CITY IN THE CITY THE GENERAL UNIVERSITY HOSPITAL IN PRAGUE Victoria Gerasimova Hannah Holmen Ekaterina Sinelnikova
Urban context General University Hospital provides basic as well as specialized outpatient or inpatient care for children and adults. They also provide comprehensive pharmaceutical care, including technologically demanding preparations of cytostatic and sterile individually prepared medicinal products, transfusion services and medical transport services. The 1st Faculty of Medicine of Charles University offers extensive resources not only for diagnostic, therapeutic and nursing care, but also for teaching, and scientific research. The hospital has the longest tradition of academic medicine in the Czech Republic. From its foundation in 1790, it remains the largest research medical institution and the main teaching institution of the First Faculty of Medicine in the country. Cooperating with many other educational institutions from all over the Czech Republic. General University Hospital is located in Prague 2, situated between Charles square, I.P. Pavlova metro station and Vysehrad. This hospital is not just a building, it is a city in the city. The Prague General Hospital city is comprised of hospital buildings, university buildings, technical facilities, walls, streets, parks, public spaces and its own transport. Such a large system creates its own difficulties in accessibility and coordination within and between hospital grounds. Navigation is unreadable and confusing, walls built around the blocks to protect hospital spaces disrupt essential access and destroy street lines. The hospital grounds are surrounded by greenery - the Botanical Garden, the Katerinska Garden, the Lost Garden, and the French garden on Charles Square. There are also many green spaces inside the hospital blocks, thus all bordering on roads or parking lots, rendering them difficult to use.
Personal experience
Access
Fences Locked access Pedestrian access Car access Building access
Scale 1:2500
Functions and Navigation
Functions
‘TUMORS’ Failing Technical appendixes
III. internal medicine clinic Department of Anaesthesiology, Resuscitation and Intensive Care Institute of Nuclear Medicine Institute of Sports Medicine Department of Nephrology II. surgical clinic Radiodiagnostic clinic I. internal clinic II. internal medicine clinic Department of Dermatovenerology Faculty transfusion department Nephrology clinic Dental clinic Pharmacy Dental clinic III. internal medicine clinic I. surgical clinic Department of Oncology - radiotherapy Radiodiagnostic clinic Department of Otorhinolaryngology Institute of Medical Biochemistry and Laboratory Diagnostics Department of Anaesthesiology, Resuscitation and Intensive Care Eye Clinic Oncology clinic I. Department of Tuberculosis and Respiratory Diseases IV. Department of Internal Medicine - gastroenterology and hepatology Headquarters Department of Pediatrics and Adolescent Medicine Department of Neurology Radiodiagnostic clinic Department of Occupational Medicine Psychiatric clinic Institute of Sexology Department of Gynecology and Obstetrics Pharmacy - Urological Clinic building Department of Urology Institute of Nuclear Medicine Pharmacy Department of Pediatrics and Adolescent Medicine Institute of Medical Biochemistry and Laboratory Diagnostics Department of Forensic Medicine and Toxicology - Toxicology Department of Pathology Department of Forensic Medicine and Toxicology - Forensic Medicine Department of Immunology and Microbiology Department of Rehabilitation Medicine Clinic of addictology Department of Dermatovenerology
Scale 1:2500
‘MALIGNANT TUMORS’ existing building appendixes and service devices (sewage/ventilation/communications/heating) poorly designed, spread randomly throughout; symptoms: damaged facade, foundations, misplaced ‘building organs’ - decreased immunity - slow decay ‘BENIGN TUMORS’ redundant ‘clots’ of building’s ‘tissue’, which, although relatively harmless and sometimes even functioning, contribute to the overall inadequate physical health of the hospital
Greenery and Parking Parking + number of places available Public Greenery Hospital Greenery
Cars/public transport Greenery/parkings
Bus Tram Parking + number of places available Public greenery Hospital greenery
Scale 1:2500
Tumors
‘MALIGNANT TUMORS’ existing building appendixes and service devices (sewage/ventilation/communications/heating) poorly designed, spread randomly throughout; symptoms: damaged facade, foundations, misplaced ‘building organs’ - decreased immunity - slow decay ‘BENIGN TUMORS’ redundant ‘clots’ of building’s ‘tissue’, which, although relatively harmless and sometimes even functioning, contribute to the overall inadequate physical health of the hospital
Scale 1:2500
Historic research 1816 The Prague General University Hospital, based on Charles Square, owes its birth to Emperor Joseph II. General hospitals were to care for the poor, in nursing homes poor women were giving birth. The hospital was also supposed to be found, orphanages, sickness for the poor, chronically ill patients, and an early psychiatric clinic. The original proposals included the placement of the hospital in the monastery and prelature on Karlov, the maternity hospital in the capitular house of St. Apollinaire, and the madhouse and sickness to the former monastery of St. Kateriny. The other hospital buildings were gradually built, urban space was constantly changing, new parts were added to the old buildings over the years. Such a gradual development of the territory introduced a kind of chaotic structure in the inner space of the hospital.
