Competition-Hospital of the Future Martin Part B
CompetitionHospital of the Future Martin Part B
Competition-Hospital of the Future Martin Part B
Connections with the town. Site-planning. Urban relations with Martin. The main objective of the design, regarding the development of the HFM, in the town-planning area, is the successful integration of the HFM grounds with University buildings, bio-corridor and south, future development. The HFM grounds are meant to be opened, bordered only by designed green areas. The pedestrian and bike passages circulating around the building, are supposed to help to read the building as the “pinpoint” and not a barrier. The green roof parks of HFM, as well as the greenery on the elevations of the base, both physically and visually, integrate the HFM with the existing bio-corridor. -HFM alley as a slow traffic „campus” road; -HFM green belt between the HFM alley and HFM grounds; -New system of walkways and plazas to integrate HFM with existing buildings of University; -Pedestrian connection with planned “south” plaza; -Car connection with the future “south” road system; -HFM Park as the extension of the bio-corridor. Car access and traffic circulation. The design provides two ways to access, the site. Primary one, from the Mala hora street north, around the existing building of Jesseniova lekarska fakulta UK v Martinie. The second way to access the site would require the development of the planned, south traffic grid. The primary north access flows the traffic into the HFM internal road system. At the beginning of the planned internal road system, the traffic is divided into the emergency, delivery, medical staff which is placed alongside the north rim of the site and patients, provided with the road turning south towards the main entrance and the patient’s parking lot. The emergency road becomes a one-way, two-lane loop, spreading, by the entrance of the emergency access into three lanes. The delivery zone parameters allow to deliver necessities, including large scale medical equipment by the heavy goods vehicles including 18-wheelers. The patient access divides into three roads, with two serving the parking places, one leading directly to the main entrance to the drop-off zone. Access for pedestrians and bikes. Pedestrians are accessing the HFM grounds primary from the north. The walkway is placed alongside the primary car access. From the west, there is the pedestrian connection with the existing buildings of JLF UK, and in south west direction, the design proposes connection with the planned urban development and further with the Slovak National Museum and Martinska akropola. Additional walkways for pedestrians are located around the building of the HFM. The systems of walkways allows to reach all of the entrances to the different parts of the HFM, as well as ground parking lots and ground parks and green areas. Access from the air. There is two heliports locations provided. The primary is located on the roof of the building allowing the direct access to the set of fast elevators, communicating the heliport with Emergency and Trauma Center, Diagnostic unit and Central operating theaters. Second, located on the ground, next to the emergency loop driveway, would be the backup heliport, in case of the occupancy of the primary roof heliport.
Competition-Hospital of the Future Martin Part B
Entrance plaza. The HFM plaza is located in front of the main entrance. The south section of the plaza is flanked with the pond with the pebble shore, bringing to mind calming images of mountain lakes. There is the vertical element, placed within the pond to help incomers to locate the HFM entrance zone. The vertical element takes shape of the granodiorite rock, which is one of the main Tatra mountains building materials. Green areas. The HFM park was designed at the east of the site. The park built of the varying levels terraces, with the walkways in between is accessible for patients, guests, workers of HFM, and inhabitants of Martin town. There are additional, roof-parks located over the first level of the building. The north roof park is accessible only for inpatients and HFM medical staff. The east roof park is accessible for both in and outpatients, HFM workers and guests. Both roof parks have diversified relief, built of small green hills, pebble plains and mountain lake like ponds. Alongside the north border of the site there is the green belt, integrating the HFM grounds with existing bio-corridor located along Silava stream. Delivery zone and parking lots. The goods delivery zone, located on the northern side of the building hidden among the designed wings of the building. Parking lots. The ground parking lot for the patients is located along the east and south-west border of the site. The ground parking for HFM staff is places within the delivery zone, on the north, along the designed park on the east and along the south-east border. Additional parking for workers is located at -1 level. The main bike park for the workers is situated at -1 level as well.
