1 2015 ARCHITECTURAL PORTFOLIO
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Contents
Selected works 2013-2015 MIAMI HERALD RESORTS
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UF school of music recital hall
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H21 - Hospital for 21st century
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2015 ARCHITECTURAL PORTFOLIO
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Miami Herald Resorts 01 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
Masterplan The site is a forgotten land in the heart of traffic routes and the previous light-manufacturing district. 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 becoming 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 lowenergy 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, meanwhile 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 beautiful 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 visually recognized as a single object, and articulates the tower’s manifestation within the Biscayne Bay urban image. 3 2015 ARCHITECTURAL PORTFOLIO
HISTORICAL MIAMI HERALD B SITE HISTORY
95 DESIGN DISTRICT
1
SITE AREA
WYNWOOD
MIAMI WORLD
EXISTING CIRCULATION
TO AIRPORT
395
PROPOSED CIRCULATION
ADRIENNE ARSHT CENTER
ONE THOUSAND MUSEUM
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MARLINS STADIUM
95
BRICHELL FINANCIA DISTRICT
CONNECTIONS
VOLUMES
BUILDING
BISCAYNE BAY
JULIA TUTTLE CAUSEWAY
D CENTER
AL
PLOTS
ENVELOPE (EXTRUSION)
ORIENTATION
HEIGHT PROFILE
URBAN LINK
SHARED PROMENADE
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MIAMI HERALD RESORTS
VENETIAN CAUSEWAY
MIAMI BEACH CONVENTION CENTER
MACATHUR CAUSEWAY MUSEUM PARK
395 AMERICAN AIRLINES ARENA
SOUTH BEACH PORT MIAMI
BRICHELL CITICENTER
URBAN CONTEXT
BIRD’S VIEW FROM THE WEST
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Lobby
Stripe 1 Access
Flagship Stores
VERTICAL BEACH MARKET STRIPE 1 CIRCULATION DIAGRAM
Loading
Information Desk
SUN ORIENTATION
Stripe 2 Access
MARKET STRIPE 2 CIRCULATION DIAGRAM
VERTICAL CIRCULATION
FACADE & INTERNAL VIEWS
Stripe 3 Access
Press Center
MARKET STRIPE 3 CIRCULATION DIAGRAM
Bay-view Cafe
NATURAL VENTILATION Mechanical Loading
Parking
Vehicular Access
ACTIVITIES 5 2015 ARCHITECTURAL PORTFOLIO
MARKET SHARED SPACES CIRCULATION DIAGRAM
VIEW FROM MACARTHUR CAUSEWAY
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VIEW OF CENTRAL STREET
VIEW FROM VENETIAN CAUSEWAY
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3 GREEN ROOF SPACES DIAGRAM
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1 Urban Camping
2 View Terrace
4 Rooftop Hiking Path
7 Culinary Ward
5 Community Garden
8 Mini-golf course
3 Sunbathe Field
6 Urban Agriculture
9 Afternoon Leisure
High Garden Mechanical
Loft Open Plan
Residential Units Sky Restaurant Mechanical
Hotel
Fitness Center Mechanical Lobby Ballroom
Bayside Restaurants
Parking Fashion Runway
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SITE PLAN 2015 ARCHITECTURAL PORTFOLIO
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INTERIOR VIEW OF CULTURAL CENTER
LONGITUDINAL SECTION 11 2015 ARCHITECTURAL PORTFOLIO
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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UF School of Music Recital Hall 02 Sep 2014 - Dec 2014 Type: Education Size: 3419 m2, 36807 sf Location: 435 Newell DR, University of Florida, Gainesville, Florida, USA Advanced Studio 3 Fall 2014 Instructor: Gary Siebein “Structure must be agreed upon, while form wants only freedom to be”. – John Cage
grams, and circulation); the building form proposes a simple volume as a box. An orthogonal building defines these spaces and appears to support the main body of the building with a clear zoning inside, based on the complexity of the strict requirements.
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.
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 Newell 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 conducive to enjoy music for the visitors and occupants.
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 prominence 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 university’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 embedded into the ground of the lot. Practice rooms also inhabit the underground 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.
