A FUTURE PROOF HOSPITAL BUILDING

Chalmers Tekniska Högskola, Göteborg, 25.3.2009

Mikael Paatela
Lic.Sc., Architect SAFA
CONTENTS

I PRESENTATION OF SWECO PAATELA ARCHITECTS

II WHY DO HOSPITALS LOOK LIKE THEY DO ?

- DEVELOPMENT OF THE HOSPITAL BUILDING

III FUTURE TRENDS

IV PRESENTATION OF • THE NEW TURKU UNIVERSITY CENTRAL

HOSPITAL ”T-HOSPITAL”

• THE NEW HELSINKI UNIVERSITY

”TRIANGLE HOSPITAL”
 I SWECO PAATELA ARCHITECTS

• FORMER PAATELA & PAATELA ARCHITECTS

• ESTABLISHED IN 1919 IN HELSINKI FINLAND

• SPECIALIZED IN HEALTHCARE DESIGN SINCE 1920s

• CONSULTANCY AND DESIGN ASSIGMENTS IN 13

COUNTRIES
– EG. FOR THE WORLD HEALTH ORGANIZATION AND THE MINISTRY
OF HEALTH IN CHINA.

• SUBSIDIARY OF SWECO ARCHITECTS SINCE 2005

HAARLA HOUSE Tampere,1924
UNIVERSITY OF HELSINKI, DEPT. OF ANATOMY Helsinki,1928
FINNISH RED CROSS HOSPITAL Helsinki,1933
UNIV. OF HELSINKI, HOSPITAL FOR OBASTETRICS AND
GYNAECOLOGICAL DISEASES Helsinki,1934
TURKU COUNTY HOSPITAL Turku,1937
TURKU COUNTY HOSPITAL Turku,1937
KILJAVANUMMI SANATORIUM Kiljavannummi,1939
HUCH, TÖÖLÖ HOSPITAL Helsinki,1957
KUOPIO UNIVERSITY CENTRAL HOSPITAL Kuopio,1959
HUCH, MEILAHTI HOSPITAL Helsinki,1965
KOTKA CENTRAL HOSPITAL Kotka,1967
LÄNSIPOHJA CENTRAL HOSPITAL Kemi,1977
HUCH, RENOVATION OF SURGICAL HOSPITAL Helsinki,1986
HUCH, DEPARTMENT OF OPHTHALMOLOGY,
OPERATING THEATRE BUILDING Helsinki,1987
THE NATIONAL PUBLIC HEALTH INSTITUTE, MEDICINE AND
VACCINE PRODUCTION LABORATORIES Helsinki,1987
OULUNKYLÄ REHABILITATION CENTRE Helsinki,1992
OULUNKYLÄ REHABILITATION CENTRE Helsinki,1992
OULUNKYLÄ REHABILITATION CENTRE Helsinki,1992
HUCH / HOSPITAL FOR ALLERGIC AND SKIN DISEASES Helsinki,1992
VAASA CENTRAL HOSPITAL, OPERATION BUILDING Vaasa,1993
TUCH, NATIONAL PET CENTRE Turku,1999
HAINAN PROVINCIAL PEOPLE’S HOSPITAL Haikou,China,1999
SULEIMANIYAH GENERAL HOSPITAL Suleimaniyah,Irak,2000
THE GREAT SAPARMYRAT TURKMENBASHY INTERNATIONAL MEDICAL
CENTER Ashgabat,Turkmenistan,2001
TUCH, T-HOSPITAL Turku, 2003, phase 1
PAATELA & PAATELA ARCHITECTS
II WHY DO HOSPITALS LOOK LIKE THEY DO?

• DEVELOPMENT OF THE HOSPITAL BUILDING

DEVELOPMENT OF MEDICAL TECHNOLOGY AND PROCEDURES IN 1900-1970s

The hospital building should be flexible to

adapt new medical procedures and new
technology in every phase of it’s lifespan

Source: Sidney R. Garfield

DEVELOPMENT OF
HOSPITAL TYPOLOGY

TUCH T-hospital, Turku 2003-2011

TUCH U-hospital, Turku 1968

•Source: prof. Jan Delrue HUCH / Surgical hospital, Helsinki 1888

CASE STUDY

DEVELOPMENT OF THE MIKKELI CENTRAL HOSPITAL IN 1840 -1985

1844 1934 1958 1992

Mikkelin lääninsairaala Ensimmäinen laajennus Toinen laajennus ja Kolmas laajennusosa

1840–1965 ja peruskorjaus peruskorjaushanke 1983-1985
CASE STUDY

DEVELOPMENT OF THE MIKKELI CENTRAL HOSPITAL IN 30 YEARS BETWEEN 1969-1999

In 1969 In 1999

FUNCTIONAL DEPARTMENTS
CASE STUDY

DEVELOPMENT OF THE VAASA CENTRAL HOSPITAL IN 1902-1995

1902 1956
Vaasan kunnallissairaala Vaasan keskussairaala

1971 1994-1995
CASE STUDY

DEVELOPMENT OF THE VAASA CENTRAL HOSPITAL IN 30 YEARS BETWEEN 1969-1999

Vuonna 1969 Vuonna 1999

FUNCTIONAL DEPARTMENTS
DEVELOPMENT OF A TYPICAL HOSPITAL BUILDING,
PROBLEMS:

