UIUC School of Architecture: Spring 2015 Rich Nation, Poor People

A HOSPITAL IN RIYADH, SAUDI ARABIA

RICH NATION, POOR PEOPLE

UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN

www.arch.illinois.edu117 Temple Hoyne Buell Hall611 Lorado Taft Drive, MC-621Champaign, Illinois 61820Tel 217.333.1330Fax 217.244.2900

HOSPITAL // ISSUE 05

PRODUCTION NOTES

CREDITS

The HOSPITAL journal is the annual, student-produced publication of the works from the University of Illinois at Urbana-Champaign vertical graduate studio program. The studio seeks to investigate the current trends of architecture with the aid of renowned professionals in the field. The intention of this publication is to share the work produced by the students with the rest of the community both academic and professional.

PUBLISHER

www.lulu.comHOSPITAL, Issue 05Copyright 2015All Rights Reserved

No part of this publication may be used or reproduced in any manner without written permission from the University of Illinois at Urbana-Champaign.

CONTRIBUTORS

Joshua ChenYan DengKaitlin GersonThomas HawkFolarin IjeluKimberly JohnsonSevara KhabibullaevaAlexandria Leppert

FACULTY ADVISOR

Professor William Worn, AIA, LEED AP, EDACProfessor and Associate Director for Graduate Studies

Sijia LiuJohnathon NelsonAngela NgErasmo OrtegaKatherine StowellAparna UvarajJienan ZhangJuliette Zidek

With its vast oil wealth, Saudi Arabia has one of the highest concentrations of super rich households in the world. But an estimated 20 percent of the population, if not more, lives in crippling poverty. Beggars panhandle in the shadows of Riyadhs luxury shopping malls, and just a few kilometers away families struggle to get by in the capitals southern slums. While the government has finally acknowledged that poverty is a problem in the kingdom, the world of the Saudi poor is largely hidden from sight.

The transformation of the Saudi health care system since 1970 has been astonishing. In 1970, there were 74 hospitals with 9,039 beds; by 2005, there were 350 hospitals with nearly 48,000 beds. Yet issues of health access and health disparity continue to grow for those people living in poverty. This Studio will design a hospital intended to serve the poorest residents of Riyadh.

In response to the need for hospital care and ambulatory care for the Saudi underserved, this studio will design a Western style hospital in Riyadh. The hospital program will include inpatient care; diagnostic and therapeutic services; administrative and public areas; support services; and outpatient clinics accommodated in approximately 450,000 GSF.

PROFESSOR WILLIAM WORN

Professor William Worn was the Director: Master of Architecture in Health Design at the University of Illinois at Chicago. In 2010, he joined the University of Illinois at Urbana-Champaign as an Associate Professor, while simultaneously continuing his role as President of Worn Jerabek Architects P.C. in Chicago.

FOREWORD

Throughout this course, various industry professionals have contributed their time and expertise to assist in the development of our knowledge and design of healthcare environments. We had the opportunity to experience healthcare architecture via guest lectures, hospital tours, and a firm visit at VOA Associates. We would like to express our heartfelt gratitude to all who participated, including:

ACKNOWLEDGEMENTS

James ArendsBrenda Bush-Molina VOASheila Cahnman Founding Principal, JumpGarden Consulting. Former: Healthcare Market Sector Leader,

AECOMTodd Eicken Senior Vice President, HDRTom Fromm Regional Director for Healthcare, BSA LifeStructuresTimothy Gregg Principal, Director of Healthcare Architecture, Proteus Group Max Komnenich Cannon Design, Healthcare Studio Former UIUC Healthcare Design Student, 2011David Kuffner AIA, CannonPatty Looker Director of Patient Experience at Cook County Health and Hospitals SystemSarah MarberryClark Miller Managing Principal, Perkins and WillJeff Reinke Past Healthcare Team Leader, Proteus GroupRebel Roberts President and COO at VOA Associates IncorporatedCarson Shearon Principal, CannonCandace M. Small AIA, LEED AP BD+C, EDAC, Associate, VOA associates Incorporated, chair, AIA Chicago Healthcare Knowledge CommunityRosemary Woodbury Healthcare Architect, Cannon Design UIUC Healthcare studio graduate 2012Scott Harding VP Facilities, Carle Foundation Hospital

06

78

14

102

18

116

142

50

128

160

IMAN & UMMAH

INJECTED NATURE

CONNECTED HEALTH

CANOPY OASIS

RIYADH GENERAL HOSPITAL

GREEN VEIL

RWC: RIYADH WELLNESS CENTER

GARDENS OF DELIGHT

PROGRAM ANALYSIS

SITE ANALYSIS

// JOSHUA CHEN + JIENAN ZHANG

// ANGELA NG + YAN DENG

// ALEXANDRIA LEPPERT + KATHERINE STOWELL

// KAITLIN GERSON + JULIETTE ZIDEK

// ARCH 572

// ARCH 572

// JOHNATHON HELSON + KIM JOHNSON

// THOMAS HAWK + SIJIA LIU

// FOLARIN IJELU + ERASMO ORTEGA

// SEVARA KHABIBULLAEVA + APARNA UVARAJ

Riyadh is the capital and largest city of Saudi Arabia. It is situated in the center of the Arabian Peninsula on a large plateau, and is home to 5.7 million people, and the urban center of a region with a population of close to 7.3 million people. The climate is classified as Hot Desert with extreme temperatures in the summer months and frequent dust storms. With climate change the Arabian Peninsula will continue to become hotter and dryer.

SITE ANALYSIS

Before 1970 1970-1990 2015 Proposed New Sub-centers of Riyadh

45 min

30 min

20 min

15 min

Urban Context Analysis

Population Density Pattern and Change in the City if Riyadh, Saudi Arabia, Al-Gabbani, Mohammed, Dr., King Saud University, De-partment of Geography, POB 2456, Riyadh, Saudi Arabia, GeoJournal 1991 24.4 375-385A Fuzzy Cellular Automata Urban Growth Model(FCAUGM) for the City of Riyadh, Saudi Arabia. Part 2: Scenario Testing, Khalid Al-Ahmadi. Alison Heppenstall. Jim Hogg. Linda See, Appl. Spatial Analysis(2009) 2:85-105http://www.arriyadhmap.com/maps/ar/

SITE ANALYSIS12 |

Prince Mohammad Bin Abdul Aziz Hospital

King Saud University Medical City

# of beds per medical facility

King Khalid University Hospital

King Abdulaziz University Hospital

Prince Sultan Military Medical City

King Fahad Medical City

King Faisal Hospital & Research Center

King Abdulaziz Medical City

Al Iman General Hospital

Dallah Hospital

Green Crescent Hospital

Specialized Medical Center Hospital

Saudi German Hospital

Dr. Sulaiman Al-Habib Hospital in Arrayan

Dr. Sulaiman Al-Habib Hospital in Al Takhassusi

Riyadh Care Hospital

Najd Consulting Hospital

Dr. Abanamy Hospital (Sanad Hospital)

Al Hammadi Hospital

Al Mashary Hospital

Al Mouwasat Hospital

1500

10 minutes

30 minutes

20 minutes

1192

1002

1095

894

800

690

500

500

450

350

300

300

255

200

200

215

190

160

122

55

Medical Centers in Riyadh

High Commission for the Development of Riyadh: Health & Educationhttp://www.arriyadh.com/eng/index.aspx/?1=1&menuId=36

ARCH 572: BEHAVIOR + ENVIRONMENT | 13

JAN JULFEB AUGMAR SEPAPR OCTMAY NOVJUN DEC

Avg. Daylight per DaySolar Radiation, Wh/m2

Temperature, C (F)

Precipitation

Relative Humidity, %

Dust Storms

Wind Direction

Monthly Average

Average, mm (in.)

9 AM

Heating Degree Hours

Frequency (%)

Prevailing Direction

Avg. High

# of Wet Days

3 PM

Cooling Degree Hours

Avg. Low

Chance of rain/day

10.75 hrs

6523 Wh/m2 8765 Wh/m2 7828 Wh/m26079 Wh/m2 7982 Wh/m2 7851 Wh/m27735 Wh/m2 7011 Wh/m2 7153 Wh/m27467 Wh/m2 7900 Wh/m2 6131 Wh/m2

16.8C (62F) 32.4C (90F) 32.9C (91F)22.9C (73F) 36.3C (97F) 23.5C (74F)18.5C (65F) 34.6C (94F) 29.1C (84F)28.5C (83F) 35.7C (96F) 19.1C (66F)

11 mm (0in.)

56%

2063 hrs.

4%

N/A


3 days

41%

807 hrs.


10%

11 hrs

10 mm (0in.)

53%

1597 hrs.

17%

N/A

1 days

36%

1407 hrs.

4%

12 hrs

24 mm (0in.)

44%

453 hrs.

12%

North-West

2 days

28%

2953 hrs.

6%

12.75 hrs

29 mm (1in.)

38%

16 hrs.

15%

North-West

1 days

24%

5879 hrs.

3%

13.25 hrs

8 mm (0in.)

32%

0 hrs.

11%

North-West

2 days

20%

8933 hrs.

6%

13.5 hrs

0 mm

36%

0 hrs.

23%

West

0 days

23%

10,229 hrs.

0%

13 hrs

1 mm

41%

0 hrs.

0%

South

0 days

27%

11,393 hrs.

