Healthcare design – Green Sky Thinking

What will the hospitals of the future look like? The audience for a recent Green Sky Thinking event got an insight from four specialists with different perspectives on designing for healthcare.

Maggie's Manchester Exterior. Credit: Nigel Young Foster + Partners

Maggie’s Manchester Exterior. Credit: Nigel Young Foster + Partners

Laura Lee, CEO of Maggie’s Centres (dedicated to helping people with cancer) opened by explaining why the design of the centres is so important. “People with cancer can feel they’ve lost control of their life. We try to give them that back. We try to take away the feeling of being ‘processed’ – that’s why there’s no reception desk for example.”

Design features strongly on the Maggie’s website: ‘Warm and welcoming and full of light and open space, our unique Centres are designed by leading architects to be uplifting places for people with cancer and their families and friends. Great architecture is vital to the care Maggie’s offers; and to achieve that, we work with great architects, whose expertise and experience is fundamental to the success of our Centres. Each architect offers a unique interpretation of the same brief, based on the needs of a person living with cancer, to create the calm environments so important to the people who visit and work in our Centres.’

Maggie's Manchester interior. Credit: Nigel Young Foster + Partners

Maggie’s Manchester interior. Credit: Nigel Young Foster + Partners

The design of the Centres perhaps runs counter to conventional thinking on what cancer patients might want. They are very open but Lee said, “Privacy doesn’t necessarily mean enclosure.” The support of other people in a similar situation is an important part of the Maggie’s approach and the design, including domestic elements, promotes this interaction and makes people feel at home.

Rather than soothing pictures, the Centres often feature more challenging and distracting artwork. “We don’t want people to lose the joy of living in the fear of dying,” commented Lee.

Healthcare planner Lucy Kalogerides identified three trends in healthcare projects: innovation, meaningful engagement and flexibility. She highlighted that innovation does not necessarily mean “new” as ideas can come from other sectors such as hospitality.

Foster + Partners, hosts for the evening, do not claim to be healthcare specialists but they are clearly learning fast. Head of studio Nigel Dancey described their first project, University of Iowa Stead Family Children’s Hospital; a new hospital for the University of Pennsylvania in Philadelphia and the Aswan Heart Centre in Egypt.

The Stead Family Children’s Hospital is designed as a “healing environment to minimise stress, encourage hope, and provide comfort.”

Every patient has a large (average 360 sq ft) private room with a large window. All post-anesthesia care unit and preoperative/postoperative recovery rooms are also private. Rooms are uniform in size, shape, and layout. Standardising rooms provides a smooth transition for families that must stay frequently, says the hospital. Every patient room includes a family zone with a foldout sofa.

Rooms are same-handed in design, which gave the designers a few problems! However this does mean that beds never share a common wall, reducing noise transfer between rooms.

As the session’s chair, the AJ’s sustainability editor Hattie Hartman, commented, all-private room hospitals divide opinion. Are the benefits of privacy offset by issues of supervision and possible isolation?

At the University of Pennsylvania construction is underway on a new hospital providing 500 private patient rooms and 47 operating rooms in a 1.5m sq ft, 16-storey facility. The new hospital will be the largest capital project in Penn’s history and Philadelphia’s most sophisticated and ambitious healthcare project.

The design and planning process for the Pavilion has been orchestrated by PennFirst, an Integrated Project Delivery (IPD) team comprising healthcare design firm HDR, Foster + Partners, consulting engineers BR+A, as well as construction management firm L.F. Driscoll and infrastructure group Balfour Beatty.

As Nigel Dancey explained, the IPD approach means 120 people working together. Staff from each group, as well as Penn Medicine clinical, facilities, and patient experience experts, work collaboratively in a specially designed “integration space” to ensure cohesion and strategic planning and reduce waste at each step of the project.

The Pavilion will house inpatient care for cancer, heart and vascular medicine and surgery, neurology and neurosurgery, as well as a new emergency department.

The design is flexible to adapt to the rapidly evolving healthcare field. Foster + Partners say: “Special care was taken in the development of the urban realm, creating pedestrianised routes and landscaped gardens and plazas to enhance the public experience.”

“From the moment of arrival, the patient experience is reframed by breaking down the scale of the hospital into smaller neighborhoods which provide a sense of community. The hospital is designed for health and wellbeing providing daylight and landscape views to patients and visitors and the ability to personalise each room.”

The team used extensive, full-scale mock-ups to test the design. Nothing can probably substitute for a physical representation but I wonder if VR and AR could help to bring designs to life for the people who will use them?

The final project presented was the most stunning – the new Aswan Heart Centre to be built on the banks of the Nile. It will include living and lab space plus rooftop gardens. From the visuals we were shown (sadly not available) it will look like a cross between the Eden Project and a colony for a new planet.

As environmental designer with Foster + Partners Anis Abou Zaki pointed out, healthcare buildings tend to have large environmental footprints – they are carbon, energy and water intensive. Buildings are generally sealed, full of energy using equipment, and generate toxic and contaminated waste.

The Heart Centre is planned to be carbon neutral, powered by a new solar farm as part of the project.

The future of healthcare was a major issue during the UK election campaign. As I sat listening to these accounts of applied expertise and innovation I couldn’t help wonder if our NHS will benefit from the same investment and attention to detail. Is it all about money or are there wider lessons here?