Healing Through Design: An Architectural Proposal for a Tertiary

Hospital in Maasin City, Leyte

_______________________________________

A Research Proposal
Presented to the
Architecture Department, College of Engineering and Architecture
Cebu Institute of Technology University
Cebu City
_______________________________________

In Partial Fulfillment of the

Requirements for the Degree
BACHELOR OF SCIENCE IN ARCHITECTURE

By:
STEWART BIEL INFIESTO
MAY ALEXA DESAMPARADO
RODRIGO MIÑOZA JR.

February 2024
 CHAPTER 1

Introduction

In the constantly changing world of healthcare development, the confluence of

architecture and healing has drawn major interest. Amidst the intricacy of current healthcare

systems, the tangible location wherever medical operations happen takes a key part in

influencing patient welfare and recuperation.

A Level 3 Tertiary Hospital, in the area of healthcare architecture, stands as a

sophisticated medical facility meant to supply specialized healthcare services and support

medical education and research. Technically, it requires a complex infrastructure with extensive

spatial planning, innovative medical technology, and an elaborate architectural arrangement that

supports smooth operation within clinical environments. Positioned strategically within the

healthcare continuum, a Level 3 Tertiary Hospital acts as a crucial node catering to heightened

healthcare needs, representing a blend of specialized treatment, technology integration, and

educational imperatives.

Maasin City, the capital of the Southern Leyte province in the Philippines, holds a 4th

class city status. As of the 2020 Census, its population stands at 87,446. Positioned on the

western part of the province, Maasin City spans an expansive 21,171 hectares and comprises 70

barangays. Functioning as both the commercial and religious hub of Southern Leyte and the

southwest region of Leyte Island, Maasin City is recognized as the Pilgrimage hub for the entire

Region 8. Based on the List of Accredited Level 3 Hospitals for CY 2023 of philhealth, the

Region 8 has only two Level 3 hospitals which is Divine Word Hospital and Eastern Visayas

Medical Center.
 The commencement of constructing a Level 3 Tertiary Hospital in Maasin City derives

from the understanding of increasing healthcare demands. Positioned strategically within the

healthcare system, the hospital aspires to provide specialized services and serve as a focal focus

for medical education and research. The major emphasis of the project is to investigate complex

architectural difficulties in healthcare facilities, encompassing spatial arrangement within clinical

settings and the seamless integration of new technologies.

Statement of the Problem

This study sought to determine how healing through design be implemented in an

architectural proposal for the tertiary hospital in Maasin City, Leyte to create an environment that

optimally supports advanced medical care and research.

In response to the challenges mentioned, the researchers aimed to address these issues by

seeking solutions to the following:

1. How can the architectural proposal enhance the patient experience for healing?

2. What measures optimize hospital layout for efficient workflow and coordination among

departments?

3. How can the architectural design incorporate strategies to be environmentally friendly,

reduce impact, and enhance disaster resilience?

4. How to incorporate advanced medical technologies to boost innovation in healthcare

services of the tertiary hospital?

5. How can the design place emphasis on the well-being and productivity of patients and

healthcare professionals by taking into account ergonomic factors and stress reduction?
Objectives

This research aims to create a healing architectural design for the tertiary hospital in Maasin City,

Leyte to create an environment that optimally supports advanced medical care and research.

In addition to the primary objectives outlined above, this research also endeavors to

achieve the following goals:

1. To investigate and propose architectural elements that contribute to an enhanced patient

experience, fostering healing and well-being within the tertiary hospital in Maasin City,

Leyte.

2. To analyze and recommend optimal hospital layouts that facilitate efficient workflow and

seamless coordination among different departments, ultimately improving overall

healthcare delivery.

3. To explore and integrate environmentally friendly design strategies, minimizing the

hospital’s ecological impact and enhancing its disaster resilience capabilities.

4. To incorporate advanced medical technologies into the architectural design, to bring

innovation, and to improve healthcare services at the tertiary hospital.

5. To design and apply building solutions that focus on the comfort and efficiency of both

patients and healthcare workers, taking into account factors like comfortable design and

stress reduction.

