Design Briefing: Health Inside

March, 2022

During the pandemic healthcare has come under scrutiny like never before and design for healthy buildings and interiors has taken on a new urgency. Will Jennings looks to recent designs for hospital and healthcare settings to discover what is changing and ask what designers can learn from them.

Drawings by Yosuke Watanabe

Ab Rogers Design’s winning proposal for the 2021 Wolfson Economics Prize imagines a petal-shaped building that allows every ward to be interspersed with gardens and greenery. The hospital roof is dedicated to allotments that produce vegetables for the kitchen and where patients can spend therapeutic time gardening.

 

The pandemic has seen us engage with health and treatments in new ways, leading us to question how our homes, offices and public spaces can support wellbeing. Looking to recent hospital and healthcare design suggests new directions in healthcare that can also inform the development of healthier interiors more generally.

Maggie’s Centres, a series of support spaces for cancer sufferers and their families designed by leading architects, have emerged as small-scale crucibles for experimenting with new design for health and healing. Maggie’s Oldham by dRMM, for example, makes nature the hero of the centre by growing a tree through the heart of the building.

Photographs by Alex de Rijke and Tim Barwell

Natural light and materials create a breathable, healthy environment for Maggie’s Oldham. The architects dRMM used wood at every opportunity; the warmth of a wooden door handle as opposed to a cold metal one can make an enormous difference to the comfort of a patient going through chemotherapy.

Hospitals present a complex design challenge. Due to scale and complexity, their design and construction can be a slow process and hospitals opening now have been in the planning since long before the pandemic began. Nevertheless, recent examples show the beginning of a move that has only gathered pace, towards hospitals that foreground a connection with nature, natural light, comforting materials and healthy acoustics as fundamental to care and healing, as well as spatial structures that prioritise interaction between departments and instinctive way-finding.

One of the Danish ‘super hospitals’, due to open in 2024, New North Zealand Hospital by Herzog & de Meuron is designed around two spatial hooks – the desire for a vast central garden, alongside short internal connections between critical spaces to ‘foster exchange between staff and patients’. The busier and more critical a department, the more central it is within the building’s plan, creating a network of spaces that not only suits a user’s treatment journey, but also facilitates smooth backstage operations for all the medical workers, facilities and servicing.

Key to Herzog & de Meuron’s design is providing a connection to the natural environment surrounding the hospital, not only as a place-making strategy but as a powerful tool of recuperation. UK researchers Centric Lab use neuroscience and geospatial data to consider connections between place and health. For their Urban Health Council project they have produced a report, ‘Nature as Healthcare’, seeking to analyse the role of nature in urban spaces beyond the aesthetic and towards the value of its proximity to our lives, working towards a symbiotic relationship where humans and nature ‘are equally dependent on and mutually benefiting from each other’.

Cleanliness is of course critical to healthcare design, and has been since Florence Nightingale’s 1859 text, Notes on Nursing. Glass and stainless steel will always remain within healthcare environments, but not all surfaces have to be wipe-clean to be clean. Christopher Shaw, Chair of Architects for Health and founder of Medical Architecture, advises, ‘It’s the last 2mm which are important – it’s what you touch, see, and to some degree smell. This matters. It affects physiology (stress), psychology (behaviour), communication (social interaction) and in a clinical setting, the biology (pathogens).’

Photographs © Nigel Young / Foster + Partners 

Samson Pavilion, CWRU and Cleveland Clinic, Ohio, USA, 2019. Foster + Partners. The central courtyard of this large teaching hospital is flooded with natural light. The furniture, including planter-benches for the central avenue of ficus trees, designed by Fosters and manufactured by Benchmark, softens the clinical environment.

In addition to a palette of soft, natural materials, Foster + Partners have crafted a healthy atmosphere using sound and light for the recently completed Sheila and Eric Samson Pavilion at the Cleveland Clinic, a leading non-profit academic medical centre in Ohio, USA. The central atrium is flooded with sunlight and the acoustics are designed for intelligibility, the challenges of a four-storey space mitigated by lining the roof trusses with Kvadrat Soft Cell panels.

Looking into the future, and a conscious response to the pandemic, the 2021 Wolfson Economics Prize asked the timely question: ‘How would you design and plan new hospitals to radically improve patient experiences, clinical outcomes, staff wellbeing and integration with wider health and social care?’ Ab Rogers Design’s winning entry proposes ‘Living Systems’ to make healthcare less alienating and anxiety-inducing by centring it within a community and offering up the ground-floor space, including a public kitchen for healthy food with local ingredients. Acting as a permeable part of the city, a vertical hospital would tower above, draped in nature and scattered with pocket parks, a physic garden and a rooftop allotment for food education, all sitting in a new urban park. It is an imaginary but tantalising vision.

Image © OMA

OMA’s 2021 film The Hospital of the Future proposes that ‘the hospital as we know it is dead’. Instead, the film speculates of a fully-automated machine that treats patients remotely and dispenses care like a logistics centre.

Looking perhaps even further into the future, the architecture office OMA, frequently pushing the progressive agenda, recently authored a film outlining possible medical futures. Technology features strongly: ‘The hospital of the future will give way to the machine. Liberating its staff from routine tasks, and leaving precision in the hands of accurate devices,’ they state. Now they have the opportunity to test these theories away from the film in a built project in Qatar, with their Al Daayan Health District Masterplan, a 1.3 million square metre super hospital. Combining teaching, diagnostics and hospitals for 1,400 beds, it will also offer a grid of garden squares and a hi-tech farm to supply medical ingredients.

So, what will this new understanding of interiors mean for our bodily health and urban environments? Driven by architects and designers, an enticing mix of ground-breaking technology, traditional natural approaches, and a people-first design ethos can be seen in hospitals from Doha to Denmark, contributing to a move away from the clinical feel conventionally associated with healthcare. A renewed interest in the hygiene of everyday environments can draw on these developments to create interiors that support both mental and physical health. Hygienic materials that can be cleaned without chemical spritzes, a renewed prioritisation of ventilation, acoustic comfort, contact with nature and a colour and material palette that support wellbeing can make day-to-day life healthier for everyone. From the horrendous global experience of Covid-19, a new future may be emerging.

 

Will Jennings