HOSPITAL DESIGN JASMINE SNYDER Thesis Research Book Environmental Effects in Healthcare Melbourne, Australia
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TABLE OF CONTENTS
INTRODUCTION
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Problem Statement Thesis Statement
Project Goals and Objectives Consultant
MELBOURNE, AUSTRALIA Base Building
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Site Analysis
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Socioeconomic Research
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Local Considerations
9
CASE STUDIES Marin General Hospital
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MHP Major Hospital
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Sidney & Lois Eskenazi Hospital
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PROGRAMMING Adjacency Matrix
17
Space Considerations Code Analysis
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Accessibility
19
Plan Prototypes
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RESEARCH Summary
26
Color and Material
27
Environmental Responsibility
28
RESEARCH STUDY
30
SOURCES
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INTRODUCTION
PROBLEM STATEMENT This project consists of a 50,000 square foot hospital that specializes in treatment for burn victims located in Melbourne, Australia. The average amount of time spent in a hospital for burn treatment is 4-9 days. Long hospital stays can affect a patient’s mood with the most common mental health issues being delirium, dementia, and depression. These common issues may stay with patients even after they leave the hospital. This hospital will provide an environment that can help prevent or diminish the mental issues that can afflict a patient.
GOALS AND OBJECTIVES Create a soothing environment ·
Assess what furniture, materials, and colors
soothe patients and caregivers/ support system. Research different companies and compare studies to decide what is the best fit. Work with doctors and nurses to create an effective space for them ·
Utilize the contacts with Wake Forest
Hospital to design spaces that are functional by collaborating with professionals. Evaluate what a healthcare facility needs ·
Survey patients and employees of healthcare
facilities through a series of questions that can help determine what works and what is lacking. Plan spaces appropriately ·
Use research, documents, and consultants to
make spaces that meet the dimensional needs
THESIS STATEMENT
for ADA and medical tools.
Hospitals are a place where patients
Emphasize wayfinding
and staff alike are under a lot of stress,
·
physically and mentally. Hospitals are
features to create clear paths and make it easy
solely designed for function right now,
for patients and visitors to navigate the space.
·
Put spaces together that relate to each other
and maximize efficiency.
Use lighting, signage, and architectural
and current design does not consider human behaviors and how the environment they are surrounded by can affect their emotions. CONSULTANT: FRED PRICE NURSE MANAGER IN BURN UNIT WAKE FOREST BAPTIST HEALTH
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MELBOURNE, AUSTRALIA Base Building Site Analysis Socioeconomic Research Local Considerations
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BASE BUILDING
INFORMATION
AXON OF BUILDING
LOCATION: Melbourne, Australia Southbank VIC 3006, Australia TOTAL AREA: 53,935 SF FIRST FLOOR: 15,912 SF SECOND FLOOR: 16,858 SF THIRD FLOOR: 16,419 SF COLUMN SPACING: 19'-4", 24'
CIRCULATION
First Floor
Second Floor
Third Floor
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7
SITE ANALYSIS
SUN STUDIES
SUMMER
LOCATION AUTUMN
Opportunities: Close to hotels Near the University of Melbourne Accesible by tram
WINTER
SEASONS
SPRING
SUMMER
AUTUMN
WINTER
(DEC.-FEB.)
(MAR.-MAY)
(JUNE-AUG.) (SEPT.-NOV.)
WARM TO HOT
MILD
COOL
SPRING
COOL TO MILD
SOCIO ECONOMICS
DEMOGRAPHICS Median age: 27 Avg. children per family: 1.3
Male 48.7%
World's 10th largest immigrant
Female 51.3%
population Hosts over a million international visitors Resident types: young professionals, international students, older couples Official language is English
CITY LIFE Government and city council value
500,000 AUD
safety, health, and cleanliness Center for arts and culture, education, dining, and shopping
400,000 AUD
Focused around a central business district
300,000 AUD
200,000 AUD
INNER CITY AREAS: AFFLUENT, GENTRIFIED OR BOHEMIAN SUBURBAN AREAS: MIDDLE CLASS
100,000 AUD
OUTER SUBURBAN AREAS: LOWER INCOME INCREASE IN PROPERTY PRICE IN
0 AUD
Lowest Avg.
