Portfolio Nayma by Nayma Khan

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Table of Content Personal Profile Undergraduate Studio Works Professional works International Design Competition Teaching Philosophy Teaching Experience Teaching sample on Healthcare Design at BUET Teaching Sample , Students work at KU Sample of Teaching Evaluation Research Interest Research Presentation Award/ Fellowship/Honors Research Poster Presentation Research Publication

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Personal Profile Graduate Teaching Assistant /Phd Student Department of Architecture The University of Kansas E-mail: n221k306@ku.edu Phone: 785-979-7010

NAYMA KHAN Mailing Address: 1712 Anna Dr. Apt.#08 Lawrence, Kansas 66044

PhD

ACADEMIC QUALIFICATION: The University of Kansas, USA, pursuing ( started 2010 )

M.A.

The University of Kansas, USA, 2013

M. Arch

Bangladesh University of Engineering & Technology ,Dhaka, Bangladesh, 2008

B. Arch

Bangladesh University of Engineering & Technology ,Dhaka, Bangladesh, 2001

Undergraduate Studio Works

at Bangladesh University of Engineering and Technology

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PROFESSIONAL WORK

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PROFESSIONAL WORK

Basement plan

First floor plan

Extension of Pan Pacific Sonargaon Hotel

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PROFESSIONAL WORK N

P o r t f o l I o 03 PROJECT NAME: Residence of Mr. Tariq Haider at Dhaka, Bangladesh Client: Mr. Tariq Haider Consultant: Freelance Project Project commencement: March, 2005 Project Completion: December, 2011 Architect: Nayma Khan

Typical floor plan

Section

Front elevation

04 Project received IAB Design Award 2002

Taimur Islam, Homaira Zaman

P o r t f o l i o 06 PROJECT NAME: Residence of Mr. Shahidul Islam Client: Mr. Shahidul Islam Consultant: Freelance Project Project commencement: June, 2004 Project Completion: December, 2009 Architect: Nayma Khan

Typical floor plan

Ground floor plan

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International Design Competition FOR FAEL KHAIR SCHOOL-CUM-SHELTERS in BANGLADESH N

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Teaching Philosophy N

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Teaching Philosophy My teaching method focuses on planning a goal-driven course and emphasizes on the integration of research and design. I believe that an effectively designed course should encourage students to explore their own thinking and experiment with new ideas. In my studio, I focus on refining studentsâ&#x20AC;&#x2122; analytical and representational skills through introducing precedent analysis and organizing software workshop within an architectural presentation. The objective is to involve my students with research before starting design and to prepare them to present their idea as professionals. For me, architectural studio is not only a procedural or systematic activity that aims to guide students in generating ideas, solving design problems, creating alternative design solutions and transforming their ideas into architectural drawings and models, but more, it is an activity that trains students in understanding configurations of space within living cultures, potentials, constraints, variables and needs for designing sustainable architecture. Therefore my goal is to introduce an innovative paradigm of evidence-based enquiry in which students learn how to think strategically about the role of spatial configuration to improve user experience in the design process and in relation to pressing questions such as the sustainability of the built environment. I teach architectural studio within this framework. Therefore, I always encourage students to challenge their ideas to move beyond traditional three-dimensional form and I help them understand how people make and use spatial configuration in building. In other words, I help my students understand how spatial configurations generate social interactions in the built environment and how social interaction impacts user experience in architecture.

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Teaching Experience

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Graduate Teaching Assistantship: Department of Architecture, The University of Kansas ,USA (from August 2011-till now )

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Graduate Research Assistantship: Department of Architecture, The University of Kansas ,USA (from August 2010-May, 2011)

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Assistant Professor : Department of Architecture, BUET, Dhaka, Bangladesh (From 30st Oct 2009-July 2010)

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Lecturer: Department of Architecture, BUET, Dhaka, Bangladesh (From 17th March 2003-30st Oct 2009)

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Teaching Evaluation

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Teaching Sample Healthcare Teaching Experience at Bangladesh University of Engineering and Technology N A Y M A

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Student Work:01 University: Bangladesh University of Engineering and Technology Studio no:

IX ( Level 5, Term -1)

Design Teacher: Dr. Shahedul Ameen Prof. kairul Enam Nayma Khan

Project name: Design of A Hospital complex Project duration : 12 weeks

Southern Medical Collage Hospital , Khulsi, Chittagong, Bangladesh

Preparation of Construction Document

Student Work: 02 University: Bangladesh University of Engineering and Technology Studio no:

IX ( Level 5, Term -1)

Design Teacher: Dr. Shahedul Ameen Prof. kairul Enam Nayma Khan

Project name: Design Through Inquiry Project Duration : 12 weeks

Program Brief : The aim of the project was to make students competent in dealing with realistic problems in an assigned setting within the given socioeconomic context. Among five given options of building types, “Health Facilities” was picked up according to the individual’s liking & strength. The Means & Outcome of Inquiry was to be submitted by a group of 3 students, consisting Literature Review, Case Study & Site Selection, while the Designphase was to be done individually.

Southern Medical Collage Hospital , Khulsi, Chittagong, Bangladesh

The Site : The selected site is at the heart of a dense residential area of the capital city Dhaka, where already an old 3-storied residence is converted into a private clinic. The neighborhood observes a mushroom-like growth of very small-scale Private Clinics & Diagnostic Centers to meet the local needs mainly. But the existing road-network makes it easily accessible from the other parts of the city.

A) Zoning : # The solution of an introvert planning in a dense & busy neighborhood, # IPD & noise-sensitive areas away from the two busy roads & their noise & dust, # Adjacent private road with low traffic utilized for the service entry, # Existing security reasons & restriction of 1 & 2-way traffic lead to the solution of a single entry for OPD, IPD & Emergency. (B) Functional Distribution : # Scarcity of horizontal site-area leads to the solution of the vertical stacking of the hospital functions into ‘Base’, ‘Buffer’ & ‘Tower’, according to the level of public access & IntraDepartmental relationships. # The 3-storied ‘Base’ consists of the OPD & the shared facilities of OPD & IPD, like - the Emergency unit, Pharmacy, Doctors’ Chambers, Pathological Lab & Diagnostic Center, Operation Theaters, Maternity, Blood-bank etc. # Level 4, consisting the Administration & some supporting functions such as Café, Prayer-hall etc. acts as the ‘Buffer’ between the OPD & IPD, as well as serving them equally.

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ARCH101 Spring

2013

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COURSE DESCRIPTION: This course is a continuation of ARCH 100, with major emphasis on the design relationships among people, architectural space, and the environment. The course is based on a series of exercises leading to the understanding of architectural enclosure as mediating between people and the outside world. Issues of scale, light, proportion, rhythm, sequence, threshold, and enclosure are introduced in relation to the human body, as well as in relation to architectural form, environment, and social and psychological factors. Students will engage in drawing, perspective projection, model building, and basic computer graphics. Prerequisite: ARCH 100

Teaching Sample Students Work at University of Kansas

Architectural Foundation II

ARCH 101 N A Y M A

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Spring 2013 PROJECT

S t u d io K h a n

Student Work: 01

FOLDING ARCHITECTURE : A Playful Pavilion

Student Work : 02

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S t u d io 2013

Student Work : 03

FOLDING ARCHITECTURE : A Playful Pavilion

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Architectural Foundation II

ARCH 101 K H A N

Spring 2013 PROJECT

2013 K h a n

S t u d io

Student Work: 01

UNFOLDING: Learning From Buildings

Student Work : 02

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Architectural Foundation II

ARCH 101 K H A N

Spring 2013 PROJECT

2013 K h a n

S t u d io

Student Work: 01

Gathering Space: A New Bus Stop for KU Campus

Student Work : 02

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S t u d io

2013

Student Work: 03

Gathering Space: A New Bus Stop for KU Campus

Floor Plan

Section Section

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Architectural Foundation II

ARCH 101 K H A N

Spring 2013 PROJECT

Student Work: 01

A learning shelter: A New Donald Hatch Reading Room

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S t u d io

2 0 1 3 ……………….

Student Work : 02

2013 K h a n

S t u d io

Student Work: 03

Analysis of form and function

A learning shelter: A New Donald Hatch Reading Room

Axonometric view

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ARCH101 Fall

2013

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COURSE DESCRIPTION: A continuation of ARCH 101 with a series of studio exercises following a succession based on analysis, form, and syntax, with an emphasis on the communication of architectural ideas. Students explore plan, section, and spatial organization, spatial sequence, structure and materiality in relation to human dwelling and the building site. The course aims to focus on the organization of multiple spaces in a building design.. Students will consider natural forces as they both shape and affect buildings, including gravity, wind, light, heat, sound, and fluids. Precedent studies, direct observation, building analysis, and site analysis are significant aspects of this semester. The main objective is to reinforce the aspects previously developed in Arch 101 and introduce new variables related to architectural design such as structural design, natural forces, building function and performance.

Teaching Sample Students Work at University of Kansas

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Architectural Foundation II

ARCH 101

Fall 2013

PROJECT

Student Work: 01

S t u d io K h a n

Student Work : 02

2013

Building an Icon : A Traffic Booth on Jayhawk Boulevard

Floor Plan

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Architectural Foundation II

ARCH 101

Fall 2013

PROJECT

2013 S t u d io K h a n

Student Work: 01

New Dwellings for KU Graduate Students

2013 S t u d io K h a n

Student Work: 02

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New Dwellings for KU Graduate Students

First Floor Plan

Second Floor Plan

Student Work: 03

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S t u d io

2013

New Dwellings for KU Graduate Students

1st Floor plan

2nd Floor plan

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Architectural Foundation II

ARCH 101

Fall 2013

PROJECT

S t u d io

2013

Student Work: 01

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Stouffer Place Community Center

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Student Work: 02

1st Floor plan

2nd Floor plan

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S t u d io

2013

Stouffer Place Community Center

Structure

2nd floor plan

1st floor plan

Student Work: 03

2013 S t u d io K h a n

Project 03

Stouffer Place Community Center

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ARCH101 Fall

2012

Teaching Sample Students Work at University of Kansas

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FALL 201 2 ……………………………………………….Student Work 01

ARCH 200 Fall

2012

……..………………………………………….…………Student Work 05

……………………………………………..…Student Work 03

Student Work 04…………………………………………………………………….

Student Work 02…………………………………………………………………….

Multi-Functional Staircase

2013

2012

…………………………………………Student Work 01

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LAWRENCE SCULPTURE GARDEN

S t u d io

ARCH 200 Fall

Student Work 02…………………………………………………………………….

…………………………………………Student Work 03

Student Work 04…………………………………………………………………….

…………………………………………Student Work 05

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Research Interest My research interest is to explore the concept of Experience Based Design (ExBD) in healthcare environment. ExBD is a user-focused design approach that was developed by the UK’s National Health Services’ (NHS) to offer patients a better experience of treatment and care. The main focus of this design approach is to make user experience accessible to the healthcare designers and planners to promote better healthcare environment. Improving patients’ experience is an operational priority to promote quality of care in healthcare environment. In most cases when patients come into contact with the services, their subjective experience is shaped by their personal interpretation of a situation based on the psychological processes, social factors and physical conditions of the setting. I believe that the ExBD approach can provide us a more comprehensive understanding of environmental variables which have an impact on patients’ emotions and help healthcare designer and architect to design patient friendly healthcare environment.

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Research Experience Year

Title/ Resource/ Supervisor

2010-2014 PhD Dissertation

Spatial Correlates of Patientsâ&#x20AC;&#x2122; Travel Experience and Satisfaction in the Hospital of Bangladesh Supervisor: Dr. Mahbub Rashid

2012-2013 AAUW

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International fellowship ( amount $ 20,000)

Making Women-Friendly Hospitals in Bangladesh: An Investigation into the Effects of Hospital Layouts on Wayfinding Problems and Patient Satisfaction among pregnant Bangladeshi Women. Principal Investigator: Nayma Khan

2011-2012 Pilot Study at

Spatial Correlates of Patients' Travel LMH Experience and Satisfaction in Outpatient for Dissertation Department- a Pilot Study

2008

M. Arch Thesis

Advisor: Dr. Mahbub Rashid, Dr. Kent F. Spreckelmeyer Study of Morphological Transformation in the Planned Residential Area of Dhaka City Supervisor: Dr. Farida Nilufar

2001

BUET Funded Project as Research Assistant

Evolution of House Form in Urban Dhaka. Under a grant from Committee of Advanced and Scientific Research (CASR,) BUET Principal Investigator: Dr. Nizamuddin Ahmed,

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Research Presentation POSTER/ ORAL PRESENTATIONS :  Poster Presentation on titled “Understanding patients’ travel experience and satisfaction in relation to wayfinding” in the 2012 Graduate Research Competition Program organized by Office of graduate studies, the University of Kansas, 2012  Poster Presentation on titled “Analyzing Patient flow in a Hospital Building: Investigation into the Methodological Implication of Space Syntax for Estimating Patient Movement to Improve Operational Efficiency in Hospital Design” in the 2011 Graduate Research Competition Program organized by Office of graduate studies, the University of Kansas, 2011.  Oral presentation on title, Understanding Patient’s Satisfaction and Travel Experience in relation to Wayfinding", has been selected for EDRA44Providence, 2013.  Oral presentation on titled “Understanding Patients’ Satisfaction in relation to Wayfinding at LMH”. Research presented at the Lawrence Memorial Hospital, Lawrence, Kansas, 2012.  Oral presentation on titled “Spatial Logic of Morphological Transformation: A Paradigm of planned - unplanned areas in Dhaka city” in the 7th international Space Syntax Conference in Stockholm, 8-11 June, 2009.  Oral presentation on titled “Making Women-friendly Hospitals in Bangladesh: An investigation into the effects of Hospital layouts on Wayfinding problems and Patient Satisfaction among Pregnant Bangladeshi Women”. Research presented at the AAUW, Shawnee Chapter, KS, October 20, 2012

INVITED PRESENTATION:  Guest Lecture, “Spatial structure Of Dhaka City,” in the 4th year Design Studio, Department of Architecture, BUET, Dhaka, Bangladesh.  Guest Lecture, “Morphological Transformation in the Planned Residential Areas of Dhaka City” in the Post Graduate Research Seminar, Department of Architecture, BUET, Dhaka, Bangladesh.

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AWARDS /HONORS / FELLOWSHIP: 

AAUW International Doctoral Fellowship, 2012-2013 (Amount $20,000)

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KU Graduate Summer Fellowship, 2012(Amount $5,000)

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KU Graduate Research Completion, 2012( Amount $250)

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Ahsanur Rahman Gold Medal , BUET, 2008 ( for highest CGPA in M. Arch)

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BUET Travel Grant for presenting Conference paper, 2009. University Merit Scholarship in different Term Final Examination( 1994-2000)

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Jessore Board , Bangladesh Merit scholarship for S.S.C Examination(1990-1992)

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Research PublIcation LIST OF PUBLICATIONS :( Books/Journals/ Conference Proceedings) Publications (Refereed Journals): 

“Evolution of House Form in Dhaka City”, Global Built Environment Review, UK. Volume 3, Issue 3, 2004 (Principal author: Dr. Nizamuddin Ahmed , Professor, Dept of Architecture, BUET)

Publications (referred proceedings):  “Constructing Genotype in Hospital Design: A comparative study of the layouts of hospital buildings in Bangladesh” Abstract and Long Paper published at 9th International Space Syntax Symposium in Seoul, South Korea, 31 October - 3 November .2013.  “Spatial Correlates of Patients’ Travel Experience and Satisfaction in Hospital Outpatient Departments", Abstract and paper published at ARCC Architectural Research Conference, 2013, North Carolina.  “Analyzing Patient Flow: Reviewing Literature to Understand the Contribution of Space Syntax to Improve Operational Efficiency in Healthcare Settings” Abstract and Short Paper published in the 8th International Space Syntax Symposium, 2012.  “Spatial Logic of Morphological Transformation: A Paradigm of planned - unplanned areas in Dhaka city.” Abstract and Paper published and presented in the 7th International Space Syntax conference in Stockholm, June 2009. (Co-author: Dr. Farida Nilufar, Professor, Dept. of Architecture, BUET).  “Transformation of Urban core and Its Impact on the planned areas in the Organic City of Dhaka” Abstract accepted for the sixteenth international Seminar on Urban form (ISUF 2009). Publication in Books : 

“Planned areas of Dhaka city in an unplanned context: Spatial logic of their Morphological Transformation”. (as co-author with Dr. Farida Nilufar, Professor, Dept of Architecture, BUET) This paper is accepted for publication in a book titled “ Urban Design Issues in Developing Countries” and to be edited by Prof Dr. Mohammad Mahbubur Rahman to be published by the UTM Press, Kuala Lumpur, Malayasia

Articles in the National Print Media:  Khan, Nayma, “The Transformation of the old houses of Dhaka” in the National Daily Newspaper ‘The Daily Star’, 20 February, 2004. (Principal author: Dr . Nizamuddin Ahmed , Professor, Dept of Architecture, BUET)  Khan, Nayma, “Fire hazards in new shopping centers of Dhaka City” in the National Daily newspaper ‘The Daily Star’ ,14 June 2002 (Coauthor: Dr . Nizamuddin Ahmed , Professor, Dept of Architecture, BUET).

