Parametric Prototype: Large Healthcare

PARAMETRIC PROTOTYPE: LARGE HEALTHCARE Dan Williamson

Vertical Studio Design Research Spring 2012 prof: Steve Hardy

TYPOLOGY 06 : LARGE HEALTHCARE

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ABSTRACT A hospital is a complex, systems of systems, building type. They are composed of a dense aggregation of parameters that contain and heal people, equipment, and supplies. There is no specific articulation of these parameters that can succinctly define the multitude of types, principals, and strategies found in the complicated realm of healthcare. This chapter investigates and explains the essential ideas and strategies of how building organization, spatial relationships, circulation, and site interface are typically arranged within large urban and suburban healthcare facilities.

Discoveries and information presented is the result of a critical analysis of a wide range of purposed and constructed ideas, methods, and precedents. The analyzed principals support the underlying design decision information necessary to understand the fundamental characteristics

employed in a large healthcare project. For the purposes of this chapter and this book, large healthcare will consider facilities of 100,000 square feet and larger or facilities contain more than 100 patient beds. This distinction allows the designer to understand the various differences in parameters between small often rural healthcare and large often urban healthcare facilities. Ultimately the expression of these parameters is influenced and shaped by local, regional and national situations.

The internal organization of this chapter is as follows: A brief introduction to the general mass and flow relationships [relationships]; a closer analysis of four massing strategies and their internal patient ward layout[type analysis]; an analysis of pragmatic structural, systems, site, expansion and code requirements [pragmatics]; and concluded with a presentation of six successful designed contemporary precedents [precedent].

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TYPICAL MASSINGS | VERTICAL VS. HORIZONTAL

Typology: Large Healthcare

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PRECEDENT MASSING ARRANGEMENTS

VERTICAL BAR

SUZHOU CHILDREN’S HOSPITAL Suzhou, China 1,204,187 SF

A vertical bar massing locates the patient rooms in a vertically extruded strip allowing for greater distant views. The vertical bar can be situated in narrow sites and is typically combined with a larger podium base that houses service and clinical spaces.

COURTYARD (compact)

LOS ARCOS DEL MAR MENOR HOSPITAL Murcia, Spain 660,387 SF

The courtyard type is a common massing strategy employed when the extents of the site allow the horizontal plane to be utilized to allow maximum daylight within the building.

PODIUM (SIMPLE)

EVELINA CHILDREN’S HOSPITAL London, United Kingdom 232,400 SF

Podium facilities are most commonly seen as they offer a larger base to locate clinical services and services spaces with close proximity without the need for drastic vertical circulation. The nursing sector is then vertically situated to provide patient rooms with best exterior views possible.

NUCLEUS

SURREY MEMORIAL HOSPITAL Surrey, British Columbia, Canada 160,00 SF

Nucleus medical facilities are beneficial in the realm of horizontal expansion. Their typically modular wing design allows them to propagate around a central service core and clinical core.

PODIUM (COMPLEX)

LEGACY SALMON CREEK HOSPITAL Vancouver, Washington, USA 469,000 SF

A complex podium design relates to the basic structure and organization of the simple podium, however, with a varied vertical massing the potential for courtyards and roof garden options become viable within the design solutions.

SPINE & PAVILION

WASHINGTON STATE VETERAN’S CENTER Retsil, Washington, USA 160,000 SF

The Spine and Pavilion design situates centrally a service and clinical massing with multiple, generally identical, nursing wards that spur off the central backbone.

Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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GENERAL RELATIONSHIPS | FLOW DIAGRAM

Relationships and adjacencies within healthcare facilities are often a starting point in understanding the layout and organization necessary to provide a clear and navigable design that is both efficient and meaningful.

A key distinction between the various flows that connect these programs within the facility are equally as important. Ideally, proposed designs employ efficient travel routes for nurses, patients, doctors, and visitors while allowing a clear separation between “front of house” and “back of house” operations.

The diagram on the right depicts programmatic relationships and the typical user group connections and flows to each.

A clear understanding of what user group needs to have access to what space is crucial in the spatial organization and massing of the health facility.