0%

12.25 hrs

0 mm

39%

0 hrs.

2%

South

0 days

25%

8994 hrs.

0%

11.5 hrs

1 mm (0in.)

36%

0 hrs.

3%

N/A

0 days

25%

6482 hrs.

0%

11hrs

6 mm (0in.)

45%

363 hrs.

1%

N/A

5 days

33%

3145 hrs.

17%

10.5 hrs

11 mm (0in.)

55%

1350 hrs.

2%

N/A

3 days

42%

1419 hrs.

10%

13.5 hrs

0 mm

36%

0 hrs.

10%

South

0.5 days

23%

11,845 hrs.

2%

9 am

avg. high

avg. low

cooling

3 pm

average

heating

Climate in Riyadh

SITE ANALYSIS14 |

Solar Path

Summer Solstice

Winter Solstice

Equinox


Qibla

N

224.15

N

+630m

+637m

Road Site

1/4

Road Site1/30

Site Context

Highway Qibla Direction

SITE ANALYSIS16 |

Qibla

N

224.15

N

+630m

+637m

Road Site

1/4

Road Site1/30

Site Topography

Contour


PROGRAM ANALYSIS

In response to the need for hospital care and ambulatory care for the Saudi underserved, the intent of this studio is to design a Western style hospital in Riyadh. The hospital program includes inpatient care; diagnostic and therapeutic services; administrative and public areas; support services; and outpatient clinics accommodated in approximately 450,000 GSF.

Inpatient Care

LDRP

Emergency DepartmentImaging

RespiratoryRehabDentalMOB

Surgical

OncologyWomen's Health

CardiacFood ServiceDistributed ITLab

PharmacyCentral Sterile Supply ProcessingCentral Staff SupportMechanical

Admin.

Public OutreachRetailFitnessChild CareLDRP

Inpatient Care

LDRP

Emergency Department

Imaging

Respiratory

Rehabilitation

Dental

MOB

Surgical

Oncology

Womens Health

Cardiac

122,626 sq ft

28,525 sq ft

33,976 sq ft

7,265 sq ft

3,870 sq ft

5,123 sq ft

1,738 sq ft

10,906 sq ft

15,663 sq ft

3,750 sq ft

5,227 sq ft

4,356 sq ft

Administration

Public Outreach

Retail Pharmacy

Food Service

Distributed IT

Lab

Pharmacy

Central Sterile Supply

Central Staff Support

Mechanical

Fitness

Child Care

Public3,396 sq ft

4,260 sq ft

786 sq ft

8,544 sq ft

3,384 sq ft

4,163 sq ft

2,899 sq ft

5,064 sq ft

2,340 sq ft

42,471 sq ft

8,750 sq ft

3,750 sq ft

3,096 sq ft

PROGRAM ANALYSIS20 |

.92 Physicians per 1000 population

2.42 Physicians per 1000 population

2.3 Nurses per 1000 population9.8 Nurses per 1000 population

2.2 Beds per 1000 population

3 Beds per 1000 population

KSA

KSA

KSA

USA

USA

USA

Hospital Stang

www.who.inthttps://www.cia.gov/library/publications/the-world-factbook/geos/us.html

State of Health

Hospital Staffing

Life Expectancy at Birth

compared to the United States

60%

9.3%GDP GDP

GDP GDP

GDP GDP

$1,722 billiona

$10,194 billiona

$30,572 per capitac$462 billionb

$5,674 billiona $257 billionb

$16,037 per capitad

$17,014 per capitac $8,925 per capitad

$5,164 per capitac$45.59 billionb

$1,581 per capitad5.6%

42%

35%

12%

7%

4%

62%

33.2% 34.4%

$

Value of Lost Output

Cost of Illness

Value of Statistical Life

35%

10%

33%

4%

18%

37%

36%

10%

5%

11%

60%

9.3%GDP GDP

GDP GDP

GDP GDP

$1,722 billiona

$10,194 billiona

$30,572 per capitac$462 billionb

$5,674 billiona $257 billionb

$16,037 per capitad

$17,014 per capitac $8,925 per capitad

$5,164 per capitac$45.59 billionb

$1,581 per capitad5.6%

42%

35%

12%

7%

4%

62%

33.2% 34.4%

$

Value of Lost Output

Cost of Illness

Value of Statistical Life

35%

10%

33%

4%

18%

37%

36%

10%

5%

11%

Disease Burden

Birth Rate per 1000 population

Death Rateper 1000 population

Infant Mortality per 1000 live births6.17 deaths

14.58 deaths

3.32 deaths

8.15 deaths

18.78 births

13.42 births

Deaths before the age of 5 per 1000 live births6.9 deaths

15.5 deaths

KSA

KSA

KSA

KSA

USA

USA

USA

USA

81.94 years77.11 years

USAKSA



https://www.cia.gov/library/publications/the-world-factbook/geos/us.html

Birth Rate per 1000 population

Death Rateper 1000 population

Infant Mortality per 1000 live births6.17 deaths

14.58 deaths

3.32 deaths

8.15 deaths

18.78 births

13.42 births

Deaths before the age of 5 per 1000 live births6.9 deaths

15.5 deaths

KSA

KSA

KSA

KSA

USA

USA

USA

USA


USAKSA



https://www.cia.gov/library/publications/the-world-factbook/geos/us.html


Inte

ntio

nal/

Uni

nten

tiona

l inj

urie

s

Non

-com

mun

icab

le d

isea

ses

DALYdue to

1

Com

mun

icab

le, m

ater

nal,

peri

nata

l and

nut

ritio

nal

15

.5%

5.8

9%

11

.3%

9.3

4%

73

.2%

84

.8%

5.80%16.3%

Malignantneoplasms

6.27%3.01%

Diabetesmellitus

4.25%7.37%

Respiratorydiseases

17.7%17.7%

Cardiovasculardiseases

14.6%14.3%

Mental andbehavioral disorders

3.18%6.95%

Neurologicalconditions

7.03%7.66%

Musculoskeletaldiseases

2.76%1.14%

Congenitalanamolies

1.60%3.18%

Digestivediseases

3.71%2.71%

Genitourinarydiseases

1.73%1.70%

Endocrine, blood,immune disorders

Roadinjury

5.97%2.20%

Poisonings0.24%0.72%

Falls1.62%0.72%

Self-harm0.13%2.13%

Interpersonalviolence

0.41%1.13%

Infectious andparasitic diseases

3.73%2.69%

Respiratoryinfections

3.45%1.36%

Neonatalconditions

4.36%1.58%

%DV 3.74%0.15%

Nutrionaldeficiencies

Fire, heat andhot substances

0.87%0.17%

Disability - Adjusted Life Years

https://www.cia.gov/library/publications/the-world-factbook/geos/us.html Wolfram Alpha. US GDP as percentage of global GDP(2013). Retrieved January 24, 2015, from http://www.wolframalpha.com/input/?i=US+GDP+as+percentage+of+global+GDPWolfram Alpha. KSA GDP as percentage of global GDP. Retrieved January 24, 2015, from http://www.wolframalpha.com/in-put/?i=KSA+GDP+as+percentage+of+global+GDPThe World Bank. Population, total. Retrieved January 24, 2015, from http://data.worldbank.org/indicator/SP.POP.TOTL/coun-tries/US?display=graphThe World Bank. Population, total. Retrieved January 24, 2015, from http://data.worldbank.org/indicator/SP.POP.TOTL/coun-tries/SA?display=graphWorld Health Organization. DALY Estimates, 2012. Retrieved January 22, 2015, from http://www.who.int/healthinfo/global_burden_disease/estimates/en/index2.html

IMAN & UMMAH

JOSHUA CHENJIENAN ZHANG

The socio-cultural values of Islam - that of the ummah, social solidarity - shared by those of the Islamic faith is what moves the design of this hospital. By submitting to those values and the spatial principles they engender the architecture is one that belongs to the genius loci, creating an environment that is less foreign, more approachable, and more livable; making a place where people can continue to demonstrate iman, faith, even in illness until the fullness of health returns.

24 | IMAN & UMMAH

Heirarchy of SpaceThe urban fabric

Spaces in an islamic city define the boundaries for the public, semi-public, semi-private, and private zones. Beginning with the main street around the mosque, streets extend to the markets and bazaars, then into the neighbourhood quarters, and finally to the home.

The compactness of the city streets provide shade and promote social interaction, responding to both the environment and to the 'ummah

public

semi-public

semi-private

private

| 25JOSHUA CHEN, JIENAN ZHANG

public

semi-public

semi-private

private

26 | IMAN & UMMAH

Heirarchy of PrivacyThe home

public

semi-public

semi-private

private

1 Hawsh (cul-de-sac)2 Vestibule3 Guestroom

LDRP module

1 Corridor2 Caregiver preparation zone3 Caregiver activity zone4 Family zone5 Bathroom6 NICU/ Nursery attachment

The heirarchy extends into each individual home. Individuals enter into a vestibule with limited line of sight into the rest of the home; all but the most intimate of friends are brought to the guestroom where the family hosts them; the rest of the house and its interactions belong only to the family who resides there.

