Rehumanization thesis

paris bunkers. university of idaho college of art and architecture graduate project thesis design. 2011

04 05 06

part 1: introduction the idea personal connection

part 2: purpose & goals

part 3: issues & theories

part 4: scientific research

part 5: precedents

part 6: site context

part 7: schematic design

07 08 10 12 13 14

18 19 20 21

24 26 28 29

32 34 36 38 40 42 44

48 50 52 54

55 56

perceptions of hospitals current design issues history of hospitals incorporating the senses--Juhani Pallasmaa architecture placebo--Carl Elliot evidence based design--Roger Ulrich

ceiling height window view stress reduction in wood colorful impacts

vidar clinic--Erik Amussen maggie centers--various landscapes--charles jencks health center--GPY Arquitectos

site location site information climate + sustainability existing vernacular existing vegetation site views site analysis

spatial diagram movement + life cloisters + corridors situation + experience changing + ordered obtuse + embrassing 50 spatial program parti diagrams

part 8: final design

floor plans patient experience visitor experience staff experience interstitial space the curve

60 62 72 74 80 82

part 9: bibliography

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the idea.

Can a space set the basis for an out of body experience? Will a tilted ceiling stimulate brain activity? Can a textured paint spark visual curiosity? When faced with a curved wall will it imply safety? Will a fluffy green carpet emulate a natural relaxant? In the grand scale, can a building become the first line of a healing therapy?

My perceptions of hospitals are formed through experiencing them as a visitor. Even as a visitor, the idea of going into the building was daunting.

Feelings of depression, isolation, and ultimately death are attached to even the parking lots. If visitors don’t feel life, how does one expect the doctors to give life, and the patients to gain life?

The psychological impacts of the built environment can be used to provide a first line of healing in a hospital setting. Alterations can be made to areas such as spatial layout, design, and materials to modify the experience of the user.

By researching the specific attributes of the built environment that can be manipulated, I propose to re-humanize the hospital into a healing environment.

Cor Wagenor, an architectural historian, notes, “A building that deals directly with people’s minds and bodies offers exceptional opportunities to come up with especially interesting solutions.”2 Hospitals have a direct impact on the people

part 1

introduction

The power of architecture can be better utilized in the development of hospitals. “Life-enhancing” architecture has to address all the senses simultaneously and fuse our image of self with our experience of the world. Having a sense of self allows the user to fully engage in the mental dimensions of dream, imagination, and desire.1 4 The architecture of a building should provide

an environment for heightened self-awareness because healing is such a personal journey. The hospital architectural experience deserves no less attention than other venues such as legislative halls, sports stadiums, libraries, and other important buildings in our lives. Isn’t it disturbing that the design of a casino that screams money provides more life and happiness than a hospital that promotes life? In addition, the casino’s architecture is carefully designed to maximize profit while rewarding the clients with every pleasurable attraction. Even a society where the values of money and pleasure outweigh health should recognize that the built environment of a hospital can increase profits by enhancing the patient experience. I think the overwhelming negative perception of a hospital is a cultural flaw that was engraved into society when medicine seemed too bloody and cruel for humanity.

That era has passed with the advent of modern medical care highlighted by minimally invasive surgeries, improved pain management, and much higher confidence in a positive outcome.

Hospitals need to be re-designed to take their role as the premiere place of healing with architectural lines that contribute to the mental and physical health of the user.

1. Pallasmaa, Juhani. The Eyes of the Skin: Architecture and the Senses. John Wiley & Sons, 1996.

2. Wagenaar, Cor. The Architecture of Hospitals. Rotterdam: NAi Publishers, 2006. Print.

who use them, whether they are patients, visitors, or the medical staff. They reveal how society treats its citizens once they have become dependent upon their services.

Through repetitions of archaic designs, hospitals are underperforming their primary function--healing the sick. Rather than offering a place of healing they have clung to designs that present anonymous institutional complexes that ultimately evoke stress and anxiety. It is my intent to design a small-community hospital that rids itself of these negative perceptions and rather highlights the importance of accommodating the patient’s obvious need of a comfortable environment that is “life-enhancing”.

personal.

part 1

introduction

I am naturally drawn to a healthy environment because I grew up in an alternative medical family. I have been treated via alternative medicine my entire life. Through my health recoveries, I have benefited from an atmosphere where my strength was recognized as vital to my recovery and thus it was supported in every way; and where my recovery imparted an increased appreciation of my body’s capabilities and thus I learned the value of diet, exercise, and relaxation. A hospital should be a place where these experiences can be enhanced. I see an exciting opportunity for me to bring the vitality and personal healing experiences of our lives into the built environment of a hospital.

5

the goal.

Hospital design provides an opportunity for therapeutic environments. The purpose of my thesis proposal is to take advantage of this opportunity. Through designing with emotions, my project will contribute to an altered perception of the standard hospital into a healing environment.

The therapeutic value of hospitals is related to their physical, social, and symbolic design. The architecture must relate to all five senses in order to provoke a life-enhancing experience. Elements of design will encourage healing through visual space, confined acoustics, natural lighting, seamlessness of indoor and outdoor spaces, and material textures.

Four significant goals will contribute to a good hospital design: • encourage patient and staff well-being • be clinically efficient • be integrated within the community • exhibit sustainable design.

part 2 1

purpose introduction & goals

Further design goals more specific to hospital design include: • reducing and controlling environmental hazards and risks • preventing accidents and injuries • maintaining safe conditions for patients, staff and visitors • maintaining an environment sensitive to patient needs • minimizing environmental stresses for patients, staff and visitors 6

existing perceptions.

It is important to acknowledge the difference between the American health care system and the Australian system. Money can be a driving factor towards the negative perceptions related to hospitals. A user’s mood will diminish they are aware of their inability to pay for their service. The Australian government has established a system that relieves the user from the stresses associated with money. In essence, health care is provided free of charge to citizens.

It is estimated that about 70% of Australia’s health expenditure is funded by the government.