Avg. Salary
Highest Avg.
PUBLIC TRANSPORT AREAS
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9
LOCAL CONSIDERATIONS
MATERIALS
CONSTRUCTION METHODS Rammed earth
FRAMING
from local quarries
Solid brick
Brick
Clad
Post and
veneer
frame
beam
Australian ashcrete is made from quality fly ash, a fine, grey powder coming from coal power plants
FLOORING
1
Australian-made bricks Concrete
Australian timber
Stumps
ROOFING
Truss
Pitched system
"ARCHITECTURE IS NOT CREATED, IT IS DISCOVERED – THE HAND WILL FIND SOLUTIONS BEFORE THE MIND CAN EVEN COMPREHEND THEM." ~ GLENN MURCUTT
CASE STUDIES Marin General Hospital MHP Major Hospital Sidney & Lois Eskenazi Hospital
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MARIN GENERAL HOSPITAL GREENBRAE, CA PERKINS EASTMAN Project composed of 3 separate buildings Replace the required acute care program Provide adequate parking Provide necessary outpatient support 294,000 SF Acute Care building 80,000 SF Ambulatory Services building 415-space parking structure Acute care building Four-stories plus a basement Emergency, diagnostic imaging, and interventional platform Private rooms: 18 ICU beds, 7 NICU beds, 91 surgery beds Patient interaction zones Referred to as "lanterns" Provided on every nursing unit facing Mt. Tamalpias Indoor/ outdoor patios Designed to support staff flexibility and efficiency Support space, staff areas, and storage all right sided for efficiency
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MHP MAJOR HOSPITAL
SHELBYVILLE, IN BSA LIFESTRUCTURES Replacement facility Flexibility Patient and family-centered care Staff efficiencies Improved medical outcomes History of the hospital was kept in mind Stone arch salvaged and incorporated into the entry vestibule Photography of architectural features from original hospital is displayed Patient experience drove all major design decisions Focus on outpatient services with a small percent of inpatient Entire second floor designated to physicians offices and exam space Inpatient unit Third floor Central bath and spa with massage room
SIDNEY & LOIS ESKENAZI HOSPITAL INDIANAPOLIS, IN HOK 1.3 million SF hospital and health campus Promote prevention, health and wellness, and an uplifting, dignified care experience 37-acre campus 315 bed hospital 100 bed emergency department 275 room outpatient center and faculty office building One of the world's largest LEED Gold healthcare campuses Design team was committed to providing patients and their families with the best possible environments for positive health outcomes Easy for visitors to navigate the building and grounds Heath-enhancing views to the outdoors Clear wayfinding Strategically placed windows in patient rooms and visitor areas Sunshine and natural environment Bright, airy feeling Materials are simple, clean, easy to maintain Moments of joy Open plazas Landscaped gardens Water features Indiana limestone Extensive public art program Highly efficient plan Serves 20% more patients Less sq ft Air quality and infection control HVAC systems uses 100% outdoor air Reduces the risk of contaminants
"AS MUCH AS THE NEEDS OF FACT, THE NEEDS OF THE SPIRIT AND THE SENSES, MUST BE SATISFIED. ARCHITECTURE IS AS MUCH A PART OF THE REALM OF ART AS IT IS OF TECHNOLOGY; THE FUSION OF THINKING AND FEELING." ~ HARRY SEIDLER
PROGRAMMING Adjacency Matrix Space Considerations Code Analysis Accessibility Plan Prototypes
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ADJACENCY MATRIX
USAGE TYPE B 27.7%
A-2 2% S-2 4%
I-2 66.3%
SPACE CONSIDERATIONS Thermal: Individual control for patient rooms Control sun temperatures Outdoor spaces need sun protection Acoustic: Natural noise from medical devices can be disturbing Design for acoustic control to alleviate stress A redesign had white noise installed in the ceilings in the hallways to help mask some of the sounds Air quality: Needs good filtration since immune systems are compromised Prevent airborne illness
CODE ANALYSIS
USE GROUPS
MAXIMUM TRAVEL DISTANCE TO EXIT
