May 01, 2017 Last Updated 10:20 AM, Apr 28, 2017

A blueprint for the future of healthcare

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As our hospitals face the increasing pressures associated with new epidemics and stretched resources, it becomes ever clearer that building design is a core consideration for our hospitals. Steven Bentley, Director, Ramboll UK explains more.

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Delivering environments that can respond to change, build efficiency, and improve patient well-being are all goals which Ramboll UK have been exploring through their work on a pioneering new £400m hospital project in the region North of Copenhagen, Denmark. The new £400m Northzealand Hospital will be the result of consolidation between three existing hospitals in the region north of Copenhagen, and is part of Denmark’s wider healthcare consolidation programme that includes the redevelopment of nine hospitals in total. A key component outlined in their design brief was the need for “creativity and innovation”, directing architects and engineers to “build for the future” and consider how our healthcare needs may be orientated in 50 years’ time.

Following a 12-month international design competition, the Architectural consortium of Herzog & de Meuron/Vilhelm Lauritzen Arkitekter were awarded the contract to design, while Ramboll were named as project management consultants and providers of engineering services. Marked for completion in 2020, the final design for New Hospital Northzealand will span over 128,000m², serve over 310,000 people and hold nearly 700 beds.

With one of the main cruxes to its design a need to ‘plan for uncertainty’ and ‘design for change’, the hospital has been planned with enough flexibility to accommodate technology yet to be invented and handle epidemics yet to be unleashed. In addition, as requested by the hospital board, the design has been completely led by best practice in patient care – seeking the best possible treatment, recovery and rehabilitation. This has led to innovative new design forms that look to change the way we consider the hospital space, and how important this can be in protecting the future of our healthcare systems.

Incorporating nature

In order to fulfil as much as possible this focus on ‘best practice’ patient care, the designers drew on studies that explored the role of environment in improving recovery time. This included a report by Dr. Robert Ulrich, a Professor of Architecture at the Center for Healthcare Building Research at Chalmers University of Technology in Sweden, which revealed patients recover significantly faster in single bed wards. It also uncovered evidence that bringing patients closer to nature improves their sense of well-being and thus speeds up recovery. In an inverted population pyramid, as faced by many European nations with rapidly ageing populations, there will be even fewer resources available as generation’s progress, so single bed wards provide a key opportunity for patient care to actually be provided by immediate family member visitors.

In response to such studies the hospital has been envisioned as a pavilion set within the surrounding forest, and the design brings together all the hospital’s necessary functions within one clover-shaped structure. The low-rise building reaches out horizontally into the landscape, surrounded by trees and native plantation, in a “soft, flowing form”. The green-field site offers an optimal physical setting, which as a natural and calming space is intended to work with the structural design to produce a space that encourages health and well-being.

Unlike many traditional hospitals the inviting and welcoming facility will maintain a human scale throughout, reaching only four floors at its highest point, gathering all functions of a hospital in one organic building, shaped like a clover leaf. As well as the wider environment, an expansive and secure roof garden set above the main diagnosis and treatment floors will ensure all patients can directly benefit as much as possible. The focus on a low building is intended to foster better exchange between staff and patients, improving communication and well-being within a building that is sustainable, safe and welcoming.

Inside, there is also an intentional creation of ‘on stage’ and ‘off stage zones’, so as to separate patients from the functional aspects of the hospital that may create any worry or discomfort. In terms of material, the bed wards will be constructed from simple prefabricated modules made from either metal or wood, as a means of both reducing on-site waste and embracing modern methods of construction that offer a clean and calming environment.

The future of medical treatment

The recent Ebola outbreak also serves to highlight the importance of hospital design being flexible enough to accommodate and contain disease as effectively as possible. With this in mind the bottom two storeys of the building, which are focused on diagnosis and treatment facilities as part of the functionality split, have been made fully flexible in order to accommodate any changes to disease prevention that might take place between now and 2020. For example, this would allow for either a layout focused on total isolation of immuno-suppressed patients, or an open plan treatment area allowing for integration of care across all departments.

Demountable walls and regular span floor plates accommodate for these changes in usage and function, and simultaneously also ensure that construction processes are as straightforward as possible. Off-site prefabrication of the upper storey ward blocks will reduce waste, ensure uniform quality, allow beta-testing of new innovation, and allow a large proportion of the hospital to be constructed in a safe and weather protected environment.

There will also be a focus on automated logistics at the hospital, with the introduction of self-driving automatic goods vehicles (AGVs) to distribute goods, food, and waste from a purpose designed service village. A separated lower-level service floor will allow the AGVs to distribute to localised vertical distribution cores across the hospital, with goods arriving and departing close to their use, before a human focus on the “last 30m of travel” to reach patients.

Electronically tagged beds will even be automatically delivered to a central bed-washing facility after each patient use – with technological assistance becoming ever more adopted in the operational aspects of the hospital as a means of reducing staff pressures.

A blueprint for the world?

In what is undoubtedly a pioneering health scheme, the New Hospital Northzealand focuses on exploring the key roles that intelligent design and a positive environment can have within healthcare provision, and in seeking sustainable design solutions for the public sector. It raises serious questions about how the UK approaches upgrading its hospitals and whether, as the Danes have done, in order to become more efficient in the future we must increase our investment today. Architects and engineers are becoming ever more central in determining the future of responsive healthcare, and New Hospital Northzealand Hospital has the potential to act as a blueprint for how this relationship is determined.

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