The commonwealth shoulders 67% of this cost covering three national subsidy schemes, Medicare, the Pharmaceutical Benefits Scheme, and 30% Private Health Insurance Rebate while the remaining 23% is covered by the States and Territories. 3 Medicare in Australia provides free treatment in public hospitals. Medicare also provides free or subsidized payments to health professionals for specific services.

The amount of these contributions depends upon one’s ability to pay.

7

part 3 1

issues introduction & theories

Through the Pharmaceutical Benefits Scheme, the government provides high subsidies on a number of prescription medicines making it more affordable for all Australians. This scheme is available to all Australian residents.

3. Castro, J.M. (2009, August 8). Health care in australia. Retrieved from http://www.expatforum.com/articles/health/health-care-in-australia.html

design issues.

The architectural difference between hospitals and prison institutions is so minuet that they often become blurred as one. Both pose similar problems of hotels, yet hotels seek to avoid any associations with them.

Each building holds a transient population that must be cared for twenty-four hours a day, seven days a week; as well as accommodating a permanent population that does the care-taking, often for many years in daily eight-hour shifts on a routine schedule. All three buildings must provide for all the physical needs of their guests, inmates, and patients, as they complete daily routines of eating, sleeping, washing, and entertaining.

The key difference between these spaces is that hotels are picked, prisons are forced, and hospitals are somewhere in between. The design of hospitals has continued to follow the institute/ prison aesthetic far past its due date. Health care technology has improved tremendously since the initial hospital template. The template for design has yet to improve to connect with the advanced approach of medical care. Because of this, the preconceived emotion towards a hospital is similar to that of entering into a prison--negative.

The physical architecture alone can not alter this sense of negativity. However it is possible to begin to relate to the psychological impacts of architecture to stimulate positive brain activity.

Architectural Psychology: An approach that allows the user to really connect with their environment.

Through spatial perception, spatial connections, spatial thinking and spatial experience a variety of relationships can be made with a building. 6 Environmental Psychology: Examines the interrelationship between environments and human behavior. Environment can relate to all things natural as well as social settings and built environments. When it comes to solving problems involving human-environment interactions, a model of human nature that predicts the environmental conditions under which humans will behave in a decent and creative manner should be used. With the use of this model one can design, manage, protect and restore environments that enhance reasonable behavior, predict what the likely outcome will be when these conditions are not met, and diagnose problem situations. 6 Attention: Understanding human behavior starts with understanding how people notice the environment. This includes at least two kinds of stimuli: those that involuntarily, even distracting, command human notice, as well as those places, things or ideas to which humans must voluntarily,

part 3 1

issues introduction & theories

Previous findings have stressed the importance of 8 ventilation, natural day lighting, noise reduction,

and privacy. 4,5 The trans-disciplinary connection of psychology is necessary for further study of the emotional impacts of the built environment.

The following list of definitions begins to set a framework for the modifications necessary.

4. Anthes, Emily. “Building Around the Mind.” Scientific American, INC. (2009): 52-59. Print.

5. Verderber, Stephen. “Architecture for health--2050: an international perspective.” The Journal of Architecture. (Autumn 2003).

6. Stokols, D. and I. Altman [Eds.] (1987). Handbook of Environmental Psychology. New York: Wiley.

and with some effort (and resulting fatigue), direct their awareness. Restoring and enhancing people’s capacity to voluntarily direct their attention is a major factor in maintaining human effectiveness. 6 Perception and Cognitive Maps: Information is stored in the brain as spatial networks called cognitive maps. These structures link one’s recall of experiences with perception of present events, ideas and emotions. It is through these neural networks that humans know and think about the environment, plan, and carry out their plans. Interestingly, what humans know about an environment is both more than external reality in that they perceive with prior knowledge and expectations, and less than external reality in that they record only a portion of the entire visual frame yet recall it as complete and continuous. 6

Environmental Stress and Coping: Along with the common environmental stressors, some define stress as the failure of preference, prolonged uncertainty, lack of predictability and stimulus overload. Research has identified numerous behavioral and cognitive outcomes including physical illness, diminished altruism, helplessness and attentional fatigue. Coping with stress involves a number of options. Humans can change their physical or social settings to create more supportive environments where they can manage the flow of information or stress inducing stimuli. 6 Participation: Enhancing citizen involvement in environmental design, management and restoration efforts. It is concerned not only with promoting citizen comprehension of environmental issues but with insuring their early and genuine participation in the design, modification and management of environments.6 Conservation Behavior: Bringing psychological knowledge to bear upon the issue of developing an ecologically sustainable society. It explores environmental attitudes, perceptions and values as well as devise intervention techniques for promoting environmentally appropriate behavior.6 9

6. Stokols, D. and I. Altman [Eds.] (1987). Handbook of Environmental Psychology. New York: Wiley.

part 3 1

issues introduction & theories

Preferred Environments: People tend to seek out places where they feel competent and confident, places where they can make sense of the environment while also being engaged with it.

Research has expanded the notion of preference to include coherence (a sense that things in the environment hang together) and legibility (the inference that one can explore an environment without becoming lost) as contributors to environmental comprehension. Being involved and wanting to explore an environment requires that it have complexity (containing enough variety to make it worth learning about) and mystery (the prospect of gaining more information

about an environment). Preserving, restoring and creating a preferred environment is thought to increase sense of well being and behavioral effectiveness in humans. 6

incorporating the senses.

Juhani Pallasmaa has a strong interest in the significance of the senses in response to architecture.

He theorizes that architecture engages our senses more than any other art form. A building has potential to respond to all of our senses. The passage of time, light, shadow, transparency, color phenomena, texture, material, detail and human scale all contribute to the experience. Each component of a building has a range of possibilities towards the complete complex experience.

Compared to a twodimensional representation, there are no limits.

Pallasmaa states that, “only architecture can simultaneously awaken all the senses.” 11

part 3 1

issues introduction & theories

12

Vision is a dominant sense that can be discussed at a level of peripheral unfocused vision versus focused vision. The very essence of the lived experience is molded by hapticity and peripheral unfocused vision.

