DESIGNING HEALTH FACILITIES FOR 2025

LESSONS WITH RECENT BEST PRACTICES

HENNU KJISIKHarris Kjisik Architects and Planners

Helsinki University of TechnologyBudapest 4.9.2009

LESSON 1

LEARNING FROM PAST SUCCESSES

Ancient Greece

• ”Healing environment”

• Fresh air, daylight, views

• Fine arts, drama, physical exercize

• Activation of patients

• Generic buildings

Renaissance

• Relationship with the surrounding city

• Generality and modularity

• Architectural quality and sustainability

The Tuberculosis Sanatoria

• ”Healing environment”- fresh air, views

• Experimentation and innovation

• Social commitment of designers

The ”Heroic era” of the 1960s and 1970s

• Flexibility – adaptabilty- modularity• Technical innovations - interstitial floors,

”plug-in” solutions• Avant garde of general architectural trends • Utopias

LESSON 2

LEARNING FROM PAST MISTAKES

What’s been going wrong?

• Too many rules and regulations

• Sort-sighted visions – ”for me, now!”

• Insufficent understanding of lifecycle costs

• Too much specialisation and mystification

• Not enough high-quality architecture

Healing environment and Evidence-based Design

• Ethocentricity – tastes differ• No absolute truths exist about colour• Too much emphasis on irrelevancies• Many results are painfully obvious• Evidence-based design is by definition

backward looking

New procurement methods

• Bad experiences for the English PFI programme

• No time or money for innovation

• Only the big boys are allowed to play

• Is it possible to create an optimal care environment while maximising profits?

LESSON 3

LEARNING FROM WHAT IS GOING ON

NOW

Care – Cure - Core

• Varying requirements• Only 30% is ”hospital”, the rest is simply a

”building” • Relationship between specialised and

general space• Does everything need to be in the same

place?

Process-based design

• No conflict with ”healing environment”

• No conflict with patient-focused design

• There is no ”wasted space” – corridors are part of the process

New concepts

• Seamless service chain

• Disease management

• Patient-centred care

• Organisational models

New functional units

• The ”core hospital”

• Other new organisational models

• Community rehabilitation hospitals

• Day hospitals

• Knowledge centres

• Generalised wards and patient hotels

Flexibility AdaptabilityWall-lessness

• Flexibility• Agility• Adaptability• Transformability• Elasticity• Versatility

• Changeability• Convertibility• Repeatability• Modularity• Generality• Future-proof!

LEARNING FROM PRESENT BEST PRACTICES

• The ”monospace” at Arras• The public areas at Del Mar, Barcelona• The buzz and acitivity at Deventer• The urbanism of Cognacq-Jay, Paris

LESSON 4

LESSON 5

LEARNING THE TRICKS

Relationship with the urban environment

• Hospital as part of the city• Urban structure as a starting point of

design• ”Normalisation” of the patient environment

Better hospitals for better cities

• Demystification needed• Breaking the stronghold of ”specialists”• Attract better architects• Organise open architectural competitions• Make hospital design a ”sexy” subject

among young talented designers

LESSON 6

ORGANISE ARCHITECTURALCOMPETITIONS TO PROCURE

FRESH IDEAS!