IHDA

Better Healthcare with Nordic Hospital Design

Päivi Sillanaukee

Päivi Sillanaukee, Ambassador for Health and Wellbeing, MFA Finland

Dear Friends, In Finland, we are aiming towards fully integrated social and health care customer pathways, and hospital design in its different dimensions is a key factor in this development. Transformation towards people-centred digital services enable comprehensive wellbeing in each person’s own situation, as well as support professionals in their daily work.

The Covid-19 pandemic has further accelerated digitalisation in our health system.

Health security has become an ever more critical factor in hospital design and in other areas as well, such as high-tech solutions for indoor air quality and avoidance of spread of microbes and diseases in indoor spaces. Cooperation in the field of design and innovation supports pandemic recovery and future resilience of our health systems.

Integrated Hospital Design Alliance is doing important work with sharing the best practises from Finland to other European countries.

Päivi Sillanaukee

Healthy and high performing hospitals - we bring Nordic design to your project IHDA business consortium consists of forerunners from different areas of healthcare. Together they form a comprehensive offering of the design and construction management of smart, customer-oriented and functional hospitals.

Healthcare analysis

Service design

Modern project management

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Architecture and master design

MEP design

Structural design

Digital solutions

Why IHDA?

• Wide experience from dozens of hospitals in Nordics, Baltics and other European countries • Time savings during design and construction • Cost savings in construction and during lifecycle • Latest hospital design information • Value from feasibility study to maintenance

IHDA supports in all project phases Hospital concept, functional planning and digitalization

Architectural, construction and technical design

Tender preparation and hospital project best practices

Hospital project management and portfolio coordination

• Master plans

• Architectural design

• Preparation of tendering documents

• Project planning and management

• Tendering best practices

• Construction alliance management

• Requirements definition and management

• Concept design and functional planning

• Digitalization and ICT-solutions • Employee and customer experience

• Technical engineering • Structural engineering • Sustainable solutions

• Evaluation of offers

• Project portfolio management

• Energy efficiency • Second opinions

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Highly experienced team from Finland •

The leading HVAC, electrical design and building automation company in Finland

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Over 200 hospital designers from personnel of 1,300 experts

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More than 60 years of experience in hospital design projects https://granlundgroup.com

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One of the largest structural engineering offices and the leading construction consulting company in Finland

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150 experts in hospital construction, design and integrated project delivery from personnel of 1,300 experts

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Key structural and geo designer in 400 hospital projects during 60 years https://ains.fi/en

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One of the most acclaimed Finnish award-winning architecture practices, more than 50 prizes and awards

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15 highly qualified and experienced architects

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Functionality and unique spatial experiences, as well as profit for clients https://k2s.fi

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The leading health and social care advisory, insights and research company in the Nordics

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More than 250 experts in Finland, Denmark, Sweden, and the UK

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Over 4000 client projects https://nordichealthcaregroup.com

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Architecture and interior design specialists for public sector buildings, such as hospitals, healthcare centers, nursing homes & wellness centers

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Over 60 highly qualified and experienced hospital architects and designers

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Over 30 state of the art hospital projects delivered globally https://aw2.fi

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Leading expert in integrated project delivery (IPD-projects) and lean construction from major hospitals to real estate and railway projects

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Over 20 lean construction and integration experts

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80 IPD-projects in Finland, 67 project alliances https://vison.fi

www.ihda.fi

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Emphasis on patients, healthcare professionals and environment drive the design of Laakso hospital in Helsinki

Located in Helsinki, Finland, the new Laakso hospital (with over 900 beds) will integrate a wide range of psychiatric care, somatic hospital care, and demanding neurological rehabilitation. The vast development project is situated right at the centre of the fast-paced capital city, encompassing both aboveground and underground construction of new facilities.

Commissioned by the City of Helsinki and the Hospital District of Helsinki and Uusimaa (HUS), the joint psychiatric and somatic hospital replaces old hospital buildings that no longer support modern care processes. In addition to the hospital wards, Laakso hospital will include clinical support services to ensure seamless and high-quality care. University research supporting the hospital functions is concentrated to Laakso hospital, which will be developed into a significant international knowledge and expertise centre.