“Focused vision confronts us with the world whereas peripheral vision envelops us in the flesh of the world.”1 Photographed centralized architectural images are not perceived as reality due to the lack of any peripheral vision. A forest context and richly molded architectural space, provide ample stimuli for peripheral vision. The preconscious perceptual realm, which is experienced outside the sphere of focused vision, seems to be just as important existentially as the focused image.

“There is medical evidence that peripheral vision has a higher priority in our perceptual and mental system.”1 These observations Pallasmaa writes about suggest reasons why the architectural and urban settings tend to make us feel like outsiders in comparison with the emotional engagement of natural settings, is their lack of peripheral vision.

Peripheral vision integrates us with space, while focused vision pushes us out of the space, making us mere spectators.

Touch is the sensory mode that integrates our experience of the world with that of ourselves.

Pallasmaa describes the idea that the body serves as the “very locus of reference, memory, imagination, and integration.”1 Architecture articulates the experiences of being-in-the-world and strengthens our sense of reality and self, as opposed to worlds of mere fabrication and fantasy.

Architecture relates, mediates, and projects meanings.

“Instead of experiencing our being in the world, we behold it from outside as spectators of images projected on the surface of the retina.” Pallasmaa

1. Pallasmaa, Juhani. The Eyes of the Skin: Architecture and the Senses. John Wiley & Sons, 1996.

11. Juhani Pallasmaa, from “An Architecture of the seven Senses,” in a+u (July 1994), pp.29, 41.

architecture placebo.

A placebo is a fake cure that works because it operates on the beliefs of the patients. It first took notice in the 1950’s when Henry Beecher provided phony morphine injections made with salt water. Most cases typically involved pain, inflammation and what are called psychogenic problems.

Literature on the subject today quotes figures as high as 33% of the percentage of patients who show improvements through a placebo effect. 2 With such a high outcome rate, it shows potential that a similar placebo can affect architecture.

Scientific literature released several books on the subject that illuminate the Style Effect. This placebo effect suggests that brand name placebos relieve pain better than generic placebos.

This stands true to a wide variety of branding stretching as far as the brand of a building. The building brand refers to the architect of the building. The more well known the architect, the more functional the building.

The healing powers of Maggie Centers (cancer treatment facilities) contributes it’s success to this placebo.

The third type is the Doctor’s Effect. “A much better predictor is the characteristics and qualities of individual doctors. The more convinced a doctor is that a drug or placebo will work, the more likely that it really will.” 12 The first line of therapy for patients is the treatment received from the doctor. A healing environment makes for a healing doctor.

psychological impacts.

A lower stress level may strengthen the immune system. Women with breast cancer have survived longer when they take part in group psychotherapy. This extension of life could be because they help each other socially, they visit each other, cooperate more with doctors, and make better use of medical facilities.

Their psychological changes soon transform into social and physical ones. It is their mind over matter, because changes in the mind 13 lead to shifts in behavior.2

2. Wagenaar, Cor. The Architecture of Hospitals. Rotterdam: NAi Publishers, 2006. Print.

12. Carl Elliot. Scrivener’s Palsy, London Review of Books, 8 Jan. 2004. pp 21-22.

part 3 1

issues introduction and theories

Another related effect is what could be called the Cultural Effect. “Psychologically minded clinicians believe that the placebo effect has something to do with what goes on in the individual patient’s head.” 12 If a person believes that the American culture is better at heart surgeries than

the European culture the individual may base their location of care based upon the cultural influence. This placebo relates back to the issue of preconceived hospital perceptions. In the American culture, hospital care is dominated by money. By choosing Australia as my destination I can take advantage of this placebo in the sense that money doesn’t take priority over care.

4. scientific research

ceiling height.

the experiment was a research study that illuminated that aspects of the physical environment can influence creativity. In 2007 Joan Meyers-Levy reported that the height of a room’s ceiling affects how people think.

She randomly assigned 100 people to a room with either an eight or a ten-foot ceiling as asked participants to group sports from a ten item list into categories of their own choice. It was noted that the people who completed the task in the room with the higher ceilings came up with more abstract categories, such as sports they found challenging or would like to play. Those in the shorter ceilings offered more concrete groupings, such as the number of participants on a team.

Meyers-Levy stated that, “ceiling height affects the way you process information, you’re focusing on the specific details in the lower-ceiling condition.” 4

The study goes on to imply that the actual ceiling height may not be as important as how high it actually feels. It’s possible to achieve these effects just by manipulating the perception of space, for instance using light-colored paint or mirrors can make a room look larger.

the incorporation

The results found from these studies can be introduced into the architecture of hospital through program design.

For example a low ceiling would be appropriate for use in an operating room to allow the surgeon to focus on the details. In opposition, lofted ceilings would better accommodate a public activity space where creativity and inspiration should be in abundance. 9

the results

part 4 1

scientific introduction research

Prior to this research, MeyersLevy had introduced the idea that elevated ceilings make people feel physically less constrained, the investigator posits that higher ceilings encourage people to think more freely, which may lead them to make more abstract connections. The sense of confinement prompted by low ceilings may inspire a more detailed, statistical outlook. These type of conditions can attribute to providing an appropriate environment 16 dependent upon the task being completed.

4. Anthes, Emily. “Building Around the Mind.” Scientific American, INC. (2009): 52-59. Print.

9. Taylor, E.M. (2009). 2009 survey of design research in healthcare settings; the use and impact of evidence-based design. Retrieved from http:// www.healthdesign.org/chd/research

window views. the experiment

done by Dr. Ulrich initiated the study of evidence based design in 1984. He evaluated surgical patients who were randomly assigned to rooms on the same corridor that were identical except for the window view: half the patients overlooked trees and the other half viewed a brick wall. Patients with views of nature went home three-quarters of a day sooner, had $500 lower cost per case, used fewer heavy medications, had fewer minor complications, and exhibited better emotional well-being. 13 In present day numerous theories are being proven through evidence based design. One project completed through evidence based design strategies focused on two key features of hospital buildings that have traditionally been considered components of healing environments: nature and daylight.

the

results

The outcomes provided sufficient evidence that presence of nature in or around buildings can positively influence health.

