Transpital Annex : Rethinking the connection between Human and Health Care

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MASTER OF ARCHITECTURE 2016 School of Architecture and Built Environment The University of Newcastle, Australia

Shik Wei Chin Course Coordinator: Chris Tucker , Michael Chapman Tutor: Emma Guthrey

Architecture Design Studio, The University of Newcastle, Australia

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PREFACE

The Transpital Annex project is submitted as a compilation of courseworks complementing the Master of Architecture. It marks the completion of the two-years professional master degree in The University of Newcastle. The book is divided into 2 parts: Architectural Research and Project Report.

TRANSPITAL ANNEX

a rethinking of healthcare industry

In Book I, Architectural Research documents the entire design process, further divided into seven parts, being Site Diagram, Concept Design, Schematic Design, NCCA Compliance Report, Developed Design, Working Drawings and Final Design. In Book ll, Project Report documents the project management of the project. it contains four broad categories, being: Project Initiation that disclose project feasibility studies and define project brief; Project Planning that includes project outlining and scheduling; Project Implementation to determine resourcing and managing procurement methods; Project Closure to conduct post occupancy evaluation and business marketing.

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ACKNOWLEDGEMENTS

This final year project would not have been possible without the support of many people. Firstly, I would like to express my utmost gratitude to my tutors: Emma Guthrey, Ramsey Awad, Chris Tucker, Michael Chapman and Drew Heath; Professor Richard LePlastrier and Peter Stutchbury who had offered invaluable assistance, support and guidance through the learning process of this architectural research project. I would like to wish to express my love and gratitude to my beloved families for their unconditional understanding & support, through the duration of my studies. Special thanks also to all my graduate friends for sharing the literature and invaluable assistance. I would like to extend my sincere appreciation to School of Architecture and Built Environment, University of Newcastle for offering me this opportunity to take part in this project. The guidance and encouragement received from all members who contributed was vital for the success of the project. I am grateful for their constant support and help.

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PROJECT SUMMARY

Transpital Annex project envisions the multitude of technological and living environmental changes impact on the necessity of human to adapt faster than any time in history. Body modification will become the facilitating tool to rematch our adapting capability termed here as plug-in.

BOOK PART I A R C H I T E CTUR AL DE SI G N Site Diagram l Concept l Schematic l NCCA compliance l Developed design l Working drawings l Final Design

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Abolishing current typology of treat and cure, the project seeks to reimagine hospital as a mechanism to enhance and expand human performance capacity. This will inspire a new industry in trans-health care whereby an entire rethink of the hospital typology is required as well as a human centered approach facilitating adaptation, remediation and evolution of the human form.

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1.0 S ITE DIA GRA M Site diagram outlines the opportunities and potential of a site in association with the oriented project type or profile. This approach is to implement an initiation to explore the real world issues and to introduce subsequent architectural strategies at later stages. This section includes preliminary site analysis in term of justification of its relevance to reflect the architecture typology by illustrating an architectural diagram on site occupation. With that, the integration of both elements inform the architectural research direction as whole to develop the project brief.

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1.1

Project Selection Rationale

The key driver for the final year project is of ‘future thinking’ which encourages questioning of an idea or interest that contributes to the ‘body of knowledge’ within architecture. This elective design project integrate architecture as research by identifying real world discussion topic which gradually being developed from the discipline of architecture.

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Project Profile

The four-weeks research, thinking and finding of self have triggered my interest in human centred experience that informs an architecture typology which led me to associated project idea. Healthcare as one of the most sensitive architecture triggered the idea of exploring the integration of human (in this case are mainly the vulnerable individual) and its architecture. This project was to challenge the existing typology, through a paradigm shift in its users empowerment. The simplified thinking to initiate the project is the experience in a hospital. Stays in hospital has always been stereotyped as ‘dreadful and inhumane’ as a result of medical, clinical and technological needs to function safely. The architecture language of it is generally massive and internalized, which is rather opposed to how individual experiences a space.