Century Tower
Stadium Road
Music Building Steinbrenner Band Hall Inner Road Site
To maneuver the possible programs in this tight site, and to follow the parallel trajectories of various design generators (soundscape, site, pro-
Maston Science Library Newell Drive
SITE SCENARIO
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. 08
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60 dB
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Itinerary 02
60 dB
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Itinerary 01
60 dB
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02
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Sound Pressure Level (dB)
Itinerary 03
Natural (wind, birds, trees) Transportation (buses, cars, helicopter) Pedestrians (talking, walking) Sound Taxonomy
SOUND SAMPLING 15 2015 ARCHITECTURAL PORTFOLIO
SOUNDSCAPE ANALYSIS
Itinerary 01
Itinerary 02
Itinerary 03
SITE PLAN AND GROUND LEVEL PLAN
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Blues Vocal Country
Brass
Jazz Pop
Classic Cello
Tone
Percussion
Vibration
Tambourine Bugle
Wind Electro
Variables
String
Frequency Distance
Folk
Recorder
Originators
Amplitude
Soundscape
Piano
Cars
Topography
Volume
Protection
Plantation Birds
Diffuse
Instruments
Music Performance
Dead-room
Brilliance
Sound
Noise
Site
Intelligibility
Clarity Width
Space
Design Generators
Circulation
Loudness Envelope
Reverberation
Acoustics
Visual
Warmth Balance Blend
Spaciousness
Localization
Context Material
Ramp Pavement Logistics
Simplicity
Program
Activities
Percussion Studio
Dialogue
Reed Maint
Silence Community
Welcome
Office
Lighting Booth Stage
Dressing
Interdisciplinary
Exhibition
Entrance
Rehearsal
Transparency
Conference
Equipments
Recital Hall Control
Sale Research Show
Practice
Green Room
Storage Cafe
Visiting
Library
Recording
Rack
Electronic Teaching
First-aid
Repair
Repair
Piano Lab
Gallery
Association
Performance
Classrooms
Connection
Students
Storage
Info Studio
Education
Restroom
SCENARIO
Proposal
Public Activities
+ Professional Rooms (Sound Isolation)
Programs Stacking
Enbedment
Verticality
Intervention
PRINCIPAL FUNCTIONS ZONING
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FACULTY & GRADUATE OFFICES PERCUSSION STUDIOS
MUSIC LABS
CONGREGATION
BACK-STAGE
RECITAL HALL
GALLERY
RECORDING STUDIOS
ELECTRONIC STUDIOS
CLASSROOMS
PRACTICE ROOMS
PROGRAM & CIRCULATION DIAGRAM 2015 ARCHITECTURAL PORTFOLIO
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VIEW ON NEWELL DRIVE
UNIVERSITY AUDITORIUM 109’-7” AMERICAS PLAZA 93’-8”
Section A-A
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CENTURY TOWER 162’-4”
MUSIC BUILDING 59’-9” TURLINGTON HALL 63’-8”
SECTION B-B
MUSIC BUILDING 59’-9”
ARCHITECTURE BUILDING 61’-2”
RINKER HALL 65’-6”
STEINBRENNER BAND HALL 34’-0”
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INTERIOR VIEW OF RECITAL HALL VIEW ON INNER ROAD
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Ceiling Reflection Paradigms
Maneuvering of floor sloping to provide easy access for both performers and audience
Shoe-box scheme for room shape to optimize acoustics
Ceiling and diffuser panels to achieve coplanar reflections
RECITAL HALL TYPOLOGY
>25’ >15’
L1
L2
-6 dB
>3’
ACOUSTIC DIFFUSION audience: >60’
stage: >20’
(coefficient)
(absorption coefficient) 1
0
125
1
4000 (frequency, Hz)
(diffusion coefficient) 1
scattering pattern
spline motif 0
100
4000 (frequency, Hz)
diffusion scattering absorption
0
125 high medium low
fractals
ACOUSTIC DIFFUSERS PERFORMANCE
16000 (frequency, Hz)
reflection path R2
reflection path R1
H direct sound
lateral reflection 70’ diffusers
source
receiver
Loudness – Adequate loudness of sound Wall 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 materials Reverberation – Sufficient time of sound decay of -60 dB Relating 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 s Envelope – Immersement in the 3 dimensional sound field Narrow width < 80-90 ft. Intimacy – Initial time delay gap [(R1+R2)-D/1120]/1000=12 ms Brilliance – Adequate support of high frequency Treble ratio > 0.70 Warmth – Adequate support of low frequency Bass ratio > 1 Balance and Blend – Sound from individual instruments blends on stage before progressing to audience
ACOUSTIC QUALITIES 2015 ARCHITECTURAL PORTFOLIO
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VIEW OF GRAND LOBBY
NEWELL DR
Turlington Plaza
OUTDOOR GATHERING
Music Building
Recital Hall
PERFORMANCE AREA
Recital Hall Entrance
GATHERING
EVENT SPACE
Rawlings Bus Stop
VISUAL INTERVENTION
McCarty Parking Garage
TRANSPORTATION HUBS
acoustical sources acoustical itinerary nodes
PROCESSION 23 2015 ARCHITECTURAL PORTFOLIO
VIEW OF SECOND FLOOR ENTRY
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BASEMENT LEVEL PLAN
SECOND LEVEL PLAN
Sound Source Century Tower Carillon Selected Music Chapter: “Spring 12”
Notes
Beams (Intervals)
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Cluster
Change of Tempo
Brick
Concrete
THIRD LEVEL PLAN
URBAN SOUNDSCAPE, CONTEXT AND ELEVATION 2015 ARCHITECTURAL PORTFOLIO