Typology: Large Healthcare

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ICON LIBRARY

Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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RELATIONSHIPS | INDIVIDUAL PROGRAM MASSING

Typology: Large Healthcare

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Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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TYPE ANALYSIS 01 | VERTICAL BAR

Typology: Large Healthcare

hidden line massing

cut floor -->

horizontal circulation

vertical circulation

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Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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TYPE ANALYSIS 02 | PODIUM & VERTICAL SPINE

Typology: Large Healthcare

hidden line massing

cut floor -->

horizontal circulation

vertical circulation

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Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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TYPE ANALYSIS 03 | PODIUM COMPLEX

Typology: Large Healthcare

hidden line massing

cut floor -->

horizontal circulation

vertical circulation

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Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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TYPE ANALYSIS 04 | SPINE & NUCLEUS

Typology: Large Healthcare

hidden line massing

cut floor -->

horizontal circulation

vertical circulation

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Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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PRAGMATIC ANALYSIS | STRUCTURAL DESIGN “Hospitals and healthcare facility design must be sensitive to and responsive to the marketplace.”

Planning, developing, and execution of healthcare design anticipates three key parameters: flexibility, expansion, economics. In terms of flexibility a healthcare facility needs the ability to adapt to change on a multitude of scales and at various times in the course of a facilities life. A result of this need for flexibility is the development of the “interstitial space.” These are smaller, generally 6 to 8 feet clear, services floors stitched between primary floors that allow a plethora of HVAC systems, electrical, and data components to weave their way to various destinations as they need.

With this larger space designated for the services of the hospital, the ability to introduce change, perform maintenance, retrofit, and upgrade is a much easier task.

Ceiling Height: 8’-6” - 9’-6” Typical

this dimension is relates to the amount of light desired from the exterior, the program of the space, and other adjacencies.

Ex. surgery spaces have a much larger ceiling height to account for operable ceiling lights, adjacent elevated physician viewing spaces, and other bulky equipment.

Interstitial Floor: 6’-8’ Typical

based on the predicted amount of change to occur, program adjacencies, and size of service components utilizing this space.

Floor to Floor: 14’ Typical

this dimension is defined by the desired ceiling height and the space necessary to allocate for the interstitial service floor.`

Typology: Large Healthcare

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Economics is a crucial factor and generally holds the most power to drastically change the course of a project. Financial constraints can often cut square footages of a project, eliminate spaces, alter finishes and materials, as well as change the structural design from concrete to steel or vice versa. With some degree of regularity, healthcare facilities are designed

to accommodate both a steel or concrete structure so that based on current market prices at the time of construction, the more cost effective solution will be selected and implemented. Commonly the implementation of either a wide-flanged steel beam and column system or a precast concrete plank and column system is the case due to the flexibility within

spatial relationships to transfer from one to the other pending the timely market decision. However, varied solutions become a possibility through the selection of non-typical systems which can directly influence the somewhat monotonous and generic spatial operations found in patient wards, corridors, and entrances.

< Structural Spans

most common in healthcare design is either a wide flange steel system or a precast plank system.

Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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GROWTH | EXPANSION ANALYSIS Expansion is a consideration that needs to be addressed early on in the conceptual thinking of a healthcare project. As populations increase, technology advances, and spatial requirements for equipment continue to grow, the designer must realize the facility as a organism that will evolve, adapt, and enlarge throughout its existence. There are generally two ways to facilitate this growth, either vertically or horizontally.

Horizontal Expansion

Vertical Expansion

Vertical expansion lends best to a more urban situation where the ability to leach out is improbable due to site limits, set-backs, or other external factors.

This type of growth can effectively be achieved through intentional planning prior to construction

Typology: Large Healthcare

with correctly sizing structural members. Often, only 2-3 floors are planned for vertical expansion to economically handle both the initial project and a later expansion project.

Horizontal expansion typically lends itself to more freedom in expansion techniques due to the nature that this type of growth is usually not pressured by site limits or set-backs. Commonly the initial design project will consider a modular wing that can be replicated and attached on the periphery at times of needed expansion. This strategy relates mainly to a nucleus type massing or an expanded courtyard type. Because horizontal expansion is able to happen with greater ease, both in terms of construction

and economics, a sometimes muddled facility is established due to a lack of foresight with initial design proposals resulting in helter-skelter agglomerations.