Existed road Existed Addit construction Parks
Scale 1:2500
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Case Study Bellevue Hospital was founded in 1736 in New York and is the oldest public Hosptial in the United States today. It was one of the first correctional institutions to implement occupational therapy including activities such as knitting, welding, and farming. The hospital was built on a plot of land which previously was Bellevue Farm. Since the establishment 300 years ago the hospital expanded with new buildings across the plot. The hospital underwent a drastic expansion in the 19th century in order to cope with the Yellow fever epidemic. Similar to Prague General Hospital Bellevue is a mosaic of buildings from different time periods, creating challenges in access and navigation. A notable adition was the Cube designed by Pomerance and Braines, built in the 70s. The building is 25 floors and 250ft by 250ft, with 1500 beds. The architects designed the addition to include all necessary diagnostic, administrative,dietary, and Laboritory spaces on each floor, combining 14 buildings into 1. This drastic approach was idealised to combat inefficient traffic patterns between departments leading to high cost in personnel and faculty maintenance. The concept aimed to decentralise and veritcalise in order to support distribution and save money, with patients only leaving for non-routine procedures. The plans placed all rooms along the facades of the building to bring in as much natural light as possible whilst putting all admin and staff spaces at the center with only artificial light, which is a large critique for the project as staff’s work environment is neglecting the human’s working day and night in these spaces. The latest addition built in 2005 is a large iconic glass facade structure, acting as a main entrance to the hospital complex. It offers a large waiting and reception area as well as more out-patient rooms. Comparatively, the new ambulatory is a more accupunctural approach sensitive to the users and purpose compared to the brutalist Cube extension.
Links: https://www.atlasobscura.com/places/bellevue-hospital http://pcfandtypecodewebstuff.s3.amazonaws.com/documents/ BellevueHospitalHistory.pdf https://www.nycurbanism.com/brutalnyc/bellevue-new-building http://www.history-magazine.com/bellevue.html
Vision Our intention is to increase the efficiency of the Prague general hospital through minor improvements. Our design envisions stitching together the diverse fabric of the hospital into one cohesive system that is clear, user-friendly and well connected.
New paths Key nodes Unblocked access Existing access New escalator Existing staircases
Goals • • • • • • •
Unify the hospital grounds through increasing pedastrian traffic Update the navigation system on campus and within the neibourhood (signage and colour markers) Introduce new social interactions through public spaces Create a heirarchy of key nodes related to the proposed pedastrian pathways Extending the bus route Rethink the existing physical boundaries (walls, edges of the buildings, etc.)