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H21 - Hospital for 21st Century 03 Nov 2014 - Apr 2015 Type: Healthcare Size: 30000 m2, 322000 sf Location: 1600 SW Archer Road, Gainesville, Florida, USA Master’s Research Project (Degree Project) 2015 Instructor: Bradley Walters & Nawari Nawari Hospital is the ultimate housing. Housing birthplaces, housing souls, housing hopes, housing equality and dignity, housing the opportunities to achieve common welfare; hospital 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, periodicals, 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 marginal 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 architecture. 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 society, 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 hospital 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 reorganization of hospital management along more bureaucratic and administrative lines. That is the reason why in the Lunder Building project of Massachusetts 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.
Part 03 includes a context study page in function and design of the existing University of Florida Shands Complex and a guideline page of the accreditation systems of sustainable healthcare buildings. It also considers 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 associated with the design proposal of UF Health Cardiovascular Center, which are concerned with hospital design trends of today and particularly with the evaluation of a scientifically contemporary standards for green buildings.
Asklepieion at Epidauros, in ancient Greece, fifth century BCE, as undeniably places for inpatient 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 resembled 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.
This project consists of four parts, which together aim to evoke a sustainable 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 canonical 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 management science into healthcare sphere and to provoke how a healthcare facilities in future can be managed and constructed. 27 2015 ARCHITECTURAL PORTFOLIO
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 forerunner 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.
500 B.C.E.
300 B.C.E.
0
500
800
Classical
1300
1500
Medieval 100: First public restroom - latrines, or necessaria, appeared in Asklepieion in now Turkey
400 C.E.: First description of a civic hospital system anywhere in the world 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
325: Earliest hospitals in the Roman Empire were built by Saint Sampson the Hospitable
Asclepieion
1150: The leprosarium of Perigueux in France
Temple Valetudinaria
1900 Modern
1920
Sanctuary Bimaristan
1940
WWI
1895: First X-Ray Image, Wilhelm Conrad Röntgen accidentally discovered an image cast from his cathode ray generator 1932: Paimio Sanatorium designed by Finnish architect Alvar Aalto was completed
1889: Johns Hopkins Hospital was founded, now it is regarded as one of the world's greatest hospitals
Skyscraper
1950
Radiology
Modernism
Open Hall
Post-war
Cold War
1772: Hôtel-Dieu de Paris fire 1824: Eugène Delacroix ‘s drawing of Military Hospital
Wards
1865: Mower General Hospital, Philadelphia, Pennsylvania 1889: Johns Hopkins Hospital founded
Pavilion
2000
Second Industrial Revolution 1978: First test tube baby were conceived by IVF, and born in Oldham General Hospital, Greater Manchester, UK
2011 Globalization
1996: First mammal, Dolly, cloned from an adult somatic cell using the process of nuclear transfer 1993: Hospital for Sick Children in Toronto of Canada, designed by Zeidler Roberts Partnership
1950: Veterans Hospital in Brooklyn opened, which is designed by Skidmore, Owings & Merrill
Escalation
Voluntary Center
1990
1965: Yale–New Haven Hospital was named as the result of a more formal agreement with the Yale School of Medicine
Antibiotics
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
1951: Massachusetts General Hospital Research Laboratory constructed, and linked by corridor to the 1821 Bulfinch Building
1944: USS Mercy (AH-8) was a Comfort-class hospital ship laid down under Maritime Commission
1842: First air-conditioned hospital, John Gorrie used to cool air for his patients in his hospital in Apalachicola, Florida
1801: Hôtel-Dieu de Paris rebuilding project
1970
1953: The structure of the DNA molecule was described by James Watson and Francis Crick at Cambridge University
1850
Industrial Revolution
1803: First medical textbook ‘Medical Ethics, or a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons’ was written
1721: St Thomas' and Guy's hospitals founded
1960
1945: First country to make the penicillin available for civilian use was Australia after World War II
1935: Beaujon Hospital located in Clichy, Paris opened
1884: Civil and Military Hospital, Montpellier, France, the transverse section shows the intake of fresh air
Enlightenment
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.