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VERTICAL SYSTEM RELATIONSHIPS

Internally health facilities are extremely complex. The vertical and horizontal circulation of not only users groups is crucial to understand, but also the circulation of supplies. Typically a clear route is established in both the vertical and horizontal directions to allow the clean transportation of medicine and other supplies to nursing wards, surgical wards, as well as the cafeteria program.

Commonly the trafficking of goods and supplies is handled in a back of house manner to keep any circulation conflicts as well as security conflicts to a minimum.

Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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DESIGNED SOLUTIONS | CONTEMPORARY PRECEDENTS HOSPITAL DE LA CONCEPTION MARSEILLE firm: SCAU

CLEVELAND CLINIC ABU DHABI firm: HDR

HOSPITAL SANT JOAN DE RUES BARCELONA firm: Mario Corea Arqutectura

Typology: Large Healthcare

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NEW MESTRE HOSPITAL VENICE, ITALY firm: Studio Alteri Spa

SANTA LUCIA UNIVERSITY GENERAL HOSPITAL MURCIA, SPAIN firm: CASA solo arquitectos

UNIVERSITY COLLEGE HOSPITAL LONDON firm: Llewelyn Davies Yeang

Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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REFERENCES: Cox, Anthony, Philip Groves, and Anthony Cox. Hospitals and Health-care Facilities: A Design and Development Guide.

London: Butterworth Architecture, 1990.

Print.

James, W. Paul., and William Tatton-Brown.

Hospitals: Design and Development.

London: Architectural, 1986. Print.

Monk, Tony. Hospital Builders. Chichester, West Sussex: Wiley-Academy, 2004.

Print.

Verderber, Stephen. Innovations in Hospital Architecture. New York: Routledge, 2010. Print.

Wheeler, E. Todd. Hospital Modernization and Expansion. New York: McGraw-Hill, 1971. Print.

Wagenaar, Cor. The Architecture of Hospitals.

Rotterdam: NAi, 2006. Print.

Typology: Large Healthcare

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PARAMETRIC PROTOTYPE: LARGE HEALTHCARE [Design investigation]

â&#x20AC;&#x153;Suburban healthcare facilities support increased automobile use, an isolation from community, and an ignorance to promote healthy and sustainable solutions within the built environment.â&#x20AC;?

Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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ARCHITECTONIC | CORRIDOR

Room | Corridor The single loaded corridor is useful for smaller wings and maximum day lighting allowed to penetrate into the wing itself. This corridor option is rare due to its inefficiencies to nurse travel distance.

Typology: Large Healthcare

Room | Corridor | Room The standard double loaded corridor is a common and quite efficient design solution. It has the benefit of reducing nurse travel distance to some extent more than the single loaded option. Structurally it generally requires two different beam spans to accommodate the corridor in the center. This option also requires a massing type with exterior views on two parallel faces for improved patient room experiences.

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Room | Corridor | Service This single loaded corridor is useful when only one facade is capable of an exterior view as service and nurse support space can take the facade with either no view or a lesser quality view.

Room | Corridor | Service | Corridor | Room This hybrid type corridor design is commonly called a racetrack type corridor and is very efficient in nurse travel distance to both meds and to patient rooms. A benefit of this design is the ability to clearly define front and back of house activities as well as provide the nursing unit with more space to function in. A downfall of this design is the amount of depth in the cross dimension compared to the single loaded corridor option which decreases the amount of daylight allowed to penetrate into the nursing space.

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ARCHITECTONIC | CORRIDOR SCRIPT Employed Parameters > corridor design room | corr room | corr | room room | corr | support room | corr | support | corr | room > room span 1 room 2 room 3 room > patient room width 15’-20’ > patient room depth 20’-30’ > corridor width 8’-12’ > service / support 20’-30’ > ceiling height 8’-10’ > floor to floor 14’-20’

Offset

through the use of filtering and offsetting the various dimensions and corridor designs are initially set up to be used for room divisions and structural member design.