“ Early hospitals were only utilised by the poor and destitute, or those near death. The wealthy and ‘well-off’ were treated at home. ”

“ Hospitals then became a symbol of medical technology and treatment techniques advances and were utilised by both rich and poor members of the growing Australian population. ”

A rectification approach was to look into the radical healthcare typology definition, that could probably transform the setting in hospital, eventually revive the tranquil ambience in it. Henceforth, Transplant as a unique was considered as the medical field to explore further, potentially inform the transformational direction to the project intention.

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Overview of Healthcare Development in Australia • Colonisation of European settlement in 1788 led to planning of health services

• late 1980’s: consolidation of privatefor-profit hospital companies triggered private hospital construction • early 2000’s: recognition of constructed hospitals in the post-war years to be rebuild • November 2006: The launching of Australasian Health Facility Guidelines as a national alignment of the plethora of different standards and guidelines for both public and private facilities

• 1816 witnessed the opening of Australia’s first permanent hospital in Sydney • Establishment of Public Works Department under colonial administrations to provide the basic public infrastructure including buildings. • 1920’s - 1930’s: minor boom in hospital development in the capital cities of the Australian states due to additional hospital beds demand • 1930’s - 1940’s: Sir Arthur Stephenson, an architect with extensive study tours overseas laid the foundations for Australian hospital design, design major hospitals which exhibited the strong tenets of modernism with streamlined broad balconies and large windows sweeping across white rendered facades • 1950’s - 1970’s: second major boom in hospital construction at suburban sites closer to their catchment population • Strongly based on functional needs and the requirements of technology and healthcare providers had led to institutional typology

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[top] Figure 1.1: Sydney Hospital - The oldest hospital in Australia, opened in 1816

[top] Figure 1.3: Royal Women Hospital

[bottom] Figure 1.2: The Royal Melbourne Hospital

[bottom right] Figure 1.5: Sunshine Coast University Hospital

[bottom left] Figure 1.4: Royal Northshore Hospital

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• National Coordination and Research Commonwealth was established to act as a facilitator of interaction between the health planners, architects and engineers in each State Government • 1974: Establishment of Commonwealth Government advisory group • 1976-1990: Establishment of Hosplan – the Hospital Planning Advisory Centre of NSW to fulfill a national need for research and information regarding the planning and design for hospitals • 2005-2010: Establishment of Centre for Health Assets Australasia (CHAA) so each State Health Department donated the guidelines and standards it had developed in previous years to form the basis for one national centre of knowledge on health facility planning and design

Impact of research: • renewed focus on patient-centre care in the design of new healthcare facilities • new designs are focussed on the needs of patients and their families (a home away from home) with the planning of hospitals modified to bring services to the patient • combination of Evidence Based Design and patient centred approach

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[top] Figure 1.6: Melbourne Royal Children’s Hospital [middle] Figure 1.7: Gold Coast University Hospital [bottom] Figure 1.8: Fiona Stanley Hospital

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1.3

Site Context

The site selection is located within the healthcare campus of John Hunter Hospital, Newcastle. Heavily frequented by patients (vulnerable in particular) and hospital staffs, the site possesses the character of complexity in negotiation with users adaptability to the typology created. This offers a great opportunity to investigate the idealogy of human-centred architecture in such context which inform the optimum experience in healthcare facility.

The progressing discussion and justification had led to a shift of project footprint as satellite building to be an integral part or annex to existing building segment. This is because emphasizing the metaphor of intervention on hospital typology.

[left] Figure 1.10: Pathology service Telehealth & Research Centre [middle] Figure 1.11: John Hunter Hospital Main Entrance [right] Figure 1.12: HMRI [below] Figure 1.13: John Hunter Hospital campus aerial view from south with proposed Newcastle Inner City By Pass

Figure 1.9: Site Plan

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Located strategically in suburban serenity surrounded by extensive ambundant healing elements, John Hunter Hospital Campus is proposed to be the project implementation location. A radical break proposal from utilitarian layout associated with public hospitals will be delivered gradually with the support of evidences.

