well im curious as to what people think about "healthcare architecture" or that particular route... when I was in school it was almost unthinkable, unheard of even as most people thought they sought to be the next boutique name.

So general impressions, what kind of reactions does the title evoke? what do you know if youve worked that route? what do you think about working that route? what comes to mind? how imporant of a niche in architecture is this? will this field be? do you find it intriguing? why or why not? etc etc.

most of the corporate firms don't do nice projects...

the hilversum klinik in zuerich by SAM architekten is probably one of the most amazing hospitals i've been in. it was landscaped by kienast.

Healthcare will be an increasingly important field in architecture, if you consider the higher living standards, an increasingly older and longer working population, changing views of retirement, and the privatization of health insurance funds. This is the case in Europe at least - more specifically in the Netherlands there is more and more experimentation in combining living with care, from very exclusive retreats to medical zoning in housing areas.

As holz.box points out, there is still a tendency to give projects to larger firms that specialize in hospitals, often with an uninteresting or bland "evidence-based design" result. But since focus is slowly moving away from large-scale complexes to a more integrated approach, there will be more and more examples of high-quality healthcare architecture in the future.

Senior housing for the pop generation? (Arons en Gelauff, "De Plussenburgh")

hey, my partner interned with them! loving their recent stuff. not so sure about the colored hallways..but, why not?


my first office did/does hopsitals. quite often really. they have a specialist or two in the office, folks who spend all day long working out the mechanical systems and mediating the arguments between the nurses and the doctors and the administrators...usually for several years at a time...

thankfully i only worked on 3 or 4 hospitals in that place. it is a very non-architectural job. most of the time is spent working through the crap i mentioned above, and the rest is spent trying to convince the client that the eden alternative really would be worth trying (if you are into healthcare you know what i am talking about) and never ever getting the chance to do it...

cuz....

well, it turns out that hospitals, in japan at least (maybe USA too?), are not being built to make people comfortable when sick, but rather to MAKE MONEY for the investors. so you get to happily design slightly-under-the-optimum rooms, organised according to a hotel-like set of rules that is at best distasteful (the accountants ALWAYS had the final say about room size and how many there should be, the goal being to get as many bodies into a place as posible for the least amount of cash upfront)...not to disparage the docs and nurses and so on, but that is really my impression of the setting they have to work in. Drove me nuts doing that work...maybe the only time i have ever considered quitting the biz. i felt like i was doing harm, when the opportunity to do good was so clearly sitting right there in front of me..

my late father was a hospital administrator all over canada, and we often talked about the shitty system that is healthcare. A bit different in Canada than japan, but similar enough that we could spend hours bitching to each other about the way things are going, and how the system is set up to discourage too much reform from happening. He would also often complain that architects are always trying to "design" his hospitals...when all he wanted was a place that functioned. I think he thought it was funny.

However, I would absolutely love to design hospitals that were truthfully based on making healing places (not the marth stewart corny kind) and that perform well as architecture too. I do believe it is possible, but oh so difficult.

i work at a firm that has managed to produce a fair amount of what could be referred to as "Healthcare Architecture" (distinct from simply producing a "Hospital"). This is not to say that the projects are, in ever case, amazing architectural objects, but that they are imaginative solutions to a complex program (including the aspect that jump mentions above - business vs. healing mentality).

and, in my inexperienced opinion, these facilities can take cues from evidence-based design to their benefit.

*in every case...

I work in a firm that does health care, and I always ask myself why can't this be more like Aalto's Tuberculosis Sanatorium at Piamio? I know there are a lot of reasons why not (many going back to our lovely code discussions in other threads), but for me, it's always something to shoot for.

i've never done any healthcare projects...

i did recently see Joe Kuspan from Karlsberger Architecture speak about their design for the [url= Dell Children's Hospital in Austin

it was pretty amazing... and it's going to be LEED gold or platinum which is close to impossible for a hospital...

most of the huge healthcare companies have a list of a few architects that they work with exclusively... i think that it depends on the client as to how much they value design... i think that more often they are realizing that good design helps people heal faster... part of the presentation that i saw featured both the architect and the owner's representative... one of the key things that the owner sees that makes good design a necessity is the ability to attract doctors for research positions...

i think that healthcare projects tend to have a pretty good budget and decent latitude for getting cool design... however there are tons of special mundane details that need to be addressed... one friend that used to work at a healthcare firm described it as a blackhole that is difficult to get out of once you start because the stuff that you learn is so specific to healthcare that it doesn't transfer well to other building types...

Here in the USA I would say healthcare architecture can keep a young architect busy for the rest of his life. With the "boomers" getting older there'll be plenty of room for growth. Also I see the gov't becoming ever more involved. Whether that proves to be good for design is yet to be seen, but it will bring in the construction $$$. And healthcare jobs, like new hospitals, have huge construction budgets. I'd like to have my % cut of that.

Everyone can complain about how the design is all about the bottom line (number of hospital beds, whatever), but how is that different from other building types? Educational projects have the same problem, more students per sq. ft.