Fences New development Public greenery Hospital greenery New paths
Scale 1:2500
Paths & Navigation Case study ‘SLOW DOWN’ by Jacqueline Donachie “ To go everywhere we need a path that goes everywhere. The discussion grows. We mark it on maps and talk about it in meetings and eventually there comes a point where we just need to DRAW it (we are artists, after all).” “When you move around the town on foot or bike and take in the new houses as well as the old, you start to notice how the paths work.” Jacqueline Donachie Artists book: https://issuu.com/jacqueline-donachie/docs/slowdown_final Article: http://jacquelinedonachie.co.uk/project/huntlyslowdown
The Czech Hiking Markers Standard It is an international system of hiking markers for tourist trails, used in more countries than any competing standard. The signs and markers can be used in both wilderness and cities. The trail usually starts with arrow signs with names of destinations and number of kilometres marked. Each trail is then colour marked by simple markers and arrows painted between white lines on fixed objects along the trail (trees, rocks, utility posts or walls) in a colour given to a specific trail. Due to the relative ease of use and low cost, the system has spread to many other countries, often by Czech people. The basic system of trails with markers painted along the trail can be complemented by other features. These additional features are not necessary for the basic functioning of the system though. • Information boards along the trail, giving information about the trail, nature protection, monuments, animals and trees along the trail. Logos of the supervising institution • Printed Maps with coloured lines showing the trails. • GPS information on each trail, board or sign • Mobile phone application with a map and site descriptions This system uses three bars with different meanings attached to different colours: • red indicates the most difficult or summit trails • blue for significant trails • yellow and green for easy or interconnecting trails Article: https://en.wikipedia.org/wiki/Czech_Hiking_Markers_System
Paths & Navigation Case study
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Navigation system of the hospital is unclear and it is easy to be lost. The new system of navigation was designed. New boards with the map of the hospital with color code appears on the node around the hospital. Colored lines on the road are spread from this boards to the department. Apart from hospital buildings the map could also show cultural buildings around the area. This navigation should help as patients as tourists to orient around the hospital grounds.
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Marks on ground related to pavilion color code Scale 1:250
2
You are here
Botanical garden
Functions and Navigation III. internal medicine clinic Department of Anaesthesiology, Resuscitation and Intensive Care Institute of Nuclear Medicine Institute of Sports Medicine Department of Nephrology II. surgical clinic Radiodiagnostic clinic I. internal clinic II. internal medicine clinic Department of Dermatovenerology Faculty transfusion department Nephrology clinic Dental clinic Pharmacy Dental clinic III. internal medicine clinic I. surgical clinic Department of Oncology - radiotherapy Radiodiagnostic clinic Department of Otorhinolaryngology Institute of Medical Biochemistry and Laboratory Diagnostics Department of Anaesthesiology, Resuscitation and Intensive Care Eye Clinic Oncology clinic I. Department of Tuberculosis and Respiratory Diseases IV. Department of Internal Medicine - gastroenterology and hepatology Headquarters
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View point Existing situation The reason why we decided to focus on this specific site is due to its incredible location and character juxtaposed by the current uncertain function and transitional usage. At the moment, this plot of land is given to secondary parking lot and predominantly used for emergency access. There exists no clear separation between the high-speed car traffic and pedestrians, which is both dangerous and unpleasant, and, as we see, is one of the main reasons why the benefits of this location are not being explored.
View point Design Therefore, our proposal for this site is to implement the main benefit of the location - the view - through pedestrianizing the adjacent route and converting the existing parking lot into a public meeting point with seating, ambient light and picturesque view. By introducing recreational aspect into this area, this concept aims to attract public as well as provide new facilities for regular users of the hospital. Within the overall vision – enhancement of pedestrian navigation – this node becomes one of the key highlights and establishes a functional reference point for both the city and the hospital campus.
Escalator access Existing situation This edge of the hospital campus is separated from the adjacent street with a natural wall in form of a very steep slope covered with wild gardens. This separation occurred naturally due to the character of the local terrain and overtime shaped the way hospital is being accessed both by visitors and medical staff. In the current conditions, the nearby tram stop, although positioned geographically closer, is not convenient due to the level difference, whilst the main entry to this side of the campus is located quite at a distance, forcing users to elongate their commute. At the same time, because of the poor connectivity to public transport, numerous members of the staff prefer to drive, which creates issues with parking and overall navigation on site.