Significance of the Study

The architectural plan for the Level 3 Tertiary Hospital in Maasin City is of utmost

importance in the convergence of healthcare advancement and architectural ingenuity. As

healthcare systems continue to improve, the actual environment where medical treatments occur

plays a key role in determining patient welfare and recovery. The planned hospital intends to
meet the growing healthcare needs of Maasin City by strategically placing itself within the

healthcare system to provide specialized services and act as a central hub for medical education

and research. The fundamental focus of the project rests in researching difficult architectural

problems inside healthcare facilities, spanning spatial organization in clinical settings and the

seamless integration of modern technology.

To the People of Maasin City:

The planned Level 3 Tertiary Hospital directly serves the residents of Maasin City by

offering enhanced healthcare services, specialized treatments, and a therapeutic atmosphere that

encourages well-being. Access to sophisticated medical treatment adds to the general health and

wellbeing of the population.

To the Local Government Unit (LGU) of Maasin City:

The LGU of Maasin City stands to profit from this research since the suggested

architectural design optimizes the work environment for healthcare professionals, enabling them

to give greater service to the community. The upgraded hospital infrastructure coincides with the

LGU's goal to foster health and well-being in the city.

To Healthcare Professionals:

The research targets the well-being and productivity of healthcare staff by including

ergonomic aspects and stress reduction features into the hospital architecture. This generates a

suitable work atmosphere, assuring the productivity and contentment of healthcare personnel.
To Researchers and Academic Institutions:

The work adds to the scholarly debate on healthcare architecture, giving insights into

tackling difficult architectural issues in healthcare facilities. It becomes a significant resource for

academics and academic institutions working in architecture, healthcare, and urban planning.

CHAPTER 2

Review of Related Literature

Healthcare Facility Design

The Philippines has progressively improved its healthcare delivery over the last decade,

but people still demand higher-quality services, which the healthcare industry should consider.[1]

Quality improvement is one of the most difficult elements to address, especially when it comes

to improving patient care. Several impediments are frequently faced, comprising various

technological, structural, and cultural aspects.[2] To handle these new changes, the Philippine

healthcare industry has been continually evolving, with several reforms and regulations aimed at

improving access to healthcare services.[1]

Healthcare facility design is a complex procedure that involves a wide range of

stakeholders and aims to integrate operational, environmental, experiential, clinical, and

organizational goals. The problems inherent in facility design stem from the dynamic and

complicated nature of healthcare, as well as the increased accountability to the quadruple goals

of improving patient experience, improving population health, lowering costs, and improving

staff working conditions. [3] The following are essential considerations before designing a

hospital: [4]

a. Functionality and Flow - The fundamental principle of every hospital design is its

effective features and meticulously planned flow. The plan must be designed in such a
 way that the distance between departments is reduced, increasing both staff productivity

and patient care. Consider the route that a patient takes from arrival to different treatment

sites. The design must provide easy navigation for patients, visitors, and medical workers.

b. Patient Centric Approach - The design of the hospital should prioritize the well-being

of patients, placing their experience at the forefront. The emotional and mental health of

patients can be greatly influenced by the physical surroundings. It is important to include

welcoming waiting areas, individual patient rooms, and areas that provide access to

natural light and scenic views. Creating a serene and optimistic atmosphere can play a

vital role in fostering the healing journey.

c. Flexibility - The healthcare industry is continually advancing, and hospital designs

should anticipate upcoming shifts in medical technology and methodologies. Plan spaces

that can be readily adjusted to incorporate new equipment or adapt to changes in patient

care strategies. This adaptability will ensure the hospital stays current and effective in the

years ahead.

d. Safety - In hospitals, maintaining strict infection control is crucial. Design elements

should encompass effective ventilation systems, surfaces that are easy to clean, and

spatial arrangements that reduce the potential for cross-contamination. Additionally,

safety precautions, such as well-marked exits, the use of fire-resistant materials, and the

incorporation of easily accessible emergency equipment, should be incorporated into the

overall design.

e. Regulatory Compliance - Hospitals must adhere to various regulations and standards to

guarantee patient safety. When designing, it is essential to consider and incorporate these

regulations to ensure the facility complies with all required standards.

 f. Aesthetic and Cultural Considerations - The visual appeal of the hospital should

resonate with its intended purpose. Take into account the local culture and community

preferences when crafting the interior and exterior aesthetics. A hospitable and culturally

attuned environment can positively impact the overall patient experience.