Single-patient rooms intimate these layers of privacy while maintaining practical limits for the activity of medical personnel

2

2

1

1

3

3

4

6

5


The patient room

general medical/ surgical module

common features-

1 family storage2 large family zone3 primary sight lines: outdoors/ plants media wall unit3 blocked sight line: caregiver preparation area4 direct line of sight to patient from washbasin5 separate male & female nursing wings6 distributed storage strategy: cabinet with through-wall7 distributed nursing strategy: charting alcoves8 all unit windows open towards Qibla9 stowable bench to perform wudu

VIP module

VIP features-

1 family room2 kitchenette

LDRP module

LDRP features-

1 rooming-in practice accomodated2 winow open to private nursery/ NICU3 scrub area 4 neonatal omnibed(s)

5

4

7

6

1

8

2

1

3

4

9

21

32

28 | IMAN & UMMAH

1. E.D.

SHELL SPACE 11. WOMENS HEALTH GARDEN12. INPATIENT PARKING

INPATIENT CLINIC SERVICEPUBLICOUTPATIENT CLINIC

ELEVATORS13. ED & LDRP PARKING

3. IMAGING4. CARDIAC CARE

5. WOMENS HEALTH6. RESPIRATORY

7. ONCOLOGY 9. REHABILITATION10. M.O.B.8. DENTAL2. LDRP EDU. & EARLY ELELU.

VIP ENTRY

M.O.B. ENTRYIMAGING ENTRY

E.D. WALK-IN& LDRP ENTRY

WOMENS HEALTH PRIVATE ENTRY

INFUSIONENTRY

OUTPATIENT ENTRIES

INPATIENT PARKING

64

53

2

1

7

8

9

10

13

11

12

N

N

PLANSGROUND LEVEL


1. E.D. AMBULANCE ENTRY 2. IT & SUPPORT3. CENTRAL STERILE

4. LABORATORY5. MATERIAL MANAGEMENT

INPATIENT CLINICPUBLIC VEHICULARFLOW

AMBULANCE FLOWMATERIAL FLOW

SERVICEPUBLICOUTPATIENT CLINIC

ELEVATORSSITE VEHICULAR CIRCULATION

E.D. AMBULANCE ENTRY

1 2

3

45

5

N

N

LOWER LEVEL

30 | IMAN & UMMAH

STAFF ENTRY

N

N

1 2

4 5

6 7 8 8

9 9

5 5

3

10 10 11

MALL ENTRY

INPATIENT PARKING

OUTPATIENT PARKING

SHELL SPACE INPATIENT CLINIC SERVICEPUBLICOUTPATIENT CLINIC

ELEVATORS

4. CENTRAL STAFF 6. ADMINISTRATION7. PUBLIC EDUCATION

8. FITNESS CENTER9. CHILDREN CARE

10. RETAIL11. RETAIL PHARMACY

5. MECHANICAL SPACE2. SOUTH CLINIC CORRIDOR 3. NORTH CLINIC CORRIDOR 1. SURGICAL PROCEDURE

PLANSPODIUM LEVEL


N

N


ELEVATORS

1. FOOD COURT10. CENTRAL PRAY HALL 2. KITCHEN

3. M/S (MALE) 5. VIP (MALE) 7. REHABILITATION (FEMALE)

9. PEDIATRIC

4. REHABILITATION (MALE) 6. VIP (FEMALE) 8. M/S (FEMALE)

1SURGICAL PROCEDURE ABOVE

2

3

7889 9

4

6

5

MAIN ENTRY FROM PARKING

10

LEVEL 2

32 | IMAN & UMMAH

N

N

2. ICU 4. REHABILITATION (M) 6. VIP (F ) 8. M/S (F )1. LDRP 3. M/S (M) 5. VIP (M) 7. REHABILITATION (F ) 9. PEDIATRIC


ELEVATORS

33

7889

1 2

9

4

6

5

PLANSLEVEL 3


N

N


ELEVATORS

3 331

1 1

2

2. ICU1. LDRP 3. M/S (M)

LEVEL 4

LEVEL 5

34 | IMAN & UMMAH

ENLARGED PLAN

INPATIENT CLINIC

DIAGNOSTIC & TREATMENT LDRP D&TLDRP EDU.SHELL SPACECLINIC SUPPORT

PUBLIC

PATIENT SUPPORT

PATIENT STAFF

WAITING & RECEPTIONE. D.

TO IMAGING

LDRP EDUCATION & EARLY EVALUATION

ELEVATORS

CIRCULATION

TRIAGE ROOMSDECONTAMINATIONCONSULT ROOMFAST TRACKFAMILY CONSULTATIONISOLATION ROOMRESUSCITATIONPROCEDURE ROOMTREATMENT ROOMSNURSES STATION & INTERNAL WAITINGSCRUB ALCOVESTORAGENURSE MANAGER OFFICEON CALL ROOM

WAITINGEARLY LABOR EVALUATIONJACUZZI ROOMFAST TRACKSHARED OFFICECONSULTATION ROOMPARENT EDUCATION SEMINARLDRP WALKING GARDEN

123456789101112131415

1617181920212223

1

2

23 4 5 6

7 8

9

10

1112

1314

15

16 17

18

19

20

21

22

23

2


FUNCTIONS

KEY

N

N

EMERGENCY DEPARTMENT


ENLARGED PLAN

INPATIENT CLINIC

DIAGNOSTIC & TREATMENT SHELL SPACECLINIC SUPPORT PUBLICPATIENT SUPPORT

EMERGENCY

OUTPATIENT

STAFF

INPATIENT/GOWNED OUTPATIENT

WAITING ROOMS

ELEVATORS

CIRCULATION

CONSULT VIEWING ROOMSRECEPTIONCHANGE ROOMPUBLIC TOILETSOILED WORKROOMCLEAN SUPPLYSTORAGEMEDICATION ROOMCLERICAL WORKSTATIONCONFERENCE ROOMCOPY ROOMSHARED WORKROOMHOUSEKEEPING

123456789

1011121314


FUNCTIONS

KEY

N

N

1 2

34

6

10

11

12

13

14

7

8

9

RADIOGRAPHY

CARDIACCATHETERIZATION

5

NUCLEAR IMAGING

MRI

CT SCAN

FROMIMAGING

FROMIMAGINGLOW EMERGANCY

RADIOLOGY

36 | IMAN & UMMAH

ENLARGED PLAN

N

N

1

4

3

8

5

7

6

11

2

12

13109

14 15 16 17 18 19 20 21 22 23

28

29

30

26

27

24

33

32

25

31

SURGICAL PROCEDURES


BLOCKING & VERTICAL CIRCULATION

KEY

INPATIENT CLINIC

DIAGNOSTIC & TREATMENT SHELL SPACECLINIC SUPPORT PUBLICPATIENT SUPPORT

EMERGENCY

OUTPATIENT

STAFF

INPATIENT/GOWNED OUTPATIENT

ELEVATORS

CIRCULATION


FUNCTIONS

WAITING ROOMS

ANESTHESIA WORKROOM

RECEOTION

ANESTHESIA STORAGE

ICU HOLDING/ RECOVERY

CLEAN SUPPLY

CONSULT ROOM

SOILED UTILITY

EQUIPMENT STORAGE

OR CONTROL ROOM

MEDICATION ROOM

NURSE MANAGER OFFICE

ICU ISOLATION ROOM

NURSE CONFERENCE ROOM

GENERAL HOLDING/ RECOVERY

MD WORKROOM

SHELL/ INTERIOR WAITING

CLINICAL CONFERENCE ROOM

SHELL/ NURSING STATION

STAFF LOUNGE (M/F)

MD DICTATION ROOM

SPECIMEN COLLECTION

iMRI OPERATING ROOM (2)

MEDICATION ROOM

SATELLITE LAB

iCT OPERATING ROOM

STRETCHER STORAGE

SOILED WORKROOM

GENERAL OPERATING THEATRE (3)

ISOLATION ROOM

MAIN STERILE CORE

SATELLITE STERILE CORECAESAREAN SUITES (2)

1

15

2

16

3

17

4

18

5

19

6

20

7

21

8

22

9

23

10

24

11

25

29

12

26

30

13

27

31

14

28

3332

PRE-OPERATIVE HOLDING & RECOVERY

SURGICAL PROCEDURES

38 | IMAN & UMMAH

MODELSCALE 1/64=1

40 | IMAN & UMMAH

dry summer windtempered air

phytofiltration

+H20

+H20

1

2

3

4

5

1 evaporative screen water evaporates through porous ceramic pipes to precondition the summer wind traditional analogue: earthenware pots

4 solar chimney utilizing thermal mass to augment the stack effect creating continuous negative pressure, drawing air into couryard throughout the day

5 formed roof roof shape serves as windcatchers

wind

2 living roof vegetation filters dust and provides an acoustic and visual buffer from adjacent highway

3 screened courtyard diffuses daylight

Sun, Wind & LightMacro environment

40 | IMAN & UMMAH


dry summer windtempered air

phytofiltration

+H20

+H20

1

2

3

4

5

1 evaporative screen water evaporates through porous ceramic pipes to precondition the summer wind traditional analogue: earthenware pots

4 solar chimney utilizing thermal mass to augment the stack effect creating continuous negative pressure, drawing air into couryard throughout the day

5 formed roof roof shape serves as windcatchers

wind

2 living roof vegetation filters dust and provides an acoustic and visual buffer from adjacent highway

3 screened courtyard diffuses daylight


42 | IMAN & UMMAH

+H20

captures small dust particles

reducesnoisepollution

stress

constant viewsto nature

IAQ strategy:natural

xdisplacement

ventilation

Patient care unit Wall type A - green lung

CorridorWall type B - trellis screen

BridgeWater fountain

Patient care unitWall type C - deep planter

mashrabiya signals Qiblaand provides visual privacy

tempered courtyard air

drawn to solar chimney

+O2

+H20

+O2

layers of visual privacy

Sun, Wind & LightMicro environment


+H20

captures small dust particles

reducesnoisepollution

stress

constant viewsto nature

IAQ strategy:natural

xdisplacement

ventilation

Patient care unit Wall type A - green lung

CorridorWall type B - trellis screen

BridgeWater fountain

Patient care unitWall type C - deep planter

mashrabiya signals Qiblaand provides visual privacy

tempered courtyard air

drawn to solar chimney

+O2

+H20

+O2

layers of visual privacy

44 | IMAN & UMMAH

The Patient ExperiencePregnancy, Labor, Delivery, and Recovery

?