The current typology of the John Hunter Hospital is contextually similar to the basis of project statement, to explore the alternative in enhancing experience in hospital from the perpsective of rethinking the value of healthcare.

John Hunter Hospital as one of the busiest healthcare facilities in the state is reported to have significant tension to optimize space use in order to meet the extensive demands from patients. This public infrastructure services a geographical area of more than 130,000 square kilometres and providing a broad range of public health care services. However, Hunter New England region is lacking of a comprehensive modern system to cater the population demographic of nearly 2million.

[opposite left] Figure 1.14: John Hunter Hospital early occupation [opposite right] Figure 1.15: John Hunter Hospital Campus occupation [bottom] Figure 1.16: General adjacent context of John Hunter Hospital Campus

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2.0 C O N C EP T DES IGN 2.1 Introduction & Development Rationale Concept Design phase establishes a fundamental project vision which provides the platform to explore, experiment and develop the project ideas in response of brief, site and researches. This would triggers the potential of the project to be branched out into various possibilities, most of the time the unexpected outcomes. The key tool to communicate the ideas is via visual illustrations and fragmentation of research findings. The site is generally well received by tutors as it offers opportunities to debate argumentative issues and rethink of the site occupation, however supported by unclear structure of project orientation.

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In this chapter, the condition of existing hospital facility is studied to identify the incorporation of architectural quality to the user requirement expectation. The concept establishment is generally structured from the institutional setting of typical public healthcare that has impacted sensory perception and spatial manipulation of users. From previous discussion of transplant as the next move from healthcare treatment vision, illustration and evaluation of its distinguishment from conventional field could potentiallt iform deinstitutionalization approaches that reflects the future outreach of the society.

023 Figure 2.0: Transplant - a ‘plug in’ to what is demanded


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Idea development

Comparatively with other medical typologies, transplant is perceived as body manipulation from loss to gain; from burden to relief. With this gap, the principle of the involvement is studied, potentially inform the conceptual orientation on redefining experience/ function of healthcare facility. The site occupation reflects the diversity of the integrated health science and translational research elemenets in this campus. Satellite building as preliminary proposal is to be developed as an adjacency to the main building, yet retain its autonomy.

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A study of an individual emotional perception seeks to provide basic understanding on how two contradicting user typology react upon planned programmatic sequences based on set parameters.

[opposite] Figure 2.1: Perception of institutional setting of public healthcare sector

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2.2 Site Context Development Observation and walk through in the hospital building summarize the evidence of the defined institutional setting where seclusion of an individual and secondary priority of concern often label the place as non-welcoming. Industrialized apperance has been a critique to many hospitals that reflects the principle of regidity and inflexibility of procedure delivery where a standard working procedure is attached. Summary of institutional setting from the analysis of John Hunter Hospital in figure 2. inform the aspects of following elements to elaborate and adjust eventually to adapt to the reformed healthcare industry.

[Left] Figure 2.2: Internalized orientation & enclosed facade have discontinued the communication of its functional typlogy as positivity [Top Right] Figure 2.3: Patient ward as the core social space is generally lack of sense of belonging [Bottom Right] Figure 2.4w: Main internal street without identity often reflects edge division, fragmentation and spaces disintegration

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Impact of alienation is greatly imposed when an individual encounters an unfamiliar perception, gradually losing his autonomy of occupying a space.

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Illustration of general healthcare treatment procedure

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2.3

Program Development

‘Progressive disclosure’ where only points of intersection advance to next hierarchy of space

Emotional mapping of living transplant donor and recipient

Preliminary bubble diagram for Transplant Centre

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2.6

Site Interpretation

The exercise seeks to identify the architectural sustained response to the total complex phenomenon of spaces, which experienced throughout a sufficient duration of time, a reflection of one’s emotional states. Eventually, constitution of spatial concept that determine boundary, pasue in the continuity of space will surface.