More specifically, it has been demonstrated that viewing nature on a screen or through a window can reduce stress and pain, while presence of indoor plants can lift people’s mood and reduce self-reported symptoms of physical discomfort.

The study also provided solid evidence that ventilation of fresh air can improve self-reported and medically diagnosed health. 2

part 4 1

scientific research introduction

17

2. Wagenaar, Cor. The Architecture of Hospitals. Rotterdam: NAi Publishers, 2006. Print.

13. Skolnick, Curtis. “Evidence Based Design Primer.” Providing Comprehensive Facility Solutions. KLMK Group, LLC, n.d. Web. 28 Oct 2010.

stress reducing. the experiment

consisted of David Fell investigating the stress reducing effects of wood and plants in the built environment. The study took a psychophysiological approach to stress and attempted to assess the sympathetic and parasympathetic branches of the autonomic nervous system.

was also no evidence of wood-plant interactions.

The study highlighted that wood provides stressreducing effects similar to the well-studied effect of exposure to nature in the field of environmental psychology. 8

The test was conducted through a series of four office environments in which wood and plants varied in presence. The first room was wood and plant, the second was wood and no plants, the third was no wood and plants, and the fourth was no wood and no plants. The experiment involved 190 university undergraduate students who were assigned to one of the four test conditions. Within each room, the candidate was to remain at ease for a ten minute base-line period, attempt a stressful task for 14-18 minutes, and then allow a ten minute recovery period. During this simulation skin conductance and heart inter-beat interval were continuously monitored.

the results

part 4 1

scientific introduction research

Wood effects were found with respect to skin conductance level (SCL) and frequency of non-specific skin conductance responses (F-NS-SCR), both indicators of sympathetic system activation.

When wood was apparent, the subject had lower SCL in the baseline period and fewer F-NS-SCR’s in all periods of the study. The plants did not have an effect 18 with respect to sympathetic activation. There

8. Fell, David. “Stress reducing properties of wood visual surfaces in the built indoor environment.” FPInnovations.

colorful impact. the associations

that we have to a certain color are reflected directly to our emotions. Atmospheres can be created through the use of colors. Bright colors provide the user with a sense of gaiety and excitement, quiet colors signify dignity and repose. 17 An intense red can formulate into a feeling of aggrivation whereas pink serves as a contirbution to reducing anxiety. Eighty-nine previous studies of color and affect were analyzed and generally supported that white, blue and green produced good moods. 16 A dark color emits a feeling of weight and sturdiness whereas a light color provides the viewer with a sense of floating and weightlessness.

color schemes should recognize the symbolic, the functional, and the esthetic aspects of architecture. A warm pallet is best used in public areas where the colors promote social interaction. Cool pallets, are more acceptible in semi-private and private spaces. The brightness of a users surroundings should never exceed the brightness of the visual task. 17

part 4

scientific research

19

16. Osgood, Charles. “A Cross-Cultural Study of the Affective Meanings of Color.� Journal of Cross-Cultural Psychology. 4.2 (1973): 135-156. Print.

17. Faulkner, Waldron. Architecture and Color. New York: John Wiley & Sons, Inc., 1972. Print.

6. site context

australia I queensland I gold coast I currumbin valley

gold coast.

The Gold Coast refers to the eastern coastline region of Australia. Within the region, there is a city called Gold Coast that I will address because it is the closest populated area to my proposed site of the Currumbin Valley.

Population. 482,566 making it the 7th largest city in Australia and is expected to increase to more than half a million within the next decade Climate. Subtropical with 287 days of sunshine annually with average summer temperatures of 66 to 83 degrees Fahrenheit and average winter temperatures of 48 to 69 degrees Fahrenheit Environment. Most biologically-diverse city in Australia with vegetation ranging from mountain rainforest to coastal wetlands Attractions and features.

• 34 miles of beaches with an average water o temperature of 72 F • A large broadwater and five major river systems • Major shopping centers as well as numerous boutiques, specialty shops and markets • More than 500 restaurants and cafes offering cuisine from around the world • Theme parks including Warner Bros Movie World, Sea World, Dreamworld and Wet ‘n’ Wild as well as several wild life parks such as Currumbin Wildlife Sanctuary • Rural hinterland stretching to the west and north of the City encompassing many natural wetlands • Tropical rainforest with abundant wildlife and numerous bush walks • Large sugar cane farms and a wealth of industry in the northern districts of the City • World-class sporting and recreational facilities • The Gold Coast Seaway providing safe ocean access and over 168 miles of navigable waterways

rural

gold

urbanization 18 miles

d coast

currumbin valley.

Destination

Minutes by Car

Co-Op Store

on site

Bakery & Cafe

on site

Primary & Pre-School

on site

Resident Offices

on site

Village Hall

on site

Currumbin Beach

7 min

Shopping Center

8 min

Cougals National Park

10 min

Airport

10 min

Brisbane CBD

60 min

tweed heads

25 miles

one mile

Currumbin Valley is the ‘Green Soul’ of the Southern Gold Coast, Australia. The valley is located just 15 miles west from the eastern beaches and is part of the Gondwana Rainforests of Australia. This rainforest happens to be the most extensive area of subtropical rainforest in the world. The Mt Cougal section of the Springbrook National Park, which forms part of the globally recognized Green Cauldron, is a highlight of this ecologically-rich valley. It is also the northern rim of a massive Mt Warning Caldera, which stretches from Byron Bay in the South to the Great Dividing Range in the west.

The untouched natural environment provides a shelter for rare and endangered plants, animals and birds. It provides the perfect setting for a healing environment that can capture the essence of its captivating landscape.

The Valley is home to The Ecovillage at Currumbin, which is where I have pinpointed my building to develop. The Ecovillage has won 29 International, National, State and Local awards ranging from UDIA National - Award For Environmental Excellence to United Nations Assoc World Environment Day Awards for its leadership and excellence in Sustainable Living Developments.

