A new 1,700-bed, 2 million-square-foot building housing clinical care and teaching and research programs, the Guilin Medical School Affiliated Hospital is expected to be completed in December 2023. However, its planning and concept so far earned it an Award of Merit as an in-progress project in this year’s Design Showcase. Inspired by a design concept of “Garden in a Garden,” a nod to the lush local landscape, the building form and exterior design mimic the region’s Osmanthus flower as they deliver generous access to nature and views. The large program was organized through a modular solution that helps break down scale and improve efficiency. The project was submitted to the program by HDR and Zhejiang Modern Architectural Design & Research Institute Co. Ltd. Here, project lead Sangmin Lee, director of Health for China for HDR (San Francisco), shares insight on some of the design solutions most celebrated by the jury.

Healthcare Design: Local requirements mandate a 24-meter height limit, but the design had to accommodate 1,700 beds. How did the team ultimately evolve the design into a series of low-rise buildings?

Sangmin Lee: We began by establishing the towers as independent centers of excellence that could maintain their separate identities. Each is located on the site so that visitors can easily navigate to their desired destination. We developed drop-off points for each center with their own distinct wayfinding aesthetic so that the journey is clear for each patient as they arrive. The separation of each center of excellence as individual brand identities is what makes this possible. Each center is a different size of Osmanthus “petal.” This was driven by balancing design, planning, and program. Each center did not need the same number of beds, and with ample room on site for the separation of the centers, the petal aesthetic manifests as a series of low-rise buildings that connect through the gardens and corridors.

You used a modular solution to accommodate the program. What defines the modules and overall campus organization?

Patient room, operating room (OR), and parking space size are all standardized. Therefore, our building blocks were set, and program needs were the focus. Different grid systems can impact an entire campus, and so to have the most efficient layout, modular design and repetition were considerably important.

Infection control played a large role in the ORs, which were designed to maximize the use of space—operating rooms in China are smaller than in the U.S. due to processes that eliminate in-room storage to maintain infection control.
The centers of excellence were sited to allow for the maximum space between one another while still maintaining maximum distance from the roads. This configuration elevates the ambience on the campus and establishes privacy from the surrounding community so the new medical campus is a beneficial landscape rather than a towering building that obstructs views. The building evolved into the series of low-rise buildings not only to follow the city guideline but also to maximize a common sight line throughout the city and its surroundings.

How did the shape of the Osmanthus flower inform the design?

The building shapes are inspired by the Osmanthus flower, the city’s representative flower. By making a series of gardens, the whole campus becomes one of the most beautiful landscapes in the city. The symbolism of the Osmanthus flower is dispersed throughout the buildings and connects visitors with the local culture and provides a sense of familiarity and belonging. Integrating images of nature also helps patients and visitors remain connected to the unique and iconic natural surroundings of Guilin. At the center of each center of excellence, or petal, is an open courtyard that brings daylight down through every level, including the bottom parking level, made possible because the building is low rise.

The above-outlined solutions not only fit the program on the site but help break down its massive scale. How did your team think through the human element of approaching such a large campus?

The series of courtyards at the center of each building have a different elemental theme: water, fire, wood, metal, and earth. This organizes the campus by theme, color, and landscape design, including art sculptures for each building. These become focal points for wayfinding and carry the patient through their journey while connecting them to the natural environment. Additionally, glass [building] podiums create transparency throughout the campus to enhance the human experience with views, light, and connection to nature.

How were you able to achieve generous access to outdoor spaces, daylighting, and views, given how much had to be fit on the site?

The limitations and challenges were very clear, but our concept of “Garden in Garden” was also based on these challenges. With a solid concept as its base, the entire planning and design process could naturally develop, evolve, and integrate with several measures such as sustainability, community, and wellness impacts.

Atop each center of excellence is a roof garden. Recessed medical floors enhance the building’s flower-like shape. Patients and staff coming up or down from the inpatient tower to these transitional floors have access to the roof gardens, sunken gardens, and courtyards to move throughout the campus and experience its garden-natured design, both between and within the buildings.

Our jury applauded the success of the vertical and horizontal stacking in your planning. What were keys to your approach?

There are a couple of key elements to solving the puzzle: (1) The circulation organization and zoning division are based on different users’ needs and behaviors, avoiding unnecessary crossovers and keeping the circulation as efficient as possible; (2) Integrating and classifying specific disciplines/departments that have similar functions or are closely related to each other was important, and it improves staff work efficiency and minimizes the patient travel distance; and (3) Large-scale shared medical technology has been centralized so that each specialty can easily get access to diagnostics and treatment, which makes treatment more efficient.

Jennifer Kovacs is editor-in-chief of Healthcare Design. She can be reached at jennifer.silvis@emeraldx.com.