The power of architecture towards better hospital buildings

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Doctoral thesis (monograph)
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Verkkokirja (78863 KB, 262 s.)
Arkkitehtuurin tutkimuksia, 2009/41
The physical qualities of a hospital building can in the best case indicate a high level of development and humanity in a given society. The academic purpose of this doctoral dissertation is to articulate the accumulated knowledge and dynamics of these qualities as well as other know-how deemed relevant to the primary quest of improving the current state of our hospitals. Its pragmatic purpose is to facilitate analysis and to assist in the development of conceptual tools meant to improve the design processes and practices, thereby creating conditions more conducive to high quality architecture. The widely held view is that recent hospital buildings have not responded to modern demands in a satisfactory manner. The hypothesis is made that this view is well-founded, and that the main reason for it is that the architectural quality of the vast majority of these hospitals has not reached the level that should be expected of major public buildings. This study claims, and attempts to show, that the underlying reasons for this lack of quality are the shortcomings in the actual design process and in the way design services are procured, as well as in an excessive emphasis on specialisation. A historic overview is presented in which the recurring themes of the study are highlighted. Four historic periods are taken up in more detail. These eras are seen by the author to be particularly relevant when creating strategies aimed at producing better buildings for health care. The examples from these past eras are analysed through drawings, old and new photographic material, site visits and discussions with present users. The study claims that only through combining lessons learnt from the past with a thorough knowledge and insight into the topical discourse can administrators, medical professionals and other user-clients, but above all architects, achieve the design quality that should be expected of our future health care facilities. The present discourse and trends have been examined through research projects and case studies, as well as discussions with major international authorities. Recommendations are made on how improvements could be achieved. Present best practices are referred to, while some topics prominent in the present discourse are critically analysed. The study concludes with a conceptual physical synthesis that consists of the presentation of two successful entries for major international architectural design competitions for health care facilities of the future. In the latter case the task was to design a city, a health care system for that city, as well as conceptual designs for the buildings serving that system. These competition entries were based on the knowledge accumulated during the process of writing this dissertation as well as experience from previous and concurrent professional practice. They provide models where lessons learnt are combined with the latest ideas on creating health care facilities that could actually become attractive places to use and visit, and would display an architectural quality of the highest order.
hospital buildings, hospitals, design processes, physical qualities, accumulated knowledge, conceptual tools, design services, architecture, architectural quality, historic periods, modern society
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