Architecture. Massing. The building consists of the below and above ground part. There is one underground level and six above ground levels. The above ground of the HFM is divided into two parts, which is two level base and four level dominant, located on top of the base. The base is composed of two wings, the shorter, north wing and longer east wing. The four level dominant is located over the joining point of wings creating the base. The dominant is playing major role in underlining the entrance zone, helping to understand how to navigate towards the main entrance of the building. The dynamic geometry of the base leads towards the main entrance of the HFM, especially taking into account the direction from the north primary access. It also opens up the building to the south pedestrian access. The base is cut with three, open-air voids filled with green. The voids bring natural light to internal spaces and on the ground level, serve as the open-air extension of the inside. The dominant, in plan, has the geometry of the five arm star. The angle of 72˚ applied between the wings of this snow flake like star helps to provide the internal spaces with unobstructed views of the mountains located nearby (especially patient’s rooms). The south west wing of the dominant creates a slanted overhang over the main entrance plaza. The gesture is yet another way to help to locate the main entrance.
Competition-Hospital of the Future Martin Part B
Connection of architecture with the natural landscape of Tatras. The architecture of the HFM complex is inspired by the natural landscape of the Tatra mountains. The Tatras leitmotif affected the massing, elevations, choice of elevation materials as well as landscape architecture. The mountain always represents robustness and solidity. The mountains for centuries were giving people shelters from the harsh weather conditions and when unwell. Those aspects, translated into the HFM architecture, are supposed to deliver calmness, impression of solidity, and safety. The dominant is supposed to be the mountain snow-cup, made of light and smooth-looking snowflakes. The vertical divisions of the elevation panels, continuous from the bottom to the top of the dominant four levels elevations are the snow cracks as it is dividing under its own weight. The perforation of the panels would be responsible for the lightness, mimicking snow, building material of the mountain snow cup. The geometry of the base is sharper. It is supposed to answer the picture of rocky, naked part of the mountain, shaped by winds and frost. The cracks of the rock are taken over by the green, forming the mountain shelves composed of Tatra grass and blooming flowers. The entrances give the sense of the entrance to the basic and most primary safe-zones of humanity, mountain caves. The landscape surrounding the HFM or taking part in creating the building (roof parks), is another connection with the Tatra. Diversified levels, soothing pebble plains or ponds shaped to be mountain lakes alike, wrap up the identification of exterior of the HFM. The interior appearance is consistent with the exterior. There is both sharp and smooth geometry, depending on the area. The interiors open to the outside with the glazing in the walls and roof, thus internal spaces are being exposed to the natural light. The dominating materials are white paneling and paint, with accents of wood on the floors and walls. Inside the patient room the wooden accent brings the warmness while the room, opens up to the view of the mountains with the panoramic windows. In the main lobby, the pond with the pebble bottom is a main feature as it creates the seating and waiting area. Access. Internal circulation. There is a clear separation of access from outside, serving different functions of HFM. The north access is allowing patients coming to or out of the Emergency and Trauma Center. It is equipped with separate entrance and exit located under the extensive overhang of the first level. The main entrance to the complex is placed in the south-west part of the HFM. The entrance is meant to be used primarily by outpatients, visitors, HFM staff and students . Along the south elevation there is a separate entrance to the office part, which could be used as alternative entrance for medical staff and students, and two entrances to the special therapeutic departments. Along the north elevation, behind the laboratory complex wing, there is a delivery entrance for the laboratory complex, kitchen, central sterilization of which all face the delivery zone. Next to the kitchen delivery entrance there is a separate entrance with the dedicated freight elevator and staircase connecting the delivery zone with the underground level. The car ramp connecting the ground with the underground parking lot and internal loading bay is as well located on the north side of the HFM.