Typology: Large Healthcare

029 Service Space

the graphical representation of the service space, when present in the routine, is lofted and applied a swatch color to visually denote the function of the space.

Structural System

the extrusion and visual representation of the structural system applicable to the corridor selection is illustrated through rectangular extrusions.

Patient Rooms

the graphical representation and room divisions is lofted and extruded to visually denote the layout of the patient rooms within the routine.

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ARCHITECTONIC | FACADE - BATHROOM RELATIONSHIP Separate & on Corridor When the bathrooms are located along the corridor, larger fenestrations become a possibility within the design proposal.

Separate & on Exterior Wall A smaller fenestration option is viable when the bathrooms are located along the exterior wall of the wing. However, this design option presents a clearer corridor to manipulate for services, decentralized nurse stations and single loaded corridors.

Typology: Large Healthcare

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Combined & in between Room When the bathrooms are located between the rooms there can be a more efficient interior design, while also allwoing for a relatively large amount of facade space for fenestrations.

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MORPHOLOGICAL | TYPE SELECTION

Typology: Large Healthcare

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MORPHOLOGICAL | LOGIC & PARAMETERS The logic behind the morphological manipulation routine developed and illustrated on the following pages is influenced by essentially four massing types (selected based on their frequency seen in precedent and ability to hybridize). A model set up to investigate primarily the patient ward of the health facility is of the premier interest of this morphological study. The architectonic model is infused into the exploration of the morphological model to more appropriately investigate the possible outcomes.

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MORPHOLOGICAL MANIPULATION | TOWER & SPINE Room | Corridor | Service | Corridor | Room

Typology: Large Healthcare

Room | Corridor | Room

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Room | Corridor | Service

Room | Corridor

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MORPHOLOGICAL MANIPULATION | COURTYARD

Typology: Large Healthcare

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MORPHOLOGICAL EXPANSION | LINE DEVELOPED

Typology: Large Healthcare

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Introduction | Relationships | Type Analysis | Pragmatics | Precedents | References

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MORPHOLOGICAL EXPANSION | ARC DEVELOPED

Typology: Large Healthcare

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MORPHOLOGICAL | SUPPORT & CLINICAL ZONE

as a separation Repetitive Partial Courtyard [arc] The partial courtyard offers the chance for facility specific social spaces outside or enclosed as well as formally acts as an opening potentially serving as an entrance or invitation to connect to a surrounding community.

Repetitive Bar [linear] The bar type offers simplicity in organization as well as ease of internal navigation. This type also offers more opportunities for exterior views for patient rooms.

Typology: Large Healthcare

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as an attachment

as a plinth

as a separation [alternate]

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POPULATION | HEALTHCARE FACILITIES STATISTICS

Typology: Large Healthcare

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DENVER 1,984,887 6 facilities 1601 beds

WICHITA 630,721 6 facilities 1474 beds

LINCOLN 300,157 4 facilities 908 beds

OMAHA 885,350 8 facilities 2037 beds

SIOUX FALLS 228,000 4 facilities 1109 beds

TWIN CITIES 3.317.308 16 facilities 3746 beds

DES MOINES 569,663 4 facilities 1382 beds

ST. LOUIS 2,812,896 11 facilities 4974 beds

KANSAS CITY 2,200,000 6 facilities 1612 beds

OKLAHOMA CITY 1,280,578 16 facilities 3085 beds

AUSTIN 1,716,291 18 facilities 2717 beds

“Hospitals relocate from older urban centers to newer suburban and exurban locations for many reasons, including the quest for proximity and access to a larger patient pool, to fill a niche caused by unchecked population growth and sprawl, and for greater profits. Suburban fringe sites are often the most attractive sites from the standpoint of institutional relocation and market expansion. In sprawl communities, a new hospital is a civic crown jewel, and its presence tends to fuel even more unchecked sprawl.”

Sprawl has thus far removed a community’s sense of place. Medical centers that are situated amongst the trampled landscape of suburban sprawl demonstrate a lack of responsibility to heal in ways not specifically associated with physicians or medicine, but of healthy lifestyles and of a sustainable future. Suburban healthcare facilities support increased automobile use, an isolation from community, and an ignorance to promote healthy and sustainable solutions within the built environment.