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Poster Presentation won Graduate Research Competition 2012

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Poster Presentation won Graduate Research Competition 2012

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Sample of Publication N

Proceedings of the Ninth International Space Syntax Symposium Edited by Y O Kim, H T Park and K W Seo, Seoul: Sejong University, 2013

CONSTRUCTING GENOTYPE IN HOSPITAL DESIGN: A comparative study of the layouts of hospital buildings in Bangladesh

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Nayma Khan The University of Kansas e-mail : n221k306@ku.edu

Abstract Space Syntax describes the spatial configuration of a building in terms of the pattern of connections. The analysis process gives a measure to each “unit” of space and describes how it relates to others in a configurational system. In space syntax literature, genotype is defined as relational and configurational consistencies in the spatial layout of buildings that express social and cultural patterns. The aim of this paper is to describe the genotype of 250-bed hospital layouts of Bangladesh. The study analyzes six hospitals of 250-bed hospital buildings within a cultural tradition. The six hospitals represent two types of hospital building forms: courtyard type and linked compact block. An “Integration” measure is used to look at the distribution of departments, their ranking order, and their difference factor value. The objective is to determine the consistency and difference in spatial patterning that exists in the layouts of these hospitals of Bangladesh. The findings show that the clinical categories of spaces do not show any consistency in the design of hospital layout; rather the social categories of spaces are more dominant in the formation of space in 250-bed hospital design in Bangladesh. This understanding is important for describing the functional relationship among different departments that comprise the hospital buildings and also for explaining how culture and social relations shape the hospital layout in Bangladesh. Keywords: Genotype, Hospital Design, Linked Compact Block, Courtyard Type, Bangladesh Theme: Building Morphology and Performativity

Proceedings of the Ninth International Space Syntax Symposium, Seoul, 2013

Genotype in Space Syntax The term “genotype” refers to all or parts of generic constitution of a cell, an individual, or an organism. In space syntax literature, this term is used to describe the systematic difference in spatial configuration between similar types of a building form from a region. The term “genotype” was first introduced by Hillier and Leaman (1974) to describe how personal and environmental factors make a difference in the design process. They argued that culture plays a big role in in modifying the unwritten design of a building’s program. The deep cultural structure that remains unchanged through several generations in the design process is called “genotype”. Later, Hillier, Hanson, and Graham (1987) define “genotype” as a consistent configurational and relational pattern of a building that represents the social and cultural order of using space in a building. They used space syntax theory and method to rank order the functions of houses according to the integration value and thereby recognize the relational structure of spatial configuration. “Space syntax” is a methodology, or a set of techniques, for the representation, quantification, and interpretation of spatial configuration in buildings and settlements (Hillier, Hanson, and Graham 1987, Hillier and Hanson 1984, Hillier 1996). It provides a systematic approach to analyzing spatial configuration and to understand how social and cultural contents are embedded in spatial patterns. In space syntax, the configuration is defined as an organization of spaces that describes the relation of two spaces considering the other spaces in the system (Hillier and Hanson 1984). The arrangement of each space is critically affected by its position and accessibility to other spaces. According to Hillier and Hanson (1984), through a systematic organization of the integration values of functional spaces, it is possible to observe the structural relation between different programmatic spaces in a building (Hiller, Hanson and Graham 1987). If ranking order of programmatic spaces according to their integration values shows a systematic numeral difference in spatial pattern, the ranking order represents the presence of cultural influence in shaping the spatial configuration of that building. Hillier, Hanson, and Graham (1987) term this type of relational differentiation of functions within a plan as “inequality genotype”. The aim of this paper is to interpret the inequality genotype in spatial patterns existing in the layout of the 250-bed hospitals of Bangladesh and to develop an understanding of how culture and social relations shape the arrangement of clinical functions in these hospitals. The analysis has been done across a sample of 250-bed hospitals by observing the difference in integration value among the clinical functions. Numerical differences in the integration value of clinical functions helps us to understand the cultural pattern that exists in the layout of hospital buildings of Bangladesh.

The Sample and the Problem Hospitals are one of the complex building types that require smooth coordination of different services and functional units. An ideal hospital form is comprised of inpatient and outpatient functions; diagnostic and treatment functions; service functions; research and teaching functions (Figure1). In the hospital layout, the outpatient and inpatient functions are connected with each other through administration, diagnostic and treatment, service, research & teaching functions. The physical relations among between these functions mainly determine the configuration of a hospital. In Bangladesh, the 250-bed district hospital provides secondary level out-patient, in-patient, emergency, laboratory and imaging services to the people. In the past, N Khan : Constructing genotype in hospital design

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the buildings that served as health facilities and clinics were not different from other buildings in terms of space, meeting functional requirements or architectural expression. But in the 1970s and 1980s, the government started to build hospitals designed to serve as secondary healthcare facilities. A great variety of shape and layout have been used among typologies in the design of 250-bed district hospitals in Bangladesh (Figures 1 and 2).

Figure 1: General Hospital Functional Relationship

Figure 2: Agraph analysis of courtyard type 250-bed hospital layout

In the courtyard plan, the compartmentalization of hospital functions is evident in the layout. All programmatic functional spaces are designed in separate blocks around a courtyard and are connected with each other through corridors. Visually, this type of layout provides certain degree of hierarchy, security and privacy. For analysis, the study took three samples from courtyard type: Hospital A—Faridpur 250-bed district hospital; hospital B—Chaina-Bangladesh 250-bed district hospital; hospital C—Kishorgang 250-bed district hospital. In the linked compact block layout, four blocks constitute the plan. All the blocks are connected with short corridors and separated by open spaces. This type of layout reduces the walking distance between departments and also ensures privacy and security. The study selected three samples from this type: hospital D-Narayangang 200-bed district hospital; hospital E-Jamalpur 250-bed district hospital; hospital F -Cox’s Bazar 250-bed district hospital (Figure 3). N Khan : Constructing genotype in hospital design

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This study is mainly concerned with the spatial analysis of these two different types of 250-bed hospital layouts to understand if any systematic relation exists between, on the one hand, the ranking order of integration values and, on the other hand, the arrangement of programmatic space within these two types of samples. The goal is to reveal the cultural pattern that exists in the layout of 250-bed hospitals of Bangladesh.

Figure 3: Agraph analysis of linked compact block type 250-bed hospital layout

Procedure of Analysis Justified graphs are analyzed for each hospital using the exterior as a root (Figures 2 and 3). In these graphs, each space- a room or a clearly differentiated space supporting clinical functionsis represented by a gray colored circle. Each transition or circulation space- passageways, lobbies and stairs â&#x20AC;&#x201C;is shown as a dark point. All clinical functions are aligned in levels to show how one must reach each space from the root. The first stage of the analysis has been done based on depth and choice -two of the configurational properties of spatial layout. According to Hanson (1998), â&#x20AC;&#x153;the depth among a set of spaces always expresses how directly the functions of those spaces are integrated with or separated from each other, and thus how easy and natural it is to generate relation among them.â&#x20AC;? The study uses the depth measure to state how directly the clinical functions are accessible from the transitional space (corridor). If the space is directly accessible from a transition space, the space is described as being at depth 1 from the transition space. If it is necessary to pass one intermediate space to get to the space under consideration, then that space is described as being at depth 2 from the transition space. Likewise, if the space passes through a minimum of two spaces, then it is described as being at depth 3, and so on. The choice measure defines the spatial layout in tree-type or ring-type layout. The presence of ring in the layout provides more choice of movement from any particular space by adding connections within the configuration. On the other hand, the tree type layout provides less choice of movement: it always forces permeability from any specific space to reach different N Khan : Constructing genotype in hospital design

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functional spaces in the layout (Hanson 1998). The movement in tree-type layout is highly controlled and predictable and supports highly framed social interaction, whereas the ring-type layout provides less control on that movement which that supports more social interaction. The second stage of the analysis uses the integration value to describe the differentiation or the relational pattern of the clinical functions. The integration value of each space numerically expresses a key characteristic of how each space is embedded in the system. Through systematic organization of the integration values of functional spaces (their rank order, their difference factor value), the study describes the structural relation between different clinical functions of two different types of layout. In this study, the difference factor (DF) computes the spread and degree of configurational differentiation among integration values of functional spaces in hospital layouts (Hillier, Hanson, and Graham 1987, Hanson 1998). In the third stage of analysis, the spatial organization of clinical functions are clustered in terms of social and service space to identify the cultural order and genotype that shape the layout of hospitals in Bangladesh.

Configuration Analysis of Hospital Layout The arrangement of clinical functions shows two varieties of spatial layout in the courtyard plan. In the first type of spatial layout, clinical functions are always accessible directly from the most integrated transitional space at depth 1. In the second type of spatial layout, clinical functions lie on a single ring so that one can enter the space at one point on the ring and leave from a different point. The three hospitals with a courtyard plan are each connected with their exteriors in a very similar way. Each of these hospitals has three entries which form two rings with the exterior. In this case, the connection of ring with the exterior forces people to enter interior space from the exterior through some specific space. A graph analysis shows that hospital A is more ringy than hospital B and hospital C. It is possible that multi-phase construction of hospital A from 50-bed to 250-bed hospital developed more connections among different functions thus making the layout more ringy. In three cases, we find the Emergency Department always lies on the exterior ring and has more controlled entry from the exterior. The transition space shows more than two links with other functions in the layout and provides more choice of movement to other functions in the layout. In each of these three hospitals, the transition space makes an internal local ring between different floor levels through connecting the vertical circulation space. In the linked compact block type, the three samples show similar patterns that form locally ringy but globally bush like sub complex. At the same time, all clinical functions are linked in tree like layout. These layouts show two entries that form one single ring with the exterior. Compared to the courtyard plan, the linked-block layout provides less choice of movement from the exterior to enter the interior complex. The Emergency Department always lies on the exterior ring and allows more controlled entry through the exterior. In all cases, the transition spaces provide more choice of movement to link the clinical functions at depth 1. As in the courtyard plan, the transitional space (the corridor) in the linked-block plan makes a local ring with upper floors through vertical circulation. The main distinction between courtyard plan and the linked-block layout is that, in courtyard type, clinical functions are placed in the ringy route, whereas in the linked compact block type layout, except for the Emergency Department, no functional space participates in the ringy route that passes through the exterior.

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Type

Courtyard Type

Linked

Compact

Block Type

Sample

Name

Min (i)

Mean(i)

Max(i)

Hospital A

Kishorgang

4.09

6.45

9.77

0.84

Hospital B

Faridpur

3.68

5.65

9.05

0.85

Hospital C

Chaina Bangladesh

3.04

5.12

8.01

0.81

Hospital D

Narayanganj

3.42

5.98

9.37

0.8

Hospital E

Cox's Bazar

5.14

7.25

13.5

0.82

Hospital F

Jamalpur

3.56

5.57

9.63

0.81

Table 1: Integration analysis as a whole

Integration Analysis of Layout as a Whole This study performed a quantitative analysis by looking at the mean integration value of each sample and in each type of hospital layout as a whole. The degree of difference between the integration values across the samples show a consistent pattern in 250-bed hospital layout. To measure how weak and strong these integration inequalities are in the layout, the study calculates the degree of difference (DF) between maximum, mean and minimum integrations values of each type of hospital sample following the same method that was described by Hanson (1998). The analysis shows that the DF of linked-compact block layout is comparatively lower than the DF of the courtyard plan. This indicates that the configuration of clinical functions is more consistent and organized in the linked block type than the courtyard type. That is, there is less configurational difference in the courtyard layout. The ranking order of DF in courtyard type layout- hospitalB (.84)> hospitalA (.85) > hospital C (.81) -represent that hospital A and hospital B are holding higher DF than hospital C,a DF that is closer to 1. That means the arrangement of clinical functions in hospital A and B are more homogenized than the hospital C. On the other hand, the ranked order of the DF in the linked compact block type layouts- hospital E (.82)> hospital F (.81) > hospital D (.80) - show almost similar value and are comparatively closer to 0. This denotes that the linked compact block type layouts have more differentiated and structured space in the layout.

Integration Analysis of Clinical Function In table 2, all clinical functions are arranged according to the rank order of integration value from least integrated space to more integrated space. The mean integration value is taken as a borderline to allocate the clinical functions under integrated and segregated zone. The integration value above mean integration indicates the most integrated functions in the layout, whereas the integration value below mean value represents the segregated clinical functions in the hospital layout. In this analysis, the mean integration value states how shallow or deep on average the clinical functions are from one another in the layout. In the three courtyard-plan hospitals, the ranking order of clinical functions shows no consistent pattern in the distribution of integration values. In this type, all corridors (COR) and vertical circulations (VER CIR) are located in the most integrated space (Table 2). The pharmacy (PH) and ticket counter (TC) are always located in the segregated zone. The kitchen is located in the most integrated zone in hospitals B and C. The integration value of the Diagnosis Department is above the mean integration value in hospital A and hospital B, whereas in hospital C, the position of the department is below the mean integration value. The operation theater (OT) is always closer N Khan : Constructing genotype in hospital design

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to mean integration in all three samples. The administration (AD) is located at integrated zone for Hospital A and Hospital C, but in Hospital B, it is closer to the mean integration value. The outpatient department (OPD) and Emergency Department (EM) do not show any consistent pattern in three samples. The positions of nursing units (ward) are in the most segregated zone across all samples of courtyard type layout. COURTYARD TYPE Hospital A

Hospital B

KIT

5.34

4.5

WARD TC

5.68 5.78

WARD EX

4.83 5.2

TC EN

4 4.6

5.84

5.28

4.61

5.87

5.29

4.8

5.96

5.37

4.94

5.74

WARD

EX OPD OT

6 6.25 7

5.51 5.62 5.79

5.03 5.36 5.56

OT EN TC

5.98 6.2 6.38

COR

7.12

AD OT KIT DIAGNO S

OPD DIAGNO S WARD OT EM

LINKED COMPACT BLOCK TYPE Hospital D Hospital E DIAGNO 4.54 TC 5.69 S KIT 5.21 PH 5.69 AD 5.24 EX 5.74 DIAGNO OPD 5.51 6.2 S WARD 5.72 EN 6.58

5.94

5.8

7.37

OPD

6.4

KIT

5.8

7.42 8.27 6.45

COR VER CIR Mean

6.74 6.93 5.65

COR VER CIR Mean

5.91 6.13 5.12

DIAGNO S VER CIR AD Mean

Hospital C

Hospital F DIAGNO 3.56 S TC 4.28 WARD 4.69 OT

5.16

5.32

6.99

OPD

5.42

OPD OT KIT

7.14 7.34 7.4

EN AD PH

5.46 5.76 6.22

6.38

7.57

KIT

6.39

6.67

8.4

VER CIR

6.69

COR VER CIR Mean

7.1 7.1 5.98

COR VER CIR Mean

9.2 10.31 7.25

COR EM Mean

6.7 6.75 5.57

Table 2: Integration Analysis of Clinical Function

In the three hospitals with linked-compact block layouts, the analysis shows some consistency in the distribution of integration pattern. Like the courtyard type, the vertical circulations (VER CIR) and all corridors (COR) are in the most integrated space and therefore easily which is easily accessible from different clinical functions. The integration values of the Diagnostic Departments (DIAGNOS) are always located below the mean integration in three samples. That means the location of diagnostic department is not easily accessible in the layout. On the other hand, the position of the Emergency Department (EM) is always above mean integration and in a more integrated zone. The pharmacy (PH) and ticket counter (TC) do not show any consistent integration pattern in the layout. As in the courtyard plan, the operation theater (OT) is closer to the mean value in the three compact-block layouts. Moreover, like the courtyard type, the nursing unit (WARD) is also positioned in the segregated zone. The analysis shows two distinct pattern of genotypical tendency in the layout of 250- bed hospitals in Bangladesh. One pattern characterizes the highly integrating transitional spaces (both corridor and vertical circulation) that assimilate all clinical functions to form a more integrating interior. The other pattern signifies the secluded position of nursing units (WARD) that are always located in the deeper area in both types of layout. But the distribution of other clinical functions does not follow any order in the spatial layout. That means the clinical functions are assembled together by placing them next to each other without following any organizational order.

