Home > 2014

Next Generation Hospital Bratislava Slovakia

For a long time the capital of Slovakia has been looking forward to getting a new hospital facility. To have a broad and diverse choice of the design of the new hospital, Penta investments set out an international competition for the definition and design of the 70,000 m² building.
The strategically located site, which is situated next to the highway from Bratislava to the North, offered the opportunity to make the hospital very visible. This site also had tight planning restraints, especially regarding the limited building height. But the most challenging aspect in this case was to design a healing environment between a noisy highway on the one side and a busy shopping mall on the other side.

The solution Dutch Hospital Design choose to deal with this was to make a sound barrier which was made by the building itself. By stretching three relatively narrow building blocks into elongated volumes parallel to each other a quiet inner court was created. Narrow building blocks where natural daylight can penetrate deeply into the building are essential for creating the necessary flexibility. Essential connections were made by adding transparent cross volumes at two locations. Those cross streets at the same time protect the inner courts against a sometimes unpleasant Southerly wind.

Using the slope on the site two ground levels were created: a lower ground level and an upper ground level. This solution helps to provide penetration of natural daylight where necessary. It also offers a solution for the logistics, where the entrances are easy to find. The slope is also used to make double use of the surface area for parking while the keeping the costs low and the orientation is still easy.
Architecturally the building can be seen as an icon on the way to or from Bratislava. The hospital design has a smart façade with an eye-catching feature using the bi gesture of dancing ribbons which adds a double layer in the façade. The simple curtain wall behind allows for freedom in the internal layouts on a fine design grid. The atmosphere inside the building is determined by a natural look and feel achieved by materials such as wood, natural stone and warm colours. In the beating heart of the building there is a strong connection between the different floors which is achieved by offering clear views of the stairs connecting each available floor, but also by offering views between the main connecting corridor and the inner courtyards.

Penny wise pound foolish?

Developing a new healthcare facility is not an occasion that arises frequently for most people. If you get this extraordinary challenge you will want to build the best possible facility.
But what is the best? ‘The best’ involves issues such as usability, safety, finance, flexibility, efficiency, sustainability, patient friendliness and so on or probably the perfect balance between all of these aspects. With regard to healthcare facilities the Dutch are famous for their ability to create high-end facilities that are efficient, well-functioning, comfortable to stay in and built within one of the lowest budgets of the Western European countries. This requires an elaborate design based on a thorough analysis of what building is really required in each particular development. As an example it is astonishing what the influence of information technology has had on providing healthcare. Extending this development to the future it will be even more amazing to see how this will influence healthcare organizations. The results it will have a great effect on healthcare facilities.

Designing healthcare facilities requires one to have a vision of conceivable scenarios in the future. The design should also prove to be able to adapt to such eventual developments. In the current rapidly changing society predicting the future of healthcare might be the hardest thing to do. Incorporating flexibility at all levels of detail in your healthcare facility can thus be seen as a must. If this issue has been left out in the design financers who are endeavouring to reduce their risks will certainly let you know.

design costs related to exploitation costs
It is generally known that the cost of real estate in healthcare consumes a minor 7-8% of the total exploitation cost of a healthcare organization. A vast portion of this sum goes towards the doctors and staff and another large amount of money is spent on the use of medical equipment. The building is just facilitating the processes in the organization which also means at the same time that if it does not suite the processes it will inhibit its efficiency. If this hindrance results in, for example, one extra member of the staff (yearly costs of around € 50,000) it justifies an extra investment in the construction costs of €0.5 mln. Economically thinking it is therefore so important to produce a well-thought out brief and design a ultimate flexible building to ensure that it will sustain being a custom-made suit for your organization.
It is therefore interesting to contemplate how healthcare projects are being managed. Generally spoken the focus lies firstly on minimizing the initial costs of the project. Included in this are the design fees. During the development phase of a project the management focuses on restraining the construction costs, one of the targets of the project . It rarely happens that in the in the early stages of a project these construction costs are considered as “just” potential exploitation costs and what the effect of brief and design decisions will have in the long term.
A little exercise on which amount of the yearly costs can really be allocated to the costs of defining the brief and designing the whole facility shows that this is just an almost negligible 0.33%. Even doubling the efforts in achieving a smart building will easily be saved during the period of use of the facility.