?

?

!

!!!

P

first trimester

1.7 - 15hrs 0.95 - 2.4hrs 0.5 - 1hr

within 1st hrskin-to-skin

2 hrs

typical first visit: 4th monthaverage number of visits: 3-6

96% births attendedby skilled physician

maternity triage

latent stage 1 labor active stage 1 labor

stage 2

freedom of movementno continuous EFM

neonatal:suctioning

dryingwarming

stage 3

help initiate breast feeding; clinical observation discharge

emphatic support and counseling

perform tahneek and taweez

initiate breast feeding

waiting

LDRP room

ambulation in maternity garden

infant mortality rate: 10/100,000maternal mortality rate: 14/ 100,000

second trimester

ultrasound

third trimester

medical record

antenataleducation

blood andurine testmaternalheart rate

fetal heart rate

birth plan formsnatural birthdoula: mothermidwife led LDactive mgt.rooming-in

4wks

Three of Saudi Arabia's Millennium Development Goals has a direct effect on the design of healthcare in the region: promoting gender equality, reducing child mortality, and improving maternal health. The first of the three is particularly important in that it empowers women to seek and attain healthcare for herself and her children.

By understanding the process, procedures, and setting expectations for antenatal, intrapartum, and postpartum care, appropriate design interventions can be put in place to enhance the experience of these momentous occasions of childbirth


?

?

?

!

!!!

P

first trimester

1.7 - 15hrs 0.95 - 2.4hrs 0.5 - 1hr

within 1st hrskin-to-skin

2 hrs

typical first visit: 4th monthaverage number of visits: 3-6

96% births attendedby skilled physician

maternity triage

latent stage 1 labor active stage 1 labor

stage 2

freedom of movementno continuous EFM

neonatal:suctioning

dryingwarming

stage 3

help initiate breast feeding; clinical observation discharge

emphatic support and counseling

perform tahneek and taweez

initiate breast feeding

waiting

LDRP room

ambulation in maternity garden

infant mortality rate: 10/100,000maternal mortality rate: 14/ 100,000

second trimester

ultrasound

third trimester

medical record

antenataleducation

blood andurine testmaternalheart rate

fetal heart rate

birth plan formsnatural birthdoula: mothermidwife led LDactive mgt.rooming-in

4wks

46 | IMAN & UMMAH

First ImpressionsDriving to the hospital

In the current paradigm, the husband must accompany his wife not only to drive her to the hospital, but also to help her make medical decisions.

Through the ponds of the central atrium, the couple is able to peer into the hospital. The noticeably cooler environment and the scintillating play of lights along their path let them know they have arrived at a safe haven.

48 | IMAN & UMMAHIMAN & UMMAH

The BeaconRushing to the hospital

48 |

| 49JOSHUA CHEN, JIENAN ZHANGJOSHUA CHEN, JIENAN ZHANG | 49

50 | IMAN & UMMAH

NativityThe LDRP room

From her arrival and registration at the maternity triage floor, an LDRP room will be made ready according to the birth plan formed during antenatal clinic visits - dimmed lights, pleasant scents, music, and accomodations for her doula.

Antenatal visits had determined that she was at low risk for birth complications, a matter reaffirmed during triage, so she is assigned to the appropriate wing of the labor and delivery department.

52 | IMAN & UMMAH

A New ChapterBecoming a father

As his wife completes the last stage of labor, the husband is led by an attendant to the LDRP room where mother and child await his arrival.

INJECTED NATURE

YAN DENGANGELA NG

Nature is injected into the hospital in hopes of improving patient outcomes, while providing a welcoming environment for family and staff to rest and enjoy. A continuous experience is shaped by this injection of nature in the form of themed archetypal healing gardens: forest, harbor, plains, islands, promontory, sea, hills, and sky. HexaShade, a smart shading system, is applied to the wall and ceiling surfaces of these healing gardens to provide continuity which assists in better wayfinding. HexaShade responds to local temperature and light levels, designed to combat the extreme climate of Riyadh. Technology is also integrated with nature in the surgery family waiting experience via smart wristbands and digi-pods. Nature is injected into the patient room by introducing an indoor accessible terrace that is oriented towards the patient bed. A double skin faade is employed to deal with the harsh southern sun, filtering daylight into the patient room.

INJECTED NATURE56 |

Condense Plan of Riyadh1918 Plan of Riyadh Inject Nature into Site

Inject Nature into Central Communal

Space

Dissolve BarrierPalm Grove GardensPalaceSuq (Marketplace)Great Mosque

City WallGuard TurretMain Traffic Line

YAN DENG + ANGELA NG | 57

Condense Plan of Riyadh1918 Plan of Riyadh Inject Nature into Site

Inject Nature into Central Communal

Space

Dissolve BarrierPalm Grove GardensPalaceSuq (Marketplace)Great Mosque

City WallGuard TurretMain Traffic Line

1. Existing Site 2. Extrude D+T and Patient Tower 3. Extrude Parking Garage 4. Carve For Circulation 5. Extrude Medical Office Building 6. Rotate Patient Tower 7. Inject Nature 8. Elevate Nature 9. Extend Nature 10. Carve Parking Garage 11. Terrace Nature 12. Define Site






INJECTED NATURE58 |

Site Strategy

INJECTED NATURE60 |

PublicEntrance

MOBEntrance

Walk-In

AmbulanceDrop-off

ServiceEntrance

StaffEntrance

Public & Admin Diagnostic & TherapeuticSupport & ServicePublic Elevator Clinical & Service Elevator

Public Circulation Ambulance CirculationService Circulation Emergency Department Circulation

0 50 100 200FT

Qibla

N

B B

A

A

Public Education/Community Outreach

Retail

WC

MOB

Fitness Center

Music Garden

Mosque

Lobby

Dining Hall/Courtyard

Staff Support

Staff Retreat

Surgery

Laboratory

Imaging

ED

MaterialsManagement

Central Sterile

Pharmacy

Ground Floor Plan


From Parking Garage

0 50 100 200FT

Qibla

N

Public & Admin Diagnostic & TherapeuticSupport & ServicePublic Elevator Clinical & Service Elevator

