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Can hospitals have complex curves?

atheodore

Our professor tasked us to design a hospital. While looking for samples for inspiration, I noticed that I haven't seen any hospitals with complex curves or anything of the like. The hospital samples I found consisted more of parallel/perpendicular straight lines, straight corridors, walls, etc. Before searching, I was planning to design a curvy hospital (since curves look more organic and imposes lack of threat), but after seeing the trend of straight lines in hospitals, I was wondering if there is a specific reason for this?

 
Apr 2, 16 1:58 am
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Time and distances are critical in hospitals.

Apr 2, 16 2:49 am  · 
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In my opinion, I do not think that curved walls would be empathetic in a hospital. I believe individuals in a high stress situation need the comfort of the familiar.  

Apr 2, 16 3:19 am  · 
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atheodore

Ah, I see. Thank you! So I guess complex curves wouldn't be very helpful in the design?

Also, can you give me some tips on how to design a large building given a large lot with a lot of requirements? :) I'm finding it excruciatingly hard to design the floorplan of this hospital since I worry too much about what the exterior elevations will look like. I tend to design the elevations first and just 'fit' a floorplan in, and it worked perfectly on small buildings like houses, etc. but that seems not to be the case in large ones like this hospital. Can I please get some advice?

Apr 2, 16 5:16 am  · 
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Have a look at the Victorian Comprehensive Cancer Centre by McBride Charles Ryan.

Apr 2, 16 5:44 am  · 
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First: Get the project program requirements together. You may have parking requirement and footprint conditions and numerous other requirements. In those requirements, you should have some function-spatial requirements and spatial inter-relationship requirements (ie. function-space clustering). You may need to think multi-floor design.

Second, focus on function/space planning and relationship of function areas and egress patterns. You can then work your way into a back and forth refinement of floor plans and elevation. Develop rudimentary mass models and then you can iterate through design refinement.

Third: Work more and more on exterior and interior elevations.

Then go from there. 

 

Misc. poins:

This basic process is essentially how large projects with substantially complex multi-department/multi-function area projects work. Hospitals are similar to large college buildings with multiple departments at least in that sense while albeit have obvious differences specific to health care so don't over extend the similarity point.

Certain function areas will have support function areas that would be clustered in these 'function blocks'. 

There is a systematic process professional architects do with healthcare. This isn't my particular area but I have seen similar scale projects done in academic buildings and campus wide work. Hospitals are similar in that sense from what I have heard and read but also have their own explicit requirements.

Before drawing up what the building looks like, get the project program together, do some bubble diagrams, flow diagrams and so forth. I think you should have your project program understand. I would imagine you wouldn't want the guys running the gurney from a helipad or other ambulance to be going through the general public / non-emergency patients lobby area. You want them to have as straight of path as possible to the ER. 

There is probably some stuff on this for guidance.

What I am getting at to you is don't put the cart before the horse.

Apr 2, 16 5:55 am  · 
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I think your problem is you are doing design process backwards.

Elevations should be waited until you have some rudimentary floor plan layout. You need to understand the spaces to be made before you compose elevations because otherwise you would be shoehorning function into poorly conceived layout in a poorly designed box.

Don't get to caught up with 'how it will look' from the outside too much. You'll get to conceptual mass models as you have laid out some conceptual level floor plan laying out function-space and egress flow. This is iterative. 

Apr 2, 16 6:04 am  · 
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atheodore

@Nick Weaver
Interesting. Thank you!

@RickB-OR
I see! I'll give it a shot. :) Thank you so much Rick! This'll help me a lot with my hospital design, and my future designs as well!

Apr 2, 16 7:24 am  · 
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Wood Guy

Curves are expensive. I used to be a contractor and furnituremaker, and did a lot of curved work. To do anything curved takes 2-10 times longer than to do it straight. Hospitals have tight budgets. Would you rather have a million dollar MRI machine or a curved facade?

That said, I agree that curves are less imposing, and I have been in hospitals with some degree of curviness, such as partition walls built as segmented curves. If there was a way to build it that was not excessively expensive I would be all for it.

Apr 2, 16 8:24 am  · 
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b3tadine[sutures]
Hospitals have tight budgets? Oooo boy is that not true.
Apr 2, 16 8:50 am  · 
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geezertect

The new VA hospital in Aurora, Colorado has some soft curves, and the cost overruns are horrendous.  If it was a private venture, it would have gone bust.

That said, you are doing this for school, not real life.  A few soft curves in corridors, etc. will look cool in plan and won't extend travel distances meaningfully.  And definitely make the elevations nice since that is what architects (professors) always look at first, whether they admit it or not.

Apr 2, 16 12:00 pm  · 
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gruen
When I worked on a $500 million hospital addition I was surprised how much that travel distances mattered & costs as well. Curves got VE'd out right away in SD, as did nice views of stuff.
Apr 2, 16 4:28 pm  · 
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natematt

This depends what you mean by complex curves. Do you mean curves at all? Do you mean reasonably placed curves? Or do you mean everything curves all of the time?