“When will hospitals become part of the solution - a carbon neutral building type - rather than continuing to be part of the problem, as a wasteful, carbon intensive building? ... Large urban medical centers in Tokyo, Amsterdam, London, Vienna, Prague, Mexico City, Moscow, and so many other cities of the world are located adjacent to or very near to rail and bus transit stations. These transit hubs are in turn linked with a network of bus, light rail, pedestrian, and bike routes. Thus, a system of primary, secondary, and tertiary circulation arteries is created over time that function as the life blood of these places.”

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LINCOLN NEBRASKA | MAJOR HOSPITALS

Typology: Large Healthcare

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LINCOLN HEALTH FACILITIES | PROXIMITY Situation The current distribution of health facilities in Lincoln has a lacking presence in the downtown and University core of the city. With a decent population of students and residents as well as a great amount of activity a need for a future facility would best situate in or near the downtown core of Lincoln to become a vital player within the developing urban context and be an active component to the community.

Typology: Large Healthcare

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LINCOLN HOSPITAL | SPECIFIC SITE DESIGN

Modonna Rehabilitation Hospital

Bryan LGH Medical Center East Campus

St. Elizabeth Regional Medical Center

Bryan LGH Medical Center West Campus

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URBAN HEALTH PRECEDENTS | SIZE AND CONTEXT St. Paul, Minnesota

Minneapolis, Minnesota

Typology: Large Healthcare

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Kansas City, Missouri

Omaha, Nebraska

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URBAN HEALTH PRECEDENTS | SIZE RELATIONSHIPS

Typology: Large Healthcare

Regions Hospital St. Paul, MN 445 Beds

Hennipen County Medical Center Minneapolis, MN 473 Beds

St. Josephâ&#x20AC;&#x2122;s Hospital St. Paul, MN 255 Beds

University of MN Medical Center Minneapolis, MN 808 Beds

United Hospital St. Paul, MN 437 Beds

Abbott North Western Hospital Minneapolis, MN 644 Beds

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Truman Medical Center (Hospital Hill) Kansas City, MO 262 Beds

Boys Town National Research Hospital Omaha, NE ? Beds

University of Nebraska Medical Center Omaha, NE ? Beds

potential site size

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Lincoln, NE | SITE SELECTION

Typology: Large Healthcare

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SITE ANALYSIS | HEIGHT RESTRICTIONS

Typology: Large Healthcare

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SITE ANALYSIS | ADJACENCIES AND CONNECTIONS This selection of this site was based upon some key adjacencies and overall proximity to the downtown core of Lincoln. The site is bordered to the north by O street, to the west by 19th street, the south by N street, and the east by Antelope Creek.

Antelope Creek offers a great opportunity to connect to a growing public park and infuse the community into the situating of this health facility. O & 19th street offer connection to vehicular traffic and access to the facility for supplies as well as ambulances. The views to both capital and Antelope Creek also offer potential design guides in the development of the patient rooms.

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IN-DEPTH ANALYSIS | ST. ELIZABETH REGIONAL MEDICAL CENTER Program

User Group

St. Elizabeth Regional Medical Center provides the following services:

Full Time

Physicians & Dentists: 70

Registered Nurses: 273

Lics. Practical Nurses: 8

Clinical Services Cardiovascular Services Cardiac Cath Lab Cardiac Rehab Cardiac Surgery Coronary Interventions Vascular Intervention Emergency Services Emergency Department Neurosciences Electroencephalography Sleep Studies Oncology Services Cancer Program Chemotherapy Radiation Therapy Orthopedic Services Arthroscopy Joint Replacement Spine Surgery Other Services Hemodialysis Inpatient Surgery Lithotripsy Obstetrics Radiology / Nuclear Medicine / Imaging Physical Therapy Special Care Burn Intensive Care Intensive Care Unit Wound Care Wound Care

Typology: Large Healthcare

Part Time

Physicians & Dentists: 12

Registered Nurses: 323

Lics. Practical Nurses: 8 Patient Statistics

Admissions: 13,710

Outpatient Visits: 117,009

Births: 2,637

Inpatient Surgeries: 4,948

Emergency Room Visits: 33,151

Number of Beds: 257 Facility Statistics

Parking: 1,500

SQ. FT. ?