Monastery Hôtel-Dieu
1945
1931: Sanatorium Zonnestraal, was designed by Jan Duiker and is an example of the Nieuwe Bouwenit, it was built as a tuberculosis sanatorium
1830
1721: St Thomas' and Guy's hospitals was founded by Thomas Guy, a publisher of unlicensed Bibles
WWII
1860: First official nurses’ training programme, the Nightingale School for Nurses was opened
1155: Kirkstall Abbey, England. Drain of the dormitory necessarium were built near water
1154: Bimaristan (Islamic hospital) of Nur al-Din, Damascus, Dimashq, Syria
820: The plan of St. Gall monastery, Switzerland
1800
1502: First hospital founded in the Americas - Hospital San Nicolás de Bari, in Dominican Republic
1043: Monastery and Infirmary in Cluny, France
625: Hôtel-Dieu de Paris was founded
55: Roman Valetudinarium (Military Hospital) in England (first century CE), as a part of Hadrian’s Wall
1700 Renaissance
707: First prominent Islamic hospital was founded in Damascus, Syria in around 707 with assistance from Christians
350 B.C.E.: Temples dedicated to the healer-god Asclepius, known as Asclepieia in ancient Greece
Origin
1200
1990: Shanghai's Number 1 Maternity hospital, China, the intense population increase questions the existing hospital management
2008: B3C - Building for the Third Century, of Massachusetts 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 massive healthcare by information technology
1979: Hospital: House of Hope, Houses of Birth, Houses of No Return drawn by Raimund Abraham
Efficiency
Information
Energy
Sustainable
Evidence
Direction
Almanac of healthcare buildings
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 doing 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 networks (fee for membership, advertising).
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SOLUTION SHOPS (Fee for service) - Consulting firms - High-end law firms - R&D organizations - Diagnostic activities of hospitals Hospital ls become focused solution shops, practicing intuitive medicine.
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FACILITATED USER NETWORKS (Fee for Membership, Advertising) - eBay - Insurance - Education - Telecommunications - D-Life (for diabetes patients & families)
Focused value-adding process hospitals & clinics provide procedures after definitive diagnosis.
Facilitated networks take dominant role in the care of many chronic diseases.
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VALUE-ADDING PROCESS BUSINESSES (Fee for outcome) - Retailing - Manufacturing - Food Services - Medical Procedures
THREE TYPES OF BUSINESS MODELS OF FUTURE HEALTHCARE FACILITIES
Data Finance EXISTING VALUE NETWORK
Contracting
DISRUPTIVE VALUE NETWORK
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Latrines or Necesaria (Sanitation Facilitating)
Beds (Inpatient Placing)
GREEK ASKLEPIEIA (350 B.C.E.)