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Smooth and reliable logistics with careful logistics planning Optimised flows of people and materials ensure that the needs of patients and staff are served with minimum disruptions and traffic. Logistics designers have produced and compiled logistics data, volumes, and plans.

With the functional, sustainable, and cost-effective solutions of functional logistics planning, they have assessed and guided the design and decision-making in the project. The results have been widely used for the design of entrances, walkways, roads, and various processes, as well as input data for the space design of buildings.

Laakso Hospital

Lifecycle sustainability combats energy costs and climate change Energy and sustainability aspects are integrated to guide the hospital design process and find the entire energy saving potential of the hospital. Cost-effectiveness of the different implemented measures is demonstrated from both the economic and environmental point of view. A carbon footprint has been calculated and a carbon footprint target has been set for the hospital project.

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Located in Helsinki, the capital of Finland

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In the project, existing buildings are being renovated and demolished and three new buildings, a parking facility, the vehicle access and a tunnel to the main hospital are being constructed

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The project was commissioned by the City of Helsinki and the Uusimaa Hospital District (HUS)

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The cost estimate is over EUR 800 million

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The scale of the project is approximately 170,000 m² gross area

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The hospital will be completed in stages in the 2020s (the first phase will be completed in about 2026).

Contact:

Jukka Vasara Vice President - Granlund Group +358 50 067 5654 jukka.vasara@granlund.fi

In the energy planning and MEP (mechanical, electrical, and plumbing) design, the designers have emphasised energyefficiency, lifecycle sustainability and actions against climate change. Sustainability has also been considered in the management of indoor conditions.

IHDA partners working together in the Laakso hospital:

The ventilation and cooling systems as well as the size of window surfaces are logically proportioned for the hospital’s entire lifecycle. Besides saving energy, this ensures that the indoor conditions remain pleasant for both the patients and the staff and that the conditions can be easily managed, currently and in the future.

AW2 Architects – Main design and architectural design together with consortium Laakson LATU (AW2 Architects Oy, Lukkaroinen Arkkitehdit Oy, Arkkitehtitoimisto Tähti-Set Oy, UKI Arkkitehdit Oy)

When it comes to energy efficiency, it is similarly important to consider the efficient lighting required around the clock in many facilities. The intelligent management of building services according to the use of the premises is what most impacts the energy efficiency of hospitals.

AINS Group – Structural engineering, rock engineering, data modelling and acoustical engineering

Granlund – Energy planning and consulting, MEP (mechanical, electrical, and plumbing) design Nordic Healthcare Group – Operational people and material logistics planning, evaluation of the plans from the operational point of view

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Recycling and renewing – renovation of Tartu University Hospital advances in stages

As the only university hospital in Estonia, Tartu University Hospital (TÜK) needed to renovate and expand their existing hospital facilities. In doing that, they wanted to follow latest international hospital design principles and build modern facilities to enable efficient and functional healthcare services.

Situated in Tartu city, the hospital and its extension area are located in a challenging hospital environment. The building complex also includes historically valuable features as well as old hospital buildings. The new buildings include facilities designed for cardiology, eye clinic, internal medicine department, endoscopy department, hospital pharmacy, laboratory, and new radiotherapy.

Focusing on functionality and flexibility At the beginning of the project, a long-term development plan for the hospital complex was drawn up. The main idea was to “recycle” what was recyclable, but at the same time renew obsolete parts with poor usability.

The complete redesign of the hospital area provided an opportunity to reorganise people and material logistics for the entire hospital. The operational goal was to introduce new multi-purpose space concepts that enhance nursing work.

For the treatment processes, versatility and flexibility were the main aims of the design. Improving technical conversion flexibility and creating a new customer-oriented atmosphere in the building were also emphasised in the design.