Rectilinear Dimensions: 500â&#x20AC;&#x2122; x 870â&#x20AC;&#x2122;

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PRECEDENT ANALYSIS | SPATIAL EFFICIENCY Evelina Childrenâ&#x20AC;&#x2122;s Hospital London, UK

232,400 Total Sq. Ft. 140 Beds 1,660 Sq. Ft. / Bed

Through an analysis of three precedent examples (selected based upon type, size, and location) an established set up figures has been developed that relates overall hospital square footage and the number of beds. This figure represents an overall spatial efficiency within the facility and idealized goal. With an general understanding of the proposed facility, the following page illustrates the initial attempts in understanding the mass necessary to accommodate within the design proposal.

Meyer Childrenâ&#x20AC;&#x2122;s Hospital Florence, Italy

361,600 Total Sq. Ft. 152 Beds 2,378 Sq. Ft. / Bed

Martini Hospital Groningen, the Netherlands

645,834 Total Sq. Ft. 570 Beds 1,133 Sq. Ft. / Bed

Antelope Proposal Lincoln, NE

240,000 Total Sq. Ft. 200 Beds

1,200 Sq. Ft. / Bed

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SITE MASSING | PRELIMINARY STUDIES

Typology: Large Healthcare

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The progression of these massing studies explored the utilization of a hybrid between a bar and partial courtyard type. Initial ideas concerning the bifurcation of program, the infusion of public, a visual and physical connection to Antelope Creek, as well as an optimization of patient room views define the goals of these massing investigations.

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SITE / SECTION DIAGRAM | CONCEPTUAL STRATEGY

The previous massing studies led to key conceptual motives that define the specific design strategies. A bifurcation of inpatient and ambulatory care is created through the infusion of a pedestrian/commercial street.

Through elevating the inpatient ward a formally inviting gesture is created towards the passersby on Antelope Creek.

Typology: Large Healthcare

A depression of a half level to the entire design is initiated to create a bifurcated entrance that separates the public/pedestrian/commercial user group from the hospital visitor/patient/ employee entrance. The bifurcated entrance is however brought into the same atrium space, thus not separating the necessary societal connection of the facility.

The ambulatory care/entrance and loading docks are situated on the west end of the site where the proximity to O & 19th street prescribes an appropriate location.

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SITE MASSINGS | REFINED

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NURSE STATION ANALYSIS | NURSE-PATIENT-MEDICINE RELATIONSHIP

As the evolution of the patient room has evolved there are three major aspects to consider in the contemporary design. First is the deliverance of medicine to the patient.

The most optimum design will provide the quickest, and most efficient path for the caregiver to acquire the medicine and deliver it to the patient in their room. This will relieve some of the strain on the caregiver by reducing the length of travel as well as achieve a faster transfer of medicine to the patient. Secondly in the design of the contemporary patient room is the new desired visibility of the patient by the caregiver without intruding into the private rooms. This visibility allows for better awareness of the caregiver to provide quick and immediate attention when required.

Finally, the third aspect is the location of the toilet. Most American patient are single-bed private room with their own toilet or a shared toilet. Toilet rooms are now seen located at the exterior wall versus the dated approach of locating the toilet on the corridor wall. The driving factor to this decision is to allow for a direct visibility of the patient to the toilet room, as well as giving the patient the clearest and shortest route to the toilet.

Typology: Large Healthcare

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Locating the Nurse

The location of the nurse within his/ her assigned patients is key in the internal layout and organization of inpatient wards. The parameters that define the location include corridor design, number of beds per room, and the inclusion or absence of decentralized nurse stations. The diagrams to the right illustrate a few possible and typical configurations of where the nurse can be situated in relation to the prescribed patients. Flexibility and manipulation of the diagrams can create hybrids and potentially innovative new solutions that help to minimize nurse travel distance.