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COURTYARD TYPE Hospital A SERVICE

Mean SERVE

Mean PUBLIC

Hospital B

Hospital C

Hospital D

Hospital E

Hospital F

KIT

5.34

KIT

5.79

KIT

5.8

KIT

5.21

KIT

7.4

KIT

6.39

TC PH AD

5.78 5.96 8.27 6.34 7 5.84

TC PH AD

OT EM DIAGNO 4.54 S 5.73

5.69 5.69 8.4 6.80 7.34 7.57

TC PH AD

OT EM DIAGNO 4.94 S 5.29

6.38 6.38 5.24 5.80 5.98 6.67

TC PH AD

OT EM DIAGNO 5.94 S 5.64

4 4 5.8 4.9 5.36 5.56

TC PH AD

OT EM DIAGNO 7.37 S 6.74

4.5 5.28 5.51 5.27 5.62 5.37

OT EM DIAGNO 6.2 S 7.04

4.28 6.22 5.76 5.66 5.16 6.75

OT EM DIAGNO 3.56 S 5.16

COR VER CIR OPD

7.12 7.42 6.25 6.93

COR VER CIR OPD

6.74 6.93 6.4 6.69

COR VER CIR OPD

5.91 6.13 4.8 5.61

COR VER CIR OPD

7.1 7.1 5.51 6.57

COR VER CIR OPD

9.2 10.31 7.14 8.88

VER CIR COR OPD

6.69 6.7 5.42 6.27

WARD

5.68

WARD

4.83

WARD

4.03

WARD

5.72

WARD

6.99

WARD

4.69

Mean PRIVATE

LINKED COMPACT BLOCK TYPE

Table 3: Cluster of Clinical Functions into Social and Service Space

Integration Analysis of Social and Service Space: According to Hillier and Hanson (1984), the organization of space reflects the living patterns of a society. In exploring the cultural order in these two types of layout, the study clustered all clinical functions in terms of social and service spaces. First, all the clinical functions of the 250-bed courtyard plan and of the compact linked type layout are grouped into private and public space (Table 3). Public space indicates the possibilities of social interaction within clinical functions that is provided by the Outpatient Department (OPD), corridor, stair, ramp and elevator. Since public space here needs less control over communication to facilitate social xpected position should be in most integrated spaces. Because private relations, the e space requires more personalization and privacy as perceived by patients and staff, this type of space needs more control over communication and movement to maintain privacy. Therefore, the placement of private space should be in the more segregated space in the hospital layout. The study grouped other functions of hospital space under the categories of served and service space, although these categories and those of public/private are not mutually exclusive. That is, it is always possible to find public spaces that are also service areas. In this analysis, the service space category denotes those spaces that do not hold any primary function of hospital but provide secondary services to patients, like ticket counter, kitchen, café, and pharmacy. The category of served space indicates that the primary use of that designated space is to provide treatment to the patient like Radiology, Pathology, Emergency and Operation Theater.

다시

COURTYARD TYPE Hospital A

Hospital B

PRIVATE SERVICE SERVE PUBLIC

5.68 6.33 6.73 6.93

LINKED COMPACT BLOCK TYPE Hospital C 4.83 5.51 5.64 6.69

PRIVATE SERVICE SERVE PUBLIC

4.03 4.9 5.29 5.61

Hospital D

Hospital E

PRIVATE SERVE SERVICE PUBLIC

SERVICE PRIVATE SERVE PUBLIC

5.72 5.73 5.8 6.57

Hospital F 6.80 6.99 7.04 8.88

PRIVATE SERVE SERVICE PUBLIC

4.69 5.16 5.76 6.27

Table 4: Integration Analysis of Social and Service Space in Hospital Layout

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Table 4 shows that, in the courtyard plan, the location of public, private, served and service spaces reveals a more systematic ordering of Public > Served > Service > Private space in the hospital layout, describing the genotypical tendency of the 250-bed courtyard-plan hospital. On the other hand, in compact-link block type, the analysis shows that the spatial allocation of social and service space follow Pubic> Service > Served> Private order, where service space is located in more integrated zones than is the served space. As a grouped function, the integration value of the served and service spaces is always in between the public and private spaces. The most distinct consistency appears in the analysis of private and public space. In all six samples of both courtyard and compact-link layout, the public space ( OPD, corridor , stair , ramp and elevator) that helps to generate more social interaction, are located in the most integrated zone, and the private space (nursing unit) that needs more privacy is placed in the less integrated zone. Exception is made in case of Hospital E, where service space (6.80) is located in the least integrated zone. The analysis of the mean integration in hospital E shows that the private space has a higher integration value (6.99) than the service space (6.88), but the difference is not distinct in the analysis. It is possible that the minor variations in the justified graphs may have altered the rank ordering without necessarily changing the function of the hospital layout in a sufficient way.

Discussion & Conclusion: The study describes the structural relationship among different clinical functions and the possibilities for exploring the cultural order in hospital layout. In this research, Integration analysis highlights the way in which the two different types of 250-bed hospital layout are similar as a sequence of social program. The design process in the field of architecture usually groups the spaces of a given building according to the function of spaces. The integration analysis shows that the allocation of clinical functions does not follow any logic in the 250-bed hospital layout. Within each type, some phonotypical pattern exists in the layout, but this doesnâ&#x20AC;&#x2122;t show any genotype tendency within the layout. The study determines that, in Bangladesh, hospital spaces are laid out without considering the hierarchical order of depth of similar functions. Therefore, the spatial configuration shows less control on patientâ&#x20AC;&#x2122;s movement. Patients can move anywhere in the building and some patient areas even have to be crossed to enter other patient areas and non-patient areas. According to Murcus (1987) this type of spatial arrangement is obvious where medical and nursing professions were not well organized. In early period until the classifications of hospital functions were firmly established, the floor plans of hospital were more ringy and confused. Over time and with the advancement of the medical profession, hospital layouts showed high degree of articulation in the distribution of clinical functions. Patient areas in hospitals began to be designed in a tree-like structure to prevent patient-to-patient communication, while staff areas began to be designed in a ring structure to facilitate easy supervision by staff (Murcus 1987). In Bangladesh, the history of healthcare delivery with formal training facilities for medical practitioners is not very old, starting as it did in the 19th century during the colonial period. At that time, the hospitals started as dispensaries which, within short time, developed into a small hospital. But the effort to institutionalize the healthcare did not solve the healthcare problem caused by shortage of skilled manpower. With a view to increase the number of medical professional, government started to establish a number of medical colleges in Bangladesh. History shows that the government took a number of initiatives to improve healthcare services in Bangladesh. Several healthcare programs were implemented to control malaria, small pox, and cholera. Family planning programs were implemented to control population growth. Hospital services were improved through the expansion and construction of healthcare facilities. However, all of these programs were implemented in isolation, which may explain why the quality of service remained poor and the N Khan : Constructing genotype in hospital design

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majority of the population had poor access to healthcare services, as well as why the medical profession never conceived a more comprehensive and unified plan for the organization of hospital space. To discover a logical functional pattern in the hospital design, the layout of hospital is viewed as a relation of social and service space. According to Murcus (1987), this type of classification is important to define social structure and to elaborate the meaning of spatial relationship of a programmed building. Power and social structures, ideas, practices and beliefs of the societies play a great role in producing the form and structure of any classification system. This study shows that the courtyard plan and the compact-link block type both have high number of transitional spaces that are connected to the functional space in hospital layout. The transitional space that represents all corridors and vertical circulations generates more interaction between people. According to Hanson (1994), this type of transition space in hospitals generates un-programmed activity that does not directly support the clinical functions but acts as a highly permissive area that people occupy according to spatial hierarchy. Like transitional space, the outpatient department also offers more socialization in waiting area. The study defines this outpatient department and transitional space as public space and the analysis shows that in both types of hospital layout, the public space is located in the most integrated area of the hospital. On the other hand, the ward and patient room where people stay for a longer time are grouped under private space that need less socialization and more privacy. The expected location of this type of space is in a segregated zone. The integration analysis shows a low integration value for the private space in hospital of both types. The exception is present only in the case of Coxâ&#x20AC;&#x2122;s Bazar whose mean integration is higher than the rest of the sample. Here the relation of hospital layout to clinical function follows the morphological order by which social relation gives spatial meaning in term of segregation and integration (Hillier 1985). Hospital design practice in Bangladesh shows a homogeneous cultural pattern in the layout of hospital functions. The analysis shows that architects follow the simple generic pattern of house form and organization in designing space for hospital. The traditional house form in Bangladesh consists of several room arranged around a courtyard (Rahman & Ferdouse 2001). A clear physical distinction between formal, family, and service zones is evident in the organization of house form (Ahmed& Khan 2000). These zones are created based on considerations of privacy and accessibility (Mahmud 2013). In the spatial layout of a residential building, the outer public zone represents the formal living area while the private zone within a house is reserved for the deep-rooted practice of local lifestyle (Ahmed& Khan 2000). Because of privacy needs, the public zone is always placed in the front of the building and is easily accessible from the outside, while the private zone is always located at the back of the building. In courtyard and compact-link type hospital layouts, the spatial organization follows the same concern about privacy and accessibility. The outpatient departments (the public space) that serve the patients for short time periods are located in the most integrated zone, and nursing units or wards (private space) where patients stay for a longer period and need more privacy are placed in the less integrated zone. That means the design process follows the pre-acquired design conception of architects, where public, private, and service area, formal and informal zone, follow strong Bengali culture, values and norms without considering the detailed spatial arrangement on the caring units. According to Prior (1988), â&#x20AC;&#x153;Space is neither a container in which the social life occurs, nor a mere reflecting glass of social practices and social categories, nor indeed a determinant of social order. Rather like language, it has elements of all these, but ultimately its significance can only be fully comprehended in the context of situated social practice.â&#x20AC;? In that sense, the structure of hospital layout in Bangladesh represents some order of consciousness and purposeful N Khan : Constructing genotype in hospital design

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interaction of social practice. Research shows that architects of Bangladesh shape the layout of hospital building according to their own pattern language. Alexander (1979) defines this pattern language as a useful tool to design various new building types. Human lifestyle, behavior, social structure, power relationships and meaning help to create individual pattern language that actually is translated into some aspect of built form. Lawrence (2000) terms these aspects as culture which is “an integrated pattern of human beliefs, customs, norms, knowledge, morals, values, behaviors and institutions shared by a group, the inhabitant of a region or a nation.” To explain how culture is translated into built form, Rapoport (1980) defined culture as a system of symbols, meaning and schema that is translated through human action into built form. The study shows that the spatial organization of hospitals reflects the culture of residential architecture practice in Bangladesh. The communication, social status, identity and social meaning of space are the most influential cultural mechanisms that shape the hospital architecture in Bangladesh. The organization of clinical functions in hospitals of Bangladesh reflects the designer’s cultural values and norms. According to Hanson (1998), “Culture may influence design both through the framework of idea and social practice which architects acquire by socialization and in the most restricted concepts and values which have been acquired during their architectural education.” This study supports the findings of Bafna (2001), where he argued that the designer’s conscious design process does not follow the order of programmatic space, but rather that the designer’s personal and cultural beliefs play a big role in formulating the core of houses. Therefore, we can confidently say that the hospital design practice in Bangladesh mainly depends on other building genotypes that the designers practice as a method of design and which are reflected in the form of an integration inequality genotype in this research. This means that life style and culture as a combination of practice and representation give meaning to space in the design of 250-bed hospital environment in Bangladesh.

References Ahmed, Nizamuddin. and Nayma Khan. 2004. "Evolution of House Form in Dhaka City." Global Built Environmental Review (GBER) 3(3): 38-48. Alexander, Christopher. 1979. The Timeless Way of Building. New York : Oxford University Press. Hanson, Julienne. 1998. Decoding Homes and Houses. Cambridge University Press. Hillier, Bill. 1985. "The Nature of the Artificial: The Contingent and the Necessary in Spatial Form in Architecture." Geoforum 16(2): 163-78. Hillier, Bill. 1996. Space Is the Machine. Cambridge University Press, Cambridge. Hillier, Bill, and Julienne Hanson. 1984. The Social Logic of Space. Vol. 1: Cambridge University Press, Cambridge. Hillier, Bill, Julienne Hanson, and H. Graham. 1987. "Ideas Are in Things-an Application of the Space Syntax Method to Discovering House Genotypes." ENVIRON PLANN B 14(4): 363-85. Hillier, Bill, and Adrian Leaman. 1974. "How Is Design Possible?". Journal of Architectural and Planning Research 3(1): 4-11. Lawrence, R. J. 2000. "House Form and Culture: What Have We Learnt in Thirty Years." Culture-meaning-architecture; critical reflections on the work of Amos Rapoport, Ashgate Aldershot. N Khan : Constructing genotype in hospital design

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Mahmud, Shihabuddin. 2013. "Transformation a Way to Make an Old Building Potential for Income Generation: A Study in Core Dhaka, Bangladesh." Emirates Journal for Engineering Research 18 (1): 67-80. Markus, Thomas A. 1987. "Buildings as Classifying Devices." Environment and Planning B: Planning and Design 14(4): 467-84. Prior, Lindsay. 1988. "The Architecture of the Hospital: A Study of Spatial Organization and Medical Knowledge." British Journal of Sociology: 86-113. Rahman, Mahbubur, and Ferdouse A Haque. 2001. "Multiple Courtyard Mansions of Dhaka: Form and Context." Traditional Dwellings and Settlements Review 12(2): 57-72. Rapoport, Amos. 1980. "Cross-Cultural Aspects of Environmental Design." Human Behavior and Environment. Advances in Theory and Research 4: 7-46.

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Spatial Correlates of Patients’ Travel Experience & Satisfaction in Hospital Outpatient Department Nayma Khan University of Kansas, Lawrence, Kansas ABSTRACT: Designing a physical environment that is safe, accessible and easy to use can significantly improve patients’ satisfaction and the quality of healthcare experience. Literature shows that difficulties in wayfinding cause delay in patients’ movement, together with loss of time, decreased safety, and increase environmental stress. However, less is known concerning how wayfinding difficulties affect patients’ satisfaction and travel experience. In this research it is assumed that an easily accessible and visible spatial layout may have direct or indirect positive effects on patients’ movement, travel time, and way finding; and, as a result, it may have positive effects on patients’ travel experience and satisfaction. The data was collected through systematic behavioral observation, patient survey, and floor layout analysis that included the measurement of actual route distance, travel distance, and spatial network distance using space syntax techniques. Findings of the study include the following: 1) patients’ satisfaction depends on age, number of visits, frequency of visits, signage system, overall layout, and design quality; 2) patients’ travel behavior is positively affected by route attributes; 3) overall patients’ satisfaction does not seem to have any relation with the patients’ travel behaviors and syntactic attributes of the layout; and 4) male and female patients’ satisfaction and travel behavior show different association with syntactic properties of the layout. It is hoped that the study will contribute to an improvement of the design of the spatial layout of the outpatient department so that patients may receive their services in the least amount of time without becoming lost or missing an appointment due to wayfinding problems; and an increase in patients’ satisfaction and travel experience. KEYWORDS: Patients’ Travel Experience, Patients’ Satisfaction, Space Syntax, Spatial layout, Wayfinding.