MOB

Child Care

Childrens Workshop

Urban Agriculture

UrbanAgriculture

Mechanical Spaces/Structure Transfer Floor

Public ElevatorClinical Elevator

Programmatic Section

Second Floor Plan

INJECTED NATURE62 |

Walk-In

AmbulanceDrop-off

ED ReceptionWaiting Area

Child Area

SecurityStation

Triage Triage Triage Triage

Bereavement Room

On-call Room

NurseManager

StaffLocker

StaffLounge

Radiography/Fluroscopy Room


CleanSupply

FluroscopyPrep Room

SoiledWorkroom

InjectionRoom

NuclearImagingRoomConference

Room

StaffLocker

StaffToilet

Copy/SupplyRoom

MedicationRoom

ConsultViewing

ConsultViewing

ClinicalRoom

Shared TechWorkroom

CT Scan Room

CT Scan Room

CT Scan Room

MRI Control Room

MRI

MRI

Clean Supply

ClinicalRoom

StressLab

SharedWorkstations

SoiledUtility

SoiledUtility

CleanSupply

StorageStorage

StorageStaffToilet

StaffToilet

StaffToilet

InjectionRoom

InjectionRoom

InjectionRoom

PatientToilet

PatientShower

PatientWaiting

Housekeeping

Housekeeping

Scrub/Gowning

Cath Lab

Control Room

PatientHolding



Radiography/Fluroscopy

Control RoomRadiography/Fluroscopy

Control Room

StaffToilet

StaffToilet

SoiledWorkroom

Nursing Station

Nursing Station

Nursing Station

CardiacRoom

ProcedureRoom

CleanWorkroom

IsolationRoom

ConsultRoom

Copy Room

PublicToilet

PatientToilet

PublicToilet

PublicToilet

HybridMROR

HybridCTOR

HybridCTOR

CleanWorkroom

SoiledWorkroom

SoiledUtility

GeneralOR

GeneralOR

GeneralOR

GeneralOR

GeneralOR

AnesthesiaWorkroom

AnesthesiaStorage

OR Control Desk

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

Imaging Reception&Waiting Area

SurgeryReception

PatientToilet

Storage

Storage

FamilyWaiting

Pre-OPWaiting

FamilyWaiting

FamilyWaiting

FamilyWaiting

FamilyWaiting

FamilyWaiting

Decontami-nation

PediatricRoom

PediatricRoom

TreatmentRoom

TreatmentRoom

GynecologicalExam Room

Eye/ENTRoom

Central Sterile Supply and Processing


Emergency Department and Imaging Department Detailed Plan


Walk-In

AmbulanceDrop-off

ED ReceptionWaiting Area

Child Area

SecurityStation

Triage Triage Triage Triage

Bereavement Room

On-call Room

NurseManager

StaffLocker

StaffLounge



CleanSupply

FluroscopyPrep Room

SoiledWorkroom

InjectionRoom

NuclearImagingRoomConference

Room

StaffLocker

StaffToilet

Copy/SupplyRoom

MedicationRoom

ConsultViewing

ConsultViewing

ClinicalRoom

Shared TechWorkroom

CT Scan Room

CT Scan Room

CT Scan Room

MRI Control Room

MRI

MRI

Clean Supply

ClinicalRoom

StressLab

SharedWorkstations

SoiledUtility

SoiledUtility

CleanSupply

StorageStorage

StorageStaffToilet

StaffToilet

StaffToilet

InjectionRoom

InjectionRoom

InjectionRoom

PatientToilet

PatientShower

PatientWaiting

Housekeeping

Housekeeping

Scrub/Gowning

Cath Lab

Control Room

PatientHolding



Radiography/Fluroscopy

Control RoomRadiography/Fluroscopy

Control Room

StaffToilet

StaffToilet

SoiledWorkroom

Nursing Station

Nursing Station

Nursing Station

CardiacRoom

ProcedureRoom

CleanWorkroom

IsolationRoom

ConsultRoom

Copy Room

PublicToilet

PatientToilet

PublicToilet

PublicToilet

HybridMROR

HybridCTOR

HybridCTOR

CleanWorkroom

SoiledWorkroom

SoiledUtility

GeneralOR

GeneralOR

GeneralOR

GeneralOR

GeneralOR

AnesthesiaWorkroom

AnesthesiaStorage

OR Control Desk

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

Pre-OPPrep Room

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

PACUBed

Imaging Reception&Waiting Area

SurgeryReception

PatientToilet

Storage

Storage

FamilyWaiting

Pre-OPWaiting

FamilyWaiting

FamilyWaiting

FamilyWaiting

FamilyWaiting

FamilyWaiting

Decontami-nation

PediatricRoom

PediatricRoom

TreatmentRoom

TreatmentRoom

GynecologicalExam Room

Eye/ENTRoom

Central Sterile Supply and Processing


Surgery Department Detailed Plan

INJECTED NATURE64 |

Receive wristband to track your loved one.CHECK IN

Relax in a comfortable pod.TOUCH DOWN

Surgery Family Waiting Experience


Customize your interactive digital world.DIGI-PODS

Look up to the sky.PRE-OP/PACU

INJECTED NATURE66 |

SECTION A-A

INJECTED NATURE68 |

7 a.m. 10 a.m. 4 p.m. 7 p.m.1 p.m.

7 a.m. 10 a.m. 4 p.m. 7 p.m.1 p.m.

https://www.youtube.com/watch?v=FvT1tpyQc4MHexaShade


PhotoResistor

Arduino UNO

Temperature Sensor

INJECTED NATURE70 |

FOREST Follow the trail to reach your destination.

Explore the bazaar and engage yourself in food produce.HARBOR

The Archetypal Healing Gardens


Learn the art of cultivating crops.PLAINS

Have your children learn the art of cultivating crops. ISLANDS

INJECTED NATURE72 |

Pause on the extreme edge to observe your surroundings. PROMONTORY

Settle down in the food hub.SEA


Reflect as you promenade around the music garden. HILLS

Let your mind drift away.SKY

INJECTED NATURE74 |

QiblaMedical/ Surgical Bed N

0 1 2 5FT

Room Area: 375sfHygiene Area: 61sf

Hygiene Area

Patien

t Area

NursingArea

Family A

rea

Indoor

Terrac

e


0 1 2 5FT


Hygiene Area

Patien

t Area

NursingArea

Family A

rea

Indoor

Terrac

e


0 1 2 5FT


Hygiene Area

Patien

t Area

NursingArea

Family A

rea

Indoor

Terrac

e

UP

UP

UP

QiblaIn-Patient Tower16 Beds/ Neighborhood

N

0 10 4020 FT

Double Height AtriumPublic Corridor

Indoor Terrace

Clinical Corridor

Retreat Room

Clinical Corridor

Public ElevatorClinical ElevatorService Elevator

8

1289

306

306

8

18

144

SECTION B-B

SUMMER

88

44

WINTER

INJECTED NATURE76 |

UP

UP

UP

1 2 3 4 5

B

A

C

6

7

8

9

10

D

1.1 2.1 3.1 4.1 5.1

B.1

A.1

C.1

6.1

D.1

7.1

8.1

9.1

Qibla

16 Beds/ Neighborhood

N

0 10 4020 FT

Double Height Atrium

Public Corridor

Public Corridor

Indoor Terrace

Clinical Corridor

Retreat Room

Clinical Corridor

Public ElevatorClinical ElevatorService Elevator

8

1289

306

306

8

18

144

Enjoy the view to natural light and vegetation.

In-patient Tower

PATIENT ROOM


Qibla

N

0 1 2 5FTPatient has direct view towards outdoors with vegetation

Perforated screen to reduce solar heat gain

Pull-down digital media screen

Accessible green space

Large family zone near bed for social support

Bed away from corridor (reduced noise levels)

Patient rolls onto right side to pray towards Mecca

Design Considerations1. Patient Outcomes2. Patient Safety3. Staff Outcomes

Medical/ Surgical Bed

INJECTED NATURE78 |

Qibla

N

0 1 2 5FT

Visibility of patient from corridor

Short distance of toilet room to staff

Short distance of toilet room from patient Continuous handrails

Design Considerations1. Patient Outcomes2. Patient Safety3. Staff Outcomes

Medical/Surgical Bed


Perforated Aluminum Sheet

Steel Treads

Glazing

Indoor Terrace

INJECTED NATURE80 |

CONNECTEDHEALTH

ALEXANDRIA LEPPERTKATHERINE STOWELL

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

- WHO Definition of Health

The main goal of this project proposal is to curb the effects of the obesegenic environment by encouraging fitness, healthy dieting, and providing access to nature. A sense of community is invoked by creating a direct connection to the existing mall by implementing additional retail and health facilities for both visitors, patients, and staff. To promote social interaction and strengthen the sense of community within the hospital, the central atrium features a farmers market as well as a grand stair that accommodates seating. In order to facilitate outdoor activities in this extreme climate, shading devices are utilized on many levels of outdoor garden space as well as entrances and walkways.

CONNECTED HEALTH84 |

Fitness Centers

Outdoor Parks / Green Space

Fresh Food Markets

Mosques

Fast Food Restaurants

Fitness Centers

Outdoor Parks / Green space

Fresh Food Markets

Mosques

Fast Food Restaurants

Area StudyDue to the large number of fast food restaurants and lack of healthy resources made available to the people of Riyadh, the main intent of this hospital is to create a center of activity that promotes a healthy lifestyle.

ALEXANDRIA LEPPERT + KATHERINE STOWELL | 85

FITNESS RETA

IL

SPA

GROCERY ST

ORE

URGENT CARE

MEDICAL EDUCATION

Connected ProgramIn order to create a stronger connection with the community, the hospital is linked to the existing mall through a series of walkways and elevated commercial and retail spaces. This facilitates walking and allows both patients, visitors and staff to take advantage of the healthy resources included in our program.


FITNESS

HEALTHYDIET

FAITH

MODER

N

MEDIC

INE

FRESH

OOD

ACCES

S TO

NATUR

E

Surrounding a celebrated stair in the atrium are ammenities that we deemed vital for maintaining a healthy lifestyle. A fitness center, farmers market, mosque, outdoor access and a healthy dining area all are featured at the entrance. These programmed spaces are visible from the exterior and display an active atmosphere.

Atrium Program


Site Plan



EMT ROUTE

STAFF ROUTE

PUBLIC ROUTE

SERVICE ROUTE

EMT RO

UTE

STAFF ROUTE

PUBLIC RO

UTE

PUBLIC

ROUTE

STAFF ROUTE

SERVICE ROU

TE

First Floor and Access Plan



Second Floor Plan


Third Floor Plan


Fourth Floor Plan


Fifth Floor Plan


INTENSIVE CARE UNIT

FITNESS

LDRP

MED / SURG

MED / SURG

PHARMACY

ONCOLOGY

RESPIRATORY DENTAL

MOB

WAITING

WAITING

WAITING

ADMINISTRATION

CHILD CARE

INTENSIVE CARE UNIT

LDRP

MED / SURG

MED / SURG

IMAGING

SURGERY

PHARMACYFARMERS MARKET / ATRIUM

REHABILITATION

WAITING

WAITING

WAITING

MATERIALS MANAGEMENT

MECHANICALCENTRAL SUPPLY

East West Section 1


INTENSIVE CARE UNIT

LDRP

MED / SURG

MED / SURG

IMAGING

SURGERY

PHARMACYFARMERS MARKET / ATRIUM

REHABILITATION

WAITING

WAITING

WAITING

MATERIALS MANAGEMENT

MECHANICALCENTRAL SUPPLY

MED / SURG

MED / SURG

SURGERY

EMERGENCY DEPARTMENT IMAGING

LDRP

MED / SURG

MED / SURG

LDRP

INTENSIVE CARE UNIT

CENTRAL SUPPLY

East West Section 2

North South Section


Upon entering the hospital, family members and patients register at the front desk and are able to download an application onto their mobile device. This application allows them to explore the hospital while still maintaining a connection with the patient. This app is designed to encourage exploration of the hospitals amenities and provide education about healthy lifestyles.