This type of standard sets the stage for an ecofriendly design. Hospitals have become one of the highest pollutants with its hazardous waste.

Using an ecovillage as my site forces a higher level of sustainability.

The population of the entire suburb of Currumbin Valley is approximately 2,700. The ecovillage alone consists of 300-400 residents over 272 acres. Thus combined produces the perfect size for a small, 14-bed community hospital. The residents already enjoy the 3.5 million resort style community facilities that includes a range from pools, to cafes, to community centers.

Eighty percent of the property is allocated for open space allowing a display of individual gardens. A well considered Body Corporate and a Caretaker Manager (and landscape team) take care of the maintenance of all common property (75% of the estate) and each lot is owned freehold.

Long-Term Averages

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Mean Max (0F)

82.04

82.22

80.6

77.72

73.04

69.8

68.18

69.44

72.32

75.02

78.26

79.34

Mean Min (0F)

68.54

68

66.2

61.88

55.22

50.9

47.66

49.46

54.14

59.54

62.78

66.02

Mean Rain (in)

7.2

7.1

8.3

4.5

4.8

4.7

3.7

4.0

1.9

4.2

5.3

6.5

Annual 75.74 59.18 62.9

Mean Rain Days

13.6

15.1

16.3

13.8

10.1

9.1

7.3

8.9

8.5

10.6

10.5

13.3

137.1

queensland average rainfall (mm)

queensland mean maximum temperature (oC)

climate.

the area poses exceptional potential for a highly sustainable building through passive design strategies. the ecovillage abides by a fairly detailed set of codes stipulating environmentally sustainable design. these same codes will be applied to my design. the average comfortable temperatures allow for a strong sense of indoor/outdoor spaces. rainfall is plentiful in the area and an important tool to take advantage of throughout the healing process conceptually. one of the most important aspects of this site is the year round sunshine. sunlight is the key factor to diminishing the SAD building syndrome. it will create great opportunities to promote a healing environment.

sustainability. figure ground of the currumbin ecovillage site

the ecovillage currently prides itself on being completely self-sufficient within it’s parameters. it employs the following characteristics to maintain this high standard of sustainability.

materials. light-weight construction recycled materials rammed earth no imported materials elimination of high embodied energy materials

passive solar designs. employed on all housing units to the extent of no mechanical services

photovoltaic electricity. residential house with passive design strategies implemented

1KW system integrated into all dwellings

passive ventilation. provided through valley breezes

water. potable water from rainwater captured on site that is treated and re-used

community. integration into the broader Currumbin valley is achieved through public transportation routes and by not being a “gated community�. southern sunlight is optimal for passive design strategies

residential houses demonstrating the incorporation of water cisterns, recycled materials, and solar photovoltaic panels

part 6

site context

28

residential house with passive design strategies implemented

the material of choice is recycled. the majority of buildings exhibit light weight construction, earth coupled raised floors, and thermal massing. the ecovillage aims to eliminate high embodied materials and prohibits imported materials. the village hall is made up of 80% recycled materials and takes advantage of rammed earth walls throughout.

site context

existing vernacular.

29

part 6

village hall community pool highlighting natural wood material

part 6

site context 30

site context

the village was brought back to life with a 25 acre native Hoop Pine forest combined with Fig Trees and scattered hardwood. various plant life of smoothshelled macademia, black walnut, fine-leaved tuckeroo, and staghorns are in abundance. the Rainbow Bee Eater and Little Pied Cormorant are just a few of the numerous birds that call the valley home. these aspects of the site are important to incorporate into the healing process. elevating the sounds of nature into the building can have positive impacts on the users of the hospital.

part 6

existing vegetation.

31

328 feet

part 6 site context

b a

32

10 0m

10

0m

view a: looking northeast out of the valley

33

part 6

site context

view b: looking east with the village hall in the foreground

staff

treatment public

e.

treatment

rooms

a.

a.

e.

e.

c.

b.

f.

d.

f.

e.

e.

e. e. e.

the initial program. spacing was

distinguished by three parts: public, treatment, and wards. this diagram illustrates the areas of each type of program in relation to the immediate context.

the public.

placed at the terminus of community space transferring into residential lots. it hugs the street boundary to create an ease of way finding for visitors and patients as well as acting as the reaching arm to bring in the community.

the treatment.

this area needs to portray a sense of safety for the patients. for this reason it is placed furthest away from any commotion and surrounded by existing trees. the natural boundaries of the site act as a shield around this area.

e.

the rooms.

e. e.

determining the needs of the patients determines the location of the wards which are better referred to as patient healing rooms. the space has been split up into two separate areas. the first of which is located in an area where there are a variety of stimulants. patients that require a higher level of activity and awareness for recovery would utilize this space that connects to the community gardens and vehicular street. the second location is to cater to the opposite needs. it is settled into an area where a relaxing environment is preferred. the location allows for maximum sunlight exposure and unobstructed views of nature.

connections.

the hospital must create strong connections with its surroundings and contribute to the ecovillage community. the width of the lines protruding from the site demonstrate the importance of that connection to the existing buildings. a. welcome center b. recycle center c. community garden d. village hall e. resident housing f. comercial housing

bicycle traffic vehicular traffic spontaneous social design. cars regulated to outside housing areas with priority given to greenways, pedestrians, and bicycles

7. schematic design

spatial diagram.

The initial bubble diagram of programming spaces focused on the overlapping and proximity conditions. How one area connects, intrudes, or separates itself from the next reflects upon its potential use. Where spaces intersect is a space that assists the user into a comfortable transition.

The diagram shows a constant interweaving of spaces where at points spaces embrace one another. This is done to produce an effect of embracement and safety within the treatment rooms. An overriding feeling that ‘everything will be okay.’ The wards, or patient healing rooms, offer a vast open space to mimic the concept of ‘room to heal’. Central to these areas is the head of operations: the physicians. By being centrally located they are able to attend to needs in a timely manner wherever they appear.

part 7

schematic design

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In order to function properly the treatment rooms must be within close distance to the medical equipment and the patient healing rooms be within visibility of the nurse’s stations. The level of sterility is another important factor in space layout of a hospital. The degree of restriction within the premise must be integrated into the circulation paths of the users. For instance a visitor must have an unobstructed pathway from the visitor check-in to the host patient without intruding areas of restriction. Employees also need an easy means of egress to react quickly to patient care.