INTRODUCTION Patient satisfaction is a useful measure in assessing patient’s experience in health care. This multidimensional concept focuses on the technical and interpersonal aspects of care, accessibility, and the outcome of the health intervention (Sitzia & Wood 1997). The purposes of measuring patient satisfaction are to understand patient experiences of health care, to promote co-operation with treatment, to identify problems in health care, and to make evaluation of health care (Fitzpatrick1984). Traditionally, the design of hospital was more focused on arranging a functional layout for the delivery of service rather than meeting the expectation of the user. Compared with the traditional concepts, the current design is more focused on creating an environment that meets and exceeds patients’ needs for safety, security, support, competence, and physical and psychological comfort (Fottler, Ford, Roberts, Ford, & Spears Jr 2000). Patient experience in the healthcare environment is an important factor in overall patient satisfaction and care outcomes. In hospital, patients get their first impression of the healthcare experience from the environment. This interaction with the environment can influence a patient’s experience and satisfaction level even before he or she receives any services. Spatial design, ambient condition, and signage system are the three environmental components that patients usually perceive when they first enter in the hospital settings (Fottler, etal. 2000). Due to complex spatial layout patients sometimes experience long travel distance that may adversely affect their satisfaction level. Literature shows that difficulties in wayfinding cause delay in patient movement through the buildings along with loss of time, decrease in safety, and increase in environmental stress (Carpman, Grant, & Simmons 1993). In this case, designing efficient spatial layout and signage system may have a significant beneficial effect on patients’ perception of care received (Urlich,etal. 2004, Harris,etal. 2002).However, less effort has been made to understand patients’ satisfaction and travel experience in relation to wayfinding in outpatient department. Therefore, the purpose of this research study is to find out if an easily accessible and visible spatial layout, signage system of the environment, and quality of design have an direct or indirect positive effects on patient’s movement, travel time, and wayfinding, and whether, as a result of these positive effects patients’ travel experience and satisfaction improve.

1.0. Spatial Correlates of Patients’ Travel Experience & Satisfaction in Hospital Outpatient Department by Nayma Khan

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1.0. BUILT ENVIRONMENT AND PATIENTSATISFACTION In the outpatient context, the environment in which the service is experienced can significantly improve patients’ satisfaction and the perceived quality of care (Becker & Douglass 2008; Becker, Sweeney, & Parsons 2008; Fottler et al. 2000; Harris, McBride, Ross, & Curtis 2002). Sitzia and Wood (1997) propose that accessibility, waiting times, waiting environment, attitude of staff, and patient information are critical components of patients’ satisfaction. Backer’s (2008) study show that patients’ perception of overall quality of care and experience depend on the physical attractiveness of the waiting room environment. Besides this, different features of healthcare settings such as clarity of signs and directions, orderly facilities and equipment, pleasantness of atmosphere are important determinants of patient satisfaction (Ware etal. 1983). To understand how spatial design of the outpatient departments could support patient satisfaction, it is important to understand the journeys that patients make through the department. In an inefficient layout, the long distances and complicated routes from the hospital entrance to the department can give the patient a poor travel experience. Literature shows that the plan and layout of the hospital might impact the ease of wayfinding and the speed of travel to various locations (Carpman, Grant, & Simmons 1993). Therefore, it is important to facilitate the movement of patients and visitors through design within the outpatient departments to ensure less walking time to locate their destination. The signage systems that aid patients in finding their way have greater influence on patients’ travel experience and satisfaction. In an unfamiliar environment, when patients engage in the wayfinding process, their satisfaction level depends on what they expect to find in that environment. In this case, poor signage systems can make them frustrated and can increase anxiety, confusion and dissatisfaction with hospital experience (Carpman et al. 1993). In addition, interior design features like floor finish, color, artwork and the layout of furniture effect patients’ physical comfort and, therefore, can influence their experience (Arneill & Devlin 2002; Becker & Douglass 2008; Harris et al. 2002).

2.0. SPATIAL LAYOUT AND PATIENT’S TRAVEL EXPERIENCE Designing a spatial layout is an important factor for patients’ wayfinding and travel experience. Research shows that people depend more on spatial layout and the other architectural features than on signage in wayfinding situations (Carpman et al.1993; Weisman 1981). A simple and regular spatial system can make the building easy to understand in wayfinding situations and can improve the experience of movement through the environment (O'Neill 1991; Weisman 1981). In wayfinding situations patients also feel more comfortable when they make more frequent visits to the hospital (Gärling, Lindberg, and Mäntylä 1983; O'Neill 1992) The travel experience of the hospital building is affected by the way in which spaces are connected, the changes of direction imposed by the circulation system, the creation of room sequences, the distribution of branching points, the availability of alternative routes, and the relations of visibility between and across spaces (Peponis and Zimring 1996). Therefore, the number of changes in direction needed to access the reception area from main entrance; the distance between the treatment rooms and the main entrance; and the number of treatment rooms that visitors and patients will pass when travelling between these areas, all need to be considered during hospital design (Khan 2011). All this suggests that physical accessibility of the spatial layout is an important factor for improving patients’ travel experience and satisfaction. In addition, visual accessibility appears to be crucial in influencing the way in which people experience the spaces (Turner, Doxa, O'sullivan, & Penn 2001) and in facilitating one’s spatial orientation and wayfinding (Gärling, Böök, & Lindberg 1986). Higher visual accesses in the spatial layout give patients a greater sense of spatial orientation in wayfinding situations (Montello 2007).

3.0. RESEARCH METHOD The study examined the relationship between spatial structure and patients’ travel experience and satisfaction in several outpatient departments. Multi-method data collection was used in this study, including systematic behavioral observation, patient survey, and the floor layout analysis.

3.1 Systematic Observation & Patient Survey All patients who entered the reception area of the outpatient department were invited to participate in the study. Informed consent of the patients was taken by the principal investigator before a systematic observation was done of patients’ behavior in wayfinding situations. Observation was conducted with synchronized watch and data collection sheets. Each patient was tracked form the entry (reception area) to the destination (clinical unit). The travel time needed to complete each trip was recorded on data collection sheets. When the patient reached his or her destination and was waiting for medical service, he or she was asked to fill out a survey concerning his or her travel experience and satisfaction. In addition, individual

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patient route and travel behavior such as the number of decision making stops, the number of times the patient needed to look around to find the way, and the number of times the patient needed to ask for directions on the movement route were also recorded on the observation sheet. Observations occurred over a 2-week period. In the study, 60 patients were observed in 80 hours of data collection.

Figure 1: Axial map analysis of the whole system and the publicly accessible system

3.2. Floor Plan Analysis The primary source of physical design data was the floor plan drawings of the outpatient department. The study focused on four departments (i.e. Pain management, Laboratory, Radiology and Surgery) that are all on the entry level of the building. The accessibility and inter-connection of the layout were analyzed using the construct of space syntax theories and method. Research has shown that space syntax variables can predict deliberate use of space in wayfinding situations (Peponis, Zimring, & Choi 1990; Zimring et.al.1998; Haq 1999;). For analysis, an axial map was produced for the whole spatial system of the study floor and the publicly accessible route of the floor (Figure 2). The “whole spatial system” refers to all circulation spaces on the study floor that were used by patients, staff nurses and doctors and the “publicly accessible route” refers to all spaces that patients could use. The axial map, which represents a set of minimum number of longest sight line that covers every circulation space in the layout, was created for the study floor. “Depth map 9”, a space syntax software program, was used to assess the relational pattern of the axial lines in the axial map (Figure 1). In this study, only connectivity and integration measures of space syntax were used. Connectivity is measured by counting the number of lines or spaces that are directly connected to another line or space. It provides the degree of choice on the line. A higher connectivity value represents more choice of movement on that line. Integration measures the relative position of any space or axial line with respect to all the space and lines in building layout. A higher integration value represents the space that is easily accessible.

4.0. ANALYSIS The research evaluates the overall satisfaction with the hospital experience, and explores differences in patients’ satisfaction across four departments. All data are analyzed in SPSS 20. In this analysis, patient satisfaction is measure in relation to patient demographic characteristic, spatial attributes, and spatial configuration

4.1 Patient Characteristics and Satisfaction Patient demographic characteristics are an important determinant in studying patient satisfaction (Cleary & McNeil 1988). In this study, the aged patients (+60age) show higher satisfaction whereas the middle age groups (36-65) are less satisfied with signage system, overall layout, and design quality ( figure 1). The

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findings are consistent with prior research that shows aged people are always more satisfied than younger and middle age (Rahmqvist, 2001; Schoenfelder, Klewer, & Kugler, 2011). Literature shows that gender difference has an impact on patient satisfaction (Rahmqvist, 2001; Schoenfelder, Klewer, & Kugler, 2011; Sitzia & Wood, 1997). The findings show that in wayfinding situations, female patients are less satisfied than male patients in relation to spatial layout, signage system, and overall design quality (Figure1). Various research (Lawton, Charleston, & Zieles, 1996; Lawton & Kallai, 2002)reported that females are more stressed and anxious in wayfinding situations than males. In wayfinding situations, more stress can be a reason for less satisfaction among female patients.

Figure 2: Patientsâ&#x20AC;&#x2122; personal characteristics and satisfaction In wayfinding situations, the study showed that patient who asked for volunteer help are less satisfied with the signage system, overall layout, and quality of design. It is possible that patients who were not confident in finding their way ask for volunteer and show dissatisfaction in order to locate their destination. The study also showed that patient satisfaction depends on the number of visits and the frequency of visits (Figure2). Patients who visited this hospital for the third time ( about 10%-13% of all observed patients) are more satisfied with the signage, overall layout, and design than patients on their first, second, and fourth visits. This finding supports that familiarity with the environment reduces the stress level of patients in wayfinding situation and at the same time increases their satisfaction level. This study showed that patients who visited this hospital fourth time were less satisfied than the third time visit patients. It is possible that due to long time gap between third visit and fourth visit patients who visited this hospital fourth time were less satisfied in this study. Table 1: Spatial attributes of Patient route Pain Management& Endoscopy

No of directional change Distance from entry Signage on

Landmark

Radiology and Surgery

Route1

Route 1

Route 2

Route 3

Route 1

Route 2

Route 3

116.42 (ft.)

246.00(ft.)

240.75(ft.)

279.67(ft.)

359.5(ft.)

354.25(ft.)

383.33(ft.)

wall

floor roof

1 7

1 7 You are here map

4 8 You are here map

1 14 You are here map

2 12 You are here map

4 14 You are here map

Atrium

Shop and setting

Shop and setting Elevator lobby1

You are here map Atrium

702

Laboratory

Atrium

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Atrium

Shop and setting

Shop and setting Elevator lobby1 Elevator lobby 2

This research only observed the main entrance that leads the visitor to the main atrium place. Within the three departments (Pain and Endoscopy, Laboratory, and Radiology & Surgery), only seven patient routes were studied. Table 1 shows the total length of the route, the number of directional changes, the number of directional signage, and the type and the number of landmark. The ‘You are here’ map, food court atrium, gift shop, and lift lobby are the landmarks in the setting. The map was placed in the central position of the atrium facing the entry. Therefore, it was visually and physically accessible to the patients. Information desk is physically and visually accessible from the entry. The findings show that the increases in the number directional change in the route also increase the number of signage and the length of travel route (Table 1).

4.2 Spatial Attributes and Patient Satisfaction The correlation analysis between spatial attributes and patients’ satisfaction with overall signage system, overall layout, and quality of design showed no significant relationship in this study. These denote that the number of signage was not related to patients’ travel experience and satisfaction in wayfinding situations. However, the number of signage is highly correlated with patients’ travel behavior (Table 2). The increase in the number of signage also increase patients travel time, travel distance, number of stops, number of looking around, number of asking for direction. Table 2: Correlation between Spatial attributes, Patients’ travel behavior and Satisfaction

Satisfie d with overall signage system

Satisfie d with amount of time taken to reach services

Satisfie d with overall layout

Satisfie d with overall quality of design

Travel time

Travel distance

Number of wall signage

-0.048

-0.072

-0.003

0.095

0.634**

0.855**

0.433**

0.678**

0.468**

Number of floor signage

0.185

-0.038

0.23

0.11

0.414**

0.511**

0.403**

0.486**

0.337**

Number Signage

-0.194

-0.139

-0.173

-0.033

0.521**

0.651**

0.254

0.500**

0.344**

0.097

-0.07

0.197

0.078

0.502**

0.657**

0.457**

0.620**

0.481**

Ceiling

Number of Landmark

Number of stops

Number of Looking Around

Number of Asking for directio ns

** Correlation is significant at the 0.01 level (2-tailed) *. Correlation is significant at the 0.05 level (2-tailed)

Table 3: Syntactic measure of Patient’s travel route

Correlation (R2)

Mean Syntactic Measure

Pain Management & Endoscopy Route1

Whole System

Rn CV

0.108

Publicly accessible system

Rn CV

0.211

Integration Connectivity Integration Connectivity

Laboratory

Radiology and Surgery

Route 2

Route 3

Route 4

Route5

Route6

Route7

1.81

2.03

1.88

1.84

1.95

1.87

1.89

24.00

19.14

23.11

25.00

19.14

22.36

1.42

1.36

1.31

1.27

1.29

1.26

1.23

9.50

7.20

6.57

5.67

7.33

6.75

5.90

4.3 Spatial Configuration and Patient Satisfaction The axial map analysis of space syntax was done for both the publicly accessible system the whole spatial system. The analysis of the observed patient travel routes in the whole spatial system show the highest global integration value (Rn=2.03) for the Route 2 which take patient from the reception area to the laboratory (Table 3). The axial map analysis of the publicly accessible system shows that the connectivity value and global integration were highest for the Route 1 which takes patient from reception to pain and endoscopy department. The axial map analysis of the floor plan reveal poor correlation between global integration and connectivity (Rn-Cn) for the whole system (R2=0.108, p<0.5) and the publicly accessible system (R2=0.211, p<0.5). Hillier, Hanson, & Peponis (1987) define this correlation as the degree of intelligibility of a layout that helps to predict the spatial structure of a whole system. The findings denote that the spatial structure of the outpatient department is not intelligible to structure knowledge in wayfinding situation.

Spatial Correlates of Patients’ Travel Experience & Satisfaction in Hospital Outpatient Department by Nayma Khan

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Table 4: Male patients’ travel behavior, syntactic route attribute and satisfaction Whole System Male Patient

Department route

Publicly Accessible System Patient route

Integration

Connectivi ty

Integration

Connectivi ty

Department route Integration

Patient route

Connectivi ty

Integration

Connectivi ty

Travel Time

-0.053

-0.009

0.097

0.148

-0.309

-0.455

-0.249

-0.478

Travel distance

0.004

-0.404

0.473

-0.201

-0.846**

-0.614*

-0.437

-0.712**

Num_ stop

-0.444

-0.421

-0.109

-0.361

-0.704**

-0.452

-0.552

-0.656*

Num_ Looking around

-0.184

-0.469

0.227

-0.289

-0.611*

-0.476

-0.527

-0.546

Num_ Ask for direction

-0.228

-0.4

0.054

-0.489

-0.54

-0.117

-0.394

-0.36

Satisfied with overall signage system

-0.149

0.049

-0.174

0.261

0.186

0.24

0.075

0.454

Satisfied with amount of time taken to reach service

0.325

0.16

0.181

-0.049

0.27

0.118

0.409

0.085

Satisfied with overall layout

-0.05

-0.174

0.012

-0.092

-0.03

-0.081

-0.01

-0.013

Satisfied with overall quality of design

0.266

0.306

-0.094

-0.033

0.742*

0.806*

0.729*

0.801*

The correlation analysis show that satisfaction for all patients does not show any relation to patient travel behavior and syntactic attributes of the layout. However, male and female patients’ satisfaction and travel behavior individually show a different correlation with syntactic properties of the layout. The study shows that for male patients, higher integration and connectivity value of the publicly accessible route will decrease travel distance, number of stops, and at the same time increase male patient’s satisfaction about overall design (Table 4). The findings indicate that if male patients choose the publicly accessible route which is highly accessible and have higher degree of choice, they may be more satisfied in finding their destination. On the other hand, when female patient’s choose route with higher integration and connectivity value, the route decrease the female patient’s travel time, travel distance, number of travel behavior, and at the same time they are not satisfied with the overall layout and design (Table 5). Moreover, female patients are not also satisfied when their travel route has higher mean integration value. Table 5: Female patients’ travel behavior, syntactic route attribute and satisfaction Whole System Female Patient

Department route Integrati on

Publicly Accessible System

Patient route

Department route

Patient route

Connect ivity

Integrati on

Connect ivity

Integrati on

Connecti vity

Integrati on

Connecti vity

Travel Time

0.087

-0.261

0.411**

-0.115

-0.761**

-0.471**

-0.749**

-0.526**

Travel distance

0.282

-0.385**

0.654**

-0.126

-0.910**

-0.699**

-0.870**

-0.709**

Num_ stop

-0.075

-0.213

0.089

-0.248

-0.407**

-0.324*

-0.450**

-0.412**

Num_ Looking around

-0.006

-0.255

0.277

-0.151

-0.712**

-0.528**

-0.762**

-0.599**

Num_ Ask for direction

-0.097

-0.137

0.038

-0.179

-0.360*

-0.256

-0.435**

-0.377*

Satisfied with overall signage system

-0.144

-0.111

-0.108

-0.11

0.014

-0.097

-0.009

-0.094

Satisfied with amount of time taken to reach service

-0.431**

-0.179

-0.334*

-0.181

0.203

0.192

0.213

0.224

Satisfied with overall layout

-0.377*

-0.105

-0.295

-0.132

0.042

0.054

-0.016

0.027

Satisfied with overall quality of design

-0.143

-0.274

0.054

-0.204

-0.275

-0.295

-0.278

-0.316

CONCLUSION The aim of this study was to understand patients’ travel experience and their satisfaction in relation to wayfinding in outpatient departments. The study focused on the satisfaction and travel experience of the patients’ from reception to three outpatient departments - Pain and Endoscopy, Laboratory and Radiology and Surgery. The study showed that spatial layout, signage system, and the design quality of the environment were important factor for improving the patient’s travel experience and satisfaction in wayfinding situation. The study also showed that personal characteristics of individual patient played an important role in determining satisfaction level. The numbers of signage system on the route have an effect 704

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on patient travel behavior. In wayfinding situations patients’ personal characteristics like age, gender, and familiarity of the environment have an effect on patients’ satisfaction levels. Integration and connectivity of publicly accessible route have the ability to predict male and female satisfaction separately. At the same time female patients are always less satisfied with the spatial layout, signage system, and overall quality of outpatient department in wayfinding situation than are male patients. Therefore, the findings of this research help us understand about how layout affects the satisfaction level of patients in hospital building. The limited number of sample size, observation departments and simple hospital layout is the limitation of this study. In addition to large sample size and more observation departments, the study needs to focus on complex hospital layout. Further studies measuring patients’ stress level would be needed for understanding the causes of dissatisfaction among female patients in relation to spatial layout.