Competition-Hospital of the Future Martin Part B
The most important element regarding the clarity of internal circulation is the main HFM core. The main core pins the dominant to the base and connects with the main entrance lobby, accessible for outpatients, guests, stuff and about-to-be inpatients (those coming for scheduled procedures). The main core runs through all the levels, both above and below ground. The core consists of eight elevators, of which six allow to transport patients on hospital beds. Four elevators reach the highest level, which is the primary heliport located onto the roof of the dominant. The middle part of the main core is occupied by the evacuation staircase. The network of all of the level’s internal circulation starts from the elevator hall, that is wrapped around the main core. The geometry of the elevator hall and location of the elevators helps to separate different occupants, including staff, inpatients, outpatient depending on the functional structure of the specific level. To ease the reach of the Diagnostic unit, especially for outpatient, there is the local staircase escalating from the main entrance lobby and connected with the first level waiting area, located next to the outpatient entrance to the Diagnostic unit. There is also a separate staircase and elevator allowing to the east roof park. The HFM has secondary staircases are connecting the dominant and base levels with the fire exits placed on the ground levels. There are also secondary elevators, mostly freight elevators, eg. connecting the kitchen with the inpatients units, located in the dominant, the Central operating theatres zone with the central sterilization and so on. Distribution of function. The building consists of the underground level, housing mostly service and storage space, multifunctional, two-level base and four level dominant, filled with satellite departments. Underground level. The underground level is occupied by the service and storage spaces. Among the various technical rooms, including HVAC rooms, electrical rooms, IT there are general storages, equipment storages, drug storage, dirty and clean linen central storages, workshops and central cleaner’s room. In the separate, enclosed part there is morgue with the access both to the main elevator lobby (at -1 level) and expedition bay. The bed disinfection station, via corridor, is connected to the main HFM core, while the drug storage, via local freight elevator, has the direct connection with the pharmacy located on the ground level. In the eastern part of the underground level the car parking lot and bike parking is located. The designed parking has a capacity of handling 70 cars and 100 bikes, belonging to the staff of the HFM. Ground level. Ground level is the main access level. The level holds the Main entrance zone, the Emergency and Trauma Center, the Laboratory complex, kitchen, canteen for staff, the central sterilization, staff changing rooms, teaching facilities for students, special therapeutic departments and administration. The entrance zone is supervised by the personnel from the reception desk, located in between the main entrance and the HFM main core Next to the reception there is the cloak room for visitors and wending machines zone. Adjacent to the wending machines zone there are consultant rooms which serve as additional/private reception of the outpatients. South to the
Competition-Hospital of the Future Martin Part B
reception desk there is the interfusing space of the cafĂŠ, rest area, playroom and rest area, opened to the open-air void. The meditation-room/chapel is located next he void as well. North to the reception/information desk, there are shops and pharmacy. The Emergency and Trauma Center has the separate entrance/exit to/from the admission hallway. There is the waiting area zone next to the admission hallway. From the admission hallway there is the direct access to the open system room (OSR) with 20 acute beds. OSR is connected with the set of three operating theatres and ICU via internal hallway. The laboratory complex (LC) is placed close to the ETC. The heart of the complex is samples registration unit from where, after registration, labeling, the samples are directed to laboratory general unit or sectional laboratory units. There is automatized line, build of analyzers, sorters within the general unit room, while more dedicated equipment is located in the sectional unit rooms. The microbiological lab part is separated from the rest of the LC with air-locks, separate for staff and samples. Separate delivery entrance allows supplies to the lab storage zone, including regular storage and cold room. The sample registration unit can hold deliveries of the samples from outside of the hospital due to the dedicated airlock with the connection to the external delivery zone. The kitchen serves both the staff and inpatients. The meals for the staff are served in the canteen, located next to the kitchen. The canteen space is opened to the open-air void. The meals for the inpatients are delivered via dedicated elevator, to the sectional kitchen, from where the complete sets are distributed. The central sterilization (CS) is connected to the Central operating theatres (first level) via clean and soiled elevator. The medical equipment which is used in the other areas of the HFM, is delivered to the CS in sealed containers, through the internal circulation. Changing rooms for staff are well connected with the underground level parking lot, ground parking lot for staff and the main core. The design, at the moment, provides four separate units, of equal area. The main teaching facilities are located next to the central changing rooms. The main teaching facilities house auditorium room for 35 students, seminar room for 15 students, conference rooms, media library, study rooms and changing rooms for students. The rooms of the teaching facilities are opened to the open-air void. Special therapeutic departments are divided into two zones: psychological/psychotherapeutic part and physiotherapy and rehabilitation department (PRD). Both zones are accessible directly from the internal circulation of the hospital or via dedicated entrances from outside. The PRD department consists of various facilities, including, swimming pool, two gyms, cryotherapy suite, hyperbaric oxygen therapy facility, and smaller treatment rooms with back training rooms, arm/hand function recovery rooms, arm/leg tensor rooms, suspension exercise rooms, magnetic field and magnetic stimulation therapy rooms, interferential, low level laser, alternating current rooms, massage rooms to name just a few (total 24 treatment rooms). The PRD had separate changing rooms for staff and patients. First level. First level accommodates the Central Operating theatres (COT), the Diagnostic unit (DU) as well as the Transplantation center and regenerative medicine (TCRM). The COT consists of 25 operating theaters, 2 delivery rooms, 3 8-bed wake up room, ICU part, 3 pre-operating rooms and additional facilities.