A separation of foot paths is crucial for ease of circulation throughout a hospital.

modified into abstracted spatial diagram

movement+life.

The healing powers of water is something that began to influence my design. Water is life-filled.

It is alive and ever-changing but never seen as random. It swings from side to side, accelerates and decelerates, rushes down and eddies upstream, it slides and pulses, swirls, expands and contract all at the same time in one breathing rhythm.

The effect that ripples have can be implemented into a circulation path that no longer acts as a route to a destination but rather transforms the space as an experience. The mass model below illustrates the ripple at a 3D scale.

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cloisters+corridors.

The majority of circulation throughout a hospital consists of corridors. It is these spaces that people most often associate with an institution. In order to ensure a healing environment these corridors must be disguised.

Additional space modifications and activities within the long hallways can alter the feelings associated with the connecting routes and ultimately how one feels upon entering their destination.

Cloisters attached to corridors can vary in program.

A relaxing agent would be the incorporation of an exterior courtyard (top figure). To stimulate brain activity something more abstract than perpendicular walls can redefine the space (bottom figure). These cloisters vary just as water does at points of impact.

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situation+experience.

When we go through a door we have to realign to a different inner state. Each room is potentially providing a different experience that should be accounted for. Every situation is unique and requires a different mood to be competed. It is important to provide the mood that is appropriate for the situation or activity.

This concept can be investigated down to the smallest detail of the door handle. It is the first thing the user will encounter upon entering a new space. To highlight this, every door handle would have a subtle difference. The rooms that relate to the same situations, i.e. therapy rooms, would maintain a consistent handle but would differ from that which would be used to enter into a patients healing quarters.

changing+ordered.

Through studying the properties of falling water it becomes a mesmerizing experience watching the water change direction, speed, and route as it encounters obstacles. This act of randomness is still seen as a pattern. The points of change begin to define an insert of space within a straight corridor. The points of impact are always apparent in moving water but don’t create a break in the flow. This sense of continuous movement should be applied to the overall spaces of the hospital.

obtuse+embracing.

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The power of right angles is one of the strongest points a designer can imply in architecture. It is taking the power of two straight edges and ultimately doubling the power. Obtuse angles can modify this power into a feeling of embracement. To further soften the edge, a material can be utilized. Straight lines are important in areas where it is necessary to think clearly such as surgery rooms and therapy rooms. How you enter into spaces with straight lines can alter the affect the space has on the user as illustrated bellow. Free curves can imply a more dream like state without practicalities and be mood-enlivening. By sewing these two extremes together the building will converse as a single whole.

ft2

ft2 staff support

300 200 500 300 100 200

open staff area 300 200 500 300 patient rooms 100 200

500 300 300 300 150 240 200

500 treatment rooms 300 300 surgery 300 150 240 200

200 300 300 50

200 300 300 50

2000 2000circulation 1400 1400

1400 1400

300 300 50 50 400 400 11520 otal 11520 13248 13248

Area 24768 24768

CLINCAL CLINCAL SUPPORTSUPPORT

STAFF WORK STAFF AREA WORK AREA

STAFF SUPPORT STAFF SUPPORT

SURGERYSURGERY

PATIENT HEALING PATIENT HEALING

PUBLIC/FAMILY PUBLIC/FAMILY

This 10-bed community hospital would accommodate the need for physical care, cardiac care, occupational therapies, lab work, small-scale surgery, in-patient rooms, and outpatient recovery rooms. The number of rooms has been determined based upon the population within proximity to the site. 7 Its dominant users will be the residents of the immediate Currumbin Valley but is located centrally to the valley to provide care for the rural outskirts. Further emergent care would consist of a transfer to the nearest full scale facility.

For the goal of this project, it is important to investigate the details of the overall impact. In TREATMENT TREATMENT order to highlight the psychological impacts of the hospital the majority of space is contributed to the therapy rooms and treatment rooms

7. Von Karolyi, Allen. Hospital Planning Handbook. John Wiley & Sons, Inc. 1976. Print

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240 150 family support 300 240 300 clinical support 400

part 7

240 150 300 240 300 400

patient

staff

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parti diagrams.

The initial design phase began with an interpretation of the circulation paths necessary for specific users.

The overall impact of the circulation route was intended to be a mesmerizing, therapeutic experience mimicking the effect of a ripple of water. The parti related towards patients began to resemble this by starting at a central point and wrapping itself around that. This gave a sense of flow and fluidity to the experience of getting to a destination. For the staff an alternate experience was necessary.

Functionalism was taken into account for their circulation. The parti related to staff focused on the need to get from one spot to the next in a timely manner. The final party combined the attributes of both while being responsive to the existing site attributes. The left begins to reach out to the landscape while the right radiates the central point.

8. final design

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a. main entrance b. lobby c. reception d. dining e. kitchen f. patient room g. nurse’s station h. staff conference room i. consultation room j. visiting lounge k. library l. bath m. nursery n. obstetrics o. respiratory p. gym q. physical therapy r. cardiology s. orthopedics t. radiology u. interior courtyard v. emergency room w. surgery x. scrub-in room y. obstetrics surgery z. lab 1. public parking 2. staff parking 3. hydrowall

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a. linens service b. equipment storage c. female locker room d. male locker room e. staff office f. on-call room g. bath h. staff lounge i. roof top garden 1. open to below

final design

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main entrance.

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visiting pod

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patient experience.