REFERENCE Arneill, A.B., & Devlin, A.S. 2002. Perceived quality of care: The influence of the waiting room environment. Journal of Environmental Psychology, 22(4), 345-360. Bafna, S. 2003. SPACE SYNTAX A brief introduction to its logic and analytical techniques. Environment and Behavior, 35(1), 17-29. Becker, F., & Douglass, S. 2008. The ecology of the patient visit: physical attractiveness, waiting times, and perceived quality of care. The Journal of Ambulatory Care Management, 31(2), 128-141. Becker, F., Sweeney, B., and Parsons, K. 2008. Ambulatory Facility Design and Patients’ Perceptions of Healthcare Quality. Health Environments Research & Design Journal, 1(4), 35-54. Carpman, J.R., Grant, M.A., & Simmons, D.A. 1993. Design that cares: Planning health facilities for patients and visitors: Jossey-Bass. Cleary, P.D., and McNeil, B.J.1988. Patient satisfaction as an indicator of quality care. Inquiry, 25-36. Fottler, M.D., Ford, R.C., Roberts, V., Ford, E.W., & Spears Jr, J.D. 2000. Creating a healing environment: the importance of the service setting in the new consumer-oriented healthcare system. Journal of Healthcare Management, 45, 91-107. Haq, S., and Zimring, C. 2003. Just Down The Road A Piece The Development of Topological Knowledge of Building Layouts. Environment and Behavior, 35(1), 132-160. Harris, P.B., McBride, G., Ross, C., & Curtis, L. 2002. A Place to Heal: Environmental Sources of Satisfaction Among Hospital Patients1. Journal of Applied Social Psychology, 32(6), 1276-1299. Hillier, B., Hanson, J., and Peponis, J. 1987. Syntactic analysis of settlements. Architecture et comportement/Architecture and Behaviour, 3(3), 217-231. Khan, Nayma 2012. Analyzing Patient Flow: Reviewing Literature to Understand the Contribution of Space Syntax to Improve Operational Efficiency in Healthcare Settings. Short paper presented at the 8th International Space Syntax Symposium, Chile. Kim, Y.O., & Penn, A. 2004. Linking the spatial syntax of cognitive maps to the spatial syntax of the environment. Environment and Behavior, 36(4), 483-504. Lawton, Carol A., & Kallai, Janos. 2002. Gender differences in wayfinding strategies and anxiety about wayfinding: A cross-cultural comparison. Sex Roles, 47(9-10), 389-401. doi: 10.1023/A:1021668724970 Montello, Daniel. 2007. The Contribution of Space Syntax to a Comprehensive Theory of Environmental Psychology. Paper presented at the 6th International Space Syntax Symposium, Istanbul. Peponis, J. and Zimring, C.M. 1996. User friendly hospital layouts: The contributions of space syntax. Journal of Healthcare Design. Vol. VIII. 109-115. Rahmqvist, M. 2001. Patient satisfaction in relation to age, health status and other background factors: a model for comparisons of care units. International Journal for Quality in Health Care, 13(5), 385-390. Schoenfelder, T., Klewer, J., and Kugler, J. 2011. Determinants of patient satisfaction: a study among 39 hospitals in an in-patient setting in Germany. Int JQual Health Care,23(5), 503-509. doi: 10.1093/intqhc/mzr038 Sitzia, J., & Wood, N. 1997. Patient satisfaction: a review of issues and concepts. Social science & medicine, 45(12), 1829-1843. Urlich, R., Zimring, C., Quan, X., Joseph, A., & Choudhary, R. 2004. The role of the physical environment in the hospital of the 21st century. The Center for Health Design. Ware, J.E., Snyder, M.K., Wright, W.R., & Davies, A.R. 1983. Defining and measuring patient satisfaction with medical care. Evaluation and program planning, 6(3), 247-263.

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PAPER REF # 8183 ‐ SHORT PAPER Proceedings: Eighth International Space Syntax Symposium Edited by M. Greene, J. Reyes and A. Castro. Santiago de Chile: PUC, 2012.

ANALYZING PATIENT FLOW: reviewing literature to understand the contribution of space syntax to improve operational efficiency in healthcare settings AUTHOR:

Nayma KHAN Department of Architecture, University of Kansas, United States e‐mail: n221k306@ku.edu

KEYWORDS:

Patient Flow, Physical And Visual Accessibility, Operational Efficiency, Health Care, Patient Satisfaction

THEME:

Building Morphology and Usage

Abstract Ensuring efficient and safe patient flow through the hospital system is a consistent problem in healthcare settings. As demand and patient complexity increases, small inefficiencies and errors in health care delivery can cause hospital overcrowding and service delay. An inefficient layout may create problem concerning patient supervision, may increase the travel time and waiting time, and may give patients a poor overall impression of the setting. Reducing delays and making sure that patients receive the right care at the right time will have a significant beneficial effect on the quality of care patients receive. Simply put, in order to improve operational efficiency, hospital planners, designers, and administrators must know those properties of layouts that have the greater impact on patient flow. The literature review shows that most attention in health care research has been given to improve staff working conditions to achieve operational efficiency. So far, no research has been reported showing how spatial layout could influence service experience and satisfaction of the patient, and how it could affect operational efficiency. Therefore, to fill the gap in the research field, this research proposes a model showing how the analytic techniques of space syntax can help understand the effects of space on patient flow, thereby providing clues for improving operational efficiency of the system. Previous space syntax studies by Lu, Peponis and Zimring (2007), Heo and colleagues (2009), Haq (1999), and Setola (2009) already show that visual and physical accessibility have significant effects on movement pattern, frequency of trip and way finding. Therefore, this paper proposes a model using these constructs of space syntax to analyze patient flow in healthcare settings. The model suggests that physical and visual accessibility of spatial layout, through their effects on patient movement, service delivery, and way finding, may help reduce travel time, waiting time, service delivery time and by increasing patient satisfaction, thereby improving operational efficiency in healthcare settings. It is expected that model will help to optimizing patient flow that is necessary to understand how the system is currently working by reviewing existing processes and determining weak or broken links of the system.

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INTRODUCTION Designing spatial layout for a hospital is a challenging job because of the complexity of functions. In past, the design of hospitals was more focused more on the requirement of functional and organizational structure. Recently, it is focused more on the needs and experience of patients. During last decade, hospitals are attempting to develop organizational cultures more sensitive to patients (Peponis & Zimring, 1996). Due to the numerous technological advances in diagnostics, medications and procedures, and modifications in health care reimbursement plans, the mode of healthcare has been gradually shifting away from the inpatient setting to the outpatient basis (Becker, 2008). As a result, the architect and planner are trying to develop efficient spatial layout for the hospital to improve the outpatient flow throughout the system. Start

Patient Check in at kiosk

Medical Record Valid

Schedule Up dated; Patient in waiting room

Treatment

Financial Statement

Finish

Go to front desk

Figure01: Patient flow process in outpatient setting.

In healthcare, patient flow is a process by which patients are served through multiple stage of care (Fig01). From a clinical perspective, patient flow represents the progression of a patient’s health status. In contrast, from an operational perspective, patient flow means the movement of patients through a set of locations (Côté, 2000). According to Hall (2006), patient flow represents the ability of the healthcare system to serve patients quickly and efficiently as they move through stages of care. Blockage in the flow can increase waiting and through put time creating a negative effect on the quality of service delivery (Vos, 2007). When patient flow is handled well, it is represented by short wait at registration, examination, diagnostic testing, surgery, placement in beds, and discharge (Belson, 2010). Thus, improving patient flow is one way of improving healthcare services. A significant amount of research has been done to understand the patient perception of quality of care (Arneill & Devlin, 2002; Omachonu, 1990; Becker and Douglass, 2008, Becker, 2008)). Yet, architects and designers lack theories and techniques to make practical decisions about how spatial layout affects the patient flow in the hospital setting. Therefore, the aim of this paper is to show how spatial layouts through their effects on patient flow can affect operational efficiency. The paper also tries to develop a model for maximizing patient flow to improve operational efficiency in hospitals. OPERATIONAL EFFICIENCY AND PATIENT FLOW According to Côté (2000), once a health care facility has an understanding of its patient flow, these flows can be used to improve the facility’s operation (Côté, 2000). Therefore, efficient patient flow may be a key to

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achieve operational efficiency in the outpatient department (Kunders, 2004). According to Wanyenze et al. (2010) a number of factors can influence efficiency and the emergence of bottleneck in health care operation during examining operational efficiency with regard to patient flow. These factors include the volume of patients seen on the daily basis, the types of patient seen in terms of stage of care, clinic policies on frequency of patient visits, the type of provider who they should see, the size and composition of the providers and the staffing model. In health care, the traditional concept of operational efficiency mainly deals with the work study, activity analysis and cost analysis. But now it also examines the content of activities, the potential contribution of new technologies and modalities of care on form of practice and organization. Additionally, it examines the mechanisms by which patient flow is coordinated among outpatient, inpatient and extended care facilities in order to achieve an appropriate match of resources to patient needs (Grover, et.al., 1990). Langabeer, in his book Health care operation management: a quantitative approach to business and logistic, points out the following five principles for improving operational efficiency during hospital design: 1) Observe movement pattern, volume and distance traveled, and analyze the length of time to move staff, supplies and other resources through the hospital system. 2) Separate patient flow from the staff to reduce overcrowding in corridor, confusion and delay that is essential to improving patient satisfaction and operational efficiency. 3) Focus on interdepartmental movement and activities on each floor. 4) Centralize services and resources, and reduce their geographical distance from patient examination room to minimize number of trip and total distance travel. 5) Use optimization to minimize costs. Here it can be noted that among the above five principles of operational efficiency, four are related to the movement and patient flow through the system. This implies that to operate hospital service delivery system efficiently, the design, planning, implementation and control of coordination mechanisms among patient flows and diagnostic and therapeutic activities are important (Vos et al, 2007). Besides this, patient satisfaction is now considered as an operational priority and an integral part of a health care organizational culture (Cardello, 2001; Parente, et al., 2005). Although there is no definite definition about the actual dimension of satisfaction, numerous studies have cited the importance of “access” as a determinant of satisfaction (Parente, et al., 2005). According to Murry & Tantau (1999), access refers to patient ability to seek and receive primary care in a timely manner. By decreasing the total time each patient spent to get the service in outpatient department, medical providers are able to serve more patients in the same amount of time, thereby improving operational efficiency and patient satisfaction. Therefore, it is important to optimizing the flow of patient though out the hospital system to achieve operational efficiency. RELATIONSHIP BETWEEN PHYSICAL DESIGN AND PATIENT FLOW The physical environment greatly affects the quality, efficiency, and efficacy of healthcare delivery in outpatient settings (AIA, 2004). To understand how physical design of the outpatient departments support care, it is important to understand the journeys that patients make through the department. Tzortzopoulos (2009) in her research mentions that patient flow can be directly enhanced through building configuration.

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She also mentions that configuration also influence the softer human aspects of patient experience. According to Peponis & Zimring (1996), the ordinary experience of buildings is affected by the way in which spaces are connected, the changes of direction imposed by the circulation system, the creation of room sequences, the distribution of branching points, the availability of alternative routes, and the relations of visibility between and across spaces. Therefore, spatial configuration can impact on patient experience and satisfaction. Studies show that the walking distances and common journeys that have taken by staff members are largely affected by the design and layout of the department (NSH, 2008). Studies also show that hospital design affects access to each and every department, with a direct impact on the movement of patients, staff, and supplies (Healthcare Financial Management, 2011). Therefore, it is important to control the movement of patients and visitors within outpatient departments to ensure less use of time on walking to locate the waiting area and treatment room. Wanyenze et al. (2010) identified that long clinic visit and waiting time could have a major impact on the efficiency and patient satisfaction. In an inefficient layout, due to the long distance from the hospital entrance to the department, patient had to walk a relatively long distance through a busy corridor. This type of layout can create problem to supervise the patient and can gave patient a poor experience. Therefore, during hospital design it is necessary to consider the number of changes in direction needed to access the reception from the main entrance; the distance between the treatment rooms and the main entrance; the number of treatment rooms that visitors and patients will pass when travelling between these areas. Therefore, physical accessibility is an important factor for optimizing patient flow; and to achieve operational efficiency the physical layout needs to be changed according to patient flow data (Belson, 2010). Physical design is also important in assisting internal way finding by ensuring that interdependent services/departments are co‐located, and by reducing movement around the site (NHS& NHSGG Report, 2006). In the case of outpatient departments, it is important that the reception is directly visible from the main entrance. This will help to ensure that people go directly to the reception staff on arrival. According to the NSH( 2003), for improving way finding patients require direct (but controlled) visual and physical access from the waiting areas to treatment rooms, and staff members require direct routes between the treatment rooms and the staff location as they visit different patients. According to Becker (2008), the physical design that increases the visibility and accessibility of the receptionist is likely to facilitate more opportunities for positive interaction. Surveillance of the waiting areas is necessary for a number of aspects of care delivery, including: controlling access into the department; identifying incidents of inappropriate or criminal behavior; monitoring patients and identifying if their condition becomes a cause for concern (NSH report, 2008). In this report it is also mentioned that the design of the building can play an important role in facilitating surveillance of the area through ensuring visibility especially as there is often little formal observation of patients in reception or waiting areas by clinical staff. Therefore, visibility and accessibility have a significant impact on the patients’ perception of journey and satisfaction. Based on the above research findings, we may safely assume that the physical and visual accessibility of spatial layout have the ability to improve operational efficiency and to maximize the patient satisfaction by moving patients and resources efficiently through the units by minimizing wait and transport time. However, a comprehensive model that brings together different spatial layout attributes and behaviors to understand the effect of spatial layout on the patient flow is still missing in the literature. Therefore, this research is an attempt to propose a model (figure 02) that could describe the relationships among spatial variables and behaviors with organizational outcomes. The spatial attributes included in the model are visibility, accessibility, connectivity and depth (Path distance). Among behaviors, there are movement (defined as the

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number of patients moving through a set of locations in the outpatient department from entry to exit); Frequency of trip (defined by calculating time for each participant patient to complete his or her journey within Global and local layout of outpatient department.); visibility (defined as the number of space that is easily visible from main entry in outpatient department) and way finding (defined as the ability to find specific destinations, such as a departmental reception, from specific origins, such as the hospital entrance).