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35 steps

47 steps

69 steps

106 steps

131 steps

A celebrated stair in the main atrium encourages walking due to its location and manageable height. The words of the Quran attract visitors and creates a sense of community as a gathering space to sit upon.


TO STAFF SUPPORT/LOCKERS

WAITING ROOM

WAITING ROOM

CONSULTROOM

REST ROOM

REST ROOMTRIAGE

TRIAGE

TRIAGE

TRIAGE

PROCEDURE ROOM

NURSE STATION

ISOLATION

TREATMENTROOM

TREATMENTROOM

PEDIAT.

PEDIAT.

GYN. EYE/ENT.

CARDIACROOM

FAST TRACK TO IMAGING

CT SCAN ROOM

CT SCAN ROOM

CT SCAN ROOM

CT CONT. ROOM

CT CONT. ROOMCATH.

LAB

CATH. CONT.ROOM

TOILET

PATIENT HOLDING /SCRUB

MRI

MRI CONTROL ROOM

MRI

IMAGING WAITING

R/F ROOM

R/FCONT.ROOM

STORAGER/F

ROOM

R/F CONT. ROOM

R/F ROOM

R/F CONT. ROOM

R/F ROOM

STAFFSUPPORT

NUCLEARIMAGING

ROOM

INJECTION

INJECTION

INJECTION

INJECTION

WORKSTATION

TOILET/SHOWER

WAITING

STRESS LAB

RADIOSOTOPLAB

IMAGING

EMERGENCY DEPARTMENT

CENTRAL SUPPLY 5 100 20 50 100

EMERGENCY/IMAGING DEPARTMENTFIRST FLOOR 1/16

Imaging and Emergency DepartmentThe emergency department is accessed from the northeast. Adjacent to the ED is the imaging department, both of which are located near an interior courtyard providing light for patients waiting for treatment.


Surgical DepartmentThe surgical suite is located directly above imaging and ED. Another smaller waiting area is located near the courtyard and allows family to utilize the outdoor garden space while maintaining a connection with the patient


Through this app family members have the ability to send positive messages to the patient room at any time during their stay.


An external shading device is used on the facade of the bedded care tower. The thickness of the shade was determined through solar studies to ensure no direct sunlight reaches the patient bed throughout the day. The change in thickness creates an undulating rhythm which can be seen on the exterior.

Patient Room Section


2

1

3

4

5

6

View of outdoorlandscape from patient bed

Short path of travel to bathroom with assisted handrail

Bathroom door swings in with safety feature to swing out for emergencies

Visibility of patient from corridors while still maintaining privacy

Sink encourages staff hand washing while maintaining eye contact with patient and family

1

2

3

Space hidden from patients for needle disposal, reduces patient stress

4

5

6

Patient Room Layout

CANOPY OASIS

KAITLIN GERSONJULIETTE ZIDEK

The Canopy Oasis hospital looked at the use of alternative medicines in healthcare and the effect of climate on design. In realizing the need for outdoor courtyards due to the intensity of the arid and hot climate in Saudi Arabia, our team chose to develop an oasis within the hospital itself. A large canopy system enveloping our site shades the building and outdoor space while allowing diffuse light to permeate throught. Through a series of enrionmental analyses, this canopy system was optimized to capture the maximum incident solar radiation throughout the year by changing form over time. It is intended to be constructed of flexible photovolatic fabric, supported by hydraulic columns and ten-sile cables. The resulting topography from the canopy determined the locations for a series of open-air courtyards and a central mosque. We focused on enhancing patient outcomes by allowing each patient room a view into the planted courtyards, away from the surrounding urban congestion. We also decided to prefabricate the rooms to al-low for an ease of construction and potential expansion.

CANOPY OASIS108 |

KAITLIN GERSON + JULIETTE ZIDEK | 109

CANOPY OASIS110 | CANOPY OASIS

Topo

grap

hy o

f Can

opy

Inci

dent

Sol

ar R

adia

tion

The images on this page depict the optimized canopy forms with their relevant solar radiation and resu-litng topographies. These topographies then informed the location of the open-air courtyards within the hospi-tal. The highest points of the canopy became the natural locations for these spaces, so as to provide maximum lighting and ventilation to the planted interior.

Spring Summer Fall Winter Overlay of All Seasons

Spring Summer

Fall Winter

Canopy Analysis


Nursing Units

Labor + Delivery

Rehabilitation

MechanicalLEVEL -01

LEVEL 01

LEVEL 02

LEVEL 03 + 04

MOB

Laboratory

Surgery

Womens Health

Materials

Imaging

Central Sterile

ED

Pharmacy

Q IB L

A

MI H

R A B

Common Prophetic Treatments include:1. Self-treatment by self-reciting the Quran2. Treatment by a relative through recitation directly over ones body.3. Consuming or being massaged with water or oil over which the Quran had been recited.Al-Rowais, N., Al-Faris, E., Mohamed, A., Al-Rukban, M., Al-Kurdi, A., Balla Al-Noor, M., ... Sheikh, A. (2008). Prevalence and pattern of alternative medicine use: The results of a household survey. Annals of Saudi Medicine, 28 (1).

The Use of Prayer

CANOPY OASIS112 |

NMecca

400200100500

MOB Entrance

Public EntranceED Walk-in

Service Entrance

Ambulance Entrance

1. Central Sterile2. Materials Management3. Laboratory4. Pharmacy5. Mechanical

6. Mosque7. Waiting 8. Treatment Rooms9. Radiography10. CT11. MRI12. Cath Lab13. Nuclear Imaging14. Rehabilitation15. Womens Health16. Administration17. Child Care18. Public Outreach19. Food Services20. Outpatient Oncology21. Outpatient Cardiac22. Outpatient Respiratory23. Outpatient Ambulatory24. Fitness Center

1

2

5

4

3

6

7

7

8

88

8

9

10 11

12

13

14 15 16

17

18 19 20

21

22

2324

9

9 9

8

8

8

8

8

8

Level -01 | Services

Level 01 | Entrances


NMecca

400200100500

DN

Labor & Delivery Entrance25. PACU26. Operating Rooms27. CT/OR28. MR/OR29. Labor and Delivery

29

2827

26

25

Level 02 | Surgical

Alternative MedicinesThere are several types of alternative medicines used in Saudi Arabia, two of the most widely used include Prayer and Medicinal Herbs. The central courtyard of the hospital is where both of these alternative medi-cines are located. There is a central two-story mosque surrounded by medicinal herbs.

01 02 03 04 05 0

Abdominal pains

Cold and flu

Cough

Diarrhea

Dental pain

Fever

Headache

Allergy

Percentage of Studied Adolescent Population

Arnebia hispidissimaA solution obtained from boiling the whole plant in water is taken as tea to relieve fever.

Euphorbia schimperianaAn extract of leaves and roots is used as a laxative.

Tephrosia apollineaGround leaves are used to treat cough.

Tamarindus indicus Fruits are used as a laxative.

Sisymbrium irioA solution obtained from boiling the seeds in water is used to relieve cold and fever.

Senna italica A solution made from boiling the leaves is used for treating constipation and stomach cramps.

Senecio asirensisA decoction made from its leaves is used for treating fevers.

Ruta chalepensis Leaves are used to cure rheumatism and abdominal colic.

Nerium oleander An extract from leaves is used for treating bronchitis, and coughs.

Moringa peregrina Oil from the seeds is used to relieve headaches, fever.

Matricaria aurea Inflorescence is used for making a tea for all stomach ailments.

Mentha longifoliaFresh leaves with tea is taken to relieve stomach-ache and head-ache.

Indigofera articulata Soaked roots are chewed to relieve toothache.

Ecbolium virdeIts leaves are used for treating skin rashes.

Achillea biebersteiniiAn infusion from its leaves is used to reduce itching.

Calligonum comosumDried stems and leaves are used against toothache.

Rhazya strictaWhole plant is used for improving bad breath, chest pain, skin rash.

Ricinus communisLeaves and roots are used to treat bad breath, toothache etc.

Nepeta deflersiana A mixture of leaves extract and tea is taken orally to ease stomach problems.