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Experimental models to demonstrate the contradiction & crossover of distinctive user typologies

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The outcome of this phase has informed the prospect of exploring topic of ‘body manipulation or modification’ which inspired by the proposition of the ‘transplant’ as an entail separation of matter and functional repair in an exchange of otherness

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Figure: an abstractive illustration of foreign matter attached to a body

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3.0 S C H EMATIC DES IGN

3.1 Introduction & Development Rationale Schematic Design phase considers broader aspects of the project development in relation to how will it behave within local and broader environments. At this phase, the layout of the building is organised according to spaces usage and orientation, basic structural aspect and its relation with adjacent site condition. A clear projection of the project big idea has surfaced and translated with as a much comprehensive representation of the scheme demonstrated using sections, plans and visual illustrations.

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The schematic phase moved from concept by prioritizing a focused direction. As the previous submission potraying the contradicting experience of two distinctive transplant typology in a space, it was not intervening to demonstrate a reimagination of what healthcare would lead to and how users will adapt or manipulate the change, but rather a mimicking of real life dilemma in hospital. Henceforth, this phase will be looking into the rationale between perception of human body and hospital as a place for body modification.

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3.2

“Our bodies are not biologically suited to cope with the sudden environmental changes they have been subjected to in recent decades,” Nutritional specialist Barry Popkin “Over the last half-century, we’ve experienced rapid and widespread changes in how we eat, drink and move. We live in a fat world because the human body — a product of millennia of evolution — can’t keep up with these changes. Our genes need more time to adapt to the multitude of technological and environmental changes.” - immunologist Mark Jackson,

“The body is not standard; it is different and unique, sometimes deformed, twisted, or scalped.” - Modulor by Thomas Carpentier

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Schematic Development

Inspired by Chris Tucker on looking on the topic from broader perspective, the John Hunter Hospital, Reimaging 2100. Courage to propose a much sustainable typology that is beyond Transplant inspired me to continue on my research. Body modification is the radical breakthrough beyond the clinical procedures in a hospital, which I focused on conveying the language of body as the architecture. It is perceived as an enhancement/ extension of human performance limitation as a result of our slow transformation pace to adapt to the change of world. Body modification does not normalize human to what we perceive as, but towards human manipulation of self without border, which in todays world, our adaptive evolution gradually dehumanising us physically to be multi-capable. That is the purpose hospital served as, where it cures and treats our source of failure, rather than advancing our capacity.

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Reflection from the fragmentation of bodies In considering various types and appearances of the body, it is important to outline where the tangible body begins and the intangible body ends. A dissection of a holistic body into constituent parts with the division of limbs from main body and the removal of individual sensing organs inform the architects in determining their proportions relative to each other as seen in figures . The fragmented body parts were then reassembled in precise proportion to project the metaphor of idealized man into the structure. However, only the exterior body parts were considered in such designs.

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3.3 Precedent Analysis Glasgow Maggies’ Centre by OMA

Maggie’s Centres are a network of dropin centres founded by Charles Jencks to provide caring environment that can provide support, information and practical to cancer affected individuals. A sequence of L-shaped, interlocking rooms around a landscaped courtyard finished by glazed glasses mainly has minimised the monotonous identity of corridors and hallways, and allow the rooms to flow one to another. The sequence of spaces is an interplay of openness, retreat and support. Transparency and fluidity are enhanced to facilitate the evidence based emotional support and practical advice to the occupants, which I have experimented previously. The honesty of representing a person emotionally and harmonize it with neutralized elements could perceive the faith of one’s. Maggie’s supplants the sterile and often alienating architecture of hospitals with an individual and warm environment inspired me on how integration of humanized architecture with healthcare complex typology made possible, creating or narrating a place that tells a story of self, aligned to my project direction, the body modification.

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What if the architecture seamlessly project the occupants ‘plug-in’ as a group within the spatial configuration?