Physical Access Visual Access

Depth (Path distance) Accessibility Connectivity Visibility

Spatial Variable

Outcome

Movement Frequency of trip (Time) Way finding

Operational efficiency

Reduce travel distance and length of time Reduce overcrowding through separate patient and staff flow Increased interdepartmental movement Increased accessibility of service and resources and geographical proximity to patient Increased Patient satisfaction

Spatial Behavior

Figure02 Proposed model for analyzing patient flow to increase operational efficency

In the model (Figure 02) it is assumed that layout attributes may have direct as well as indirect effects on patient flow and any direct and indirect relationships between spatial variables and spatial behavior may have ability to increase organizational outcome. That means, an easily accessible and visible spatial layout may have direct or indirect positive effects on patient’s movement, frequency of trip, visibility and way finding that may increase operational efficiency. In this research , it is also assumed that operational efficiency may be achieved through reducing Travel distance & time and time to serve patient, increasing accessibility to service and resources and geographical proximity to patient , increasing inter department movement and patient satisfaction. Research has shown that Space syntax theory provide us a systematic and quantitative account of building configuration, to assist our understanding of how buildings function as organizational resources(Peponis & Zimring, 1996). It has the ability for analyzing the spatial layout and how it’s effect the distribution of movement and the pattern of presence of people, over and above the effect of functional flow or the spatial allocation of activities (Hillier, Hanson and Peponis, 1984). Therefore, the following section will show how it could be used for analyzing patient flow to improve operational efficiency.

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SPACE SYNTAX: AS A FRAMEWORK FOR STUDYING OPERATIONAL EFFICIENCY In health care setting, from entry to exit, the patient has to pass through a set of conditions, activities, services, or locations that can be described as a network which is highly related to the configuration of the system. To identify and understand how physical design can be integrated to facilitate patient flow it is necessary to understand the spatial relations of a hospital building. According to Hillier, hospital is a strong program building in which all or most spatial relations and sequence are predetermined by categorical identities and functional needs (Hillier, 1996). He defines the program of a building as the spatial dimension of the interface among different categories of people and their functions in a building. In general, two kinds of interface usually occur in building: one between inhabitants and visitors, and the other between different categories of inhabitants. In a strong program building like hospital the entire required interface in the building occurs in a predictable manner. That means all the interfaces are predefined by the program of building. If we could define the interface between visitors (patients) and inhabitants (staff/physicians) properly, it should help to design the spatial layout to control patient movement though out the system.

Figure 03: A floor plan represented as a graph of connections, depth and accessibility Source: Peponis & Wineman, (2002).

Space syntax as a framework to study healthcare environments is a relatively new concept to healthcare design research. Studies presented in the space syntax literature explain that space syntax theory, which was developed by Bill Hillier and his colleagues in the 1970s, has the ability to explain and predict human behavior within the context of a designed environment (Sailer, 2007). It provides us with a systematic and quantitative account of building configuration to assist our understanding of how a hospital building functions as an organizational resource. In this theory, spatial configuration and user behavior are correlated in term of visual and spatial connectivity (Hillier and Hanson 1984). Kim & Lee (2010) investigate user costs in the design of health care facility using space syntax. Their research demonstrates the effectiveness of spatial analysis by using space syntax for user experience in hospital ward design alternatives. In space syntax, the integration value is used as a significant index to analyze spatial configuration, which is a topological measurement of accessibility in the built environment. It is calculated from the reciprocal of

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mean depth. That means lower mean depth will represent higher integration value, higher integration value will show us a shallower and more accessible space. Haq (1999) shows that people who entered from space with lesser mean depth had a better opportunity to explore the hospital layout within a fixed time. Various researches also demonstrated that space syntax variable has the ability to predict deliberate use of space in way finding situation (Peponis, Zimring, & Choi, 1990; Zimring et. al., 1998; Haq 1999; Wiseman, 1981). Peponis et al. used space syntax theory and methodology to understand the spatial search behavior (Peponis et.al., 1990). This research suggested that spatial exploration could be predicted by the space syntax measure of integration. Wiseman (1981) in his study showed that in studying building when the average number of connection per choice in a floor plan increased, it decreased cognitive mapping ability and way finding performance. Later, Haq (1999) found that during open exploration, as people are learning the hospital, their search is predicted by the number of choice point that can be seen from a node space. All those choice point that counts all other lines of the spatial system that intersect the original axial line could be measured by connectivity (Haq, 1999). In space syntax, connectivity represents the number of other spaces directly accessible from it. Based on these finding, it can be suggested that integration and connectivity measure of space syntax can be used for analyzing accessibility and way finding situation in the healthcare setting.

Figure 04: Generating Isovists: (a) a hypothetical indoor environment (b) The shaded area is visible from a person’s Observation point within the environment (c) the resulting isovist and its basic measurement. Source: Franz, Gerald. (2008)

Previous research also establish the importance of visual accessibility for the way in which people experience the spaces and how they use the whole complex (Turner, et. al., 2001). Heo (2009) shows that visual connectivity is a significant factor in determining the frequency of trip and movement pattern on the path in a hospital building. In public areas of a hospital building like the outpatient department, visibility of reception and information area, the density of movement, and the alternation of lively and private spaces, all these factors that comprise the pattern of space use contribute to the quality of hospital building and direct encounter with medical providers and patient satisfaction (Peponis & Zimring, 1996). In space syntax, isovist and isovist field (Figure 04) provide visual understanding of space when people move in a space. In architectural research, Benedikt (1979) first defined isovist as “the set of all points visible from a given vantage point”. Turner et al. (2001) combine isovist to space syntax theory to get a better description of

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spatial configuration and the functional consequences of the design based on visibility among all location. Visibility graph analysis has the ability to define isovist fields that can determine the accessibility and the visibility between nodes in the configuration even if these nodes are not directly visible. All these findings show that space syntax has the ability to examine the impact of accessibility, visibility and connectivity in spatial layout on spatial behavior. The understanding may help designing layout of the hospital to move patient efficiently thought‐out the system with a minimum travel distance and time and to reduce overcrowding through separate patient and staff movement. Besides, designing efficient layout may increase interdepartmental movement and accessibility of the services and resources and patient satisfaction. As space syntax theories and techniques grew out of the need to develop a tool to help designers to understand how the built environment influences behaviors, the use of space syntax as a framework to recognize the potential of spatial layout in facilitating specific organizational operation is justified in this context. CONCLUSION Now a days, Healthcare system facing serious problem related to integration of people, process, technology, procedures, politics and other variables (Brewer, 2008).Therefore, design should be flexible to adapt the complicated interplay among individuals, the environment and the process Most existing research in the healthcare setting suggests ways to improve the physical design of inpatient department (Ulrich et al., 2004; Becker, 2008). In most cases, they focus on the design of single vs. multiple occupancy patient room, the design and maintenance of heating and ventilation system, the provision of outside view and natural light, the design of interior spaces to control nosocomial infection, to reduce length of stay and pain medication use, to improve to patient satisfaction, and to reduce stress and anxiety (Ulrich et al., 2004). But, significantly less empirical research has done on outpatient facilities (Becker, 2008). According to Becker (2008), research that has been done in outpatient settings has shifted their focus more on the service oriented measure like patient perception of quality and patient satisfaction. At present, the design of healthcare facilities are more focused on achieving diverse objectives, ranging from providing appropriate environment where care can be delivered to increase operational efficiency and improving patient flow and patient satisfaction ( Tzortzopoulos et.al.,2009). So, there is a need for further research for analyzing patient flow to improve operational efficiency. The findings of this research show that to achieve operational efficiency, good alignment of a patient’s physical journey with his or her clinical journey is important. They also show that better and quicker delivery of care and patient’s journey are highly linked with the configuration of the system. This literature review also shows that fewer studies have been done regarding the relationship between the design of spatial layout and the patient flow for achieving operational efficiency. Tzortzopoulos et.al. (2009) in her study tried to identify how health care service design and building design can be integrated to facilitate increased performance both in terms of service delivery and future changes. Findings of her research indicate that current design approaches and innovation are restricted due to functional barrier in the design process, and there is a need to support the development of operation driven design that satisfies diverse needs. But she did not provide any model for evaluating the physical design for analyzing patient flow to maximize the quality healthcare service delivery. Therefore to fill the gap in the research of healthcare design and operation management, this research proposed a model for analyzing patient movement by using space syntax theory to achieve operational efficiency.

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Spaces syntax as a theory about space and human behavior has been widely used for analyzing building and urban area. The contribution of space syntax to study healthcare environments is comparatively less. Most of the research studies mainly use space syntax theory to study the movement pattern of nurses in inpatient setting (Lu, Peponis and Zimring, 2007; Heo, et. al, 2009). Heo and colleagues explore how the nurses may modify or adopt their behavior according to the characteristics of the area within which they work. Haq (1999) studies the use of space syntax to understand the deliberate use of space in wayfinding situation in hospital buildings. Setola (2009) studies the flow pattern within the hospital complex. In this study, space syntax theory and technique are tested to study the connection of spaces to identify the relevance and the critical factors of flows and paths system. However, this research did not study on patient satisfaction or operational efficiency. Kim and Lee (2010) use space syntax to simulate user’s experience and movement for investigating design alternatives in inpatient setting. No research has yet been done to study spatial layout for operational efficiency. Since hospital is a complex system of interrelated functions requiring constant movement of people and goods, it is necessary to find out the spatial properties that help shape the ways in which patients explore, engage, and understand function of the facility or space. The knowledge will help make practical decisions about how layout affecting the operational efficiency of hospital building. The proposed model for analysis patient flow under the framework of space syntax theory using the space syntax construct can be a helpful guide for the future researcher to improve and review the design to ensure efficient patient flow through the system to increase operational efficiency in the health care system. REFERENCE Arneil.A.B. & Devlin, A.S. (2002). Perceived quality of care: the influence of the waiting room environment. Journal of Environmental Psychology. 22 (4), 345‐360. Becker, Franklin (2008). Ambulatory facility design and patient’s perception of healthcare quality. Health Environments Research & Design, vol 01(4), 35‐54. Becker, F. and Douglass, S.J. (2008). The ecology of the patient visit: Physical attractiveness, waiting time and perceived quality of care. Journal of Ambulatory care Management, 31(12), 124‐137 Belson, David (2010). Improving Efficiency in the Safety Net: Management Engineering Practice and Cases. California HealthCare Foundation. Benedikt, M. L. (1979).To Take Hold of Space: Isovists and Isovist Fields. Environment and Planning B, vol. 6, 47–65. Brewer, Barber B. (2008). The System Research Organizing Model: A Conceptual Perspective for Facilities Design. Health Environments Research & Design, vol 01(4), 07‐19. Cardello, D.M. (2001). Improve Patient Satisfaction with a Bit of Mystery. Nursing Management 32(6), 36–8. Côté, Murray J. (2000). Understanding Patient Flow, Decision Line, vol 31(2), 8‐10. Franz, Gerald. (2008).From space syntax to space semantics: a behaviorally and perceptually oriented methodology for the efficient description of the geometry and topology of environments. Environment and Planning B: Planning and Design, volume 35, 574‐592.

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Grover, Prakash L & Flagle Charles D. (1990). Operational Efficiency research in Department of Veterans Affairs Health Services HSR: Health Service Research, part II, 25: 1. Hall, Randolph W. (2006). Patient Flow: The new queuing theory for healthcare. OR/MS Today Haq, Saif‐ul (1999). Can Space syntax Predict Environmental Cognition? Paper presented in the 2nd Space Syntax Symposium. Healthcare Financial Management (2011). Design for success: efficiency and effectiveness through facility design. Retrieved from http://findarticles.com/p/articles/mi_m3257/is_11_57/ai_110532635/. Heo, Yeonsook; Choudhary, Ruchi; Bafna, Sonit; Hendrich, Ann; Kaiser, Marylyn P (2009). A Modeling Approach for Estimating the Impact of Spatial Configuration on Nurses’ Movement. Paper presented in the 7th Space Syntax Symposium. Hillier, Bill Hanson, Julienne (1984). The Social Logic of Space. Cambridge University Press Cambridge. Hillier.B (1996). The space is the machine .Cambridge, UK: Cambridge University Press. Kim, Youngchul & Lee, Hyun Woo (2010). Analyzing User cost In a Hospital Building: Methodological Implication of Space syntax to Support whole life Target Value Design. Lean Construction Journal, 55‐65. Kunders, G D. (2004). Hospitals: facilities planning and management. Tata McGraw‐Hill. India: New Delhi. Lu, Yi, Peponis, John, Zimring, Craig (2009). Targeted Visibility Analysis in Buildings Correlating Targeted Visibility Analysis with Distribution of People and Their Interactions within an Intensive Care Unit. Paper presented in the 7th Space Syntax Symposium. Murray, M., and Tantau, C. (1999). Redefining Open Access to Primary Care. Managed Care Quarterly 7(3), 45–55. NHS Greater Glasgow’s Community & NHSGG (2006). Report on initial scoping exercise to determine patient and cares views on the physical design of the New South Glasgow Hospital. Retrieved from http://library.nhsggc.org.uk/mediaAssets/Community%20Engagment/NewSGHFinal.pdf. NHS Institute for Innovation and Improvement (2008). Patient flow: Quality and service improvment tool. Retrieve from http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_t ools/patient_flow.html. Omachonu, V.K. (1990). Quality of care and the patient: New criteria for Evaluation. Health care Management Review, 15(4), 43‐50. Parente, Diane H.; Pinto, Mary Beth; Barber, Joseph C. (2005). A Pre‐Post Comparison of Service Operational Efficiency and Patient Satisfaction Under Open Access Scheduling, Health Care Management Review, Volume 30 (3), 220‐228. Peponis, J. & Zimring, C.M. (1996). User friendly hospital layouts: The contributions of space syntax." Journal of Healthcare Design. Vol. VIII. 109‐115

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Peponis, John, Wineman, Jean (2002). Spatial structure of environment and behavior. In Robert B. Bechitel, Arza Churchman (Ed.), Handbook of environmental Psychology, 271‐291. New York, NY: John Wiley & Sons Inc. Peponis, J., Zimring, C. & Choi, Y.K (1990). Finding the building in Way finding. Environment and Behavior, 22(5), 555‐590. Retrieve from http://www.chcf.org/publications/2007/12/improving‐efficiency‐ management‐engineering‐comes‐to‐the‐safety‐net#ixzz1HeCyTrG1 Sailer, Kerstin (2007). Movement in workplace environments configurational or programmed? Paper presented in the 6th Space Syntax Symposium. Setola, Nicoletta (2009). A New Approach to the Flows System Analysis in the Teaching Hospitals. Paper presented in the 7th Space Syntax Symposium. The American Institute of Architects (2004). Redesigning the Office for Family Medicine: Promoting Efficient and Effective Work Processes through Design... Retrieved from http://info.aia.org/nwsltr_print.cfm?pagename=aah_jrnl_2009_battisto2. The Institute for Operations Research and the Management Sciences (INFORMS). Lionheart Publishing, Inc. Turner, A., Doxa, M., O’Sullivan, D. (2001). From Isovists to Visibility Graphs: A Methodology for the Analysis of Architectural Space. Environment and Planning B: Planning and Design, Vol. 28, pp. 103 – 121. Tzortzopoulos‐Fazenda, P & Codinhoto, R & Kagioglou, M & Rooke, J & Koskela, L J (2009). Design for operational efficiency: the case study of a hospital redevelopment, in: 'HaCIRIC International Conference', Imperial College London, Brighton, UK. Conference 2‐3 April 2009. Ulrich, R. S., Zimring, C., Joseph, A., Quan, X., & Choudhary, R. (2004). The role of the physical environment in the hospital of the 21st century: An once‐in‐a‐lifetime opportunity. Concord, CA: The Center for Health Design. Vos L, Groothuis SG, Van Merode G (2007). Evaluating hospital design from an operations management perspective. Health Care Manage Sci, vol 10, pp357–364. DOI 10.1007/s10729‐007‐9034‐7. Wanyenze, et.al. (2010). Evaluation of the efficiency of patient flow at three HIV Clinics in Uganda.Aids Patient care and STDs. Vol‐24, num‐7, Mary Ann Liebert, Inc. Dio:10.1089/apc.2009.0328. Weisman, J. (1981). Evaluating architectural legibility. Environment and Behavior, 13, 189‐204

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Ref 052 Spatial Logic of Morphological Transformation A Paradigm of Planned - Unplanned Areas in Dhaka city

Nayma Khan Bangladesh University of Engineering and Technology, Department of Architecture, Dhaka, Bangladesh nayma92@arch.buet.ac.bd Farida Nilufar Bangladesh University of Engineering and Technology, Department of Architecture, Dhaka, Bangladesh farida@arch.buet.ac.bd Keywords organic city; Dhaka city; land use pattern; morphological transformation; planned and unplanned areas Abstract Cities are in a continuous process of change and readjustment of its different parts, which are spontaneously developed or deliberately planned under different socio-economic and political conditions in different period. Over the history, different parts of Dhaka city, which is the capital of Bangladesh, have undergone various physical and functional transformations. It is observed that in spite of several controls, the planned residential areas of Dhaka city have experienced morphological transformation in land use pattern with a minor change in the spatial layout to adapt with the community need. As a result, the planned residential areas tend to become transformed into an unplanned state in relation to their physical layout and distribution of non-residential function. The paper aims to find out the spatial logic of morphological transformation of functional pattern in planned residential areas of Dhaka city. This paper therefore explores the interrelation between land use pattern and spatial structure of three planned residential areas of Dhaka city by adopting a spatial analysis based on â&#x20AC;&#x2DC;Space Syntaxâ&#x20AC;&#x2122; theories and techniques. In an attempt to investigate the reason for morphological transformation of functional patterns, the study focuses on the analysis of their spatial transformation through the comparative syntactic analysis during the historic process of growth of Dhaka city within which the planned areas are embedded. In this paper, when planned areas are tested as an independent system, the spatial analysis shows minor changes in the spatial structure of the local area. But when it is analyzed as an embedded part of the whole system, it has been revealed that due to the changes in the global organic spatial structure of Dhaka city, the planned areas were more integrated in the process of time with the whole urban system which appear to be the main cause of morphological transformation in functional pattern of the planned residential areas. Thus unplanned grid of Dhaka city played an important role to transform the planned parts.