Realy the best thing would be to allwo the houses to be easily altered would mean a lot in that contest. If there was a need for a room this or that size, acces from where the building mass frame out. If the architecture could be revised and changing form and contenst is the architectural mean to perform the best blueprint ; by the wish of the user.
Good design would then be an architects try out and see attitude but it also would mean, that building structure build by a particular method would be the key to offering addisional cubic meters.

along the lines of what aquapura said, i expect healthcare architecture to get more interesting BECAUSE of the growing boomer market. the entitled-to-the-best generation will push healthcare design forward in the same way that it's pushed almost-suvs/wagons, activewear superstores, coffee shops, and electronics forward. bland wallpapered hallways lined with acrovyn rails and rubber base will no longer do.

the nasty flip side is that the next couple of generations after the boomers will foot the bill.

I started out in Health Care work out here in Cali. It is interesting here only if you think that 8-12 month plan checks on tech closet upgrades are interesting. OSHPD oversees health care design and can suck the life out of any architect that attempts to do it for a living.
j

i hope you are right steven. i am very doubtful, based on experience here in japan (a nation that is already entering the hyper-aged society). as far as budget goes, most of the cash goes to equipment and tech, not design. in fact i think most often the developers were largely anti-design. healing environments almost NEVER came up in meetings. And when they did it was usually to shoot the idea down; the best one i heard was when the landscape surrounding a mountain retreat type of place for long term psych-care was nixed in favor of asphalt (this was in a forest of all places). the nominal reason was that patients might trip on the grass. the actual reason was they didn't want to pay someone to maintain the place. In the end it was all about cost/m2 and number of beds. anything outside that viewpoint was hard to communicate...

aquapura, we also did lots of school in my office. I have done 4 of those as well. not overly large, about 7000-8000m2 each. On that end the story was entirely different, perhaps because the govt was involved, or maybe there really is a different attitude. Our office introduced the open-plan school to Japan nearly 30 years ago, and we spent a LOT of time making experiential spaces for kids that really were innovative since then. light years ahead of what is possible in canada nowadays. Money was tight for these projects as well (relatively; budets were still large) but we were encouraged to do things like introduce landscape into the interior of the school, create biotopes as educational spaces as extension of the classroom, and the whole open-school approach is basically demanding of spatial originality to begin with...so no, i don't think healthcare is the same as other building typologies at all. There is a real problem with the culture that surrounds healthcare...

which is why Jencks and his friends have spent so much effort creating those Maggie centres. Hospitals should be healing, but instead they are sources of stress. I don't know what architects can do to remedy this situation, but have banged my head against the system enough to worry that it will get worse rather than better...

here is hoping my intuition is incorrect.

I agree with joshcookie.... I'm an interior designer in California working for a firm that specializes in healthcare design. We only do interiors but we are constantly working with healthcare architects. The process in California is absolutely ridiculous with OSHPD. They scrutinize every little thing to the point of insanity, not to mention detrimental to the architect's budget... backcheck after backcheck and still trying to get it "out of OSHPD". If you're interested in healthcare design, stay out of California.

Check out the Center for Health Design's website for more info...http://www.healthdesign.org/. They are leaders in research on "healing environments." Also healthcare design magazine... http://www.healthcaredesignmagazine.com/Showcase.htm (a good page to see a showcase of healthcare design projects). There's also a school down south (I'll have to think of the name) whose MArch program specializes in healthcare design. Then there's Jain Malkin's book "Hospital Interior Architecture" if you're interested at all in the interiors...space planning, lighting, finishes, etc. She also goes into great detail about the different parts of the hospital, how they function, and how to optimize the healing effects.

I am fortunate that I work for one of the leaders in "healing environments". We work on very custom projects for healthcare interiors. Not all super high budgets but definitely maximized in aesthetics. We are extremely busy and I can't see the field diminishing in the slightest. I often daydream of going into hospitality design, but that sector is so volatile with its ups and downs and quite susceptible to the strength of the economy I'm afraid. Luckily more and more healthcare projects are shooting for a hospitality design look. Beautiful carpet, lighting, wall covering, etc. The only problem from an interior perspective is "infection control". Everything has to be extremely cleanable, not to mention very durable as these interiors get changed every twenty years compared to a hotel's five or an office's ten. Most items specified for healthcare buildings have to be extremely efficient, safe, cleanable, durable, etc, etc. Takes a lot of thought, knowledge and technical wherewithall (sp?).

I feel for healthcare architects as they have to be even MORE technical than the interiors. I think if you are a technical architect who doesn't mind working on the same project for three to five years and you are truly interested in helping create an environment that helps people heal (evidence shows that the design of the building--access to nature and daylight--actually quickens healing time), then I say 'go for it'.

3 out of the last 8 projects i've done are healthcare related. I never set out for it to be that way thinking that there were mostly duds (the precedent unfortunately has been set). But I found it was less about spec writing and really about design issues. I enjoy it. And they make for the best clients.