By Steven Bentley, Director, Ramboll UK
When the New North Zealand Hospital in Hillerød, Denmark, delivered its brief for the design of a new hospital, it asked for “creativity and innovation” and spoke of the opportunity to “build for the future”. Located in the region north of Copenhagen, the new £400 million hospital consolidates the area’s three existing hospitals, and is part of Denmark’s wider healthcare consolidation programme that includes the redevelopment of nine hospitals in total.
Following a 12 month international design competition, the architectural consortium of Herzog & de Meuron/Vilhelm Lauritzen Arkitekter were awarded the contract to design, while Ramboll were named as project management consultants and providers of engineering services. The final design for New North Zealand Hospital will span over 128,000 sq m, serve over 310,000 people and hold nearly 700 beds. It is marked for completion in 2020. Interestingly, one of the main cruxes to its design is the need to ‘plan for uncertainty’ and ‘design for change’. The hospital must be flexible enough to accommodate technology that is yet to be invented and handle epidemics that may yet be unleashed. In addition, as requested by the hospital board, the design is to be fully led by best practice in patient care.
Incorporating nature
The greenfield site offers an ‘optimal physical setting’, with the structural design intended to work alongside natural space to maximise recovery times – such as ‘on’ and ‘off ’ stage zones to separate patients from functional hospital aspects. The designers drew on outside studies, including a report by Dr Robert Ulrich, Professor of Architecture at the Center for Healthcare Building Research in Sweden. Ulrich’s work revealed patients recover significantly faster in single bed wards, and that bringing patients closer to nature improves their sense of well-being and thus speeds up recovery. In an inverted population pyramid there will be fewer resources available for an aging population, so single bed wards provide a key opportunity for patient care to be provided by immediate family member visitors.
In response to studies such as this the hospital has been envisioned as a pavilion set within the surrounding forest and the design brings together all the hospital’s necessary functions within one clover-shaped structure. The low-rise building reaches out horizontally into the landscape, surrounded by trees and native plantation, in a “soft, flowing form”.
Unlike many large scale hospitals, the inviting and welcoming facility maintains a human scale, arranged around an expansive and secure roof garden set above the main diagnosis and treatment floors. The low building is intended to foster better exchange between staff and patients, improving communication and well-being within a building that is sustainable, safe and welcoming. The bed wards will be constructed from prefabricated modules made from either metal or wood, as a means of both reducing on-site waste and embracing modern methods of construction.
The future of medical treatment
The recent Ebola outbreak highlights the importance of the need for hospital design to accommodate and contain disease as effectively as possible. The bottom two storeys of the build- ing are comprised of diagnosis and treatment facilities, and have thus been designed to be fully flexible in order to accommodate any changes to disease prevention that might take place between now and 2020. For example the design allows for either full isolation of immuno-suppressed patients or fully open plan treatment.
Demountable walls and regular span floor plates accommodate for any changes in usage and function, including expansion. This ensures that construction processes are as straightforward as possible. Off-site prefabrication of the upper storey ward blocks will reduce waste, ensure uniform quality, allow beta-testing of new innovation, and allow a large propor- tion of the hospital to be constructed in a safe and weather protected environment.
There will also be a focus on automated logistics with the introduction of self-driving automatic goods vehicles (AGVs) to distribute goods, food and waste from a purpose designed service village. A separated lower-level service floor will allow the AGVs to distribute to localised vertical distribution cores across the hospital, with goods arriving and departing close to their use, before a human focus on the “last 30m of travel”. Electronically tagged beds will even be automatically delivered to a central bed-washing facility after each patient use – with technological assistance becoming ever more adopted in the operational aspects of the hospital.
A blueprint for the world?
A pioneering scheme, the New North Zealand Hospital focuses on exploring the key roles that intelligent design and a positive environment can have within healthcare provision and in seeking sustainable design solutions. It raises serious questions about how the UK approaches upgrading its hospitals, and whether, as the Danes have done, in order to become more efficient in the future we must increase our investment today. Architects and engineers are becoming ever more central in determining the future of responsive healthcare, and New North Zealand Hospital has the potential to act as a blueprint for how this relationship is determined.