Competition-Hospital of the Future Martin Part B
There are 4 septic theaters, with separate circulation, 2 operating rooms for robotic surgery, 2 rooms for transplant surgery and 20 general operating rooms. Each of the general operating rooms is planned as hybrid, to hold both the surgical team and mobile imaging devices (~54 m2). Each of the operating rooms is accommodated with patient preparation room as well as surgical team preparation room. The staff enters COT via air locks and while at the COT, the staff has rest area with sleeping units available. The galleries for the students/relatives are located next to chosen operating rooms, including 3 general operating rooms as well as 1 transplant surgery and 1 robotic surgery room. The COT houses sectional sterilization unit and sectional lab unit. Sectional lab unit is connected with pneumatic tube with the Laboratory complex on the ground level. The COT can be accessed: From the main elevator hallway (connection with the departments above); Directly from the Transplantation center and regenerative medicine; Pre-operating rooms zone. The pre-operating rooms zone is dedicated for the inpatients receiving one-day procedure with COT facilities. It consists of 3 rooms with total of 24 beds, changing rooms for patients, staff facilities. The Transplantation center and regenerative medicine is placed next to COT and DU. The patients from TCRM can be transported immediately to both COT and DU, with separated circulation. The Diagnostic unit (DU) is divided into: Imagining examination rooms zone-specialized (IER); Imagining examination and examination rooms zone-standard (IER); General Examination Room zone (GER); Endoscope center zone (ECZ). Imagining examination rooms zone-specialized, accommodates CT, MRI, X-ray, PET/CT, SPECT/CT, PET/MR, gamma camera, mammography, densitometry, biopsy under the control of X-ray/ultrasound/CT, angiography rooms. The zone can be accessed from the other zones of the DU as well as via separated access dedicated for TCRM and COT. The Imagining examination and examination rooms zone-standard houses USG examination rooms and gynaecologic-obsteric rooms. The gynaecologic-obsteric rooms are accommodated with the hygienic patient stall and directly connected with USG examination rooms. Each of the DU parts can be accessed via general reception, located west to the main core or locally, through the dedicated entrances, supported with the dedicated sectional receptions/nurse stations. Level +2/+5. Levels from +2 to +5 accommodate satellite departments, respectively: +2-Head Centre (HC); +3-Surgery Centre (SC);
Competition-Hospital of the Future Martin Part B
+4-Internal Medicine Center (IMC); +5-Women-Mother-Baby (WMBC) and Onco-dermatology Centre (ODC).
Besides patients rooms (one bed), each of the levels, provides examination rooms, seminar rooms for students, room for visitors/social day room and additional patient care and service rooms. The nurse stations are located next to the elevator hallway, allowing easy access to all of the patient rooms. The WMBC includes neonatology center with separated ICU room for newborns, room for preemies, room for observed babies and general baby room. Within the IMC there is the ICY part with 10 ICU beds of which 2 are located in individual one-bed rooms. Heliport. The primary heliport is located on the roof of the building. There is a direct access from the heliport to the main core with elevators. The facilities for the heliport/transport unit staff are placed next to the main core.