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3.5 Design Development Site Development

Understanding the community outreaching importance to engage with the next healthcare typology, the architecture is set to deinstitutionalize typical place making complication and create a welcoming healthcare. Design planning of the body modification centre seeks to achieve coherence of John Hunter Hospital and HMRI, a programmatic hyrid of social engagement, discoveries, experiments etc. With the revised proposition, a relocation of project site to the intermediate location between JHH and HMRI sets the new perspective of empowering human in the building manipulation informed by site potential.

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Massing Strategy

The body transform model seeks to unplug the densely packed box of JHH and conveyor belt system into urban recognized. This specialised medical centre focuses on the human body manipulation of organs and limbs, specifically on the experimental and research stages

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Idea of progressive disclosure is implemented where sense of familiarity is gradually imposed with the interconnection of programs. Each space creates a story with user as the body modification program is conveyed in intimate scale.

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First Floor Plan Public Outreach

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Ground Floor Plan

Involvement : A guest-centred counter interaction where the person is engaged with the staffs throughout entire period with well-informed of self-body.

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Lower Ground Floor Plan

First Floor Plan Acoommodation

Involvement : A guest-centre counter interaction where an individual(patient) is engaged with the staffs throughout entire period with well-informed of self-body.

Nature : An indulge to bush land & courtyard calming ambience for stay-in patients

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Ground Floor Plan Rehabilitation / Recovery

Restore : a landscape integrated restorative faciltiies to empower self-restorative capability of person received body parts modification., where nature is the catalyst.

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4.0 N C C A C O MP LIA N C E 4.1 Introduction NCCA Compliance phase identifies and incorporate relevant practice of the National Construction Code Australia into the schematic design submission. The compliance is assessed on the Building Code of Australia to satisfy the performance requirements of proposed building. The submitted report outlines the preliminary key issues of compliance with the NCCA for the Body Modification Centre. Remark: The building site for final submission has been changed at following phase, however, the critical compliance requirements and relevant solutions are reviewed and implemented into the new site.

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5 .0 DEV E LOP E D D E S I G N 5.1 Introduction & Development Rationale Developed Design phase emphasizes on architectural elements exploration of forms, spaces, spatial quality, materiality, construction methods, technologies, environmental-friendly systems etc as an integration to be an entity. An intimate scale of the project is addressed to resolve the most concerned issues, potentially to be translated and applied throughout the entire project. Reflecting on the initial idea of questioning the user experience in a hospital, the various topics have been explored as the methodologies to reveal the justification. A simple question was asked - what would be the contextual scenography in a hospital from the perspective of ‘future-proof’ thinking?

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The potential orientation could be an adaption facilitator for body modification, transpital. Future world will require human to adapt to new technological and environmental changes faster than any time in history. Perception of hospital to treat and cure soon lean towards to substitute an incapable, dsyfunctioning body with an active and customized to need one, externally and internally. Evidence of intensive experiments on transplant, implant, regrow and prosthetics could transform hospital into whole new industry with new language.

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5.2 Design Development The scheme has progressively developed from setting new typology into intervening and re-justifying the current fabric of built environment. From the Schematic stage feedbacks, few key points have been acknowledged or highlighted to be considered: • strengthening of nature as the ideal healing elements • consider the metaphorical approach to ‘invade’ on hospital main building to reflect the project idea of ‘modification . manipulation’ clearer. • Justifications of injecting the modification onto physical building context conclude the need of repurposing the future urban role of hospital. A shift of building footprint from the low plateau against the hospital to the existing ward block was decided to better demonstrate the transformation of hospital. The research findings of revealing the supposed identity of hospital as a place for body modification, beyond treating and curing have justified the fact that the pace of our biological adaptation to the fast broader environmental change is insufficient. This explains the existence of ‘futuristic’ terms of implant and prosthetics to help us cope better.