The designers examined international examples of the main principles of hospital planning, and the most suitable for the Tartu Children’s Hospital, Day Surgery unit, ENT (ear, nose, and throat) and cardiology units were further developed to serve Tartu’s requirements.

In the functional planning, the hospital designers defined the main processes for the different patient groups in close cooperation with the personnel. The designers also estimated the number of personnel needed for the patient service production, defined the number of rooms and beds needed for the patients and support processes and draw the connection charts and schematic layouts of the departments according to the processes.

Sustainability and natural light as key elements of the architecture In the architecture, the main theme is a strong reformed network of inner streets and lobbies, which will significantly improve mobility and orientation in the building from the perspective of patients. The focus of the exterior

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The renovation of Tartu University hospital •

Located in Tartu, Estonia

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Design phase: 2011 – 2021

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Construction phase: 2012 – 2023

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Client: Tartu University Clinic

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Project size: 59,500 m² gross area

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New wards accommodate about 260 beds.

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All wards have teaching facilities for the University of Tartu Faculty of Medicine.

architecture has been the timelessness and sustainability of the facade surfaces. In 2016, the interior design of the renovation phase 2 won the Estonian Association of Interior Architects’ annual award.

The key goal of the interior has been to bring natural light inside the deep building frame through glass-roofed lobbies and inner streets. Wood surfaces and white shades and gloss levels have been widely used in the interior. All client, staff and material traffic of the hospital has been situated into a new indoor street.

Achieving goals step by step The renovation of Tartu University Hospital has taken place in several stages. With the help of hospital designers, Tartu University Hospital was able to involve the staff in planning and update their plans based on the best international practices in the conceptional and functional planning. After the validation of the plans, Tartu University Hospital was able to move forward with their updated plans and start the renovating project and the constructions of the new buildings.

Contact:

Matti Anttila Principal designer - AW2 Architect +358 40 861 3740 matti.anttila@aw2.fi

IHDA partners working together in Tartu university hospital: Nordic Healthcare Group – Concept planning of the renovation project and support in the functional planning and programming of the new Children’s Clinic building, the new Day Surgery and ENT (ear, nose, and throat) building and the new cardiology building AW2 Architects – Main and architectural design together with INTEGRATED and Conarte Ltd, interior design, Functional design in cooperation with Nordic Healthcare Group, Interior design (Estonian Association of Interior Architects’ annual award for the renovation phase 2, 2016) AINS Group – Medical Technology supervision

Contact:

Antti Alho Senior partner - Nordic Healthcare Group +358 40 534 6658 antti.alho@nhg.fi

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Patient volume data and service needs guided the design of Viljandi Hospital in Estonia

In the province of Viljandi in Estonia, constructing a new Healthcare Center was planned, and support in designing the hospital concept was needed. Concept planners and architects draw up a project plan as the basis for an architectural design competition for the upcoming Viljandi Hospital.

Attention was paid to how the new Healthcare Centre serves the population of the area in a diverse manner and how the integration of services can be carried out efficiently. Designers brought their expertise in healthcare and hospital planning and together with local hospital authorities, these were applied to the Estonian framework.

Hospital designers analysed the current use of healthcare and healthcare resources, provided functional requirements for the architectural design of the Viljandi’s new healthcare facilities. Operational designers made calculations on capacity needs and evaluated existing plans for their efficiency and functionality.

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They made suggestions on how to improve the existing plans and how to combine the results to the layout and facility planning in collaboration with other experts. In 2018, a functional plan for the new Healthcare Center was ready.

Framework for evaluation ensured efficient and integrated design The designers also established a framework to assess the works submitted to the architectural design competition.

The framework supported the selection of the architect office responsible for the implementation and helped evaluate design dimensions that had been identified as part of the operational design.

In the evaluation, operational and architectural designers emphasised the modularity of the plans, integration of specialised and primary healthcare services, consultation opportunities for nursing staff and doctors along with conceptualisation of space solutions. Based on the results of the architectural design competition, the medical technology of the new hospital was designed by Finnish experts.