As a patient the circulation route throughout the building is designed as a form of treatment in itself. The entrance is framed by the main dining area to focus views on the pleasure of eating and social interactions involved with the task. From the lobby area there are two options for access into the building. One responds to those in need of treatment and the other for interaction with existing patients. As a new patient the journey begins with a modified hallway that re-introduces the natural environment. The walls curve in response to the human figure and establishing a sense of safety and embracement for the treatment following.

semi-private

private public

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After the appropriate treatment is finished the circulation path continues in a similar fashion into the patient healing rooms. The design of these rooms is specified for maximum comfort to the patient. The overall cluster is to ensure direct views into each room from the nurses station as well as a shorter distance from one room to the next. The door into the room is varied to give a sense of personalization and individuality to each room. Upon entering the room the first section of space is defined by the curve of the wall. It is shaped as a more open space to provide room for the staff to treat the patient.

As you move deeper into the room the geometry changes to define the bed as a private space.

The ceiling over this space corresponds to the limitation of the patient. The glass ceiling allows for the patient to be laying in bed indoors but able to see directly to the exterior sky. The sloping of the ceiling serves two purposes. It allows the rainwater to act as a visual stimulant while being

captured into a cistern. It also provides a forced perspective towards the natural environment.

The ceiling drops in height over the bed to inform a more intimate area. This change in elevation allows for the use of clerestory windows. The light transferred through these provide natural art with intriguing shadows projected onto the wall being viewed from a sitting position in bed.

The bathroom walls are lowered to let the light protrude into the space.

Once enclosed in the private space of the room, the patient has the option of opening or closing the curtain to a semi-private lounge. This area is designed for personal visitors as well as an area to place personal belongings. This nook then leads to the private decks. These decks are enclosed within the form of the building to act as a barrier from complete exposure to the natural elements.

As the healing process continues, the patient can get further exposure by making use of the visiting courtyard area.

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part 8

view of the patient room showing the distinction of spaces and expansive view of nature

patient pod

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visiting patio library visiting lounge

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lobby patient pod dining

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visitor experience.

As a visitor circulating the building the most important attribute is social interaction. To respond to this, the design allows for multiple levels of intimacy. After entering into the lobby the space immediately preceding is the dining area. This open connection is made to encourage the dynamic atmosphere associated with eating into the lobby waiting area.

Thus altering the mood of the user upon entering into the building. The dining area itself, is the most public level of intimacy for visiting. The involvement of cooking and eating is a stimulating task that provokes pleasure. The rooms expansive view to the outdoors intensifies this experience.

Continuing onto the patient rooms, visitors have the option to take advantage of the semi-private area within the patient room. This space is the most intimate for a visitor and patient to interact. The curtain acts as a door into the space to maintain

a level of transparency. The furniture is developed to accommodate the needs of a visitor staying for various levels of time.

The seating is functional for lounging or as a daybed. The dresser is suitable to store personal belongings.

For a more public visit, the option of continuing on to the visitor pod is available.

Within this area one can enjoy the openness of the main room or continue on to the library.

The library is available to educate both the patients and the visitors with information related to health and diseases. By having this type of knowledge accessible it helps put the users more at ease with the treatment needed. This pod also offers access to the outdoors. The visiting deck area is designed to allow for a more therapeutic visit where an interaction with nature is made.

southwest perspective of treatment pod, visitor pod, and patient pod

final design

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staff entrance.

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staff experience.

If you are a staff member, your entrance is separate and hidden from the public. Upon entering the building you face an interior courtyard to maintain a seamless transition from outside to inside, bringing nature into the building with you. From here you can choose vertical circulation to the staff facilities (1); a direct route to the nurse’s station (2); or immediate entrance to the treatment rooms (3). Each circulation path varies to correspond to the final destination. The circulation is an experience in itself.

When you go up to the private staff corridor, the hallway is modified to maximize social interaction.

The space expands and contracts in areas to create niches and nooks. The path then becomes a continuation of the staff lounge. The actual lounge faces south to take advantage of the southern light. The offices are equipped

with views of the interior courtyard for further inspiration with difficult cases.

When circulating from the staff entrance to the nurse’s station a different mood is achieved. The experience is meant to relax but stimulate the mind to prepare for working with the patients.

The glass wall of the restricted corridor frames the interior courtyard full of natural elements. The wall itself begins as a dynamic waterfall. It is a hydro wall that serves multiple uses throughout the building. It acts as a water cistern to collect the rainwater runoff. This water can then be used as grey water throughout the building as well as for irrigation purposes. The interior side of the wall is a glass facade so the water flow is visible providing a mesmerizing stimulant. The opposite side of the wall is open to the elements and is thus formed out of fiberglass to allow for water overflow to run down into the courtyard without damage to the structure itself. As you continue down the hallway the hydro wall transforms into transparent

Access to the treatment rooms is designed with a focus towards functionality. Proximity of spaces determines where each type of therapy will occur.

The ER rooms are located next to the surgery rooms; the physical therapy connects to the small gym. The obstetrics area takes into account the elevated noise levels produced from labor by being tucked furthest from the relaxing therapies The treatments that evoke higher stress levels are relieved through views to the surrounding nature or water features of the interior courtyard.

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glass allowing a full view of the green space. This encounter with the natural environment releases anxiety and stress before interaction with the patient. The geometrical shape of the hallway is designed to allow maximum interaction with the outdoors. The curve in plan distorts the line of sight to refocus on your surrounding elements.

Each alteration to the space eliminates the typical institutional feel of a long corridor.

undulating surface accommodates planters and cisterns

part 8

spigots on exterior allow for drainages

fiberglass modular panel systems collects rainwater from roof

UP

UP

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3D section cut through courtyard demonstrating hydro wall and hallways connection with nature

UP UP

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interstitial space.

The glass corridors serve as a way-finding element.

They run continuously throughout the building becoming interstitial space from outside to inside between adjacent pods. This juxtaposition of spaces allows for a sense of place within your surroundings. It makes the user aware

that the space to follow is serving a different purpose. When the corridor is connected with the room of a building it begins to bleed itself into the framework. Along the treatment corridor, the glass walls extend to form the ceilings of the treatment rooms. This allows for maximum light to extend past the corridor into the therapy rooms.

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the curve.