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In fact, Prosthetic has been integral part of our daily life. Humans, being disabled or able bodied rely heavily on prosthetics without we realizing, such as phones, elevators, vehicles, clothing etc. from the perspective of medical, intangible prosthetics include implants, artifical replacements for shoulders, knees and hips are common. However, prosthetics for the physical body modification is somehow dedicated for special needs and individual who can afford. This familiar perception reflects the past perception of hospitals, and it should be rectified for human equity. The Developed Design phase aims to unify the scattering pieces of body modification and human adaptation into a comprehensive system, which inform the intention of intervening a hospital typology into a facilitating tool.

Prosthetic [traditional definition] “An artificial device to replace or augment a missing or impaired part of the body” - Merriam Webster

[new definition] A functional and aesthetic artificial/ hybrid device to replace or augment the human body or the human environment to benefit the user.

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Architectural Relationship

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An understanding of the intervention of ‘prosthetic’ invention creates a dynamic relationship between architecture and body that enable one to access and engage a building with more ease and fluidity.

Replacement and Regrowing

The high dependance on “prosthetic” devices has informed an intangible architecture relationship that allow one to reach out and interact with the built environment. Often, objects that transform the spatial quality and comfort such as escalator, lift, door etc. Without realizing much, architecture has been engaging users before such statement is established. The idea of ‘architectural prosthetic’ helped to rethink the project as the relationship between body, physical environment and prosthetics to determine the performance duration of these three elements, magnifying its opportunity as an asset to future healthcare industry.

Precedent Study

Disappearance of mammalian embryos ability to replace developing body parts reflects the trend of declining regenerative capacity over the course of an organism’s development is mirrored in the evolution of higher animal forms, leaving the lowly salamander as the only vertebrate still able to regrow complex body parts throughout its lifetime. The Salamander-style amputation regeneration triggered the question of How does the regrowing part of the limb “know” how much limb is missing and needs to be replaced?

Reflected in the perspective of architecture quality, the study sets as a reference on the proposed building typology as an intervention to ‘normalized’ functioning system, on how does a merge of new typology influence the old and integrate as a unified body with minimum destruction. The illustrations questioned how architectural elements, such as circulation, material, mechanical systems, could become the implanted connection to the axes.

The clear subtraction within the fabric allow the idea of ‘trans-pital’ to evolve, where inefficient spaces fade away and subtituted with program specified and hybrid-enabled spaces to facilitate future industry of healthcare. amputation

sealant, making good

grafting

growth & poliferation

formation

Source: 2008 SCIENTIFIC AMERICAN, INC.- by Ken Muneoka, Manjong Han and David M. Gardiner

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Extended Body: Interview with Stelarc

Diabetes: Of life and limb - montrealgazette

Manipulation of human body is always the topic for artists in elevating the depth of self -discovery. Stelarc’s artistic strategy revolves around the idea of “enhancing the body” both in a physical and technical manner.

Diabetic amputee Mortimer Zameck, 79 once encountered a dilemma - lose a leg or lose his life. Amputation is the hidden face of diabetes. It is one of the leading causes of lower limb loss throughout the world. An estimated 70 per cent of all lower limb amputations are related to diabetes, the International Federation of Diabetes said.

His works have represented the second level of existence where the body becomes the object for physical and technical experiments in order to discover its limitations.

The interest argument which causes the anxiousness and insecurity in him was overwhelmed by fear that the loss of his leg would mean the loss of mobility and independence, and of not being “a normal person” anymore. Skeptical of the idea of ‘normal’ has been greatly influencing the courage of human to enhance themselves physically to look different.

A call for technologically enhancement to our body to be recognized as extendible evolutionary structure, breaking apart ffrom the prejudice as limited capability due to the lacking of modular design in it. A great thinking behind all sorts of human body abstract ties to the idea of utopian perfect body, where we sometimes dont recognize self as perfect entity. If a human is not this entity sitting wtih two arms and two legs, what justifies a oerfect human? His behaviour, responses or capability in socially acceptable manner?

The effects on modern world’s common diseases have triggered the need to study the methodology to modify a person’s adaptability to new external sources inhaled into our biological body, instead of curing just the disease.

