Last week, we spoke to Eric Meub, Design Director at HDR Lost Angeles, about the design challenges healthcare interiors face – past, present and future. We learned a lot, but after our discussion, we also began to notice the heavy weight of the fact that these challenges are a moving target.
Healthcare environments all around us, including the ones being built this very minute, have hyper-individualized struggles and needs, and the rate of change and unrest in these environments also seems to be a new constant.
As healthcare design teams move forward with projects-in-progress, they must design a massive amount of agility and flexibility into those environments.
This week, we shine a spotlight on several of HDR’s works-in-progress and recently completed projects – healthcare environments that we know will be asked to do many things, including the unexpected, for many people in the future. As you read through these projects and our interviews with each design team, you’ll notice that each environment intends to be exceptionally functional and a stunning work of design. However, we encourage you to carefully consider how these spaces might be used in a future we cannot predict. This year, we all have learned to expect the unexpected!
>iKure, Baruipur, West Bengal, India
Project Notes: “Approached by iKure, a leading-edge Indian social enterprise specializing in healthcare delivery, our Design 4 Others team was tasked with designing a new central clinic and headquarters in Baruipur, West Bengal. The client specializes in high-tech, low-cost healthcare delivery, and expected the clinic’s design to take a similar approach. This presented a challenge: how can a building adopt a research-based approach to computational design while maintaining a low cost of construction?”
“A major component of iKure’s work lies in optimizing healthcare delivery using a sophisticated AI-driven model developed together with IBM’s Big Data team. A similar algorithmic approach was taken for the building’s massing: thousands of iterations of a random form were analyzed for their suitability for the building’s program and the amount of shade that they provide during the day. As the form-finding algorithm evaluates each iteration, it learns from its successes and failures and carefully evolves into a form that maximizes the available shade.”
“The eventual result? A courtyard building, reminiscent of the traditional villa style in West Bengal. The final form features an abundance of smaller lightwells ringing a single, larger courtyard. This layout allowed for a clear, efficient ring-road circulation; importantly, the small lightwells sit at the intersection of each hallway, giving users a sunlit beacon to move towards. This effect is most pronounced at the entry lobby, where users are greeted with views of lightwells at both north and south. Porous brick towers have been placed at each aperture, which filter light both in and out of the building – in the evening, they stand as beacons for the larger Baripur community.”
“In an inversion of the algorithm-led development of the building’s massing, where the architect interprets and adapts a computer-generated form, the brick perforations are the result of custom software interpreting and adapting an architect-driven design. The software takes a photograph or sketch as its input and attempts to replicate it in brick form; a real-time physics simulation allows unstable iterations to fall to the ground. The bricks collapse repeatedly until they eventually learn to form a structurally-sound version of the intended design.”
“This optimization and the shade-based massing tool use only local labour and vernacular techniques. Instead of using computational design to merely realize a complex form, these approaches ultimately increase equity by enabling others to build in a way that is both performance-driven and place-based.”
In an officeinsight interview, Jason-Emery Groën, vice president & design director at HDR in Kingston, Ontario, Canada, walked us through how this project was different.
“iKure is this amazing entity in West Bengal that uses very high-tech methods to deal with the challenges of the local environment,” Groën said. “They don’t have the medical staff they need to serve the people in their communities, so they focus on point-of-care technology, and training community members to use simple devices and interfaces to help administer a series of care processes.”
During site visits ahead of creating the planned prototypical hub and clinical space, Groen and his team noticed the low-lying land masses and monsoon-heavy climate of the area.
“We really got a sense of the culture, and of the local materials that were prevalent. In West Bengal, the ground is heavily clay-based, and so bricks are very abundant. The way of life there is related to two big things – harvesting the agriculture, and making bricks in-between the rainy season. Families demonstrate their desire and plans to expand and progress by building the stack of bricks in front of their house higher and higher.”
The HDR team wanted to bring the local culture and local materials into the design – but it also wanted to take a step further to express the way iKure uses technology to solve real problems.
The team used AI technology to design brick walls in a way that was guaranteed to stand the test of time. They also used technology to help balance and maximize the coverage of daylighting in both the rainy, overcast and drier seasons.
The size of the project meant there was even more room for creativity, Groën noted.
“This was so unique for us because it was a smaller-scale project that let us push the limits of the technology in a way that a larger project wouldn’t allow for.”
