HOSPITAL DESIGN
CASE STUDY ON HOSPITAL BUILDINGS
NATIONAL CASESTUDY
Aga Khan University Hospital and Medical College.
• Architects: Payette Associates with Mozhan Khadem (design consultant).
• Construction Started: 1971
• Completed: 1985
• Area: 84 acre
• No. of bed: 721
• Operator: Aga Khan Health Services.
Aga Khan University
1971
In 1971, Aga Khan commissioned the planning and design of a new teaching hospital, together with a medical college and school of nursing, in Karachi, Pakistan.
2006
In 2006, the hospital was accredited by the Joint Commission International for achieving and maintaining the highest international quality standards in healthcare.
Completed in 1985, the Aga Khan University (AKU) has become the premier academic medical center in Pakistan.
1985
Highest International Quality Standards In HealthCare
• Providing services in general medicine, surgery, obstetrics and gynecology, and pediatrics with special units for intensive and coronary care, ophthalmology, and orthopedics.
• A private wing of 127 beds is being constructed as part of the hospital, but the bulk of its accommodations are designed as general five-bed wards and semi-private rooms in order to be in reach of Karachi's less affluent and sprawling population.
Architectural Features
• The AKU hospital complex was conceived as an integrated complex of buildings, verandas, and courtyards, providing a rich continuum of experience from exterior to interior.
• Some courtyards are designed for private contemplation.
LANDSCAPE
• The strong exteriors of the structures blend in mass, color and texture with the desert surroundings.
• Perhaps the most important transformation has been the maturity of the landscape.
• The courtyards, with fully-grown trees and lush vegetation, have achieved their fullest expression.
• There is still, running, and splashing water on patterned pavements.
• There are aromatic flowering vines, trees and shrubs.
• These richly textured landscaped spaces, which incorporate reflecting pools and fountains, produce a pleasant microclimate in contrast to the formidable climate of Karachi.
Healing Gardens
• They provide respite for patients, their families, caregivers, and students, prefiguring the healing gardens that are prevalent in hospital design today.
SKETCH
Form
• Far from being an object building, the architecture forms a sequence of interlocking, “interiorized” outdoor rooms that are intended for particular patterns of use.
MASTER PLAN
FURTHER EXPENSION
• Initially campus provided approximately one million square feet of space for hospital, academic, housing, and service functions.
• Ten years after opening, the campus began to feel the pressures of evolving approaches to healthcare delivery and new research initiatives, triggering several master plan iterations to guide campus growth.
• These master plans have produced a series of new buildings and courtyards built over the past 18 years, representing approximately 600,000 square feet of new space.
• Limiting the height of the project to three floors, with elevators moving one stop up or down from a middle service level, minimizes the use of mechanical means.
BUILD (EXPENSION)
INFILL & EXPENSION
SOME OF THESE BUILDINGS ARE INFILL ADDITIONS AND EXPANSIONS TO THE ORIGINAL COMPLEX; OTHERS REPRESENT THE INITIAL PHASES OF NEW SECTIONS OF CAMPUS DEVELOPMENT.
ALL OF THEM HAVE BEEN DESIGNED AND CONSTRUCTED TO EXTEND AND ELABORATE THE ORIGINAL ARCHITECTURAL VOCABULARY OF THE CAMPUS.
IT IS NEARLY IMPOSSIBLE TO DISTINGUISH BETWEEN THE ORIGINAL COMPLEX AND THE VARIOUS INFILL ADDITIONS AND EXPANSIONS, DUE TO THE CONSISTENCY OF THE ARCHITECTURE (TECTONICS AND MATERIALS) AND HOW GRACEFULLY THE ORIGINAL BUILDINGS HAVE AGED AND ENDURED.
AGA KAHN UNIVERSITY HOSPITAL SITE PLAN WITH UTILITY CORRIDOR AND NEW INCINERATOR LOCATION
PURPOSE OF WASTE INCINERATION PLANT
• The purpose of the project was to replace an existing incinerator that could no longer handle the load of biomedical waste.
• The old incinerator was part of the original campus design and construction, completed in 1985, at which time it was on the western edge of the campus.
• Since then, the university acquired additional land, which landlocked the incinerator within what is now a developing precinct for ambulatory care.