Herbs and plants widely used in traditional Saudi medication2Common health symptoms treated1

1 Musaiger, A. O., & Abahussain, N. A. (2014, August 22). Attitudes and Practices of Complementary and Alternative Medi-cine Among Adolescents in Saudi Arabia. Global Journal of Health Science, 7(1), 173-79. doi:10.5539/gjhs.v7n1p173

2 Thomas, J. (2012, January 20). Vegetation. Retrieved from Plant Diversity in Saudi Arabia: http://plantdiversityofsau-diarabia.info/

CANOPY OASIS114 |

UP

UP

-

DN

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NMecca

400200100500

Level 04 | Nursing Units

Level 03 | Nursing Units


250

-

-

1 2 3

A

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Patient Rooms | Prefabricated

Patient Room | View from Bed

CANOPY OASIS116 |

Main Reception | Level 01

Patient Room | View from Door

Surgery Waiting | Level 02


Patient Room | View from Footwall

Mosque | Courtyard

CANOPY OASIS118 |

Longitudinal Section Perspective

Transverse Section Perspective


Central Courtyard

RIYADH GENERAL HOSPITALJOHNATHON NELSONKIM JOHNSON

Riyadhs General Hospital was designed with three particular goals: improve user experience, provide access/views to nature, and respect cultural values of the region while operating as a westernized healthcare facility. Designing for the user was important for us as research has shown better patient outcomes come from patient happiness. We also realized that the experience of the family and staff were equally important. We used the building mass as a guide to the main departmental areas from the exterior and continuing that understanding of place throughout the interior spaces. The experience in between places was also important to us. Hallways, lobbies and waiting areas, became important areas we needed to focus on. We took cues from the regions response to privacy and places designated for relaxation and then translated those ideas for our in between areas. During an analysis of our site and neighbors, we saw that minimal spaces were allotted for parks. Green spaces were found only at hotel resorts. Our desire for visual and physical access to green spaces led our design of gardens that spilled from the rooftops to the ground. We incorporated green spaces using xeriscape plants on the ground level for first floor users and vehicles driving past, climbing vertically towards the towers and onto all horizontal surfaces. These greenspaces offer visual support for users and acts as a tool used to reduce the solar heat gain occurring on the rooftops.

RIYADH GENERAL HOSPITAL122 |


Main EntranceMOB

ServiceAmbulance


Main Entrance

MOB

Service

Ambulance

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JOHNATHON NELSON + KIM JOHNSON | 123

1Main Entrance

Emergency DepartmentImaging

MOBFood Service

Support Services

2Surgery

MOBChild Care CenterChildrens Garden

3Mechanical

Support Services

4Labor and Delivery

VIP Suits

5Sky Lobby

Healing Gardens

6 - 15Bedded Care


solar heat gain on building exterior surfaces based on information found using ecotech

+1735000 Wh/m267000 Wh/m2

Light reflective material in order to reduce solar heat load on roof

Vertical shading required to reduce solar heating load

Green roofs to reduce solar heat load on roof

horizontal surface to protect from northern and southern sun

vertical louvers to protect from eastern and western sun

motif found in saudi arabian prints. Pattern has horizontal and vertical elements that assist in protecting solar heat coming from the east and west facing facades in addition to the northern and southern light coming in due to the buildings orientation

Sun ShadingThe base of the hospital is angled due to the site conditions and is in the best position to minimize solar heat gain the patient tower, however is at the worst possible angle. To combat this and still maintain the building position (which for culture reasons necessitated its placement on site) solar shading in the form of intricate 3D printed screens which would work both vertically and horizontally were developed.


1 2 3 4 5 6 7GREEN SPACES ARE INTRODUCED THROUGHOUT THE HOSPITAL BOTH INSIDE AND OUTSIDE IN ORDER TO CREATE VIEWS.

PATIENT ROOMS ARE DESIGNED FOR FAST TURN OVER RATE IN ORDER TO.

PATIENT WAITING ROOMS DESIGNED FOR PATIENTS TO WAIT OUTSIDE OF THE PATIENT ROOMS. THIS FREES UP MORE ROOMS AND ALLOWS PATIENT TO WAIT IN A LES STRESSFUL ENVIRONMENT.

WAITING ROOM NODES ALLOW FOR PRIVACY FOR FAMILY AND FRIENDS AND OFFER AN ALTERNATIVE TO THE TRADITIONAL WAITING ROOM

THE PUBLIC HALLWAYS ARE WRAPPED WITH WAITING NODES THAT ARE PLACED NEXT TO RETAIL SHOPS AND PUBLIC SERVICE AREAS.

AFTER CHECKING IN WITH THE RECEPTION DESK, THE NEXT STOP IS TRIAGE WHERE INITIAL PHASE BEGINS AND ICON AND WRISTLETS ARE GIVEN TO PATIENTS IN ORDER TO AVOID

THE RECEPTION ARE FOR THE ED IS OPEN AND EASY TO ACCESS. PATIENTS RECEIVE INITIAL INFORMATION HERE AND THE RECEPTION DESK STAFF CONTINUALLY CHECK ON THE NEEDS OF PEOPLE WITHIN THE GENERAL AREA.

MOTHER EXPERIENCING AN SKIN INFECTION COMES IN WITH FAMILY. PATIENT

PROVIDED FOR PATIENTS UPON CHECK-IN

FAST TRACK CHECK IN & ICON SELECTION ACUITY LEVEL ACQUIRED

WAITING TIME AND ORDER, COLOR CODED ACUITY LEVELS

TRIAGE RESULTS, PROFILE CREATED

DATABASE

WRIST-LET

PROJECTED ICON

ELECTRONIC DEVICE

*Inspired by Arneill, Aliison., & Devlin, Ann S. 2002

GSEducationalVersion

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0 16' 32' 64'SCALE: 1/32" = 1'-0"Ground Floor (1st Floor)

The Waiting Experiance: ED


Main Entrance

Community Outreach Center

IT Support

Dining Services Support

Womens HealthRehabilitation Outpatient

Ambulatory Care

Retail Pharmacy

Gift Shop

Patient Waiting Alcoves

ReceptionCath Lab

MRI 1

MRI 2

Cont. Rm

Cont. Rm

Cont. Rm

CT Scan

Cont. Rm

Cont. Rm

Radiography

Injection Rooms

Lab

Stress Lab

Nuclear Imaging

Hot Waiting

Cont. Rm

PatientPrep.

Admin.

ED Entrance

Team Station

Support Services

Triage Rooms

ProcedureRm.

Cardiac Rm.

Isolation

Ambulance Entrance Support Services

ResultsWaiting

Exam Rooms

Child Care Center Fitness Center

Cardiac Rehabilitation Center

Administration

Support

Pre-Op

Oncology

Dental Services

MOB SupportServices

Respiratory Therapy

Childrens Garden

Surgery Waiting

High AcuityPICU

Low AcuityPICU

Hybrid MMOR

Hybrid MMOR

Sterile Core

OR OR OR OR

OR

OR

Soiled WorkRm.

MD WorkRm.

Lab

Anesthesiology

ORControl

Surgical Alcoves

Hybrid CTOR

MaleLockers

FemaleLockers

1st Floor

2nd Floor


Main Entrance Exterior Main Entrance Interior

ED Waiting Alcove Hallway ED Results Waiting

Surgical AlcovesAbove the main ED waiting alcoves on the first floor are surgical alcoves. On the surgical floor the staff break and meeting rooms have been decentralized and placed in these alcoves. Frosted class over the light wells allow for natural light to floor into the surgical floor while still protecting patient privacy and restricting direct sun exposure

Waiting AlcovesInspired by traditional Islamic architecture the alcoves provide a semi-private waiting area, that are part of the hospitals decentralized waiting experience. Each alcove contains a screen that displays the patients position in the que and allows family to easily monitor where loved ones are. Helping to de-stress the waiting experience is one part of ensuring the best patient outcomes.


Bazaar

Security Desk

Womens Prayer Room

MensPrayer Room

Mechanical Space

Central Sterile Pharmacy Laboratory

Labor and Delivery

VIP Suits

3rd Floor 4th Floor

5th Floor

Healing GardensA major portion of the hospitals patient experience centers on the expansive gardens. The main gardens are on the 5th floor as part of the sky lobby. To the east a general garden with curved paths and a large fountain create a quite healing oasis. To the west is the rehabilitation garden which uses linear paths to reduce confusion and contains a labyrinth and specialized rehabilitation area with ramps


agave

bromeliad

bromeliad

eriogonum-fasciculatum

euphorbia_myrsinites

agave

bromeliad

bromeliad

eriogonum-fas

ciculatum

euphorbia_myrsinit

es

agave

brome

liad

brome

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eriogon

um-fas

ciculatu

m

euphor

bia_my

rsinites

Childrens GardenLocated outside the child care center on the 2nd floor, the childrens garden features enclosed learning and play spaces. The garden also contains several free standing green walls to help teach kids how to tend garden.


Team Station

Team Station

Staff LoungeConference

Clinical Elevators

CleanClean

Soiled

ConsultationFamily Waiting

Soiled

Care Giver Area

Patient Area

Family Area

Med / Surge Neighborhood6-15th Floor


Hand Washing Station Headboard

Respecting Islamic CultureAs a team it was decided early in the design phase to stay true to the program and create a western style hospital but still make reasonable accommodations for the strict religious culture of Saudi Arabia. Gender separation was not prioritized, however quibla direction was. To achieve this we curved the patient tower and arranged beds in the most convenient and respectful way. Patients in all beds can easily roll to their right and be immediately aligned to the quibla direction to facilitate easy prayer as required 5 times a day.

Oversized Family AreaTo Accommodate Large Saudi Families

GREEN VEIL

THOMAS HAWKSIJIA LIU

...Man could make Paradise on Earth, make the Desert Bloom, that he was Creator and Steward...

Gardens and Courtyards can be a powerful healing supplement in the right conditions. With a bridge spanning the main road and several specialized courtyards within, Green Veil strives to take healing gardens to the next level. Three bed towers rise up to help disrupt direct solar radiation with the help of a double skin facade derived from cultural patterns and historic facades. The gardens within adapt to each department that they are located in to best meet the needs of the patients and the staff alike. From the grand main courtyard to its smaller counterparts, Green Veil moves to heal through the comfort of Nature.