Contact:

Antti Alho Senior partner - Nordic Healthcare Group +358 40 534 6658 antti.alho@nhg.fi Contact:

Anssi Hakarinne Head of medtech unit +358 40 659 8300 anssi.hakarinne@ains.fi

Viljandi Hospital •

Largest general hospital in Estonia

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Outpatient and diagnostic clinic

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Surgical clinic

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Clinic of Emergency Medicine and Internal Medicine

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Psychiatric clinic

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Welfare center

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Addiction Treatment and Rehabilitation Center

IHDA partners working together in Viljandi Hospital: Nordic Healthcare Group – Concept planning and creating evaluation framework for architectural design, capacity calculations AW2 Architects – Concept planning and creating evaluation framework for architectural design, architectural design for the competition?

AINS Group – Medical technology design for the new hospital

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User-oriented design and strong alliances build World’s Smartest Hospital in Oulu

Oulu University Hospital (OYS) is one of the five University Hospitals in Finland, and it provides specialised medical care for 750,000 Finns. Fully renovated and rebuilt by 2030, the hospital aims to be the World’s Smartest Hospital through integration of professionals in various fields including health care, hospital design, ICT solutions, engineering, and construction. The vision challenges not only the design and construction of the new facilities, but also the ways the hospital operates and develops its functions.

Master Plan as a platform for long-term development In the biggest building project in Northern Finland, new facilities and renewing hospital functions are built to meet the future needs of specialised medical care.

Hospital designers developed a long-term strategy and master plan for the construction and renewal of Oulu University Hospital. A master plan was prepared in cooperation with the management and personnel of the hospital. The joint work started with planning the renewal of operating models and the development of the Future Hospital concept, aimed to improve the productivity and effectiveness of the hospital’s operations.

Future space solutions will be constructed to support renewed practices, to improve productivity and the effectiveness of care.

The renewed operations emphasise the joint coordination of functions and human, space, and equipment resources as well as digital solutions.

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Smart facilities are flexible, accessible and promote multi-professional work, serving the needs of different user groups. Future users of the new facilities have been involved in the design process from the beginning.

In the mega project, integration of all parties is the key Design and construction of the new hospital is conducted by using Integrated Project Delivery (IPD) model. IPD harnesses the talents and insights of all participants to optimise project results and maximise efficiency through all phases of design and construction.

The project owner, key designers, and contractors form a joint project organisation – sharing the goals, benefits and risks and aiming for continuous improvement. The ambitious project goals are achieved via developing a culture of commitment, transparency, and trust as well as decision making which are best for the project.

Design for the users, with the users To reach the goal of World’s Smartest Hospital, designers and builders are taking full advantage of user-oriented design, virtual technology, and adaptable facilities. Technical features and structures of the facilities are designed to be future-proof – they can be quite easily modified as the requirements change or develop over time.

Oulu University Hospital focuses strongly on offering patientcentered care. For instance, in designing the new children and women’s hospital, a lot of attention is paid to children having their parents with them during hospital visits.

One of the focus points for design is occupational wellbeing and flexible cooperation of healthcare professionals. The design methods used are highly interactive and based on the needs of healthcare professionals and their patients. Service design is used as a tool to ensure functionality of the facilities.

Recycling energy reduces both energy use and emissions The ventilation systems of the hospital are designed to maximise energy efficiency and minimise CO2 emissions.

To reduce energy usage, energy is also recycled within the hospital. For instance, surplus heat generated by one hospital process is recovered and recycled to where energy is needed.

Oulu University Hospital renovation program in numbers: •

200,000 m² of new hospital complex, 600 patient rooms, mainly single rooms

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3–4 projects carried out in stages

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Total costs 1.6 billion €

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Projected completion: First Stage 2022-2023, Second Stage 2024-2028, Demolition of old buildings 2028-2029

Contact:

Pekka Narinen Chief Operating Officer - AINS Group +358 40 500 1411 pekka.narinen@ains.fi Contact:

Jouko Kuisma Vice President, Digital transformations Nordic Healthcare Group +358 50 468 8881 jouko.kuisma@nhg.fi

IHDA partners working together in Oulu University Hospital: Nordic Healthcare Group – Long-term strategy and master plan for the construction and renewal of the hospital area. ICT-requirements specification, defining ICT-vision and the UUTE -program for next generation hospital ICT solutions.

