A collection of 150 architects, engineers, and other experts contributed to the Union of International Architects’ 28th public health seminar in Florence, Italy, last June 2008. Under the seminar’s theme “The culture for the future of healthcare architecture,” the first day featured a discussion about the construction of children’s hospitals and a tour of the newly inaugurated A. Meyer Children’s Hospital in Florence. The next two days consisted of presentations on topics such as the culture of innovation, planning for catastrophic events, sustainability, and humanization.

Meyer Children’s Hospital was a good reason to organize the congress in Florence. The extension of the hospital was put into operation at the end of 2007. Numerous scientific studies concerning the psychology of children and the corresponding requirements of a facility for children, including their legal rights in the hospital, have been the basis of the new extension’s design. Speakers from the United States, Russia, and Israel showed their examples of children’s hospitals in comparison with Meyer Children’s. Attendees discussed how the materials, colors, natural and artificial lighting, and public and personal zones can create particular atmospheres. Children are not small adults and require different considerations, such as including an extra bed and adding separate rooms for playing (or even learning). Children require special treatment and nursing services—a challenging task on all levels of involvement.

Recognizing cultural differences
Participants from all over the world presented their papers revealing different cultural aspects from their countries. A patient’s healing process has specific requirements that are very often linked with his or her cultural background.
This is especially important within ethnic groups and religious traditions.

Nowina Mohd. Nawawi, associate professor at the International Islamic University Malaysia, explained the requirements for the different ethnic groups that live together in this large country. In a hospital, the groups have to be separated to achieve good treatment results. It is essential that cultural expectations are considered. For example, strict gender separation needs to be followed not only in rooms, but also throughout whole departments and zones. And sometimes even separate hospitals are called for.

A presentation by Egyptian architectural consultant Zakia Shafie further explained the aspect of patient separation requirements based on social class. Designing healthcare spaces based on social class is a reality that we don’t even try to think about in Western countries, although we have been aware of it for a long time.

In need of innovation
Great expectations are always connected with the notion of innovation. For many years now, the building industry has been asking for new ideas for sustainability; however, concerning energy consumption, the hospital is far from sustainable. A hospital project presented by a group of Dutch architects and engineers showing a concept without any CO2 emissions was received by attendees with high interest.

Is it important that healthcare architecture is innovative? Yes, it needs to be. The development in healthcare medicine and medical technical equipment is developing very quickly, and hospitals usually adopt such methods spontaneously. The planners of these facilities should respond with a modular and flexible design concept to make such changes possible over the whole lifecycle of a hospital building.

Creativity after catastrophes
Looking at the effects of catastrophic events happening across the world, it has been obvious that in each case healthcare organizations are not prepared to provide adequate solutions. Examples from China and the Philippines explained the extent of these events and what they mean for the built healthcare environment.

Prosperidad C. Luis of Luis and Associates presented the initial findings of the Philippines’ Department of Health Technical Working Group, which was formed in response to the World Health Organization’s campaign for world disaster reduction. Comprised of health policy makers, practitioners and administrators, architects and engineers, and emergency-response personnel, the group is determining the structural and functional indicators of “safe hospitals.” In the occurrence of a catastrophic event, are we in a position to build facilities and put them into operation quickly? What are the concepts of prevention, and what kind of organization is capable to manage such challenges?

The culture of humanization in the form of wellness
The concept of humanization presents important aspects during the process of planning for healthcare. One such aspect is adapting environments for an aging world population. In a paper from Switzerland, architect Karin Imoberdorf of Itten+Brechbühl, Inc., explained the development of dementia and the design solutions the firm adopted in a nursing home for the elderly. The aging population will require more medical attention, and it is clear that in the Western world a large number of hospital patients are elderly persons.

Another aspect of the notion of humanization is the requirement of prevention. We are all aware, that if we would live healthier—eating less heavy food and engaging in more physical training or sport—we could keep our health for a longer period. According to a presentation by Hans Eggen, senior partner at Itten+Brechbühl architects, wellness has become an international trend, and physical therapy has moved from the premises of the hospital into private centers. The dream for wellness stimulates our fantasy for holiday destinations. For example, the extensive renovation of the Grand Hotel Dolder in Zürich designed by Norman Foster and realized by Itten+Brechbühl offers a special wing providing guests spa and wellness services. The spa and wellness services are attracting customers in the same way resorts have been attracting customers with golf courses.

The Public Health Group will hold its next international seminar in October 2009 in Buenos Aires. In South America experts from all over the world are expected to present their papers. Everyone interested is invited to take part as a speaker or as an attendee to gain valuable information. Tours of local hospitals will make it possible to get a personal view of the facilities and the healthcare requirements in a large metropolitan city. The Public Health Group is a platform to cultivate professional networks and increase the understanding of the worldwide healthcare environment.

View abstracts from this year’s Public Health Group seminar

Hans Eggen, Dipl. Arch., ETH SIA, is Director of the International Union of Architects—Public Health Group and a senior partner at Itten+Brechbühl, Inc.