CASE STUDY

A) Guilin Medical School Affiliated Hospital

Guilin, Guangxi Zhuangzuzizhiqu, China

Figure 45: Guilin Medical School Affiliated Hospital Source: https://www.hdrinc.com/portfolio/guilin-medical-school-affiliated-hospital

PROJECT

FACT PROFILE

Location : Size : Capacity :

1 Zhiyuan Rd, 2,769,554 sf 1400 beds Lingui District, (257,300 m²) Guilin, Guangxi, China

Status : No. of storeys : Built up area: Under construction 4 185,800 sqm

INTRODUCTION

The Guilin Medical School Affiliated Hospital is located in one of the most spectacular destinations in China. A beautiful city on the west bank of Li River, Guilin is famous for its beautiful landscape, limestone karst mountains, and the fragrant sweet Osmanthus trees.

The new 1,700-bed, two-million-square-foot hospital will accommodate clinical care, teaching and research programs, which are currently provided in the co-located medical school and hospital campus. The new hospital is designed as a new futuristic model that promotes medical and wellness tourism in harmony with nature. Here, a holistic health journey blends eastern and western medicine to define a new path toward total health. (HDR, n.d.)

Figure 46 : Four storey building inspired by local culture and nature Source: Guilin Medical School Affiliated Hospital

CONCEPT

The Hospital Design was inspired by the Local Culture and Nature of the area. The design concept of the project, “Garden in Garden,” is inspired by the natural landscape and culture of Guilin. Both the form and exterior design of the building are inspired by Guilin’s flowering Osmanthus. Osmanthus patterns throughout the facility create an aesthetically and physically healing environment. Several courtyards with therapeutic landscapes, roof gardens and light wells will improve the patient and staff experience. (HDR, n.d.)

PROGRAMME ARRANGMENT

On the new campus, each petal of the Osmanthus is a center of excellence and provides clear wayfinding to both patients and staff. This efficient design greatly improves workflow and medical circulation within each center of excellence, while making sure that the medical resources are evenly distributed.

The goal was to create a modern, garden-style hospital full of sunshine and greenery. The series of inpatient towers placed throughout the site are also unique, providing plenty of views and natural sunlight for the patient rooms and centrally located family zones.

The symbolism of the local Osmanthus flower is dispersed throughout the building and gives its visitors a sense of local culture and belonging. The integration of nature into the hospital not only provides visually appealing imagery, but also helps patients and visitors remain connected to the unique and iconic natural surroundings of Guilin. (HDR, n.d.)

Figure 47: Design concept Source : Guilin Medical School Affiliated Hospital

DESIGN STRATEGIES FOR GOOD USER EXPERIENCE

Multiple towers:

Each department was segregated in multiple independent centers. A segregated theme of water, fire, wood, metal and earth was given to each tower by providing different colours, sizes, landscape design and art sculptures to identify easily on the site. These become focal points for wayfinding and carry the patient through their journey while connecting them to the natural environment.

Glass podiums:

Additional glass podiums create transparency throughout the campus to enhance the human experience with views, light, and connection to nature.

Low height:

The building is low heighted buildings were placed while maintaining maximum distance from the roads to prevent noise from the vehicles. It also elevates the ambience on the campus and establishes privacy from the surrounding community so the new medical campus is a beneficial landscape rather than a towering building that obstructs views. The building evolved into the series of low- rise buildings not only to follow the city guideline but also to maximize a common sight line throughout the city and its surroundings.

Floor wise planning:

On top of each center of excellence is a roof garden. Recessed medical floors enhance the building's flower-like shape. Patients and staff coming up or down from the inpatient tower to these transitional floors have access to the roof gardens, sunken gardens, and courtyards to move throughout the campus and experience its garden-natured design, both between and within the buildings. (HDR, n.d.)

Figures 48 : Images and views of the structure Source: Guilin Medical School Affiliated Hospital

INFERENCE

The circulation organization and zoning division are based on different users' needs and behaviors, avoiding unnecessary crossovers and keeping the circulation as efficient as possible. It will also help in handling crowded situations systematically.

Integrating and classifying specific disciplines/departments that have similar functions or are closely related to each other was important, and it improves staff work efficiency and minimizes the patient travel distance. This method will tremendously help the senior patients to locate certain areas without any guidance, due to commonly seen eye sight issues. Large-scale shared medical technology has been centralized so that each specialty can easily get access to diagnostics and treatment, which makes treatment more efficient.