AINS Group – Construction management, Supervision, Cost-risk analyses, Risk management, Structural and element engineering, Foundation engineering, Acoustical design, Building information modeling BIM Granlund – HVAC (heating, ventilation, and air conditioning), building automation design, medical equipment design, electrical design, tele and security design, fire safety engineering

Design and construction are carried out together, in collaborative alliances. Two alliances are responsible for the first phase, buildings A ja B, completed in stages between 2022 and 2023.

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The Bridge Hospital uniquely combines modern and traditional hospital architecture at the heart of Helsinki The Bridge Hospital in Helsinki, Finland, is a world-class trauma and cancer hospital that was completed in 2022. Connecting the two specialised functions, Cancer and Trauma Hospital, via a bridge, has been not only a functional but also a structural challenge and a rare architectural opportunity.

The architecture of the hospital is fully integrated into its surroundings, and the building assumes its place in the cityscape, while still respecting the status and style of the old hospital area. The architecture of the bridge hospital is based on a series of spaces formed by several high lobbies that allow the intuitive orientation of the patients and staff and lots of natural light into the building.

User-experience and city skyline highlighted in the architectural design The wedge-like and meandering shape of the plot, as well as the existing buildings, which must be closely linked to the new hospital with their functions, have brought their unique aspects to the architectural design. Likewise, the requirement for the existing hospital to continue operating during the construction project. The planning has been carried out in close cooperation with the authorities responsible for urban planning and building protection.

The “Helsinki Built Environment” theme has been used to solve the building’s key architectural challenges. The huge mass of facades reflects the Helsinki sky and the sea surface of the adjacent Seurasaari Bay on the glass surfaces of the aluminum facade. Art has also been widely utilised inside the building to bring comfort to customers as well as to facilitate orientation inside the huge building.

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Visualization of the bridge hospital lobby space Patients and staff come first in designing solutions The Bridge hospital is a very complex and technically demanding hospital building in terms of functions – including the Raptor operating room and the MRI (magnetic resonance imaging) room connected to the neurosurgical operating room. However, at the heart of the building’s basic functional solution are the patients and their expert care.

The functional solution is based on “domain and pathway” thinking, where the internal hierarchy of each function is uncompromisingly optimised and the relationship of each function, to the spaces supporting and serving it, is planned prioritising short distances, and eliminating unnecessary patient transfers.

Special attention has also been paid to the wellbeing of the staff. A caregiver with good and comfortable workspaces and equipment provides the best care and service to the patient. Technical and functional solutions have been designed in cooperation with the healthcare professionals. Every solution has been tested in a specially built simulation facility before actual construction.

The hospital’s MEP (mechanical, electrical, and plumbing) design is also based on functionality and adaptability. For patients, the hospital environment will be safe and comfortable.

For the hospital staff, the integrated digital systems will ease the daily work.

IHDA partners working together on the Bridge hospital: AW2 Architects – Main and architectural design together with Team Integrated Silta consortium (AW2 Architects Oy, Brunet Saunier Architecture, Harris-Kjisik Architects, B&M Architects), Interior design Granlund – MEP (mechanical, electrical, and plumbing) design, telecommunications and building automation design, as well as for fire protection design and fixed hospital equipment together with Ramboll.

AINS Group – Project and construction management, Structural engineering, Building information modeling, Moisture control, Construction product compliance Nordic Healthcare Group – Validation and development of plans in emergency unit and operation units

Energy-efficient and uninterrupted flow of power and data Energy efficiency is a key part of the project. All waste energy generated in the building is recovered and recycled inside the building. This reduces both operating costs and CO2 emissions.