In the next few years, hospital administrators will be involved in new hospital

construction projects to address the shifting market demands associated with an aging

population. [5] Caring for patients is not easy work, but effective design decisions may assist

staff members to do their duties to the best of their abilities. From active considerations like the

distance between staff members and patient rooms to passive decisions like furniture and wall

color, a space's design influences patients from the time they enter a facility. Knowing what

questions to ask the staff and what research to conduct for each individual project is the hallmark

of a smart healthcare designer, and these decisions will assist to raise the overall facility's level of

care.[6]

Patient-Centered design

Patient-centered design is an approach that prioritizes the needs and experiences of

patients in the design of healthcare facilities, services, and technologies. It encompasses various

fields, including healthcare and architecture. In healthcare, patient-centered design involves

creating care environments that consider patient perceptions and expectations of the physical

environment, aiming to improve the patient experience and well-being.[7] In architecture,

patient-centered design focuses on creating hospital spaces that positively impact patients' mental

well-being based on their lived experiences, with an emphasis on factors such as hospital

location, access, identity, and human interactions.[7] Additionally, in the context of digital
health, patient-centered design involves understanding both user and clinical realities to create

valid and effective health information technology systems.[8] Overall, patient-centered design

aims to enhance the quality of care and the overall experience for patients across various

healthcare settings.

Patient-centered design can be used to improve patient engagement in healthcare by

placing the needs and experiences of patients at the forefront of the design process. This

approach can lead to the development of more effective and user-friendly healthcare solutions.

For example, in the context of architectural design, the concept of a "Patient Hub" envisions a

truly patient-centered, department-less facility, where all critical functions occur on one floor,

aiming to bring care to the patient and enhance patient experience and overall efficiency.[9] In

the field of digital health, patient-centered design grounded in user and clinical realities is

essential for the valid design of health information technology systems. It involves understanding

and accommodating both user characteristics, tasks, context of use, needs, and preferences, as

well as clinical workflows and organizational requirements, to avoid design errors and ensure the

acceptance and appropriate use of the products by patients and healthcare delivery systems.[8]

Furthermore, patient-centered design can aid the development of health tools that consider a

patient’s healthcare journey and health needs more broadly, supporting patients' health

management alongside the complexities and priorities of daily life.[10] By incorporating

patient-centered design principles, healthcare systems and technologies can be tailored to better

meet the needs of patients, ultimately leading to improved patient engagement and outcomes.
 Ergonomics in Hospitals

Ergonomics is an applied science that deals with adapting work and the workplace to the

worker's features and skills so that he or she can execute job obligations successfully and safely.

It considers the worker's physical abilities in connection to the physical demands of the job, as

well as his or her mental and emotional state in relation to the way the work is structured.[11]

Ergonomics strives to create safe, pleasant, and productive workplaces by incorporating human

capabilities and limits into workspace design, such as body size, strength, skill, speed, sensory

capacities, and even attitudes.[12] Ideally, changes are made to the worker's furniture,

equipment, and tools, as well as the work environment, to allow the person to function properly

without putting himself/herself, coworkers, or the public at risk. [11]

Hospitals provide several potential for ergonomic stresses to show as injuries or repeated

stress illnesses. Patient handling and uncomfortable postures are two major ergonomic

difficulties in hospital settings.[13] Extensive study has been undertaken into the ergonomics of

hospitalization, with the majority of studies seeking to determine the extent to which hospital

management should give hospital workers leeway in designing techniques to balance an

acceptable workload with high quality treatment. [11] Many common duties for hospital workers

can result in unusual postures, such as twisted, hyper-extended, or flexed back positions,

reaching, and lateral or side bending. Awkward postures can put more strain on the spine and

joints, leading to muscle and tendon fatigue and/or joint discomfort. Awkward postures need

more physical power because muscles cannot work efficiently.[13] Estryn-Béhar, Madeleine

stated that an analysis of the interplay of several elements impacting care—physical strain,

cognitive strain, affective strain, scheduling, ambiance, architecture, and hygiene protocols—is

critical. When striving to enhance overall patient management, timetables and common work
areas must be adjusted to meet the demands of the team. Participatory ergonomics is a method of

leveraging particular information to make broad and meaningful improvements to the quality of

care and working conditions.[11] Here are some considerations:[14]

a. Increase floor space in patient rooms, including restrooms and nurses' stations, to create

an extra workplace. Adequate space reduces the need for difficult postures when working

in a room crowded with equipment and inhabited by guests.

b. Construct rooms with wider doorways and more floor space for patients who need

bariatric equipment and larger furnishings.

c. Elevate or lower the location and increase the number of electrical outlets to decrease

unnecessary bending and kneeling on the floor, or standing on furniture.

d. Purchase step stools that have been ergonomically built and tested for usage during

operations. Although most workers prefer to arrange supplies between their shoulders and

knees, this is not always practical when reaching or bending for high equipment or

supplies that cannot be placed at a lower level. Careful usage of any step stool is required,

and coworker help is encouraged.

e. Special hospital beds that convert to chairs remove the need for bed-to-chair transfers,

which lowers the risk of injury. This piece of equipment is time and space efficient.