>Shirley Ryan AbilityLab, Chicago, Illinois, USA. 1,200,000 square feet
Project Notes: “The Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago) is the top rehabilitation destination for adults and children with the most severe, complex conditions – from traumatic brain and spinal cord injury to stroke, amputation and cancer.”
“We designed the 1.2 million-square-foot facility, in partnership with Gensler and in association with Clive Wilkinson Architects and EGG Office, as the first-ever “translational” research hospital in which clinicians, scientists, innovators and technologists work together in the same space – surrounding patients, discovering new approaches and applying (or “translating”) research real time. This translational approach means patients have 24/7 access to the brightest minds, the latest research, and the best opportunity for recovery.”
“As an innovator in the healthcare industry, we were responsible for the design and programming of healthcare and research environments and all translational planning concepts.”
KEY FEATURES OF THE ABILITYLAB INCLUDE:
>Each of five ability labs [Think + Speak Lab, Legs + Walking Lab, Arms + Hands Lab, Strength + Endurance Lab, and Pediatric Lab] provide for both active and visible “front stage” patient work with clinicians and researchers, as well as private, heads-down “back stage” space for analysis and planning.
>An innovative “wet” lab allows researchers to study diseases, conditions and injuries that can only be solved at the cellular level. Scientists are able to increase the number and speed of discoveries because they are co-located with clinical teams and patients.
>Design elements play a vital role in patients’ therapy and recovery. Curved walls, for example, allow for more natural and “frictionless” movement, especially for people with physical disabilities and those who use wheelchairs for mobility.
>The 10th floor Sky Lobby is the welcome center and communal hub with beautiful therapy gardens. The floor’s vertical volume is accented by a tapered ceiling plane that rises as it moves toward the transparent curtain wall that wraps the floor, maximizing daylight and expansive views.
>The thoughtful design of space unites with bold and motivating interior graphics and wayfinding to support Shirley Ryan AbilityLab’s brand.
>Color climbs to a crescendo as all pathways focus on the collaborative zone of the ability labs. Each lab is defined by its specialty and graphics, and integrated to create opportunities for measurement and metrics, thus reinforcing that “therapy happens everywhere and progress is measured in everything.”
>With an average stay of 24 days, inpatient rooms were designed to provide visual access to restrooms, places for personal keepsakes and sweeping views of the city oriented to encourage movement and progress.
>Extensive landscaping and green space at both the street-level and throughout the upper spaces afford access to gardens. A green roof system tops the building. These features promote a healing environment and provide practical benefits such as the absorption of heat at the roof and the diversion of rainwater from entering the city sewers.
>Shirley Ryan AbilityLab Pediatric and DayRehab Center, Glenview, Illinois, USA. 20,000 square feet
Project Notes: “Tucked away inside a speculative office building in suburban Chicago lies a new rehabilitation outpatient center for the Shirley Ryan AbilityLab, a specialty, non-profit hospital serving patients with the most severe, complex conditions. Catering to both adults and children, the interior design for this facility needed to solve several challenges. Importantly, the spaces for children and adults had very different requirements in terms of equipment and atmosphere, yet still needed to project a unified brand identity. Dividing the space in two resulted in awkwardly long, linear spaces – a spatial challenge solved using a series of floating volumes and colored acoustic baffles.”
“The reception area serves as a gateway between the two distinct spaces. Curved walls allow for “frictionless” movement, especially for people with functional impairment – frequently accompanied by pain – and those who use wheelchairs and other mobility devices. They also introduce a softness as patients enter their respective spaces.”
“Like the Shirley Ryan AbilityLab hospital in downtown Chicago, everything about the interior design of this outpatient facility speaks to optimism and hope, including the creative use of bold, energetic colors with expansive white surfaces. Here, patients no longer require hospitalization, but still require intensive rehabilitative care.”
“In the Day Rehab space, colored baffles gradate from red to orange to yellow, intuitively defining various zones within the space. Together with the floating volumes, the baffles break down the length of the therapy space, while also providing acoustical comfort and intuitive wayfinding. Floating volumes define various treatment areas, and are used for mounting equipment and to provide discreet areas for storage – while allowing open views across the space for patient safety. Bright colors and ample access to daylight encourage and energize patients in their rigorous therapy.”