1. Foreword Cities are always developed and transformed through the interaction between different social, political, economical, and technological forces. Dhaka represents a composite urban form developed through ages. Indeed, above the level of technology and economic condition of the population, the pattern of aerial expansion and the urban form of Dhaka have been dominated largely by the physical configuration of the landscape in and around the city (Islam1996). Dhaka city has been spontaneously developed without any rigid planning proposal. The Proceedings of the 7th International Space Syntax Symposium Edited by Daniel Koch, Lars Marcus and Jesper Steen, Stockholm: KTH, 2009.

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growing city seems to have exhibited a series of informal and organic spatial patterns. Within this framework, some parts of the city have been deliberately planned as residential areas to provide the citizen with civic facilities. In such planned schemes, land is subdivided into plot and infrastructure is constructed following conscious design by the authority in which land use is defined according to the master plan. In contrast, major part of the city has been developed organically in which land is subdivided through private initiative, roads are laid to serve their need without any approved plan. In process of time, these spontaneously developed organic areas start operating as part of the whole city with continuous adjustments. On the other hand, the planned areas, in spite of several controls, have undergone morphological changes in land use pattern to adapt to the community need with the passage of time. Not only that, due to the weakness in planning rules and zoning policy, non-residential functions invaded into the planned residential area to meet the demand of the growing population. Authority sometimes amended the rules to accommodate such changes, which in turn affected the character of the planned residential areas. As a result, the planned residential areas have changed into a mixed land use pattern and transformed into an unplanned state in relation to their physical layout. (Khan 2008) The objective of this paper is to understand the morphological transformation of planned residential areas of Dhaka city caused by the changes in the functional and spatial configuration of the urban grid. The paper uses methods of configurational analysis of the urban grid for three large planned residential areas of Dhaka city, Dhanmondi, Gulshan, and Banani, to understand any systematic relation between spatial structures and the functional pattern by analyzing the measure of accessibility of the changing spatial structure of these areas. It also tries to understand the domination of the unplanned organic spatial structure of the city, if any, on this process of transformation of the planned schemes. The research methodology in this paper is based on "Space Syntax"1 that is used as an analytical tool to understand the configurational properties of the spatial structure that shapes the morphology of the planned residential areas of Dhaka city within the process of urban evolution. This research also gathered land use data for statistical analysis. However here the research mainly focuses on the spatial analysis of Dhaka city by space syntax that will explore the way in which urban growth brought about changes in the configuration of the global structure. It also tries to analyze the spatial framework of planned residential areas under study within the evolving spatial structure of the city. In space syntax analysis axial maps2 were developed based on the Dhaka city map collected from the "Survey of Bangladesh" (SOB)3. According to the administrative boundary, all the axial maps of planned area in different study period from (1963-2007) has been processed in "Depth Map"4 to reveal the attributes of the spatial structure and to find out the transformation of spatial measure of axial lines as an independent system and also as embedded system. Later on, this will be compared to the changing land use pattern to understand the morphological transformation of planned residential areas. The study will attempt to identify whether the residential development and their further transformations in land use pattern follow any spatial logic because of their overall distribution in the urban grid.

2. The development of Dhaka city and it's spatial morphology Dhaka is one of the oldest major cities in South Asia. Through out its history, the city of Dhaka expands from a medieval trading town to a large metropolis. Its existence as the primate city has been consistent over a period of nearly 400 years (Islam 2005). The city of Dhaka is centrally located, almost in the middle portion of the country. Because of its geographical location and administrative position, the city has been enjoying most of the physical, economical, and social advantages and thus has been receiving primary impulses for its steady growth. However, in its stages of development, the city of Dhaka has developed without any robust planning guideline and shows no comprehensive urban design. Within its framework, two distinct spatial patterns are dominant in Dhaka; they are the planned and unplanned (i.e. organic or informal) patterns. However, the major part of this growing city is organic in nature. The pattern that exists in the historic city is the winding and intricate street

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network, continuously twisted in and out, and were tortuous to an extreme degree in some places. The organic character of the old part of Dhaka is particularly distinctive because of the density of its built-up areas in comparison to the looseness of the later organic developments. Vast areas of the new city are also organic in nature and developed in an informal way without any detail planning intervention. They are labyrinthine mixture of lanes, by-lanes and cul-desac like old Dhaka but wider and less intricate. However, these spontaneous developments including the large urban blocks and main streets were incorporated into the broad land use proposals of the initial Master Plan in 1959 and it they appear as longer and wider lines in the city structure. Land uses are of a mixed type however, residential use gets prominence. The main thoroughfares appear as the major shopping strips.

LEGEND 1. Wari 2. Ramna 3. Dhanmondi 4. Gulshan 5. Banani 6. Mirpur 7. Uttara

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Figure 1 Location of the planned residential areas within the urban grid of Dhaka city Proceedings of the 7th International Space Syntax Symposium Edited by Daniel Koch, Lars Marcus and Jesper Steen, Stockholm: KTH, 2009.

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Planned parts of Dhaka mainly followed a grid iron pattern with a land use as prescribed in the master plans. The grid pattern of roads was introduced in the city for the first time in Wari and Gandaria in 1885. Latter in 1905, Ramna was planned as government residential district. The first evidence of planned residential areas under the planning authority was found in 1948 when the East Bengal government created a planning division under which a physical plan for Dhaka city for its future growth was made. According to this master plan, some residential area were developed which include Azimpur and Motijheel residential colony for public employee and Dhanmondi residential area for upper class people. Comprehensively planned residential areas of Gulshan, Banani, etc. are the successors of this type which were developed by the city authority DIT (presently RAJUK). Some of the residential areas or estates were developed by National Housing Authority according to their plan, which include Mohammadpur and Mirpur for lower and lower-middle income groups. Another major planned residential project was the Uttara Model town (1360 hectare), which was planned by DIT and located about 20 km from the centre of the city. In the later period, Baridhara was developed in 1972 as high-class residential area acquiring 150-hectare land. The state sponsored planned extensions for the upper classes were contrasted with the unsanctioned, spontaneous, tawdry development in the organic areas of Dhaka. Planned residential areas Dhanmondi, Gulshan, Banani, are important example of this type. Their street layout follows a rigid gridiron pattern with some semicircular arcs. The land formation exerted a little influence on the new development and this why they are found globally to be in some way more logical or imposed upon their surroundings. All these three areas were developed in the early fifties in the method of site and service scheme to provide residential accommodation for high and higher middle-income group of population in Dhaka city. The high space and service standards and physical designs of these schemes have an aura of Western suburbia, modernity, and status. They essentially follow the civil lines model of British era, like Ramna, though without the imperial grandeur. The study of the physical growth of the city shows that from the early stage of their development, the planned residential areas always remained on the periphery of the city. In addition, the development of planned residential areas always followed the arterial roads or highways of the Dhaka city (Figure 1).(Khan 2008) It is important to mark the distinction of the organic order from that of the 'strict hierarchy' in planned schemes, as in the former case they take the form of a 'vine' whereas while planned they appear as a 'tree' (Nilufar 1997).

3. Evolutionary stages of Dhaka and the planned residential areas In its evolution, the city of Dhaka has been experiencing a process of rapid change in its land use structure, which influenced the development of residential areas. This section of the paper will attempt to understand morphological transformation of the city grid and relational position of the planned residential areas through configurational analysis of the spatial structure of Dhaka city. The planned areas under study appeared in early 50's, but not fully developed. Therefore, in this section the analysis is carried out in different stages of the city's growth using the available maps from 1953-2007. It has been revealed that in the process of expansion, the spatial structure of the city shows some major spatial changes at a global scale. The global integration core of Dhaka appears to have had a dynamic structure that has been transformed with time; although it shows a continual expansion and shift in succeeding phase of growth. It provides evidence of a shift in importance from the old city towards the newer part; and prefigures the future trends. With all it's idiosyncrasies from the established planning theories, the harmonious development of Dhaka's land use with its morphological transformations is significant. In a previous research, it has been revealed that the global integration core of Dhaka identified the functional core, both commercial and administrative, in each corresponding period. The core appears to have a socio-spatial character in which it connects the activity centers, like Chawk, Fort etc., and supports bazaar activities along its path (Nilufar 1999). Moreover, the linear cores of traditional period have changed into ringy and hollow ones, which contained large pockets of un-built and open areas. As compared to more established western cities, this might be referred to as a condition of unplanned growth in rapidly developing cities. (Nilufar 1997)

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Figure 2 Planned areas in the evolutionary stages of Dhaka city The map of 1953 shows that the total system of Dhaka city was made up of the intricate and dense organic development in old Dhaka as the integrated part and very loosely built areas in the northern part in new Dhaka as the segregated parts. (Figure 2) The global integration core (R=n) revealed a strong connection between the existing old city and the flourishing new city and took the form of a fork with a long tail. At this stage, among the three-study areas only Dhanmondi (partially developed) appeared on the city map adjacent to the global integration core and the Mirpur Road, which was later developed as the primary road of the area, has a gridiron layout with a lake dividing it into several parts, as planned by architect R. Mc Connel (Hashem 2001). In the 1960's two high-class planned residential areas, Gulshan and Banani, were developed. The map of 1963 shows, the city had grown much in comparison to the previous stage and it revealed as an integrated whole with some segregated parts in its northern and eastern extreme (Figure 2). The integration core was very much at the physical centre of the city. All the highly integrated lines were within the newer parts of Dhaka. Dhanmondi, which was planned in previous period, is Proceedings of the 7th International Space Syntax Symposium Edited by Daniel Koch, Lars Marcus and Jesper Steen, Stockholm: KTH, 2009.

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almost completely developed in this period. Syntactic analysis of 1963 map show that major roads of Dhanmondi coincide with the global core of Dhaka city. At this stage, the study area Gulshan was partially developed at the northern periphery of the city over an area of 715 acres. It was far away from the global integration core of Dhaka city in the initial stage. After the independence (in 1971), as there was a demand for more plots in Gulshan area, the government acquired more land at the northern part of this area for extension. Finally, Gulshan was developed as high-class residential area with 986 acres of land (RAJUK 2002). Although RAJUK started the residential development program of Banani in 1961, it was developed as a medium density high-class residential area after the independence in 1971 with 140 hectare of land and continuation of a lake, which exist inside Gulshan and Banani. In 1973, the growth of Dhaka city indicated by the previous stage comes to fruition. But the tendency to consolidate the urban grid was much more striking at the periphery than in the centre. The global integration core was identical to the core of 1960's and started to grow towards north. At this stage, Banani appeared on the map beside Gulshan residential area. But these two areas remained far away from the global integration core of this period. However, the study area Dhanmondi became part of the global integration core (Figure 2). In the map of 1987, the city had grown very little in comparison to the previous stage except the development of Progoti Sharani Road on the eastern edge of Dhaka. For that, the integration core remained static. In this period, Dhanmondi residential area was attached to the global core but Gulshan and Banani could not yet attain any global importance. In 1995, the total structure of the city gave the impression of being well balanced with integrated parts at the physical center and segregated part toward the periphery. The global integration core consists of two reverse wedges which coincide with three major thoroughfares (Mirpur Road, Mymansingh Road and Green Road) and Dhanmondi was attached to one of these wedges. The integration core was inclined toward east with respect to the total city structure and started to follow the Bijoy Sharani and Dhaka Mymansingh Road. Gulshan and Banani residential area were close to the global core of Dhaka city and started to get the global importance in this period (Figure 2). In the map of 2007, we find the structure of the city has extended further towards east with a segregated part in the east and north side of the city. Progoti Sharani Road located at the east side of Gulshan area started to get a degree of global importance. As a result, Gulshan and Banani residential area gained global importance in the city. The global core has extended beyond the limit of the previous stage and spread toward north and southeastern portion of the city (Figure 2). In this period, the spatial structure of Dhanmondi planned area show very little change in comparison to the previous stages. These observations regarding the shifting nature of global integration core shed light on the analysis of planned areas as embedded system in the city grid.

4. Transformation of the planned areas â&#x20AC;&#x201C; spatial analysis as independent system The morphological study shows very little change in the physical layout of the three case study areas (which are residential areas named as Dhanmondi, Gulshan, Banani) has taken place through out the study period (1963-2007). In this process, the block and street pattern exhibits minor changes, but the total number of plots gradually increased due to the multiple numbers of successors. The land use study represents that some higher order activities (central functions or non-residential functions) of the city invaded in the planned areas following the major thoroughfares of the city. Due to increased demand of community facilities and economic activities in those areas drastic changes in the land use pattern over the period have been observed.(Khan 2008) As a result, some parts of the residential areas have been converted into non-residential functions and in most of the cases those transformation took place along the band of the roads which in turn changed the morphological character of planned residential areas. Here the spatial character has been examined in order to identify any basis for the morphological transformation in land use pattern from the configurational character of these areas. (Figure 3)

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2007

Local Integration ( R4)

Figure 3 Local integration pattern of case study areas as independent system For syntactic analysis of the study area as independent system, axial maps were produced following to the administrative boundary of the residential areas at a 10 years regular interval from 1963-2007. The axial maps of Dhanmondi consist of a number of parallel long lines, passing through each other. The grid of the axial map has a strict right angle of intersection. The axial map of Gulshan consists of a mixture of short & long segment of lines. Among which longest line of the axial map forms the central spine of the spatial structure in Gulshan. In Gulshan the number of axial lines has gradually increased which denotes that Gulshan is gradually developed through out the study period. The axial maps of Banani consist of a number of parallel lines, both long and short lines, passing through each other. Here also the longest lines of the axial map constitute sort of the spinal structure of the system. In this part of this research, the syntactic analysis of local and global integration was carried out as an independent system excluding the greater spatial system of Dhaka city. It is important to note that for local integration this research analyses at R= 4 as Dhaka (newer part) represents a strong intensified local area effect at the radius 4 ( Nilufar 1997)5. The syntactic analysis of small-scale urban grids show that the primary and secondary roads of the planned areas gain the maximum local (R4) and global (Rn) integration value which constituted the local as well as global integration cores of those independent systems6. Such a character implies that those roads are more easily accessible from and with the planned areas. It is well understood that the planned residential areas being a small independent

Proceedings of the 7th International Space Syntax Symposium Edited by Daniel Koch, Lars Marcus and Jesper Steen, Stockholm: KTH, 2009.

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Banani

Gulshan

Dhanmondi

systems represent a localized system in which the locally important roads always coincide with the global integration core (i.e. Rn of independent systems) and get importance to the local inhabitants as well as to outsiders. Analysis shows that this spatial character stayed more or less consistent throughout the study period. Therefore, the case study areas remained intelligible as an independent system. According to space syntax, in a more intelligible system the movement pattern is predictable from the measure of integration, and by this it is meant that the most integrated lines are most intensely used by the people (Hillier et al.1987). As a result, while comparing the present land use data with the local integration pattern (R4) of these case study areas, the study shows that with the passage of time the nonresidential activities have invaded along those locally important roads violating the planning regulations as these roads were initially assigned for residential uses (Table 2). In the initial master plan, non- residential, i.e. mainly commercial function was not allowed in any of these three residential areas except the circle-1 & circle-2 of Gulshan. Later on, in response to spontaneous transformation/ evolution of land uses, non-residential functions were allowed on certain streets with conversion fee7 within those planned residential areas of Dhaka. Besides, the access roads located at the inner parts of the planned residential areas contain the larger number of plot used for residential purpose.