Dutch Hospital Design offers you expertise in smart healthcare facilities which are based on a smooth, IT-supported process and ready for all kind of future changes. Call for further information: info@dutchhospitaldesign.com or call to Arnold Burger +316 557 10 150.

How to respond to the future of healthcare

This is the subject of the presentation by Architect Arnold Burger at the international congress of the IMAGINE Institute in Paris on the 4th of November 2014.
The subject of the seminar is: ‘ Hospital and territory, the hospital of the future ‘
More than 200 people are expected to attend the Congress with approximately 20 speakers, including architects, politicians, hospital managers, etc, who will be presenting their views on this subject.
The conference will take place at the IMAGINE Institute located on the campus of the Necker Enfants Malades Hospital in Paris. For more information on this institute please follow this link.

Netherlands scores high in European Health Consumer Index

“The Netherlands is the only country which has consistently been among the top three in the total ranking of any European Index the Health Consumer Powerhouse has published since 2005.”

This text was taken from “Euro Health Consumer Index 2013 report” by Health Consumer Powerhouse, a company “based in Sweden which “monitors and compares healthcare systems among 35 countries, including all EU member states as well as Canada.”

The complete report can be downloaded here.
The website of the Health Consumer Powerhouse can be found here.

 

Prevent a hospital being a hit-and-miss Chinese museum

A hospital that works

A Dutch newspaper recently reported that large museums are emerging all over China, but without art collections or exhibitions of any significance. Dutch expertise from the renown museums like the Rijksmuseum is flown in by the Chinese to let museums become more than a status project where ‘size matters’. For hospitals a similar situation exists. But where a museum without art is basically a waste of money, a hospital that does not function is much worse.

In many countries where the economy has grown over the past decade, the health care facilities have not improved at the same speed as their infrastructure, offices, shops or hotels. In many Eastern European countries, but also in Asia, the Middle East or Latin American countries governments or investors have discovered healthcare. Often the idea is that building a new hospital, healthcare as a whole will reach a higher standard. Although a new building will certainly be a boost for the quality of healthcare, the building alone will not do it. A hospital that actually works is what we need. The knowledge and lessons learned in the development of Dutch hospitals will be useful for this.

Also in the Netherlands new hospital building have not always led to a hospital that works well. Sometimes a hospital is a status project, resulting in a hospital that is, at its best, a nice piece of architecture, but that is too large and expensive. More often a new hospital is the outcome of a negotiation process with medical specialists on space, which also leads to extremely large buildings with poor logistics. Even worse, the first thing that needs to be done after moving into the building, is rebuild it. Exploitation costs often rise, where one would expect more efficiency. Several Dutch hospitals experienced large financial problems over the past years after having moved to their new home.

Despite the economic crisis, and the ever increasing need to make wise financial decisions, hospitals struggle to do so. Designing the building is often about bricks and installations, without considering how the hospital organization is supposed to work in it. Often logistics principles like Just in Time are abused to limit the space, resulting in trolleys with materials, equipment and beds blocking hallways or even worse, they don’t arrive at the right time and place at all. Another, almost classical example is that no space for paper archives is foreseen, assuming that everyone is working paperless, when at the same time ICT is no part of the project or is implemented after the building was finished.
But by planning healthcare processes better, there is lots of space to save. However a more efficient hospital is often perceived by doctors as ‘taking away their rooms’, leading to endless negotiations or discussions between managers and doctors. The result: too much space in the wrong places.

Furthermore when designing a hospital one still tends to use old hospital building standards set by a government agency, that until 10 years ago financed hospital buildings. Nowadays hospitals have to finance their buildings like any other company needs to and these do not suffice anymore. Considering that ICT developments have gone fast over the past decade, there is so much more possible, with less or different kind of space.