• The new facility is designed for two new state-of-the-art incinerators that meet international standards for air pollution mitigation.
• The hospital desperately needed this new facility, as Karachi does not have any municipal system able to handle medical waste.
• Operations at the new facility are fully automated.
ENERGY CONSUMPTION
• This new facility is designed for cogeneration and Aga Khan University currently receives all of its domestic hot water from the waste heat of this facility.
• As part of the utility master plan, the second incinerator, when combined with the first, will generate steam for hospital operations and the chilled water plant.
• The exhaust stacks for the incinerator are concealed within the concrete enclosure tower, which may eventually be integrated into a future building constructed on top of the facility.
• Emissions are continuously monitored by both Aga Khan University and the manufacturer.
• Additionally, the system has two levels of air filtration.
Waiting Areas
• Others define shaded outdoor waiting areas where patients’ families hold vigil for loved ones undergoing surgery.
Islamic Architecture
• In a continuation of the grand tradition of health-care in the ancient Islamic world with its major hospitals, this facility provides a pleasing setting for patients, students and staff, in the belief that environment plays a part in aiding recovery and increases productivity.
• The physical planning/design team visited sites where the classic Islamic architectural traditions are revealed in their highest form.
SUSTAINABILITY
• The architects have responded to these climatic conditions by traditional and indigenous principles of environmental control.
• Non air conditioned areas are designed to take advantage of natural ventilation.
• Major fenestration opens to the north.
• Wind-catcher devices channel prevailing breezes across hot double-membrane roofs.
• The lush planting and use of water in the courtyards greatly temper their micro-climate.
• Even with the severe heat, it’s possible to limit the use of mechanical air-conditioning to the diagnostic and treatment areas, medical school and private wing.
BRISE SOLEILS AND WEEPING WALL CLADDING
JALI BLOCK SCREEN
CAPTURED BREEZES COOL THE BUILDING, THE OVERHANGE SHADES THE WINDOWS
BULDING ORIENTATION AND PLACEMENTS MODULATES THE DIRECTION AND INTENSITY OF WIND
COOLING OF SURFACE BY EVAPORATION OF WATER
Basic Technology: Hala Tiles
• 300Year Old Tradition Hala is a small town 180 miles from Karachi in the interior of Sind (southern Pakistan) and is a major traditional tile making center, where the indigenous craft of making' decorative tiles still survives in its original form.
• These tiles are locally known as Hala tiles.
Structure
• The structural system is concrete frame utilizing a minimum of expensive reinforcing steel.
• Exterior walls are double-insulated concrete block, made on the site, with textured cement plaster finish.
• Roof surfaces are terracotta tiles.
• Interior floors are terrazzo tiles; exterior paving is pre-cast concrete and local marble.
• The resulting heavy concrete and masonry enclosure works to advantage in reducing the penetration of intense solar radiation.
CONS
• All vertical pedestrian travel is by stairs, although at times this can be awkward for patients in wheel-chairs and stretchers - the provision of ramps is minimal.
INTERNATIONAL CASESTUDY
GENERAL HOSPITAL OF NIGER
Location: Niamey, Niger
Architects: CADI
Area: 3400 M2/ 3,65,972 SQFT
Year: 2016
Lead Architects: Liu Chen, Xing Bing
Category: Hospital
Project Background
• The Republic of Niger (Niger) is a landlocked country in Western Africa with over 80 percent of its land area covered by the Sahara Desert.
• Niger’s subtropical climate is extremely hot and dry with annual average temperature up to 35 centigrade.
• The rainy season is from July through September. The rest of the seasons are dry seasons and its annual precipitation is low.
• Niamey is the capital of Niger and the center of politics, economy and culture.
• The project is committed by the Chinese and Niger governments, aiming to build a large scale general public hospital together in order to improve and upgrade the local medical facilities.
Location
• The site is located on a wide flat sandy tract around 7km at the northern side of the center of Niamey city.
• Local people expect a new hospital could upgrade their living conditions.
• The place is a developing residency with weak infrastructure.
• People hope the currently building hospital could improve their lives.
•
CLIMATE
• Niger’s subtropical climate is extremely hot and dry with annual average temperature up to 35 centigrade.
• The rainy season is from July through September.