Employee Spaces: B (Business) Reception, Cafeteria, & Conference: A-2 (Assembly) Inpatient Spaces: I-2 (Institutional) Outpatient Spaces: I-2 (Institutional) Closets: S-2 (Storage)
B: 300' A-2: 250' I-2 (Inpatient): 200' I-2 (Outpatient): 200' S-2: 300'
AREA PER GROUP B: 3,4OO SF A-2: 4,800 SF I-2 (Inpatient): 10,200 SF I-2 (Outpatient): 5,800 SF S-2: 720 SF
OCCUPANT LOAD
INTERIOR FINISH CLASSIFICATION
B: 22 A-2: 320
USE
EXIT PASSAGE
CORRIDORS
ROOMS
I-2 (Outpatient): 58
B
B
C
C
S-2: 2
A-2
B
B
C
TOTAL OCCUPANT LOAD: 444
I-2
B
B
B
S-2
B
B
C
I-2 (Inpatient): 42
RESTROOMS PER SPACE Inpatient Rooms: 1 per room Employee Spaces: 1 Visitor Spaces: 1 Assembly Spaces: 5
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ACCESSIBILITY
EXAM ROOM
SURFACES
TURNING CLEARANCES
ACCESSIBLE ROUTE
MINIMUM # OF WHEELCHAIR SPACES USE
MIN. NEEDED
B
1
A-2
6
I-2 (Inpatient)
2
I-2 (Outpatient)
4
ACCESSIBILITY
ADA RESTROOM
PUBLIC RESTROOM
PRIVATE RESTROOM
MOUNTING HEIGHTS
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PLAN PROTOTYPES
PLAN PROTOTYPES
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PLAN PROTOTYPES
"WE NEED BETTER ARCHITECTURE AND PLANNING: MORE IMAGINATIVELY EXCITING, MORE INVOLVING, MORE OUR OWN." ~ ROBIN BOYD
RESEARCH Summary Color and Material Environmental Responsibility
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SUMMARY
THESIS RESEARCH The average amount of time spent in a hospital for burn treatment is 4-9 days,
IMPACT ON MENTAL HEALTH OVER TIME
but the stay may be longer if the patient receives surgery and needs to
Full Recovery 33.3%
recover. If the burn is serious enough a patient may need to go to a rehab facility before going home. Since physical health is the primary goal, a burn victim may cope with
Did not fully recover 66.7%
psychological trauma from surgeries, pain, and intensive care by themselves. Hospital stays can affect a patient’s
DEPRESSION
1 month 15% 12 months 6%
mood with the most common mental health issues being delirium, dementia, and depression. These common issues may stay with patients even after they leave the hospital. A study that analyzed patient mental
79%
1 Month 16%
health with recovery and how long they spent in a hospital showed a higher depression score at baseline
ANXIETY
12 Months 10%
and spending more nights in a hospital were associated with significantly reduced odds of recovery. Designing a space where patients and
74%
caregivers feel comfortable can increase their satisfaction in the time spent in the hospital. Clear navigation can also increase the level of satisfaction patients and caregivers feel while staying at the hospital.
HIGHER DEPRESSION SCORES AT 1 MONTH WERE ASSOCIATED WITH LOWER ODDS OF SELF-REPORTED RECOVERY AT 12 MONTHS, AS WERE SPENDING MORE NIGHTS IN A HOSPITAL AND GREATER LEVELS OF PAIN
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COLOR & MATERIAL
COLOR
MATERIAL
Australia uses Western color theory; no
Materials for healthcare design must
specific color has a different meaning
meet certain specific requirements to
to them than as recognized by
ensure the safety and health of
Western culture.
patients and doctors alike.
Warm colors are associated with passion, happiness, enthusiasm, and energy. Orange is a vibrant and energetic color
Flooring should be non-slip and high
that can be associated with change
durability.
and movement. It is considered a friendly and inviting color. Yellow is associated with hope and is considered the brightest and most energizing of colors.
Furniture fabrics should be antibacterial/ anti-microbial and
Cool colors are calming and relaxing.
finish surfaces on tabletops, counters, etc. should be able to handle harsh
Light blues are considered refreshing
chemical disinfectants.
and friendly. The shade of blue can have a varying impact on the tone it is creating.
Ideally, inpatient rooms would include blankets and pillows that are able to be thoroughly disinfected, or, if the hospital policy is to throw everything away, they are made from sustainable materials.