The location chosen has beautiful view and smell of flowers which will help enormously in reducing the commonly experienced medical odor. The good view and ventilation will help to reduce the stressful atmosphere and suffocating ambience.

Using colour and size or scale to signify a specific department in the structure is made to give individual identities to all areas, which is also an environmental characteristic feature of the research.

B) Karunashraya, Home for terminally ill patients

Marathahalli, Bangalore, India

Figure 49: Karunashraya hospice Source:https://static.wixstatic.com/media/bfc9d9_4b00dce50866459f99f28dcb5e31b40d~mv2.jpg/v1/fill/ w_560,h_374,al_c,q_80,usm_0.66_1.00_0.01/Karunashraya_JPG.webp

PROJECT FACT PROFILE

Location : Size : Capacity :

40, Varthur Rd, 2,769,554 sf 55 beds Kundalahalli, (257,300 m²) Marathahalli, Bangalore, India

Status : No. of storeys : Built up area :

Built in 2004 Ground floor structure 3400 sq

INTRODUCTION

Karunashraya meaning 'Abode of Compassion' is a huge establishment. It is a hospice for terminally ill cancer patients. It is covered in lush greenery, bird song and peace, in the middle of a busy city that houses the hospice that caters to palliative care. The hospice has been offering in-patient care since 1999 and home care since 1995, tending to over 17,500 patients and touching the lives of their families by providing a supportive environment.

It was inspected as a registered charitable trust by the Indian Cancer Society (Karnataka Chapter) and Rotary Bangalore Indiranagar to provide free professional palliative care for advanced stage cancer patients who are beyond cure. (Karunashraya, n.d.)

Figure 50: Karunashraya landscape - open spaces Source:https://archnet.org/sites/5185/media_contents/44827

CONCEPT

A hospice with a soul, designed to create a calm nurturing environment for the elderly. A place in the midst of the busy city which feels like it’s in an isolated area away from the day to day chaos. The facility provides various activities and has numerous architectural elements to encourage a peaceful and spiritual environment to the patients. (Karunashraya, n.d.)

PROGRAMME ARRANGEMENT

The building is situated in 8200 sq. Are a plot and the total build up area is 3400 sq. The hospice is focused around a large expanse of water that generates a sense of peace and calm. The front of the complex houses an administrative area, conference facilities and a day-care center. The wards are located towards the rear. (Karunashraya, n.d.)

A typical module has a central nurses' station and washing area, while each patient has an individual space that leads out to a verandah overlooking the water.

The building facade is of stone with composite masonry- cladded with locally available granite. The building is designed in a way that all

Location Temperature & odor control

Visual connectivity & Social interaction Natural connect

Focal Points

Figure 51: Site plan Source : https://archnet.org/sites/5185/media_contents/44824

rooms of the patients receive natural lighting and ventilation. The patients can relax with a view of greenery on one side and water on other of their ward. The building has five to house in-patients wards. Recreational activities include indoor games, watching TV, newspaper etc. A 100 seat auditorium is provided which is fully equipped with modern communication facilities for conferences and training. Solar energy is used to serve power to the Lighting in the wards and also exterior. (Karunashraya, n.d.)

Figure 52: View towards the fountain in the water body Source: Google maps Figure 53: Open ground for activities Source: https://archnet.org/sites/5185/media_contents/44827 Figure 54: View from the ward Source: Google maps

INFERENCE

The structure is a great example of for the research, as most of the design elements contribute to stimulating the mental health of the patients while making the space a comforting and peaceful environment. The water body, stone facades and green spaces and landscapes used in the design has calming and soothing properties which help in reducing stress in the surrounding. The use of local stone for façade also gives a sense of familiarity. The large number of trees and water fountains reduce the noise from the roads to an extent where it isn’t unpleasant or disturbing. The amphitheater and courtyards create spaces where the patients can socialize and get rid of their loneliness and fear. The activities carried out in these spaces further helps them psychologically.

C) Maggie Centers, UK

Maggie Manchester, London West

Fife and Lanarkshire Centers, UK

Maggie's Centers are a unique typology, an idea envisioned by Margaret Keswick Jencks, a terminally ill woman who Believed that cancer treatment environments needed good design. Combining spaces to rest and reflect, these unique buildings include gardens, private rooms and gathering areas.