The topics calls for manipulating possibility of biological body capacity in this competitive information age, which responded to need of repurposing hospital for such facilitation.

Figure 5.1: Stelarc’s illustration of extended body - a ‘Third Hand’

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Copenhagen Health Care Centre for Cancer Patients by NORD Architects It came to my awareness that architecture in itself can be healing and have a positive influence on people’s recovery. The architects highlighted the key is to have a human scale in the architecture and establish physical surroundings with a homey atmosphere. The healthcare centre should be a place where you come to get better, get knowledge – and have fun. The client’s brief is create awareness of cancer without stigmatizing the patients and to create a home-like centre instead of conventional hospital. The resolution was a design of iconic series of small traditional houses shaped connected by a raised folded roof shaped. Similar context to my site, the building is located in the Copenhagen University Hospital compound so that patients can go to the healthcare centre after their treatment at the hospital.

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Internally, the spaces planning is inspired from the perspective of a cancer patient where they deinstitutionalize typical place making complication and create a welcoming healthcare. Patients are welcome with a comfy lounge area with no reception areas but assisted by volunteers who have dealt with cancer. The journey experience foster a house compound circulation, which includes a courtyard for contemplation, spaces for exercises, a common kitchen, meeting rooms for patients groups etc. This precedent has clearly exemplified the nucleus of todays’ definition of health care institute that is motivated by community intervention. Its main interest of interactive scenography have inspired me to challenge the idea of deinstitutionalization, a subtraction and addition to the existing fabric, at the same time acting respectful to human-centered perspective.

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5.4

Site Fragmentation

[top] Figure 5.2: Indication of the building segment to be modified [bottom] Figure 5.3: Exploded isometric of removed strucutre

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Figure 5.4: John Hunter Hospital cross section

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Figure 5.5: Massing study of existing John Hunter

Figure 5.6: Massing strategy of the proposed Transpital

Hospital

Annex

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A functional and responsive architecture to facilitate the modification and enhancement of the industry in recognition of humancentered experience is essential. It redefines synchronization of human body and its performance that varies for every unit, Therefore, an adaptative layout and spatial coordination to future modification is considered,

Figure 5.7: The diagrams illustrate the sensitvity response to user perception of a space and potential configuration

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Figure 5.8: Existing massing blocks interconnected with linking bridges

Figure 5.9: A ‘dissection’ to the block informed by the reconnection of courtyard, landscape and visual connectivity

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Transpital Annex Level 0 092

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Transpital Annex Level 2 096

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Transpital Annex Level 3 098

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5.5

Program Connectivity

Body as a projected metaphor for the building is understood as a manipulating component to exercise the empowerment of user oriented in portraying a language of each space.

“A building is an incitement to action, a stage for movement and interaction. It is one partner in a dialogue with the body.” - Robert J. Yudell

Figure 5.10: Parasite intrusion experiment to the building fabric

Physical, environmental and psychosocial coping strategies for ‘modified’ personnel inform programmatic design too. Physically, the building provides space for physical therapy, mirror techniques, and virtual environment coping strategies. Environmentally, the design allows for direct connection with the surrounding environment in the form of outdoor practice space. Psychosocially, it incorporates spaces for group therapy and education as well as social support.

Photo by Serge Najjar

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Modification & configuration elements As a personalized and sensitive typology to individual different character, a balance between medical and non-medicalized mechanism to ensure minimum discrepancy of desire functional specified prosthetic that enhance one’s performance. It would be at forefront of new treatment typology with access to green, supporting information and recovery.

Healing elements Governance of interpersonal confrontation for post modification adaptation program exert some form of surveilliance, often perceived as ‘normal’ interaction. Regardless of the fundamental need of such assistance in one’s recovery, adequate zone of negotiation & seperation are imposed as the breakout of continuous monitoring on one. Different from conventional healthcare deliverables approach, proposed program in Transpital Annex question the validity and ratio of planned therapy program the most ideal treatment to a ‘modified’ person?