• The rest of the seasons are dry seasons and its annual precipitation is low.
MASTER PLAN
MASTER LAYOUT PLAN
Ground Floor Plan of the Emergency Building
Ground Floor Plan of the Outpatient Building
Outpatient Building, Emergency Building and Public Hall
• The public hall is an important connecting and distributing space for the public.
• A well-designed hall shall be open to the public and provide the easy access, function of sheltering , good ventilation without using air conditioners and energy saving.
Second Floor Plan of the Outpatient Building
Ground Floor Plan of the Inpatient Building
Inpatient Building and Ramps
• The inpatient Building is designed into a two-story courtyard space, connecting by continuous ramps and cloisters.
• In addition, it can meet the hospital accessibility requirements without lifts and elevators.
Second Floor Plan of the Inpatient Building
GROUND FLOOR PLAN OF THE MEDICAL TECHNOLOGY BUILDING
Medical Technology Building
• Medical Technology Building consists of four floors, including all important medical equipment's and operating rooms in the hospital.
• The external wall adopts the single small-opening windows and the external sunshade in order to reduce the heat exchange.
Second Floor Plan of the Medical Technology Building
Third Floor Plan of the Medical Technology Building
Forth Floor Plan of the Medical Technology Building
EXTERIOR DETAILS OF MOSQUE
Muslim Worship Hall
• Islam is the dominant religion in Niger, therefore we have considered Muslim worship halls scattered in the hospital in the design.
• Meanwhile, these worship halls can be transformed to temporary camping sites for patients and their families.
• Niamey is the capital of Niger and the center of politics, economy and culture.
• The population of Niamey is about 1 million and Islam is the dominant religion.
Building Sun-shade
In the hot and dry environment, building shading has significant influence on the indoor temperature.
In order to avoid direct sunlight, a number of external sun-shade components are designed.
The gaps between the shading panels and the walls form air microcirculation around the windows, which is conducive to carry off the surrounding heat. The architectural technology of this sunshade system has high durability with in-situ concreting.
Insulated Roofing
• Insulation is the simple and effective way to reduce the indoor temperature.
• All the roofs are designed with thermal insulating layers, which are prefabricated concrete panels, to reduce the heat transmission.
Natural Ventilation
• Buildings are mostly designed with the opened veranda of two sides’ entrances, forming good natural convection and improving the physical experience of people inside.
• The gaps between the shading panels and the walls form air microcirculation around the windows, which is conducive to carry off the surrounding heat.
Roof Drainage
• Precipitation is quite low throughout the year.
• However, the heavy rainfall is intense with strong winds, the leaves and dust blown by strong wind could plug the drain normally.
• Open-designed drainage is easy to clean and meanwhile presents an important facade element.
• The local loose sandy soil is conducive to the natural infiltration of rain as well.
Corridor
Corridors connect various blocks of the hospital. The pillars of the corridor are widened to provide a larger sunshade area.
Corridors connect various blocks of the hospital. The pillars of the corridor are widened to provide a larger sunshade area.
The architectural technology of this sunshade system has high durability with in-situ concreting. CorridorCorridors connect various blocks of the hospital. The pillars of the corridor are widened to provide a larger sunshade area.
The architectural technology of this sunshade system has high durability with in-situ concreting. CorridorCorridors connect various blocks of the hospital. The pillars of the corridor are widened to provide a larger sunshade area.
Adoption and Construction of Traditional "Tyrol" Exterior Wall
• Since Niger is located in the west Africa inland, bulk import of common exterior wall material is highly expensive.
• Under perennial high temperature and illumination intensity, erosion of the building exterior wall would be serious.
• Local traditional process "Tyrol" style exterior wall is adopted in the exterior wall design.
• The typical construction method is to manually spray the mixture, which is composed of the local river sand and white cement/water under a specific ratio, on the exterior wall surface.
• This kind of material not only achieves low construction cost, but also has high durability under hot & dry weather with easy maintenance.
Link to the Environment
• The relationship between architecture and the environment not only consider the natural environment where the building is, but also the local economy and social impact.
• Therefore, a local traditional construction methods ensure the building is built with low cost, good quality and high durability.
• In such way, the building is not only adaptable to the local climates and environment, but also integrate into the local culture.
Elevation
Details Drawing
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