Supporting (Storage and Mandatum-Kitchen)
Treatment (Spatial Division of patients and resources)
Division (Dividing of a great hall)
Orientation (Direct Sunlight)
Galleries (Basic circulation spaces)
INFIRMARY OF MONASTERY IN CLUNY (1050)
Wards (Male and Female inpatient units separated)
Lobby (Supporting and welcoming)
ST THOMASâ&#x20AC;&#x2122;S HOSPITAL (1721)
Temple (Modular System established by the temple)
Hall (An integrated program in infirmary)
Zoning (Walled organization for the sicks)
Pavilion (Longitudinal arrangement on behalf of natural air) HĂ&#x201D;TEL-DIEU DE PARIS (651)
Corridor (Rational connection between pavilions)
Pharmacies (Pharmaceutic Supporting)
Control (Visiting group are guided by main entrance)
Ventilation (Shaft excluded for air and heating)
Skyscraper (Stacking configuration for inpatient program)
Administrative (Enlarged supporting volume attached to inpatient part)
Lean (Shorten distance to access to patients)
Street (Clear circulation like a main street)
Department (New zoning strategy for contagion)
Lighting (Orientation of patient tower)
JOHNS HOPKINS HOSPITAL (1889)
Height (Volumetric Increase) PAIMIO SANATORIUM (1932) 29 2015 ARCHITECTURAL PORTFOLIO
Logistics Dynamics (Multiples transportation cores (Convenience of services of to achieve efficiency) each inpatient tower) BEAUJON HOSPITAL AT CLICHY (1935)
Escalation (Juxtaposed inpatient tower with pavilion layout)
Complexity (One integrated testing and supporting tower connected to all inpatient towers)
Mobility (Maximum consideration of circulation in compact space) USS MERCY AH-8 (1943)
Functionality (Food and water treatment on lower deck)
Rehabilitation (The space on roof deck for rehabilitation)
Technology Incorporation (Laboratories and medical (Old pavilions incorporated in facilities are located in the heart longer and wider towers) of the X-shape) YALE-NEW HAVEN HOSPITAL (1965)
Accessibility (Modernized wings are connected to the consolidated core)
Core (Rearranged tower core for mechanical, ventilation, and services)
Greenness Efficiency (Atrium garden is visible from many (Minimizing travel distances for of the building's lounges and medical staff) consultation rooms) H3C MASSACHUSETTS GENERAL HOSPITAL (2011)
Convenience (Maximizing the number of patient beds per floor)
Opportunities (Massing reflects the five-story bed tower is separated from the procedural floors below)
Density (Most compact layout of beds)
ELEMENTS OF TEN CANONICAL HOSPITALS IN HISTORY 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 instances 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 observation therefore facilitates a panoramic comparison between the various
projects: How will the ideologies steer the shifts of hospital architecture? What positions did or does hospital architecture occupy in past and today? 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, Skyscraper, 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 31 2015 ARCHITECTURAL PORTFOLIO
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Specialty Hospital
Parking Structure
Medical Clinics Tower
UF Health Shands Cancer Hospital
SITE CONDITIONS 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.
CONNECTIVITY AND EXPANDABILITY 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.
Wing of Solution Shop
Wing of Value-Adding Process
UF Health Shands Children’s Hospital
UF Health Shands Hospital
UF Health Shands Cancer Hospital
DAYLIGHTING AND VISIBILITY
FUNCTIONALITY
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.
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.
VIEW FROM THE WEST SIDE THROUGH ARCHER ROAD
In different business models, there are three types: solution shops, value-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 authentically as solution shops. But over a century they have mixed in value-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 conflated three business models in the same building. The first step of innovation must separate different business models into separate institutions whose processes, resources, and profit models are corresponded to the 33 2015 ARCHITECTURAL PORTFOLIO
VIEW OF THE PUBLIC ENTRANCE FROM THE MAJOR PARKING STRUCTURE 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 segregation 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.
To achieve to deconstruction of health care institutions into the two different business models: solution shops and value-adding process activities. This can be done by creating hospitals-within-a hospital, or by building distinct facilities. In either case, the work done within each business 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 becoming solution shops or value-adding process hospitals, or simply expect 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 generation 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 situations 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 generation hospital paradigm further. The design for the new Cardiovascular Center employs the thoughts which has been discussed in previous chapters regarding the H21 (hospital 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 services 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 rehabilitation, 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 technology 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 landscape 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 elsewhere on campus and materials flow. Site landscape facilities will include 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 groundcover 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 environmental 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. Electricity conservation stratagem include sun shading, high-efficiency air handlers, low-E windows, low-energy light fixtures, and cascading daylighting; 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.
