In 2014, Lausanne University Hospital in Lausanne, Vaud, Switzerland, sought to bring its existing children’s hospital, located across the city, onto its main campus.
The new 6-story facility would consolidate pediatric services under one roof and complete a coherent mother-child medical hub within the main campus. Additionally, connecting the children’s hospital with the existing hospital’s maternity building would allow for seamless collaboration between pediatric, gynecology, obstetrics, and neonatology teams.
Lausanne University Hospital site challenges
But before the project team could start site preparation to integrate the new facility on the main campus, it faced several challenges related to the campus location.
“The site was extremely dense, with limited surface area, a metro line running beneath it, and a complex network of underground tunnels connecting existing hospital buildings,” says Jean-Baptiste Ferrari, administrator and partner of Ferrari Architectes (Lausanne), which along with Architects von Gerkan, Marg, and Partners (GMP; Renens, Vaud, Switzerland), designed the new Lausanne Children’s Hospital.
The existing hospital buildings on the main campus strongly influenced the design approach, shaping both the architectural concept and the construction strategy, Ferrari adds. First, the site chosen for the new children’s hospital, between the maternity building and main hospital entrance was partially on a hillside. Secondly, it was important that the new building not obscure views from the maternity building to the natural landscape to the north. “To accommodate the full program within the constrained site, we had to build downward,” Ferrari says.
Specifically, the design concept called for a terraced inverted L-shaped building. The eastern portion of the building, between maternity and the main hospital entrance, consists of three stories, partially underground and cut into the sloping terrain so that the roof is nearly at ground level on one side. Here, the design team planned a landscaped rooftop garden, two floors of examination and treatment spaces, and a 200-space underground parking garage. The perpendicular, street-facing western portion of the new building comprises a 6-story tower that forms the base of the “L” and houses 71 inpatient beds.
To build downward the project required excavation of approximately 200,000 tons of soil. A tunnel connecting the main building to the maternity ward—which ensures fast and secure circulation between the two in the case of emergency situations, such as complications during childbirth—had to be demolished and rebuilt during the project. The new building also would sit above an existing metro line. Fortunately, Ferrari says, the metro line was constructed with the structural integrity to support development above it, and metro service was disrupted only for one day to connect a new station directly with the children’s hospital.
“The metro station was originally constructed as an open-air facility, with the foresight to include substantial linear foundations beneath the platforms. These foundations were specifically designed to support a future building above, anticipating the constraints of urban development,” Ferrari says.
“In Switzerland, building above existing infrastructure is a common practice due to the dense urban context and limited available land. Once the pre-existing foundations were in place, the construction of the hospital followed a relatively straightforward sequence: structural walls were erected directly on the supports, a slab was poured to create a stable base, and the hospital was built above.”
To avoid structural risk to existing buildings, the team also adjusted the original project plans, repositioning the basement of the new children’s hospital so that the excavation occurred below the lowest level of the maternity building.
“During the competition phase, the basement of the new hospital was planned to be just 2 to 3 meters from the façade of the maternity building. In the execution phase, this distance was increased to 6 meters to reduce the risk to the maternity ward, which is a very old structure and therefore more vulnerable. The goal was to avoid any destabilization or collapse during excavation,” Ferrari says.
“To protect the maternity building, a retaining wall was constructed using secant piles—columns placed very tightly next to each other. These piles stabilize the soil and form a continuous wall that shields the existing structure during excavation. … Our team included experienced geotechnical engineers who are familiar with these challenges and ensured the safety of the existing building throughout the process.”
How Lausanne University Hospital minimized operational disruptions
Another priority on the project was minimizing disruption to ongoing operations within the existing hospital. For example, construction of a temporary sealed wall protected the lower floors of the maternity ward from dust, and a new pedestrian bridge and elevator were built to maintain access to the main hospital building.
“Positioned along the street, the building is clearly visible from the city, reinforcing its civic role without obstructing views or light to the adjacent maternity building,” says Stefan Walter, associate partner at GMP. “This visibility, combined with direct transit access, makes the hospital both accessible and symbolically integrated into the life of the city.”
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Robert McCune is senior editor of Healthcare Design. He can be reached at [email protected].