• LACK OF FUTURE ENLARGEMENT SPACE ON SITE

• HOSPITALS HAVE GROWN IN PHASES,

» INEFFICIENT PROCEDURES
»INCREASED RUNNING COSTS / PATIENT

• OLD BUILDINGS LIMIT OPTIMAL LAYOUTS

FOR NEW MEDICAL PROCEDURES ( eg. Day surgery, imaging, etc. )
 III FUTURE TRENDS

PROBLEMS

• LACK OF FUTURE ENLARGEMENT SPACE » MASTER PLANNING

ON THE SITE

• HOSPITALS HAVE GROWN IN PHASES, » INCREASING EFFICIENCY/

• INEFFICIENT PROCEDURES
• INCREASED RUNNING COSTS/PATIENT
MINIMIZING RUNNING COSTS

• OLD BUILDINGS LIMIT OPTIMAL LAYOUTS » FLEXIBLE HOSPITAL BUILDINGS

FOR NEW MEDICAL PROCEDURES
( eg. Day surgery, imaging, etc. )
» HUMAN PATIENT AND WORK
ENVIRONMENTS
MASTER PLANNING…

• MASTER PLAN AS A ROADMAP FOR FUTURE DEVELOPMENT PHASES

• A SCENARIO FOR THE FUTURE ROLE OF HOSPITAL FOR THE NEXT 10 – 30 YEARS

Castle Peak Hospital,

Master Plan, Hong Kong
INCREASING EFFICIENCY / MINIMIZING RUNNING COSTS…

• THE CORE HOSPITAL CONCEPT

INCREASING EFFICIENCY / MINIMIZING RUNNING COSTS…

• RUNNING COSTS

THE RUNNING COSTS OF AN ACUTE CARE HOSPITAL IN 2-3 YEARS ARE EQUAL TO ITS
INVESTMENT COSTS, SO WHAT IS EXPENSIVE ?

YEARLY RUNNING COSTS OF AN ACUTE CARE HOSPITAL

PERSONNEL SUPPLIES MAINTENANCE AND RUN- OTHERS

AND MEDICINES NING COSTS OF BUILDING
70 % 10 % 5% 15 %
INCREASING EFFICIENCY / MINIMIZING RUNNING COSTS…

… is the design criteria still the traditional patient flow ?

Vuodeosastolle Huoneeseen VO/ Huoneeseen VO/ Huoneeseen VO/ Huoneeseen

Jne.

1)

Sairaala info - ilmoittautuu

- odottaa
Hoitoon - raportti + virheet
- jne
2)

- ilmoittautuu
- odottaa Tutkimuksiin poliklinikalle - ilmoittautuu
- raportti + virheet - odottaa
Lääkärin tapaaminen
- lääkäri tutkii - raportti + virheet
- lääkäri katsoo tulokset, antaa
hoito-ohjeet

- ilmoittautuu
Tutkimuksiin röntgeniin - odottaa
- raportti + virheet
- rtg-tutkimukset
INCREASING EFFICIENCY / MINIMIZING RUNNING COSTS…

… OR AN EFFICIENT PATIENT FLOW

THE PATIENT FLOW OF APP. 80% OF PATIENTS IN

TUCH IN 2010.
INCREASING EFFICIENCY / MINIMIZING RUNNING COSTS…

•“HOT FUNCTIONS” CONCEPT

– ALL ACUTE CARE UNITS IN CLOSE CONNECTION TO • EMERGENCY AND OUT-PATIENT-DEPARTMENT

EACH OTHERS
• OPERATION DEPARTMENT
• ICU AND CCU
• IMAGING
• OBSERVATION
INCREASING EFFICIENCY / MINIMIZING RUNNING COSTS…

• CELL APPROACH IN WARD PLANNING

– One cell for 8 to 10 patients with

• Patient rooms
• Nurse’s station
• All supporting services
INCREASING EFFICIENCY / MINIMIZING RUNNING COSTS…

• Cell concept in wards • Flexible patient rooms

 IV PRESENTATION OF

FLEXIBLE HOSPITAL BUILDINGS… THE NEW TURKU UNIVERSITY

CENTRAL HOSPITAL T-HOSPITAL
HUMAN PATIENT AND WORK
ENVIRONMENTS…

THE NEW HELSINKI UNIVERSITY

CENTRAL HOSPITAL ”TRIANGLE – HOSPITAL”
TURKU UNIVERSITY CENTRAL HOSPITAL: OLD SITE
 MASTER PLANNING…

TURKU UNIVERSITY CENTRAL HOSPITAL: OLD AND NEW SITES

TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL PHASE I 2003
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
HUMAN PATIENT AND WORK ENVIRONMENTS…
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
ENLARGEMENT OF THE TUCH T-HOSPITAL, IN 2007-2011
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL PHASE I IN 2003
T-HOSPITAL, ENLARGEMENT PHASE II COMPLETED IN 2009-1010
T-HOSPITAL, ENLARGEMENT PHASE III COMPLETED IN 2011-2012
T-HOSPITAL, ENLARGEMENT PHASE IV COMPLETED IN 2011-2012
TURKU UNIVERSITY CENTRAL HOSPITAL: T-HOSPITAL
THE NEW HELSINKI UNIVERSITY CENTRAL HOSPITAL /
”TRIANGLE HOSPITAL”
”TRIANGLE HOSPITAL”
HUCH / MEILAHTI HOSPITAL ARE WITH THE NEW
PRIMARY HEALTH CARE BUILDING COMPLETED 2009
”TRIANGLE-HOSPITAL” COMPLETED 2010
PROPOSED TRAUMA CENTER BUILDING
HUCH / ”TRIANGLE HOSPITAL” site plan
HUCH / ”TRIANGLE HOSPITAL” facade
HUCH / ”TRIANGLE HOSPITAL”
TACK