Maggie's is a cancer caring organization that aims at providing comfort to patients. It is not a palliative care center nor a hospice. Neither do they indulge in medical treatment. Maggie's Centers provide emotional, social, and psychological support. They aim at positive outcomes through the domesticity of spaces in their centers by creating an informal environment for patients to respond positively to the work of caregivers.

The therapies offered at a Maggie's Contra are: Nutritional advice with specialist support for managing hair loss and skin care. Emotional Figure 56: Maggie's Manchester center Source:: https://www.archdaily.com/786370/maggiessupport/counseling with stress reduction cancer-centre-manchester-foster-plus-partners/and relaxation workshops. Support 5720b90de58ece0c35000005-maggies-cancer-centregroups to focus on the emotional impact manchester-foster-plus-partners-photoof cancer. Gardening groups to participate in horticultural activities. Courses and talks on exercise, healthy eating, emotional wellbeing, managing post-treatment challenges, partnering with the medical team, and keeping up momentum. Different methods of relaxation such as controlling anxious thoughts, meditation, creative writing, bereavement support, expressive art, and exercise. Frank Gehry's homely center in Dundee looks as if a child made its roof out of folded foil while Zaha Hadid's in Fife, with its shark-like exterior made of sparkling silicon carbide grit, allows its visitors to move, in a bold metaphorical way, from darkness to light. Maggie's Centers aim to build spaces that inspire people to explore the things they can do to help themselves to live with, through and beyond cancer in their lives.

Figure 55: Maggie's London west center Source: https://www.archdaily.com/38246/richardrogers-wins-stirling-prize-for-maggies-centre

With more than 20 Maggie's Centers spread throughout the United Kingdoms, most of them designed by world-renowned architects, all centers are designed by a set of design features laid out by the organization. These features are observed in almost all the centers.

The red striking red wall of Maggie's London West Centre by Rogers Stirk Harbour + Partners acts as an optimistic, energized, restorative feature that psychologically communicates the influence that the centers intends to envelop a patient into. It creates its own little world in the midst of the busy city life. Though small, Maggie's Centers comprise an intriguing architectural complexity. The interior spaces are subdivided in a way as to allow for private as well as communal spaces at the same time allowing users to feel part of the whole building.

Figure 58: Maggie's Lanarkshire center counselling room Source: https://www.dezeen.com/2014/10/20/reiach-and-hallarchitects-maggies-centre-lanarkshire-walled-gardens/

The ceiling heights and room sizes are kept similar to those in a typical house. The partition walls fall short of the ceiling as this allows, according to Jencks, 'spaces to flow into each other while allowing a datum of visual privacy.'

The kitchens in all the centers are perceived as Figure 59: Maggie's Fife center kitchen table the heart of a home where the table is a place Source: to sit and read, talk to other people, and find https://www.zaha-hadid.com/2016/12/05/maggiesfife-10-years/ support from professional experts.

Figure 60: Maggie's Manchester center floor plans Source: https://www.archdaily.com/786370/maggies-cancer-centremanchester-foster-plus-partners

INFERENCE

The programme and design of the center are carefully tailored as to provide the most appropriate as well as desirable atmosphere to patients battling cancer. Every aspect and detail of the design and space within the center is controlled and designed with the idea of providing a home-like, comforting place for the patients.

The success of these centers speaks for the accomplishment of the design and programs offered. A center like Maggie's Centre is required in or around every hospital offering cancer treatment. Providing a cancer caring center, with a similar programme and design features, in Mumbai can be the start of a series of caring centers.

CONCLUSION

Healthcare centers as one of the most important environments for human survival have undergone extensive changes with time, changing in every era throughout history. The facilities we see today are a result of the requirements during each time period that demanded for these changes to occur. With these changes the users have had different views on these spaces with different approaches. The advances in the healthcare industry is tremendous, the development in science, economy, and technology have provided ample facilities for improving the treatment of patients and greatly assisted physicians and medical staff.

However, with these advancements the negligence towards physiological needs of the patients increased as the clock was clicking, hence these emotional or mental needs and support were merely met. In addition to this, the spatial complexity, stressors, and the priority of medical and therapeutic aspects over the other factors formed an unfavorable environment not only for patients but also for staff and visitors. As the demand for healthcare increased and with the development overall in all fields the introduction of compressed and compacted spaces came into being which with time resulted in damage