A mock-up version of the curved wall was made as a study investigating the emotional triggers of a modified space. This wall was designed to provide a sense of safety by eliminating power points. A straight line is a very powerful statement in architecture. By bringing two of these together to from a right angel, the effect is doubled creating a super power. The curve modifies these right angles into a more welcoming angle: obtuse.

The obtuse angle gives a sense of embracement.

In contradiction to this is the acute angle which releases a sense of hazard. Our mind associates sharp points with danger. The intent of this space was to reduce stress associated with the typical hospital hallways as shown above.

9. bibliography

Anthes, Emily. “Building Around the Mind.” Scientific American, INC. (2009): 52-59. Print.

A journal article that uses brain research as a way to craft spaces that relax, inspire, awaken,

comfort and heal. Includes examples such as Louis Kahn’s Salk Institute to demonstrate the

effects architecture can have on the user.

Asmussen, Erik. “Living Architecture: the Rudolph Steiner Seminar in Sweden.” Kindred Spirit. (May 2005).

This article refers to the research studies of Steiner in corrolation to the anthroposophy ap

proach to healing. It highlights key architectural attributes to the theory of healing through spirit.

Castro, J.M. (2009, August 8). Health care in australia. Retrieved from http://www.expatforum.com/ articles/health/health-care-in-australia.html A site that breaks down the Australian Health care System to a degree that is understandable

without previous knowledge in the subject.

Coates, Gary. Erik Amussen, Architect. Byggforlaget, 1997.

A comprehensive monograph covering the work and ideas of Erick Asmussen. This book provides a systematic record that shows Asmussen’s considerable achievements in a sympathetic but objective maner. It is a study that explores in detail the main principles that underlie Asmussen’s architecture.

David Peters, Ed. Understanding the Placebo Effect in Complementary Medicine. Churchill Livingstone.

2001.

A study showing how placebo effects can be applied to architecture. It provides proven facts and statistics about how a placebo actually works.

Faulkner, Waldron. Architecture and Color. New York: John Wiley & Sons, Inc., 1972. Print.

This book brings together the impact of the scientific world of color into the aesthetic built environment. It studies what colors effect our emotions and in which way, and how these colors can enhance a space and create more meaning to the user.

Fell, David. “Stress reducing properties of wood visual surfaces in the built indoor environment.”

FPInnovations.

This paper was a research study done to investigate the stress reducing properties of wood as a visual effect. It provides evidence that wood provides stress-reducing effects similar to the well-studied effect of exposure to nature in the field of environmental psychology. The practical implication of this effect is to provide stress reduction as a part of the evidencebased and biophilic designs of hospitals.

Jencks, Charles. “Nature talking with Nature.” Architectural Review. Jan 2004: 66.

Jencks provides an insight towards how to design with the natural world. He focuses on what natural design should embody. Also specifies how to incorporate the built environment in ways that intertwine seamlessly with the natural environment.

Jencks, Charles. The Garden of Cosmic Speculation. China: Kwong Fat Offset Printing Co. Ltd, 2003.

Print.

A scientific approach to designing landscapes based on the cosmo universe. The ideas and thoughts behind the meaning of specific garden layouts.

Juhani Pallasmaa. “An Architecture of the seven Senses.” A+U. (July 1994), pp.29, 41.

The writing of Pallasmaa focuses on the strong visual heirarchy architecture has devoloped.

He argues that architecture should relate to all seven senses, imagining that the skin has eyes as well. The theories and concepts that he describes are important to integrate into my design to produce a complete realm of healing.

Osgood, Charles. “A Cross-Cultural Study of the Affective Meanings of Color.” Journal of CrossCultural Psychology. 4.2 (1973): 135-156. Print.

A study evaluating the associations of specific colors in relation to human emotions. The comprehensive findings of 89 previous studies relating to the same topic.

Pallasmaa, Juhani. The Eyes of the Skin: Architecture and the Senses. John Wiley & Sons, 1996.

Pallasmaa discusses his theories that apply to the use of senses within architectural design. He heightens the importance of allowing the body to experience a building. The ways in which he recommends this be achieved is through sensory recognition.

Skolnick, Curtis. “Evidence Based Design Primer.” Providing Comprehensive Facility Solutions. KLMK Group, LLC, n.d. Web. 28 Oct 2010.

This group goes of of Ulrich’s initial studies of Evidence Based Design and impliments the theory into multiple case scenerios. It is very useful to include the proven methods of ways to improve healing into my design.

Stokols, D. and I. Altman [Eds.] (1987). Handbook of Environmental Psychology. New York: Wiley.

These collective writings provide a further insight in the definitions of psychological architecture. It’s important to creating a psychological space that relates to the emotions of the user.

Taylor, E.M. (2009). 2009 survey of design research in healthcare settings; the use and impact of evidence-based design. Retrieved from http://www.healthdesign.org/chd/research This website offers a range of experiments and standards in the realm of designing for healthier environments.

Ulrich, Roger, Ph.D. “Effects of Healthcare Environmental Design on Medical Outcomes.” International Academy for Design and Health Dr. Ulrich was a major contributor to the evidence based design movement. This type of testing has become a very influential player in the redesign of health institutions. It proves the theories necessary for an improved healing environment.

Verderber, Stephen. “Architecture for health--2050: an international perspective.� The Journal of Architecture. (Autumn 2003).

This article begins to address issues related to healthcare from a futuristic approach. It establishes the importance of home and community-based care, the functions of nature as a therapeutic modality, patient empowerment, and the need for new paradigms in the treatment setting.

Von Karolyi, Allen. Hospital Planning Handbook. John Wiley & Sons, Inc. 1976. Print This book was used in determining the spatial program needed in relation to the size of the hospital. It provides information regarding room size requirements and specific program requierments for hospital functionality.

Wagenaar, Cor. The Architecture of Hospitals. Rotterdam: NAi Publishers, 2006. Print.

This book provides information ranging from the sociological views of hospitals, the possibility of a healing environment, precedents that impact a change in the traditional, and a conceptual variety of ways to improve the architecture of hospitals.