Generally the more curves you put in a building, the more inefficient it is. You can have curves on a larger scale, but as soon as you start throwing them everywhere, as happens a lot in school, they really don’t work well for any kind of building.

There are plenty of examples of hospitals with lighter curving. Of hand I think of, Rush Medical Center,   Herzog and Demuron had an interesting proposal for a clover shaped low-rise hospital, and I have been in a few hospitals with filleted corners in patient rooms because they thought it would be calming. I’ve worked on proposals for a few fairly curved exteriors, and I have seen a lot of single bend hospitals. The cost per sqft is insane in hospitals though, so programming really does drive things, to the point that a lot of it is done by people who specialize in medical planning. So the main take away should be that you can do it, as long as you aren’t being inefficient.  

Hospitals have tight budgets? Oooo boy is that not true.

Depends on the hospital b3tadine… lots of them do. And the others you normally have to pry the money out of their hands. It is not easy to get a hospital to just pay for things well above and beyond just for quality design.
 

Apr 2, 16 5:01 pm  · 
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Wood Guy

Hospitals have tight budgets? Oooo boy is that not true.

That's been my third-hand experience, from what I hear from several family members who are doctors and nurses, another who was a risk manager at a hospital, and several friends and former clients who are doctors at hospitals.

I've never been involved in hospital design so I don't know how far the budgets really go, but I heard a lot about how many beds had to be cut from the design of the local hospital, which is beautiful (as far as hospitals go) but was apparently over budget.

Apr 2, 16 5:22 pm  · 
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ivorykeyboard

Rush Hospital by Perkins + WIll

Apr 2, 16 6:41 pm  · 
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You can look at Prentice Women's Hospital too (pour out some Old Style for a fallen Homie). Don't just do curves because you like them, make it work in several ways. That's how Rush and Prentice both work/worked.
Apr 2, 16 6:45 pm  · 
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Carrera

Been in this one (teaching hospital)...each one of the 4 crescents is a quarter of a circle and contains patient rooms and at the centre of each arc are nurse stations…innovative at the time - Minoru Yamasaki 1979.

 

Apr 2, 16 7:03 pm  · 
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chigurh

formal precedent as design driver for specific program - lame.

Apr 2, 16 7:04 pm  · 
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Carrera

Guess the more you look the more you see – Winnie Palmer Hospital; Orlando, Florida; 2006; Jonathan D. Bailey, FAIA

Apr 2, 16 7:33 pm  · 
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atheodore

Thank you so much for your help! I appreciate it :)

For now, I think I'm going to settle for a plan that consists of parallel and perpendicular walls, though I'll still put a few things in the exteriors just to keep things more interesting.

@Carrera
I didn't see that one before. It looks amazing! Thank you!

Apr 3, 16 12:44 pm  · 
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geezertect

^^  If you're not sick before you go there, you probably are when you get a look at the place.  Yeech.

Apr 3, 16 1:00 pm  · 
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Carrera

^ Didn’t say it was “good” just pointed out that it was “curvy”….Orlando after all is the Land of Disney :)

Apr 3, 16 1:55 pm  · 
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Curves on the inside are a huge problem if they are more than curved vertical walls as they create places for dust to collect. Dust is the Nemesis of infection control. If you are in a clinic, a good one that does surgery you will notice as you move from public space to the surgery that spaces become more sparse and clean. Ledges and non vertical spaces can accumulate dust and germs so curves like we find in blobachure will never be a good fit in a hospital which is constantly fighting dust and infections. You want smooth surfaces with no seams and no ledges on the inside. Also need to keep privacy and visual control in mind one person is often responsible for multiple patients depending on the intensity of care.

Hospitals, especially the areas that need to be at the higher levels of infection control such as wards and surgery are wickedly expensive per square foot.  They also need huge corridors to move gurneys and consequently any space in the building has to have those huge halls because if a fire occurs people in beds need to be wheeled out in horizontal evacuations.  I think the minimum clear size of a hospital corridor is 8' but there are different standards in each state. Curves can be wasteful in the rectangular world of hospital equipment, the space spent on architectural expression can be costly in the bed towers and surgery and ICU wards.  Often you see the architectural budget spent on the non critical areas, lobbies, food courts, parking and offices. and on very nice finishes on rectangular buildings.

Over and OUT

Peter N

Apr 3, 16 3:07 pm  · 
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@b3tadine[sutures] @Wood Guy, as someone who has spent most of my career working at/for hospitals, the capital budgets for new construction seem to be generally large and I have certainly seen money spent on amenities/extras (hospitality services/patient satisfaction/market differentiation is a big deal now). However, I have never seen overtly frivolous (albeit child friendly perhaps) design/expenditures and cost control/lean operations is a growing focus.

I found gruen's point re: "travel distances" noteworthy. Also geezer, I get the sense it wasn't simply an architectural form issue, that resulted in the ridiculous amount of moment being spent to complete that VA project...

Apr 10, 16 10:36 pm  · 
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