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Diagnostic Units 12000 SF
Administrative Offices 4200 SF
PACUs 5000 SF
MRI OR 3000 SF
OR Supports 3000 SF
Roof Garden 3000 SF
Bed Support 3000 SF
Kitchen 3000 SF
UF Precision Medicine Hub 23000 SF Central Processing Department 15000 SF
Operation Theaters 8000 SF
CDSS center 6000 SF
CCUs 5000 SF
ICUs 5000 SF
Mechanical 21000 SF Shands Pavilion 6000 SF
Advanced Molecular Diagnostics Center 3000 SF
Intermediate Beds 15000 SF
Locker Room 3000 SF Outpatient Clinics Center 6000 SF
Cardiac Stress Test 2100 SF Specimen Collection 3000 SF
Mechanical 21000 SF
Electro-physiology Rooms 2750 SF
Outpatient Echocardiography 6000 SF Cardiovascular Clinics 11000 SF
Gift Shop 1360 SF
Locker Room 3600 SF
PET 1250 SF
SPECT 1250 SF
CDU 2000 SF
Emergency Department 10000 SF
Imaging CT 3925 SF
SOLUTION SHOP
VALUE-ADDING PROCESS
Patient Management Center 3000 SF
Sterile Processing Receiving Dock 3600 SF
CafĂŠ 1450 SF
Vestibule 2000 SF
SUPPORTING
PROGRAMS 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. 35 2015 ARCHITECTURAL PORTFOLIO
Family Center 3500 SF
Conference Center 2025 SF
COMMUNITY CONNECTION
Diagnostic Units 12000 SF
Administrative Offices 4200 SF
Roof Garden 3000 SF
Shands Pavilion 6000 SF
PACUs 5000 SF
Operation Theaters 8000 SF UF Precision Medicine Hub 23000 SF
MRI OR 3000 SF
OR Supports 3000 SF
CDSS Center 6000 SF
Intermediate Beds 15000 SF CCUs 5000 SF Mechanical 21000 SF
ICU 5000 SF
Advanced Molecular Diagnostics Center 3000 SF Bed Support 3000 SF
Electrophysiology Rooms 2750 SF
SPECT 1250 SF
Mechanical 21000 SF Locker Room 3000 SF
Cardiac Stress Test 2100 SF
PET 1250 SF
Imaging CT 3925 SF
Outpatient Echocardiography 6000 SF
Vestibule 2000 SF
Outpatient Clinics Center 6000 SF
Kitchen 3000 SF
Specimen Collection 3000 SF
Family Center 3500 SF Cardiovascular Clinics 11000 SF
Patient Management Center 3000 SF Conference Center 2025 SF
Central Processing Department 15000 SF
Locker Room 3600 SF
Gift Shop 1360 SF
Emergency Department 10000 SF CDU 2000 SF
Café 1450 SF
SOLUTION SHOPS
VALUE-ADDING PROCESS
(BUILDING WING A)
(BUILDING WING B)
Sterile Processing Receiving Dock 3600 SF
PROGRAMMING RELATIONS 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. 2015 ARCHITECTURAL PORTFOLIO
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INCORPORATION
LIGHTING
OPPORTUNITIES
CONVENIENCE
(Building Wing of Solution Shop)
(Sky Lit Space Organizes the Framework)
(Reunited Value-Adding Process Wing in Paradigm)
(Outpatient Programs Linked to Parking Facility)
ACCESSIBILITY
FLEXIBILITY
CLARITY
SERVICE
(Public Access from the Central Garden)
(Hanging Extrusions Enhancing the Interior)
(Main Street Providing Clear Logistics and Circulation)
(Service Floor Accommodation Located in Middle)
SUPPORT
DYNAMICS
DIVISION
ORIENTATION
(Imaging Programs Support the Value-Adding Process)
(Interchangeable Spaces for Future Technology)
(Efficient Division Strategy through a Matrical Grid)
(Facing Green Areas and Daylighting for Nursing Units)
CONSOLIDATION
INTER-BRIDGING
MATRIX
PROXIMITY
(Advanced Medical Programs Fused Together)
(Bridges across Two Wing Provide Connections)
(Sub-divisions with Matrical Relations Spatially)
(Shortest Distance to ORs and Support Programs)
SPATIAL STRATAGEM OF SOLUTION SHOP WING
SPATIAL STRATAGEM OF VALUE-ADDING PROCESS WING
SITE PLAN
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Mechanical
Shands Pavilion
Operation Theaters Mechanical
Roof Garden
OR Supports Intermediate Beds PACUs
Administrative Offices
Diagnostic Units
Operation Theaters MRI OR Intermediate Beds Operation Theaters
ICUs UF Precision Medicine Hub
CCUs Intermediate Beds
Mechanical
CDSS Center
Central Processing Department Mechanical Kitchen
Advanced Molecular Diagnostics Center
Bed Support
Cardiac Stress Test Outpatient Clinics Center
Imaging CT Electrophysiology Rooms
Outpatient Echocardiography
SPECT PET Family Center
Imaging CT
Cardiovascular Clinics Specimen Collection
Sterile Processing Receiving Dock
CDU Gift Shop Conference Center Vestibule CafĂŠ
Patient Management Center
Emergency Department
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VIEW FROM THE NORTHEAST CORNER ON ARCHER ROAD 39 2015 ARCHITECTURAL PORTFOLIO
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EARLY SKETCHES
