Design Approaches to Contemporary Healthcare Architecture
Ronson Lui 雷卓浩
Contemporary healthcare architecture has evolved from creating functional building design to a specialised design domain that contributes to and enhances the patient-healing process. Salutogenic, or human-centric design principles can create an effective healing environment and a caring atmosphere for patients and healthcare professionals. In land-scarce Hong Kong, creating optimal salutogenic environments requires not only suitable environmental opportunities, but also harnessing the right technologies and design strategies. Using the Queen Elizabeth Hospital Ambulatory Care Centre Extension as a case study, this essay sheds light on how quality-healthcare spaces can support a positive healing process and address issues of sustainability and wellness.
Contemporary design approaches
With the need to contain a myriad of clinical equipment, accommodate a range of medical processes and create segregated circulation flows for visitors, patients, and staff, healthcare architecture is one of the most complex building types to design and implement.
Nowadays, public expectation for such facilities, be they a hospitals, outpatient clinics, or for long-term care, is no longer restricted to delivering efficient and effective medical care.
Such facilities are also expected to support the healing process through human-centric and environmental design strategies. Applied in healthcare architecture, such salutogenic design principles can create an environment that facilitates healing and provides a pleasant atmosphere for staff and visitors. In Hong Kong, creating optimised healthcare facilities requires both finding a suitable environment and harnessing the right technologies and design concepts. This essay about the thinking underlying the Queen Elizabeth Hospital Ambulatory Care Centre Extension (ACCE) shows how strategies drawing on the ideas of green design, user experiential design, active living strategies, the use of colours and the juxtaposition of clinical and transitional spaces can all contribute towards creating a healing environment that fulfils both the functional and safety aspects of treating patients and the need for a high-quality healing experience.
Completed in 2016, ACCE, also known as QEH Block T, stands at the southeast corner of the Queen Elizabeth Hospital (QEH) campus. To its north is QEH Block R, the Institute of Radiotherapy and Oncology, and to its west, the hospital’s Ambulatory Care Centre. The eleven-storey building provides outpatient and day hospital facilities for seven clinical departments. It comprises a network of three-dimensional green spaces, including sky gardens, vertical green carpets and planter balconies, that combine to create a unique contemporary identity for the decades-old QEH whilst encouraging a pleasant healing experience. Visitors approaching the building first encounter a ‘green carpet’ of dense vertical climber plants that forms a continuous natural shaded facade leading from the podium block carpark and link bridge to the edge of the building facing Gascoigne Road. This natural feature not only provides natural ventilation to the car park but also softens the outline of the building as the line of sight transitions from the open grounds of the Club De Recreio to the ACCE tower facade along Gascoigne Road. ACCE is designed as a stepped terrace to allow daylight penetration to its neighbouring Block R – something a monolithic tower block would not have allowed. The building’s terraced form creates two generous platforms at Level 4 and Level 9 that serve as sky gardens for patients and staff respectively. The gardens feature appropriate facilities for the needs of their different users. For example, Level 4’s therapeutic garden, as well as offering space for patients to socialise, is planted with herbal plants used in various healing processes. To improve their motor dexterity, patients are encouraged to plant their own herbs in the garden. . To create a place of respite for staff, Level 9 has light tubes that draw light from an enclosed corridor below to illuminate the garden at night without using electrical lighting. The use of full-height glass parapet shields the garden from gusts of strong wind while offering a panoramic view of the surrounding neighbourhood. Openings between the panels allow natural ventilation without compromising security.
Designing the patient experience
The main lobby is the first point of contact for patients entering a healthcare facility. Such spaces should offer a welcoming atmosphere while also directing them towards their destination. It is therefore important that they provide both intuitive wayfinding guides and a memorable spatial experience. ACCE’s main lobby, located at the Level 2 concourse, is contained within a ‘glass box’ three-storey-high facade that allows daylight to fill the concourse to create an airy and voluminous entrance, very different from most people’s notion of what a hospital entrance should look like. The facade is fitted with circular dots of varying density that reduce glare and heat without detracting from the views its transparency offers.
Active living is incorporated into the building’s design through a curved staircase sited prominently at the Level 2 Concourse. As well as creating a point of visual interest within the concourse, the staircase’s unique design encourages people to try it out rather than use a lift. Coupled with relevant activities, the hospital lobby is also used to foster social engagement and generate the vitality that so often is beneficial in the promotion of healing.
The history of QEH is showcased on a feature wall running along one of the link bridges. The wall documents the hospital’s milestones from when the site was chosen in the 1950s to the completion of the ACCE. Each milestone highlights an event significant to both QEH and Hong Kong. The outcome is a site of interest that fosters a sense of belonging and pride in the hospital’s contribution to society for both staff and visitor is alike.
Drawing on studies that show a relationship between colours and their positive influence in experiencing space, ACCE’s design incorporates colours that accentuate the spatial qualities of interior spaces and so promote a delightful and stress-free environment. Coloured window panels on the link bridge leading to ACCE’s Level 2 Concourse offer a welcome distraction as the changing direction of sunlight cast ever-changing patterns on the floor through the day to the delight of those passing through. Colourful and cheerful graphics are used on another set of staircases to encourage people to use them and to provide intuitive wayfinding. Transitional space outside clinical spaces need not be a design afterthought. Instead, through the use of natural light and pleasant views, it can become the site for a much-needed breathing space after a clinical consultation or treatment. Every one of ACCE’s clinical floors features a simple rectilinear galleria space to facilitate easy wayfinding and provide space for visitors of different mobility levels to walk, pause or rest. Both ends of each galleria open either to planters or to exterior views to create a pleasant and calming environment.
Future of healthcare architecture
Salutogenic design strategies such as easy-to-navigate layouts or green features applied to healthcare facilities can have a positive impact on a patient’s healing journey. A holistic approach, amalgamating medical planning, architectural and landscape design, and wayfinding strategies, is essential to creating a positive user experience and putting patients at ease. With the availability of new construction technologies and digital architectural tools, healthcare architecture can embrace and integrate these innovations into design while maintaining a humanistic approach that prioritises the needs of patients, visitors and staff.
Ronson Lui is a director at Wong Tung and Partners Limited. He received his degree from the university of Melbourne and specialises on healthcare projects, mixed-use developments, hotels and commercial projects.
QEH ACCE Patient Healing Garden on roof setback
QEH ACCE Vertical green at link bridge
1 Staff Garden
2 Patient Healing Garden
3 Planter Balcony
4 Green Roof Link Bridge 1
5 Green Roof Link Bridge 2
6 Vertical Green at Link Bridge
7 Green Carpet at South Elevation Podium
The Green Carpet at South Elevation Podium at QEH ACCE Block T
The Green Carpet provides natural ventilation to Podium Carpark