Hospital administration and management must work to create or promote a culture of

safety that reduces ergonomic risk to caregivers. This culture includes adequate resources to

acquire lifts and other equipment to assist health care personnel in completing their duties while

lowering their risk of harm.

 Healing Architecture

Healing architecture refers to the design of healthcare settings with the intention of

promoting health and well-being. It involves the use of various architectural elements to create a

supportive and therapeutic environment for patients and staff. Research in this field aims to

understand how characteristics of healing architecture impact clinical practice and patient

experiences. However, it is noted that there is currently no common or operative definition of

healing architecture, and there is limited knowledge of how it shapes clinical and patient

outcomes.[15] Some aspects of healing architecture include the integration of nature, color, and a

patient-centered approach to design, aiming to contribute to the well-being and recovery of

patients.[16][17] Further research is needed to fully understand the impact of healing architecture

on healthcare outcomes.

According to a scoping review,[15] there is no common or operative definition of healing

architecture, and there is limited knowledge of how it shapes clinical and patient outcomes.

However, some aspects of healing architecture include the integration of nature, color, and a

patient-centered approach to design.[16][17] One example of the application of healing

architecture is the design of a children's hospital with a healing architecture approach and based

on the green building concept4. Another example is the use of Snoezelen and healing

architecture in the design of delivery rooms to improve women's birth experiences and

patient-centeredness of care.[17] Further research is needed to fully understand the impact of

healing architecture on healthcare outcomes.

Specific design elements of healing architecture in healthcare settings can include the

integration of nature, color, and a patient-centered approach to design. For example, the

application of healing architecture in a children's hospital involved incorporating aspects of color

and nature into the building, as these elements are believed to contribute to patients' recovery

rates.[16] Additionally, the use of Snoezelen and healing architecture in the design of delivery

rooms has been studied to improve women's birth experiences and the patient-centeredness of

care.[17] While there is no common or operative definition of healing architecture, these

examples illustrate how specific design elements are being considered to create supportive and

therapeutic healthcare environments. Further research is needed to fully understand the impact of

these design elements on clinical outcomes and patient experiences.[15]

Eco-Friendly and Disaster-Resilient Hospitals

The Philippines has been actively promoting the development of eco-friendly and

disaster-resilient healthcare facilities. The “Green and Safe Health Facilities” program, initiated

by the government, aims to establish a network of climate-smart healthcare facilities while

ensuring the delivery of high-quality and equitable healthcare services. [21] This program

reflects a comprehensive effort to integrate environmental sustainability and resilience into the

country’s healthcare infrastructure.

In line with this initiative, several hospitals in the Philippines have made significant

strides in implementing eco-friendly and disaster-resilient measures. For instance, the Philippine

Heart Center (PHC) has integrated sustainable and energy-resilient strategies into its emergency

shelter design, adopting an environmental health lens to enhance its resilience to disaster. [18]

Similarly, St. Paul’s Hospital of Iloilo (SPHI) has been proactive in embracing environmental

sustainability, with a focus on making its facilities not only green and sustainable but also

disaster-resilient.[19]

The commitment to creating safer and disaster-resilient hospitals is further evidenced by

the discussions and activities that have taken place. The first RTWG meeting for Safer and
Disaster-Resilient Hospitals, for example, was aimed at promoting safe hospitals from disasters

through the support of hospital preparedness and recovery plans.[20] This meeting laid the

foundation for prioritizing activities, developing toolkits, and engaging in global dialogues to

enhance the resilience of healthcare facilities.

The efforts of the Philippines in transforming its healthcare landscapes to be more

environmentally friendly and disaster-resilient are commendable. By integrating measures such

as natural ventilation, typhoon resistance, and eco-friendly waste management, the country is

taking significant steps towards building a more resilient and sustainable healthcare system.
 BIBLIOGRAPHY

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