medieval hospital and medical practice. Aldershot, England: Ashgate.
Christensen, Clayton M., Jerome H. Grossman, and Jason Hwang. 2009. The innovator’s pre-scription: a disruptive solution for health care. New York: McGraw-Hill.
Goldin, Grace. 1994. Work of Mercy: A Picture History of Hospitals. Boston Mills Press.
Guenther, Robin, and Gail Vittori. 2008. Sustainable healthcare architecture. Hoboken, N.J.: John Wiley & Sons.
Miller, Richard L., Earl S. Swensson, and J. Todd Robinson. 2012. Hospital and healthcare facil-ity design. New York: W.W Norton & Co.
Nickl-Weller, Christine, and Hans Nickl. 2013. Hospital architecture. [Salenstein, Switzerland]: Braun.
Thompson, John D., and Grace Goldin. 1975. The hospital: a social and architectural history. New Haven: Yale University Press.
Winkel, Steven R., David S. Collins, and Steven P. Juroszek. 2007. Building codes illustrated for healthcare facilities: a guide to understanding the 2006 International building code for healthcare facilities. Hoboken, N.J.: Wiley.
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Duo Feng
Master of ArchitectureUniversity of Florida, Gainesville, Florida, USA
Address: 1331A SW 13TH ST, APT 1116-B, Gainesville FL 32608E-mail: [email protected]: (+1)352-665-1117, (+86)29-3333-0818
Thanks for Reviewing.