VIEW FROM THE SOUTHWEST CORNER NEAR CANCER HOSPITAL
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VIEW OF THE GARDEN IN BETWEEN TWO WINGS
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VIEW OF THE PUBLIC ENTRANCE OF THE CARDIOVASCULAR HOSPITAL 43 2015 ARCHITECTURAL PORTFOLIO
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VIEW FROM THE DIAGNOSTIC UNITS 45 2015 ARCHITECTURAL PORTFOLIO
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VIEW OF THE INTER-BRIDGES FROM THIRD LEVEL
LONGITUDINAL SECTION OF SOLUTION SHOP WING 47 2015 ARCHITECTURAL PORTFOLIO
VIEW FROM THE CENTRAL PATH OF SOLUTION SHOP WING
VIEW FROM THE SOUTHWEST CORNER NEAR CANCER HOSPITAL
AXONOMETRIC SECTION OF SOLUTION SHOP WING AND VALUE-ADDING PROCESS WING
VIEW FROM THE LOBBY OF VALUE-ADDING 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 economics is dispiriting. In the healthcare field, changes have been occurring 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 canonical 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 interrelated 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 paradigms: models, patterns, tool-sets of assumptions about a field, profession, 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 consideration is being taken to measuring the caliber of needs and to promote the results. The landscape of all aspects of healthcare is changing. 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. Flexibility Above all, flexible. Because of its size, multimillion-dollar building program 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 changing 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. However, 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 reconfigured as needed allows a potential flexibility. But still, the solution to keep both functionality and dynamics is under exploration. Expandability Expandability consideration should begin at the planning stage, however 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 55 2015 ARCHITECTURAL PORTFOLIO
ongoing expandability of the design is the participation of the users. For example, in the practical scenario of this project, the cardiovascular hospital 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 represents the greatest chance of enduring. Vertical Integration Associated with the flexibility, vertical integration (redesign and rethinking 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 project, 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 vertical integration for programs grouping and indicates how facilities, equipment, 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, physicians’ 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 architectural 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 mission 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 architecture. The discussion naturally boils down to three broad areas: (1) possibilities 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 historians 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 discoveries 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 Modalities, 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.
Designers of future healthcare facilities will probably be quested to create 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 patientcare 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 facility 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 proposal, 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 ultimate hope of what we have been long preservingâ&#x20AC;&#x201D;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.
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. Mechanical, 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.
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 Architects. Bowers, Barbara S. 2007. The medieval hospital and medical practice. Aldershot, England: Ashgate. Christensen, Clayton M., Jerome H. Grossman, and Jason Hwang. 2009. The innovatorâ&#x20AC;&#x2122;s prescription: 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 facility 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 Architecture University of Florida, Gainesville, Florida, USA Address: 1331A SW 13TH ST, APT 1116-B, Gainesville FL 32608 E-mail: d.feng@outlook.com Phone: (+1)352-665-1117, (+86)29-3333-0818 Thanks for Reviewing.