Period R=n Max R=n Min R=4 Max R=4 Min

1963 1.94 0.82 2.19 0.96

1973 2.07 0.76 2.34 0.90

1987 2.14 0.78 2.38 0.89

1995 2.22 0.84 2.43 0.80

2007 2.14 0.73 2.43 0.63

R^=Rn-R4

0.97

0.98

0.97

R=n Max R=n Min R=4 Max R=4 Min

2.54 0.39 2.54 0.39

1.95 0.74 2.51 0.96

1.71 0.51 2.50 0.39

1.66 0.51 2.54 0.55

1.75 0.52 2.60 0.35

R^=Rn-R4

0.99

0.81

0.84

0.89

0.85

R=n Max R=n Min R=4 Max R=4 Min

N/A N/A N/A N/A

2.63 1.00 2.63 1.18

2.75 1.04 2.74 1.20

2.52 0.69 2.76 0.58

2.68 0.64 3.01 0.59

R^=Rn-R4

N/A

0.96

0.98

0.99

Table 1 Syntactic variables of planned areas of Dhaka city as independent system Such a pattern of inconsistency between the land use transformation and syntactic attributes of the independent systems lead to look beyond the boundary of planned areas. To find out any logical cause behind such socio-spatial unpredictability, the planned residential areas were analyzed as a local spatial systems articulated within the whole urban system. In the next part it is examined how the integrated (R=4) roads of local areas (i.e. planned areas) became part of the global integration core of the organic city (unplanned city). In doing so, the paper describes how the planned residential areas of Dhaka city are plugged in the organic city grid, which is primarily unplanned in nature and grown spontaneously without any pre-conceived planning perspective. Thus it tries to determine any spatial logic behind the land use transformation as occurred in the planned residential areas of Dhaka city. Comparison of recently introduced non-residential function with the spatial structure of independent system (Figure 4, 5, 6) suggests that land use conversion seems to follow the local integration (R4) pattern in individual areas. This represents an accurate representation of the

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assumptions as extended by space syntax theory. Following this, it appears that the independent system of the planned areas have been evolved effectively as residential neighbourhoods. In spite of that some idiosyncrasies raised suspicion. Such as, few roads having lower local integration (R4) value contain higher percentage of nonâ&#x20AC;&#x201C;residential activities, such as South Gulshan Avenue and North Gulshan Avenue. In the same way, in Dhanmondi, Road 2, 4, 5, 6, 7, 8 show the similar pattern. Major incongruity lies with the fact that the land use transformation within the residential areas were not limited within localized activities; rather they attracted city scale commercial functions.

Name of Road

BANANI R/A

Seg-01 Mirpur Seg-02 Road Satmasjid Road Road #27 Road #02 Road # 04 Road #12 Road #09 Road # 26 Seg-01 Seg-02 Seg-03 Seg-04 North Gul. Ave. South Gul. Ave. Road #103 Road #113 Road # 116 & 126 Kamal Ataturk Road #11 Road #04 Road #08 Road #10 Gulshan Avenue

GULSHAN R/A

DHANMONDI

R/A

Area

Local Integration (Rn) (Independent System) 2.02 2.31 2.41 2.31 2.01 1.55 2.01 2.02 2.16 1.68 2.41 2.60 2.51 1.98 1.96 2.18 2.23 2.05 2.95 2.90 3.0 2.62 2.40

Global Integration (Rn) (Independent System) 2.1079 1.732 2.1404 2.0972 1.7447 1.266 1.6033 1.6033 1.9048 1.126 1.6363 1.7459 1.3247 1.3941 1.2388 1.403 1.4632 1.3475 2.6784 2.5226 2.5093 2.5093 2.2921

Global Integration (Rn) (embedded System 0.80 0.79 0.70 0.74 0.75 0.75 0.66 0.66 0.70 0.66 0.64 0.68 0.68 0.70 0.66 0.66 0.64 0.64 0.69 0.67 0.65 0.65 0.65

Land use (%)

Res.

Non-res.

2.09 16.98 28.85 23.25 30.76 34.48 35.3 49 10.86

97.91 83.01 71.64 76.75 69.23 65.51 64.7 51 89.14

20.87 24.5 19.14 25 52.17 34.48 59.25 6.25 21.96 42.75 52.83 36.73

79.13 75.5 80.85 75 47.83 65.51 40.75 93.75 78.04 57.25 47.16 63.27

Table 2 Transformation of land use pattern following the ranking order of the integration value and functional order of the street system as independent system (2007).

5. The urban core and the planned areas as embedded system In this part, the aim is to understand how the land use pattern of the planned areas has been transformed in relation to the changing configurational properties of the spatial structure of Dhaka city. This leads to analyze the planned residential areas as embedded system in the organic urban grid of Dhaka city. The properties of urban core define the spaces, which are more easily accessible or best integrated into the urban layout as a whole. In this research, the pattern of the global integration core of Dhaka city is formed of the highest 10% globally integrated lines. This integration core shows the pattern of accessibility to the area from the surrounding context and represent how the inside of a settlement can be reached from the out side and where the greatest possibilities of movement are likely to occur. Rather this study mainly concentrate on to compare the global integration core of planned areas as an embedded system with the urban core of Dhaka city of 2007 to show how much it is overlapped with the planned area. (Figure 4, 5, 6)

Proceedings of the 7th International Space Syntax Symposium Edited by Daniel Koch, Lars Marcus and Jesper Steen, Stockholm: KTH, 2009.

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DHANMONDI RESIDENTIAL AREA 3

6 Meter

Land use Pattern 2007 Legend: Commerc ial Residential Educ ational Medic al Community Fac ility

Local Integration Pattern As an independent system

Global Integration Pattern As an embedded system

Figure 4 Comparison of global integration core of Dhanmondi between embedded and independent system with the land use pattern in 2007 From the evolutionary changes (Figure 2) it is evident that, at the early stage of the study period, the study areas like Dhanmondi, Gulshan, Banani once lying at the periphery of the city and was developed as a secluded layout with distinctively different local structure from their surrounding. Due to the inward as well as outward growth of the city and the changes in the integration pattern of the whole system, the global core of Dhaka city tend to shift and the case study area become more integrated with in the whole system. These changes in the morphological character of the study area as a part of the whole city must have some influence in transforming the morphological component specially land use in the planned areas. Here it is important to note that the case study areas were initially located at the edge of the city which was later engulfed by the successive growth (unplanned) of the city. The following part shows how the once segregated planned residential areas laying at the edge gained higher position in terms of integration in due course of city growth. In spatial analysis, changing position of case study areas in terms of global position must have some impact from 'edge-effect' 8. This paper conjectures that as the city experienced

Proceedings of the 7th International Space Syntax Symposium Edited by Daniel Koch, Lars Marcus and Jesper Steen, Stockholm: KTH, 2009.

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enormous growth for which the mean depth from most integrated lines must have varied and the predicted impact of edge effect is obvious on the case study areas while they were on edge. However, this research did not consider radius-radius to defuse the 'edge-effect' in order to avoid the complications of using different radius for global integration.

Local Integration Pa ttern As an independent system

Land use Pattern 2007 Legend: Commerc ial Residential Educ ational Medical Community Facility

GULSHAN RESIDENTIAL AREA 3

6 Meter

Global Integra tion Pattern As an embedded system

Figure 5 Comparison of global integration core of Gulshan between embedded and independent system with the land use pattern in 2007 Through out the study period as an embedded system the integration value of the primary and secondary roads of the planned areas, which constitute the integration core of the planned areas had gradually increased and were coincide with or adapted as the highest integration lines of the Dhaka city. That means in planned areas the most integrated roads are very much globally known, as a result through out the study period the planned areas could not developed as a distinct residential neighborhood which is very important to retain the residential character. According to the space syntax theory those road which are more spatially connected and known to the people attract certain type of land use which benefit from the presence of people.(Hillier, 1996) For that,

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the integrated core of planned area become more accessible by the people from the surrounding context and attracted non-residential land use in the residential environment that transforms the total morphology of the planned areas in Dhaka city.

BANANI RESIDENTIAL AREA 3

6 Meter

Land use Pattern 2007 Legend: Commercial Residential Educ ational Medical Community Fac ility

Globa l Integration Pa ttern As an embedded system Local Integra tion Pattern As an independent system

Figure 6 Comparison of global integration core of Banani between embedded and independent system with the land use pattern in 2007 Moreover, due to the shifting character of the functional core of Dhaka city, the organization of its different parts created demand for new spaces for new urban activities at convenient location with better accessibility and better environment. The primary road of planned areas under study has the highest integration value as embedded system got the priority for city scale commercial function.(Khan 2008) This condition is applied to Dhanmondi area as Mirpur Road was the most integrated road and this road transformed into a shopping street in the process of time. Similarly, for Gulshan and Banani primary roads contain the city scale commercial function. (Table 2)

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By comparing the land use pattern of the planned area with the global integration value, It is revealed from the figure 4, 5, 6 that the integration pattern of the independent system is quite different from that of the embedded system. Many parts of the planned area attained higher global integration value while it is embedded in the city grid and the land use pattern directly corresponds to those. It can be stated that land use invasion seems following the highly integrated lines and the character of the residential area is being drastically changed. This case is evident from Road 2, 4, 5, 8, 9A, 10A in Dhanmondi. In case of Gulshan, land use of Road 96, 99,100,102,101,126,132,133 shows a synchrony with the integration pattern revealed as embedded system, which is drastically changed in compared to independent system. In the similar pattern Road no 7, 10, 12 of Banani holds concentrations of non- residential functions, which has attained higher integration in embedded system. All these suggest that the dominating cause of land use transformation is determined by the organic city grid over the planned areas of Dhaka city.

6. Conclusion The brief historical and morphological overview has been highlighted the fact that because of unplanned nature of growth as well as with its vast territorial expansion, Dhaka city has undergone radical changes, not only in its sprawl but also through its internal physical transformation. In this city, planning intervened as piece meal efforts, which included a number of planned residential and commercial areas. Whereas, since historical time, organic growth characterized the spatial structure of Dhaka in general. The research findings show that the articulation of the planned areas within the spatial structure of the organic city of Dhaka reveals an inner order in organizing the planned area as a part of the whole system. In the process of transformation, each planned area, in spite of its rigid planning pre-determinants, has gained strong focus on its own local spine; at the same time those roads seem to attain global importance to certain degree. As a result, the city scale commercial function tends to grow along these local spines of planned residential areas. This sort of land use transformation beyond the rigid planning rationality seems has robust influence from the organic city grid as it engulfs the planned areas in due course of time. Over and above, this research identifies the influence of the global integration core of the organic city over its planned parts. The study reveals that the planned areas adopted certain degree of land use transformation, which is mainly guided by the pattern of local spatial structure of the planned area and the changing pattern of the growing city grid. Indeed, due to the shifting character of the global core of the unplanned spatial structure of Dhaka, the planned areas attained more global importance in certain phases. Thus it can be stated that the integration pattern of a organic city, like Dhaka, grasps the identity of the planned area and those area ultimately are being articulated with the unplanned part of the city grid with rigorous maladjustments with pre-planned decisions. As a result, city scale function invaded in the residential environments taking the lead from the global integration pattern of the city. Therefore, the finding of this research makes useful contribution to the knowledge of planning and development. Through understanding the inner order in organizing the planned area as a part of the whole urban system, this research will help to adjust the practical decisions of the planned residential area of Dhaka. In this process, any new planned interventions can be guided for possible transformation in due course of time and can also be planned through understanding how the transformation takes place and what aspect needs to be taken care off, if the city needs to remain as a workable whole. The research findings will create some amount of incentive for future researcher to improve the unplanned state of planned residential area due to their morphological transformation of land use pattern. So that, they can be adjusted at the right time and retain the residential character before turning to an unlivable state.

Notes 1 Space syntax defines the degree of spatial order, which exist in organic and planned layout by analyzing the spatial configuration. This theory also proposes a fundamental relation between configuration of space in a city and that way that it functions. Integration is the relative depth or shallow ness of the system seen from any particular point within it. The integration value is then Proceedings of the 7th International Space Syntax Symposium Edited by Daniel Koch, Lars Marcus and Jesper Steen, Stockholm: KTH, 2009.

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rank order in to seven integration band varies from red to blue to represent the degree of integration. The set of most integrated street are collectively known as global integration core. The nature of the integration core, its shape size, coverage and so on depends basically on the connectedness and geometry of the urban system and on its mode of growth Axial map is the basis of layout analysis. This refers how far observer can have an uninterrupted impression of visibility and permeability as they move about town and look at distance towards the various directions. The map is derived by drawing the fewest and longest lines of uninterrupted permeability, which are necessary to cover all public open space of an area the size of the system is measured in terms of the number of lines. (Hillier and Hanson 1984) The SOB published maps of 1963, 1973, 1987, 1995, & 2007 are used as base map for generating axial maps. According to the administrative boundary, all the axial maps of planned area in different study period from (1963-2007) has been processed. As in the map of 1953, among three study areas, only 10% area of Dhanmondi was developed. For that the syntactic analysis was carried out for the year 1963-2007 Depthmap is primarily a computer-based program to perform configurational analyses, which come under the umbrella term of `space syntax'. Space syntax analyses examine the relationships between components of space; each analysis starts with a representation of the spatial components, then makes a graph of these components, and finally analyses this graph using for the most part, conventional graph theoretical measures. In a previous research on localities and neighborhoods of Dhaka, it has been identified that new Dhaka represents intensified local area effect at the radius- 4, whereas the historic part characterized its localities at the radius- 3. (Nilufar 1997) In any urban system, the integration core consists of most integrated road of the system and it mainly depends on the connectedness and geometry of the urban system and on its mode of growth. Conversion of land use or building use was allowed to Road 27, Road 2 & Satmasjid Road in Dhanmondi; Gulshan Avenue, & North and South Avenue in Gulshan and Kamal Attaturk in Banani. Edge effect is a phenomenon in axial analysis that occurs when the road that lie along the periphery of the axial map become segregated purely as a function of the size of the boundary selected for analysis (Penn et al., 1998).

References Hillier, Bill, Burdett, Richard, Peponis, John, and Penn Alen. 1987.Creating life or does architecture determine anything?. Architecture and Behavior, vol-3 n-3 : 233-250. Hillier, Bill. 1996. â&#x20AC;&#x153;Cities as movement economies,â&#x20AC;? In Space is the Machine. United Kingdom. The Press Syndicate of the University of Cambridge. Hashem, Maqsud. 2001. Trends of Development in Dhanmondi residential area of Dhaka city M.U.R.P Thesis. Dept of Urban & Regional Planning. Bangladesh University of Engineering and Technology. Islam, Nazrul. 1996. Dhaka from City to Mega city. Dhaka: Urban Studies Programme. Department of Geography, Dhaka University. Islam, Nazrul. 2005. Dhaka now: Contemporary Urban Development. Bangladesh Geographical Society (BGS). Department of Geography, Dhaka University. Nilufar, Farida. 1997. The Spatial and Social Structuring of Local Areas in Dhaka City - A Morphological Study of the Urban Grid with Reference to Neighbourhood Character within Naturally-grown Areas. PhD diss., University of London. Nilufar, Farida. 1999. Spatial Structure of Urban Core and the Process of Transformation in Dhaka. Abstract and Paper accepted and Published in the Proceedings of the Sixth International Seminar on Urban Form (ISUF 1999), July 23-26 Italy. Khan, Nayma. 2008. Study of Morphological Transformation in the Planned Residential Areas of Dhaka City. M.ARCH Thesis, Department of Architecture, Bangladesh University of Engineering and Technology. Penn, A., Hillier, B., Bannister, D., and Xu, J. 1998. Configurational Modeling of Urban Movement Networks. Environment and Planning B: Planning and Design, 25, pp. 59-84.

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Rajdhani Unnayan Kartipakkha (RAJUK). 2002. Dhaka Metropolitan Development Plan (DMDP). Detail area plan for Begunbari Khal and its influenced area, Location 4, Ministry of Housing & Public works, Government of Peoples Republic of Bangladesh.

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Contact: Nayma Khan Graduate Teaching Assistant /PhD Student Department of Architecture, University of Kansas E-mail: n221k306@ku.edu Phone: 785-979-7010