General construction methods and main materials. Systems. Brief. Structure and elevations. The structure of the building, including foundations, slabs, columns, staircases and the elevator’s shafts made of reinforced concrete to allow adjustments of the systems during the life-span of the building (additional perforations of the slabs). Some elements, including roof parts implemented in the form of steel structure. Partition walls providing proper acoustic insulation (especially satellite departments) as well the protection from the magnetic field/X-rays in DU. The elevation of the base finished with the prefabricated concrete panels with texture. The dominant part finished with perforated metal panels. Glazing clear with the greyish tone. Systems-general. Heating. The ground heat exchanger, to consider as the main source of the heat, supported by the natural gas cogenerate engine. The heat pump powering system of the low temperature heating. The roof, additionally insulated with the layer of greenery/soil. The sun to penetrate the interior during winter season (passive) and warm up the concrete panels (base). Cooling. The ground heat exchanger, as the main source of the free-cooling, supported by the natural gas unit. The deep windows to prevent from overheating of the interior. Ventilation. The ground gravel heat exchangers to lower the temperature of the air in the summer season and to heat up the temperature of the air in the winter season (respectively lowering by 10˚C in the summer and heating up by 20˚C in the winter time). In the summer time the air drained from the humidity, during winter time moisturized. The air purified from dust, microorganisms and allergens. Average reduction of the demand: 1-2 kW/m3 (peaks), which translates to 2540% of the operating costs. Grey/rain water utilization The rain water collected from the roof and external pathways into the rain water tanks. The rain water, after treatment, used to flush the toilets and for maintenance purposes (watering green areas). The system enriched with the grey water collecting/purifying units.
Competition-Hospital of the Future Martin Part B
Heat recovery system The heat recovery system will collect the heat from the used water (grey water). It will be used to initially warm up the water distributed in the building through the hot water systems. Lighting The building will be equipped with dimmable fixtures controlled by the light sensors, reacting to the intensity of the natural light. The light fixtures are meant to exclude the light pollution effect.
Cost of construction. The HFM building designed in a way to meet the expenses expectations described in the competition brief and answers to the questions.
Competition-Hospital of the Future Martin Part B
Annex.2-Table of proposed balance for the "B" part. NO
FUNCTION/DECRIPTION OF THE VALUE
NUMBER
8
Area of the territory Proposed area of the hospital grounds Building area Number of underground levels Sum of surface areas of underground levels Number of above ground levels (excluding roof heliport) Sum of surface areas of above ground levels Floor area in total
1 6 -
9
Number of operating theaters
28
10
Number of beds
11
Number of employees
1 2 3 4 5 6 7
(including 3 TCRM and 2 delivery operating room next to delivery rooms) (excluding ETC admission open room system beds and Diagnostic Unit GER)
Number of proposed parking spaces in total Number of proposed parking spaces within the object grounds 14 Area of the traffic services 15 Pedestrain areas and spaces 16 Greenery areas (including roof parks over +1 level) 12 13
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
Main entrance zone Emergency and Trauma Center Diagnostic unit Laboratory complex Central operating theatres Woman-Mother-Baby centre Onco-dermatology centre Surgery centre Internal medicine centre Head centre Special therapeutic departments Teaching facilities (students) Central changing rooms-medical staff Central sterilization Bed disifection station Administration Morgue Kitchen with staff canteen
Patient room (inpatient)-single room including patient's bathroom 36 Operating theatre-general 37 Operating theatre-septic 35
AREA (m²)
% if applies
56 153,0 100,0% 40 374,0 71,9% 14 924,0 26,6% 5 801,0 38 410,0 39 681,5 -
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415
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in accordance with the competition brief
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-
542 377 -
7 517,5 13 581,8 26 986,4
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20 4
13,4% 24,2% 48,1%
2 082,2 1 522,5 3 380,4 644,8 4 626,2 1 170,1 819,5 1 897,2 1 969,6 1 638,1 2 025,6 593,8 887,4 574,2 259,3 754,3 270,4 438,4
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24,1 54,6 54,6
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-
-
Competition-Hospital of the Future Martin Part B
Operating theatre-transplant surgery 39 Operating theatre-robotic surgery excluding technical room 38
2 2
73,8 82,8
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