The technical systems are significantly more automated than in hospitals in general. Backup power systems ensure that the most critical systems receive power without interruption. Data transfer requirements are also very high – the amount of data transferred through the hospital network is huge both inside the hospital and to the outside world.

The Bridge Hospital •

Located in Helsinki, the capital of Finland

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71,500 m² gross area

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5-9 floors, 215 beds and 4 wards

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58 intensive care units, 69 day hospital beds and 16 operating rooms

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Outpatient clinics

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Restaurant, lecture and teaching facilities

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Awarded with Tekla BIM Awards in 2023 as the best public project

Contact:

Matti Anttila Principal designer - AW2 Architect +358 40 861 3740 matti.anttila@aw2.fi

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Designing a human-sized service concept that promotes health and wellbeing at every age

The concept designed for the new Espoo hospital weaves together human-scale service units from medical and healthcare wards to rehabilitation and wellbeing facilities to create a service campus that is like a small town with its squares, winding streets, parks and city blocks.

The concept of a “bed-less” hospital merges architecture and process design to activate the vitality that everyone possesses, whatever their illnesses or age. The aim is to provide not only hospital care but also other services generating wellbeing for the customers and people living in the vicinity.

Rethinking the hospital The international architecture competition for the design of a new hospital in Espoo was organised by the City of Espoo together with the Finnish Association of Architects. The goal was to find a design for a hospital that promotes health rather than just treating diseases.

With their entry entitled “Orchid” because of its flower-like shape, K2S Architects won the first prize. According to the panel of judges, the winning design was “a centre of vitality and wellbeing without a trace of institutional feeling”.

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The design introduces spatial solutions communicating kindness and humanity. The design concept supports easy access to care services. Within the area, public, semi-public and private spaces are clearly defined. While most of the hospital is to be newly constructed, the design also integrates an existing hospital building for the accommodation of the elderly and a children’s daycare centre.

Ideal conditions for those who are healing and those who provide healing The hospital wards differ according to their functions, but the similar design and consistent facility solutions enable smooth passage for healthcare professionals between wards. The wards are designed to promote multidisciplinary care and active rehabilitation to support patients’ speedy recovery and return to their usual, independent living in the home environment.

The free mobility spaces around the wards provide flexibility and multifunctionality. For instance, in epidemic situations the level of isolation can be increased gradually.

The patient rooms are arranged around internal courtyards.

The rooms face the outside of the building, while the spaces around the inner gardens function both as a recreation area and a common living space. Combined with all the glass facades, generous amounts of sunlight enter the patient rooms.

The green spaces are interlaced with the buildings and inner courtyards, offering direct contact with nature that is a vital part of the healing process. The dynamic shape of the wards encourages patient mobility, and the patient rooms with their beds are designed more for hotel-like overnight sleeping than for constant bed rest. The way in which the facilities are situated in the wards enables adaptable processes for arranging the medical treatment and healthcare services.

Entrance area as the navigational hub and a lively market area At the heart of the service campus is a multifunctional entrance lobby that is easy to locate. Various healthcare and service units connect to the lobby like flower petals to the centre.

The lobby with its restaurants and courtyards forms a living, breathing market area through which customers navigate to different services related to medical treatment and healthcare, rehabilitation as well as recreation.

Practicality, enduring dignity and changeability are essential in designing and selecting furniture and interior solutions.

The interior materials and colours are also chosen to serve customers with impaired eyesight or spatial awareness.

Architectural concept for the new Espoo City Hospital •

Located in the city of Espoo, Southern Finland

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Client: City of Espoo

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Size 56,600 m²

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Medical and healthcare wards, service facilities for rehabilitation and wellbeing, accommodation for the elderly, daycare centre for children, recreational areas, restaurants

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Concept designed in 2008

Contact:

Kimmo Lintula Architect, adjunct professor – K2S Architects +358 40 564 7576 kimmo.lintula@k2s.fi

IHDA partner K2S Architects Ltd created and designed the award-winning architectural concept for the new Espoo City Hospital.

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