134 | GREEN VEIL

Main EntryED Walk-in

Ambulance

Staff Entry

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Qibla

Site Plan with Concept Development

ServiceOutpatientEmergencyLoop

Ambul.

Main

MOB

D&TPUB

LIC MOB

D&TPUB

LICD&T

MOB

PUBLICD&

TLDR

PPAR

KING

PARKIN

GPAR

KING

D&T

MOB

PUBLIC

D&T

LDRP D&

TMOB

PUBLIC

D&T

LDRP

PARKIN

GPAR

KING

Zoning according to the arrangement of different entrances.

To separate people and vehicles, raise MOB to second floor directly connectd to the parking garage.

To provide a continuous connection among the quadyards outdoors, move Surgery on second floor with LDPR.

Move the LDRP to third floor, to provide a relatively independent level for pregnant women.

Quadyards with different expression come with the staggered bed tower .

Inp.

Inp.

Inp.

Traffic

Traffic

| 135THOMAS HAWK + SIJIA LIU

Ambul.

Main

MOB

D&TPUB

LIC MOB

D&TPUB

LICD&T

MOB

PUBLICD&

TLDR

PPAR

KING

PARKIN

GPAR

KING

D&T

MOB

PUBLIC

D&T

LDRP D&

TMOB

PUBLIC

D&T

LDRP

PARKIN

GPAR

KING

Zoning according to the arrangement of different entrances.

To separate people and vehicles, raise MOB to second floor directly connectd to the parking garage.

To provide a continuous connection among the quadyards outdoors, move Surgery on second floor with LDPR.

Move the LDRP to third floor, to provide a relatively independent level for pregnant women.

Quadyards with different expression come with the staggered bed tower .

Inp.

Inp.

Inp.

Traffic

Traffic

136 | GREEN VEIL

Islamic GardensDiversity

...interplay between Real and Ideal, Practicality and Fantasy, Tangible and Symbolic, Physcial and Metaphysical, Urban and Natural...

Beauty

Conservation

...richness of the Soul and the humble appearance of the body...

...element of enviornmental concern, a basic tenet of Islam...

Contextuality...requirement to have a garden designed in response to other elements of architecture...

Individualism...considered central to Islam, where each person is responsible directly to God and bearing in mind that individuals also have a duty not to harm their neighbors ...

Multiple-Use...central to the Islamic Garden, which should provide food and water not only for inhabitants, but also animals and birds, to shade and protect...

Moderation...need to maintain balance of man with nature, to neither impose a form of rational will on nature, nor submit to a concept of nature...


Nursing Units

LADR

Mechanical and Transfer Floor

Surgical Support

Surgical Procedures

C-Section

Holding

PACU

Waiting

Outpatient Respiratory

Oncology

Outpatient cardiac

Womens Care

Ambulatory

Dental

Imaging

EmergencyCafe

IT Support

VIP

Administration

Staff Support

Retail Pharmacy

Gift Shop

Childcare

Education

Rehabilitation

Fitness

Mechanical

Service Court

Food Services

Material Mgmt.

Processing

Administration

PharmacyLab

Mechanical

OutdoorShell space

West and East

VisorsSouth North

88

41

Visors

Bed Tower Atriums

Shell Space Expansion

Stacking and Ciruclation

138 | GREEN VEIL

Main Entrance

ED Walk-in

Staff

Service

Ambulance

0ft 25ft 50ft 100ft

N

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25ft50ft

100ftN

Level: 01ED - MOB - ImagingThe first level houses the Emergency Department as well as that of Imaging. The lower level of MOB is also located on the buildings west side and is available through boht the entrance courtyard and the second level bridge from the parking structure across the main street. The entrance courtyard continues through the public middle section fof the buildign and connects to the side courtyard seen in the rendering

below.


0ft 25ft 50ft 100ft

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Level: 02MOB - SurgeryThe second level is the primary connection to the parking structure takes place, allowing for direct access to all outpatient sections of the MOB as well as a straight path to the central circulation core. Surgery is located on the buildings east side directly above ED and Imaging

Main MOB AccessWith the second level being the primary access point to the MOB, it wanted to become a more grand gesture. By having the bridge curve into the building from the neighboring parking structure, it not only puts emphasis on the bridge itself, but also the main courtyard that it embraces. Cultural screens and access to a second floor courtyard right at entry gives a more comforting

feel as the space is entered.

Surgery CourtyardThe courtyard located on the buildings eastern most side on the second level is dedicated to the surgery staff. It is a courtyard away from the public to allow the surgery staff to relax for a moment during their shift or between operations.

140 | GREEN VEIL

0ft 25ft 50ft 100ft

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25ft50ft

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Level: 04LADRLADR is located on the fourth level, above the mechanical floor and begins the section of the building with inpatient rooms. The LADR is divided into three main sections, two of which house the LADR rooms. They are divided in two with respect to non-native methods and more native and culture based methods. The last section holds the NICU and C-Section. Courtyards separate the sections with views and their is a personal labor walk courtyard on the eastern side.


Consultation

On-Call

TLTBedAlley

Nurse Manager

MedRoom

SoiledUtility

CleanSupply

Staff Lounge

Relaxation/PrayerCorner

Team Conference

TLT

Nurse Team Station On-Call

TLT BedAlley

Nurse Manager

MedRoom

SoiledUtility

CleanSupply

Staff Lounge

FamilyWaiting

Consultation

Central Reception

Staff Lounge

FamilyWaiting

Consultation

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Level: 05 - 09Bed TowersThe bed towers located at the top of the building are divided into three. The primary reason being gender separation and to offer more views for the patients in the rooms.

Room LayoutThe rooms are primarily laid out with patient safety in mind. The angling of the facade also allows for clear views outside from the patient bed as well as clear view of the patient from the perspective of the staff walking along the corridors.

142 | GREEN VEIL

Mechanical/Shell Space

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Level: 02Mechanical FloorThe primary mechanical floor is located between the LADR and Surgery floors. This allows for the specific HVAC for each department to be easily divided, with surgery receiving its need for heavy HVAC and LADR and the Bed Towers receiving what is necessary.

Room LayoutMost of the support for the building is located on the lower level. This includes the delivery and service area as well as additional mechanical spaces that may be needed. Key support departments like Processing and material Management are located more directly under Surgery to allow for direct access through a separate elevator core.


Bed Tower

LDRP

Mech.

Mech.Mech.

Ambulatory OR Support

Mech.

Mech.

EmergencyImagingImaging

C-SectionWomen

Gym.Lobby

Lab.

Waiting Bridge PACU

lDRP

Mech.

Service Lobby

Admin.

Bed Tower

LDRP

Mech.

Mech.Mech.


Mech.

Mech.


C-SectionWomen

Gym.Lobby

Lab.

Waiting Bridge PACU

lDRP

Mech.

Service Lobby

Admin.

Bed Tower

LDRP

Mech.

Mech.Mech.


Mech.

Mech.


C-SectionWomen

Gym.Lobby

Lab.

Waiting Bridge PACU

lDRP

Mech.

Service Lobby

Admin.

144 | GREEN VEIL144 | GREEN VEIL

| 145THOMAS HAWK + SIJIA LIU | 145THOMAS HAWK + SIJIA LIU

RWC: RIYADH WELLNESS CENTER

FOLARIN IJELUERASMO ORTEGA

This project looks to promote health and wellness as a lifestyle through the use of designed elements within the hospital. This leads to us changing the idea of what a hospital can be and what it can offer the community. The project combines retail with hospital program to create a place for the entire community. The hospital can become a community center because of the way Saudi mall culture permeates all aspects of life.

148 | RWC: RIYADH WELLNESS CENTER

SITE PLAN

| 149FOLARIN IJELU + ERASMO ORTEGA

HEALING GARDENS

Using EBD ideas, these healing gardens are designed to help in the patient healing process while promoting a healthy lifestyle for both clinicians and family members.

CONNECTION GARDENS

These gardens become a hybrid between traditional islamic gardens and waiting spaces for both patients and clinicians. The mix of traditional plantings with winding paths leading to areas of interest creates successful spaces.

25m

5m

APRICOT TREE

PLUM TREE

MULBERRY TREE

QUINCE TREE

POPLAR TREE

FebNov

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FebOct

Jun

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MarSep

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FIG TREETREFOIL

POMEGRANATE TREE

DOG ROSE

RED JUDAS

TexturesAccessible Protection ViewsWaiting

REHAB HEALING GARDEN

CHILD AREA GARDEN

ENTRY GARDEN

COURTYARD GARDEN

150 | RWC: RIYADH WELLNESS CENTER

CourtyardCreate an enclosure to shield from sun and focus interest inwards

Step backsUpper Floor setback and create shaded terraces and bed tower nature spaces

AbsorbThe curve creates a full edge towards the south while orienting itself towards the mall

ExtendCreating a public corridor to the garage extends the usable indoor area for retail and outpatient services

Diused LightA second skin is set in place to create a skin that absorbs the solar radiation before it hits the building



AbsorbThe curve creates a full edge towards the south while orienting itself towards the mall

ExtendCreating a public corridor to the garage extends the usable indoor area for retail and outpatient services

Diused LightA second skin is set in place to create a skin that absorbs the solar radiation before it hits the building



AbsorbThe curve creates a full edge towards the south while ori

UIUC School of Architecture: Spring 2015 Rich Nation, Poor People

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