Nowadays hospital can be run like a business using scarce capacities in an efficient way, supported by ICT. Preventing large queues of waiting patients, no more nurses walking for miles and the facilitation of multidisciplinary collaboration between doctors, needed to face the medical challenges of the future; all that is not possible in a building that is based on standards from before the year 2010.
Designing hospitals is about (re)designing logistics processes in the first place, based on the primary processes of the future. Ideally you would go ‘back to the future’ and see what working in a hospital is about in 2050. But 5 years looking forward, is hard enough. Future scenarios that describe the challenges for your hospital, forces architects and engineers to come up with an adaptable building. What if healthcare shifts to home care, what if doctors do their outpatient visits via Skype, what if the governments cuts budgets furthermore? Start answering these questions before drawing a building.

In the Netherlands this way of designing is upcoming. There are enough logistics engineers, management consultants and operations research experts that more and more work together on building projects with architects and construction engineers. This has resulted in more future proof buildings, an important aspect of sustainability. Now let’s see if, besides museum expertise, Dutch Design will find its way in the rest of the healthcare world.

Annelies van der Ham, Healthcare innovation consultant

Dutch Hospital Design designs a new Hospital for Michalovce

Dutch Hospital Design recently took part in a design competion for a new hospital in Michalovce, a town in Eastern Slovakia. The competition arose from Svet Zdravia’s (client) ambition to achieve similar high healthcare standards to Western Europe and to consolidate various healthcare facilities in the region into one complex in Michalovce. The project involves a minimal renovation of the existing hospital of about 9,000m² and the addition of a new building of around 13,000m².
A core challenge here was how to strategically go about the placing the buildings and functions on the site bearing in mind that the existing buildings would be demolished in the near future and further extensions and alterations should remain possible..
Dutch Hospital Design’s solution consisted of connecting 3 uniform building blocks which have links to the existing buildings. The new building has been laid out in such a way that it can function independently and offers space for future new additions. The uniform blocks have a flexible layout and allow for various functions and layouts for future renovations. The main infrastructure in all cases will remain unchanged.
The architectural treatment reflects this layout making the building legible for a visitor. The gap between 2 blocks has been widened making a clear entrance. The blocks consist of white plastered facades which are connected by transparent glazed passages allowing views to the surroundings and for daylight penetration. The internal facades and the facades where people come close to have a warm timber cladding. Whilst this architecture has a modern appearance it does however blend into the local architecture and thus by the local construction methods. In this way the risks and the building costs remain manageable and affordable.

IBA selected to install UMCG Proton Therapy system

IBA (Ion Beam Applications SA) Belgium, the world’s leading provider of proton therapy solutions for the treatment of cancer, has been selected to install the Proton Therapy system at the Universitair Medisch Centrum Groningen (UMCG) The Netherlands.

Wassenaar Engineering will be responsible for the structural design of the new proton therapy facility.

Link to offical IBA press release

Elisa Carter: “Wanica Health Centre – the pride for every Surinamese”

On a sunny, almost-like Surinam Friday afternoon, somewhere in the middle of the Netherlands Elisa Carter looks back with enthusiasm at the period in which the design for the Wanica Health Center was realized. “I was asked by the Surinamese government to reactivate a stalled project in a short time. I therefore needed a party which was able to translate ‘the Surinamese model’ into a building.” Elisa Carter, who has worked with architects before since 1984 and has performed governance tasks in several Dutch hospitals including Rotterdam’s Erasmus Medical Center, challenged us to come up with an innovative plan.
Despite the tight time constraints we did not immediately start with sketching, but we instead began with just asking a series of questions first. “I really doubt if they are excited about their job”, Elisa Carter wondered, but afterwards she very much appreciated this approach of the challenge by asking many questions first. “That was very professional, these questions were very necessary and stimulated me to find out what we really wanted.”
During some workshops held in Paramaribo with those who were directly involved in the project, the real meaning of the Surinamese model was “discovered”. “You have the important skills of good listening and with your knowledge and experience you also have a great ability to translate our desires into a design”.
During the presentation held after a few weeks, everyone seemed to be very excited. “You have done a ground-breaking task and it is formally approved by the entire government and the Advisory Board of the President. I really don’t let myself become convinced quite easily (when it comes to my profession), but this was a combination of everything: modern, innovative, sustainable, a community-like setting and good logistics. On top of that, I generally do not like something modern, but as soon I am convinced I will keep my mouth shut and that is what happened.
The design represented the sky high ambition to become the best hospital in the Caricom region: the pride for every Surinamese “.

Read more about the Wanica Health Centre