“A calmer atmosphere was required for the pediatric side to keep children focused on their physical, occupational, and/or speech-language therapy. Floating volumes define two separate therapeutic spaces. Ceiling baffles, walls and floors in muted colors are juxtaposed against the bright colors of children’s equipment and toys used in treatment. A family waiting area features similar calming colors and is a place for parents and siblings to wait during therapy sessions.”
“Corridors double as treatment space to maximize efficiency; white walls encourage children to focus on the floor’s colored circles, which are spaced at specific intervals as therapy aids – emblematic of how design serves not only as an aesthetic backdrop, but as a tool for treatment, too.”
Intentional Material Choices: “In order to maximize mobility and safety for patients, rubber sheet flooring is used in most spaces because it’s easy to walk on, easy to clean, and provides a cushion for patients who may need it. The flooring is made of natural rubber, a rapidly renewable resource that is PVC-free and does not require any waxing, stripping or finishing. It also has great footfall sound absorption, and is easily repairable without requiring the removal of large expanses of the material. Wall protection, acoustic baffles and carpet were selected for their recycled content, and both carpet and baffles are recyclable. Low volatile organic compounds paints, adhesives, sealants and furnishings improve indoor air quality, helping to ensure a healthy building for patients and staff.”
Our interview with Tom Lee, design principal at HDR Chicago, revealed the intricacies of the outpatient facility’s identity, and its ability to help people of all ages heal.
“The Shirley Ryan AbilityLab tower in Chicago has a very unique, different atmosphere – its presence really commands attention and is geared to getting patients to work really hard early on in their recovery,” Lee said. “At the outpatient facility, we wanted to continue that atmosphere and that brand, but in a subtler way. Our challenge was to take this really non-descript suburban building and instill the energy and the branding power that exists at the tower, into the outpatient environment. It offers similar programming, such as the use of corridors as therapy spaces, but the colors and finishes and materials come in more subtly.”
How to design for two very different patient populations under one roof?
“There are really two sides to this project – a day rehab facility for adults, and then a pediatrics facility. We wanted to set the two sides apart, and each facility feels very different. On the pediatrics side, there’s a very tangible blend – a blurring of lines – between play and therapy. We used a cooler color palette, and had a more muted materials and finishes palette, because all of the pediatrics toys and equipment provided such a bright base. On the adult day rehab side, we used a warmer, but still very vibrant palette.”
Anchoring the two separate facilities is a middle section filled with staff areas, shared spaces, and meeting spaces.
“The shape of the building was one big rectangular block, and the spaces were very long and linear, which wasn’t ideal,” Lee said. “We created a series of floating objects that would break up the space, and we also installed acoustic baffles to the ceiling with a cascade of colors moving from warm to cool.”
>Westmead Hospital Innovation Centre, Westmead, NSW, Australia. 75,300 square feet
“The Westmead Innovation Centre forms part of the Westmead Redevelopment – the largest hospital redevelopment in New South Wales, Australia. With a highly flexible and adaptable plan, the centre will be an environment that stimulates research and development, promotes interaction and knowledge sharing, and fosters creative and strategic thinking.”
“The design has been inspired and informed by Yerrenin – an indigenous term for meeting. It is designed to encourage collaboration, including “bump spaces” where staff naturally interact and share ideas through the day, exhibition space, large meeting environments, social spaces and a “new ways of working” space at the top.”
“Its prominent location on the campus creates a new identity for the Westmead Health Precinct.”
In an officeinsight interview, Ron Hicks, Principal and National Director of Health at HDR in Sydney, Australia, noted the uncommon stars that were aligning to make the Westmead project special.
“We were bringing two independent hospitals – an adult facility and a pediatrics facility – together to the middle of the campus to integrate and see what positive things could come from that integration.”
“This project is also unique for its inclusion of a third major partner – the University of Sydney, whose medical school was already associated with Westmead. The University of Sydney wanted to become significant partners in this building project, which is located on the western fringes of Sydney, an area that is expanding with a lot of new development.”
“Out of that partnership came the task of taking part of the hospital and creating an innovation center for students and professionals. The resulting Westmead Innovation Centre is a dynamic environment where the public, students and companies can come together for many different types of activities and gatherings. It’s quite a unique offering.”
“This hospital is also in the public sector in Australia, so a space like this is quite an achievement, and it moves our public healthcare to new places – new types of environments that bring new ways of working in public healthcare setting.
“The design of this hospital has a much more urban, public place-making role compared to many other hospitals and healthcare environments.”