ENVIRONMENTAL RESPONSIBILITY
COMMUNITY 10%
AIR 10%
MIND 10%
MATERIALS 10%
WATER 10%
WELL V2
SOUND 10%
NOURISHMENT 10%
THERMAL COMFORT 10% LIGHT 10%
MOVEMENT 10%
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ENVIRONMENTAL RESPONSIBILITY
Aims to achieve high levels of indoor
Promote human productivity and
air quality across a building’s lifetime.
provide a maximum level of thermal comfort among all building users
Covers aspects of the quality,
Bolster occupant health and well-
distribution, and control of liquid
being through the identification
water in a building
and mitigation of acoustical comfort
Requires the availability of fruits and
Reduce human exposure, whether
vegetables and nutritional
direct or through environmental
transparency
contamination, to chemicals that may impact health
Promotes exposure to light and aims
Promotes mental health through
to create lighting environments that
policy, program, and design
promote visual, mental, and biological
strategies
health
Promotes physical activity in everyday
Support access to essential
life through environmental design,
healthcare, build a culture of
policies, and programs
health that accommodates diverse population needs
RESEARCH STUDY TEAM: JASMINE SNYDER & HANNAH RICHARDS
HOW CAN DESIGN IMPROVE HEALTHCARE?
INTERVIEW: WILLIAM WINSTEAD
For our research study, we created a survey to learn how patients viewed healthcare facilities and if they felt there were areas that needed improvement through design. There were 17 questions varying between multiple choice, ranking 1-5, and short responses. Additionally, we interviewed 2 healthcare professionals
MEDICAL STUDENT SCRIBE AT CARETODAY CLINIC As a scribe and medical student, William
and asked their opinions on how
brought unique insight to our research. He
healthcare environments could
put a strong emphasis on the importance of
improve.
communication, especially between different parts of a medical facility and how
STIMULATION THEORY Arousal perspective: behavior is influenced by how stimulated we are by our environment. In hospitals, patients can be overstimulated by noise, lighting, etc. which can affect their recovery
the layout can play a role in the success or failure of this. He also talked a lot about how important he believes access to daylight is not only for his patients but also for the medical staff’s own health and sanity. William further added to his point about daylight when he discussed his favorite place being the lobby where there is a large atrium and windows that let lots of light into the space.
process. In this research study we looked at how the environment can impact patients and employees in the healthcare system.
KEY THEMES & TOPICS:
WAYFINDING PRIVACY LIGHTING COMFORT
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RESEARCH STUDY TEAM: JASMINE SNYDER & HANNAH RICHARDS
SURVEY RESULTS
INTERVIEW: FRED PRICE
8 1y - 2y 7.1%
6
4 6m 1y 35.7%
Within 6m 57.2%
2
0
LAST TIME IN A MEDICAL
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2
3
4
5
NURSE MANAGER
LEVEL OF COMFORT
WAKE FOREST BAPTIST HEALTH
FACILITY
As a person who has worked in several burn units, Fred knows what is missing from an effective hospital unit. He believes the nurses
8
Specialist 7.1%
station should be barrier free, the nurses
ER 7.1%
need a break room that does not look as 6
Clinic 28.6%
sterile as the environment they work in, and the more access to daylight the better. He knows that patients need their rooms to be a
4
safe space and that hallways need good acoustic control in order to minimize stress
2 Hospital 7.1%
on patients. Fred thinks it is good to
Primary Care 50.1%
0
TYPE OF MEDICAL FACILITY
QUALITY OF PATIENT ROOM
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2
3
4
5
incorporate areas of outdoor space for both employees and patients so they can have fresh air and sunshine.
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Support Role 21.4%
7.5
INCORPORATION OF OUTDOOR SPACE SHOULD BE IMPORTANT
5
NURSES HAVE NEEDS THAT, WHEN MET, CAN Patient 64.4%
COVID Testing 14.2%
EMPLOYEES- MAKING THE PATIENT 0
REASON FOR VISIT 31
MAKE THEM BETTER AND MORE EFFICIENT
2.5
1
2
3
QUALITY OF LIGHT
4
5
EXPERIENCE BETTER ACOUSTIC CONTROL IS AN IMPORTANT FACTOR OF INPATIENT AREAS
SOURCES APA
SOURCES APA