Narrowed layout with hardscape typology triggers the consiousness of occupants on their surrouding. Such courtyard in existing site is perceived as a form of survailliance, which explains the minimum use on site.

With the input of self-improving on readaptation to the new environment, spacing configuration shall lead to enable growth, healing and wellbeing without compromising equity between users.

Figure 5.12: Proposed Glostrup Hospital’s Neuro Rehabilitation Centre by Henning Larsen Architects

Emphasized visual connection between the patient rooms and the surrounding landscape. Building floors are to be well coordinated in relation to central needs of the users and have incorporated numbers of recreational outdoor spaces for readaptation purposes.

Figure 5.11: Existing courtyard in John Hunter Hospital

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Sensitive interpretation of patient’s accommodation by considering the unstable emotional condition(perhaps uncertainty of treatment) and physical inconvenience. Discussions with tutors have identified the significance of positive distraction that supports the healing process via wide viewing angle from external factors to diminish the sense of insecurity. Besides, simplicity of a room as compared to complex emergency and supply need in ward could greatly please the stay in experience, which possible in smart layout.

[top] Figure 5.13: generous connection to nature in a healing space [bottom] Figure 5.14: Diminished perception of paralled corridor that often triggers fear & uncertainty

Figure 5.15: Facade modification in accordance to internal functionality and connection to exterior

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Figure 5.16: Overview of the Annnex entrance into edgeless courtyard

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Figure 5.17: Social breakout zone provision to the formal clinical levels

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6.0 WO RK IN G DRAWIN GS 6.1 Introduction The Working Drawings phase looks into the important or symbolitical building parts to discuss the construction practicality and approaches. A development of a partial part discloses the human scale response to the spatial quality and experience. With my project orientation towards human-centred environment in relevance to the project central idea, space use configuration are studied to suit the target user groups, instead of repeating conventional specifications. Construction method is nontheless being considered of the practical issue of safety, sustainability, flexibility and adapatation to existing operating building.

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7.0 FIN A L DES IGN 7.1 Introduction As the project development is approaching its conclusion for submission, it was essential to reflect and compile the essence of the entire design progress which intended to create the identity of the project,

beyond the presentation of its structural fabrication. This chapter covers the finalised design amendments, including drawings and visual illustrations to reflect the project.

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Courtyard level - a node of entire annex where social engagement integrates most. Weightless and flexibility to inevitably weave into the landscape as the integral part of a building, expressing the constitution of borderless spatial relation.

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Accommodation - a space of temporality is often neglected in public health sector as a compromisation for beds. In Transpital Annex, the axial connection of interior space to both courtyard and landscape quality form the seamless visual quality. Nature, regardless of coverage is integrated as part of building primary aspect. ‘Personalised care’ is the integrated practice of medicine and patient care based on one’s unique biology, behaviour and environment. Personalised care uses genomics and other molecular-level techniques in clinical care; as well as health information

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Modification & Configuration - a nucleus of the annex that impose the enhancement on an individual. Seclusion for negotiation between both prosthetist & patient on ground level with extensive connection to research experimental laboratory encourages translational input and output of modified human body. 120

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Figure 7.3: View of patient accommodation from north

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Figure 7.4: Aerial view of proposed Transpital Annex from east

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The orientation of the upper stretch into the courtyard and at the same time extruded from the unifrom fabric outline responds to the linearity of the core program of the Transpital Annex - Body Modification in an axis, a fragmentation to the accommodation aspects and general hospital facility. Besides, a reconfiguration of non-human scale mass of existing levels is delivered according to programmatic hierarchy and connection sequences. Instead of proportional relation of a space and user, the

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approach taken is establish a well-informed spaces transition based on the treatment typology. This eventually eliminate the need of corridors.

[opposite] Figure 7.5: Sectional perspective A1-A1’ [bottom] Figure 7.6: Sectional perspective B1-B1’

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127 Figure 7.7: Proposed Transpital Annex view from courtyard


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