Escalator access Case study Hong Kong’s Center-Mid-Level Escalators Hong Kong is one of the most densely populated areas in the world, situated amongst very mountainous terrain the metropolitan city has adapted connections between central and mid-level districts using 800m of escalators and walkways. First commissioned in the 80s the project was realised in 1993. The system includes 18 escalators and 3 inclined moving walkways, sections are elevated and others are on ground level due to the challenging terrain. In 2010 approximately 85,000 people used the system according to Transport Department patronage surveys. Furthermore it was noted the project relieved demand of more public transport, yet not reducing traffic of motor vehicles. Between 6am to 10am the escalators go downhill and uphill from 10am till midnight, if users want to travel in the opposite direction they need to use the stairs and ramps next to the escalators. There is connections to each street the system crosses through. Article: https://en.wikipedia.org/wiki/Central%E2%80%93Mid-Levels_escalator
Escalator access Design Solution to this issue we see in penetrating this border by introducing a vertical connection – the outdoor escalator. We believe this will help to draw attention to dysfunctional sections of the campus land and help to organize a new healthier circulation system. The concept is to integrate the escalator into the existing terrain in order to save space as well as to allow the beautiful wild gardens become part of the regular commute.
Scale 1:250
Pavilion A7 Existing situation The area around Pavilion A7 is full of parking spaces and the hill, which makes access to the building difficult and confusing. The building itself looks as collage from different styles of architecture. In 2020, the structural research was made by OBERMEYER studio. The research says the structure of the building is collapsing and the building should be demolished.
Pavilion A7 Design Pavilion A7 was decided to demolish due to the week structure and build a new building. One part of the existing facade was decided to preserve, as it creates a visual connection with the main etrance to this hospital block. New structure of the building creates a square where people can spend their time - as patients, doctors or just passers by.
Pavilion A7 Design From the Benatska street, was decided to demolish the wall that separated hospital area from the street. The building creates a new street line with a public space in front of the entrance to the Pavilion A7. The pavilion has underground parking with access from the Benatska street, which allows to remove old car parking around the building.
Square behind Institute of Scientific Information 1.LF UK and VFN Existing situation This currently enclosed square has great potential because of its calm charecter thanks to the existing cafeteria structure, enclosing it from the street. Nevertheless, because of the fact that the internal square is currently enclosed also by the wall, this space is not being used as much and it could. Therefore, our proposal for this space is to remove the wall in order for it to become more interactive with the urban space outside.
Square behind Institute of Scientific Information 1.LF UK and VFN Design Scale 1:500
Node on the Apolinarska street Existing situation The new superblock in Katerinska opens up a new square, providing better amenities for staff as well as new public amenities. By placing the bus stop after the elevated crossing priority is given to the pedestrians. By introducing a large square the gynecology building is able to breathe more and a new social interaction is able to occur with the cafe and event space connecting the square and new block.
Node on the Apolinarska street Design Scale 1:250
Node on the Apolinarska street Design
Conclusion Unify the hospital grounds through increasing pedastrian traffic - New important access point – escalator - Establishment of continuous pedestrian paths in places where they are currently missing Update the navigation system on campus and within the neibourhood - Urban color-coding - Updated signage, mapping and positioning of information boards Introduce new social interactions through public spaces - Public view point near the Church of St.Jan - New square in place of a parking lot in front of the Birth Clinic - Public spaces proposed within the two AD projects - Opening of the square behind the Institute of Scientific Information Create a heirarchy of key nodes related to the proposed pedastrian pathways - Urban proposal for the six specific nodes Extending the bus route - New pedestrian access to Botanicka Zahrada stop - Addition of a new stop on Apolinarska street Rethink the existing physical boundaries - Reshaping of the street line near Pavilion A7 and within the Apolinarska node W - Opening of the blocked entrances on the main routes: Psychiatry gardens and Apolinarska street