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NURSE TO PATIENT | QUALITY OF CARE

Typology: Large Healthcare

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NURSE TO PATIENT | TRAVEL & SYSTEMS EFFICIENCY

Typology: Large Healthcare

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PATIENT ROOM DESIGN | DIAGRAMMATIC EVOLUTION

1. EFFICIENT DOUBLE LOADED CORRIDOR

the selection of a typical and spatially efficient corridor design is selected to initiate a spatially optimum inpatient wing. the views of the standard implementation are directly perpendicular to the corridor.

2. EFFICIENT INCLUSION OF SUPPORT SPACE

a racetrack type corridor offers the benefit of closely adjacent meds and supplies.

4. AMOUNT OF FACADE FOR EXTERIOR VIEW

typically the short dimension of the patient room is given to the exterior view where as the long dimension given to the depth from corridor dimension, which increases the cross-sectional dimension and decreasing daylight penetration into the nursing core.

Typology: Large Healthcare

3. HYBRID CORRIDOR

through a bifurcation of the support space and relocation to the interior edges of the patient rooms the ability to utilize a single corridor is realized. this reduces the cross sectional dimension, reducing the overall sq. ft.

5. ROTATION OF ROOM

through a rotation of the patient room the longer dimension is given preference to the exterior view while still maintaining its overall organization properties.

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6. STRUCTURAL CONFLICT

with the rotation of the patient room the typical structural design is slightly compromised and needs to be accommodated.

8. EXTERIOR SPACE

the “saw tooth” design allocates exterior space at the ends of each patient room.

7. STRUCTURAL RESOLUTION

through the removal of two internal columns and the shifting of the exterior column inward, the “saw tooth” patient room design is a functional option. a small cantilever is employed to stretch the reach of the patient room.

8. PATIENT BALCONY

the exterior space is appropriated to a balcony space available to each patient room.

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PATIENT WING DESIGN | DIAGRAMMATIC EVOLUTION

1. TYPICAL BAR CONFIGURATION

2. INHERENT EXTERIOR VIEWS

4. COMBINE HYBRID CORRIDOR & SPLAY

5 END CONNECTION

a typical bar configuration is common for many corridor design choices and lends well for chances of hybrids and manipulation.

through combining the hybrid corridor design with a splayed bar configuration, an opportunity for optimizing exterior views for the patients is achieved.

Typology: Large Healthcare

when two bars are located adjacent to each other the exterior view of the inner facade is directly facing the other building, diminishing the quality of the view.

connecting one end of each bar allows a moment of internal circulation to transfer between each bar.

3. SPLAY OF EACH BAR

through a minor splay of each bar about similar end points the exterior view of the inner facades opens up.

6. END CONDITION

the end condition of the bars lends well to the infusion of public space as well as a hinge point for the remaining portion of the health facility.

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6. MIRRORED LOGIC

the logic of the splay and connected bars is mirrored about the connection hinge space. the mirrored logic inherently produces usable and functional space for treatment, ambulatory care, and administration components of the health facility. the hinge space acts as a connection point for all internal aspects within the design proposal. conceptually the hinge space is realized as a central atrium space that serves as entrance for both the health programs of the solution as well as the public and commercial programs that are incorporated into the design. the notion of a central hinge point creates a physical understanding of a connection between healing and the community.

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RESOLUTION | SITE PLAN

Typology: Large Healthcare

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RESOLUTION | EXPLODED AXON

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RESOLUTION | LEVEL 5 ATRIUM PERSPECTIVE

Typology: Large Healthcare

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RESOLUTION | LEVEL 2 ATRIUM ENTRANCE

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RESOLUTION | SECTIONAL AXON OF PATIENT WING

Typology: Large Healthcare

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RESOLUTION | PATIENT ROOM EXTERIOR PERSPECTIVE

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RESOLUTION | GROUND LEVEL COMMERCIAL STREET & LONG SECTION

Typology: Large Healthcare

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RESOLUTION | LEVEL 3 PLAN & SECTIONAL PERSPECTIVE

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RESOLUTION | NORTH EAST STREET PERSPECTIVE

Typology: Large Healthcare

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Dan Williamson

Vertical Studio Design Research Spring 2012 prof: Steve Hardy