5.4. Hospital

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Also at the edge of a Pedestrian Sanctuary and within the 400M Through Street Network there is a need to accommodate medical facilities, following the principles of Biophilic Urbanism.


05 4 01 Hospital.jpg


Problem-statement: Hospitals have advanced requirements for germ isolation and patient protection; yet their patients also have a basic need to stay connected to their neighborhood environments.


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Discussion:: In the past, it was assumed that the best way to maintain sterile conditions and patient comfort was to isolate hospitals in remote campus locations. This practice has caused excessive driving for patients and staff, and contributed to the fragmentation of urban areas.


However, a hospital facility need not be confined to a single massive building. Many hospitals successfully use a cluster of several buildings, inter-connected with subterranean spaces as well as overhead bridges. Sensitive areas can be located in the subterranean levels, such as surgery and nuclear medicine facilities.


05 4 02 Hospital.jpg

Two hospitals in Portland, Oregon — one a disconnected supercampus that requires driving for almost all visits, and the other, integrated into the walkable neighborhood fabric. In this way, the hospital complex can integrate with the surrounding walkable street network, providing a vital connection for patients to the life of the neighborhood.


In addition, there is a growing recognition of a connection between healing environments and the desire for close exposure to nature, or so-called “biophilia”. This recognition is now driving the “greening” of hospitals, as they move away from an isolated industrial factory typology, and toward a model that embraces the neighborhood and its human and natural life.1,2


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Therefore:

Build hospitals as integrated facilities within their neighborhoods. If necessary, use bridges, tunnels and subterranean levels to connect different buildings and functions as needed across the walkable street fabric.


05 4 03 Hospital.jpg


Create a Walkable Streetscape around the hospital, with a mix of other uses including clinics, offices, commercial spaces and residences…




¹ A major movement in so-called “biophilic” hospital design was begun in part by a famous paper by Roger Ulrich (1984), “View through a window may influence recovery”. Science, 224(4647), 224-225. (Available on the Web at https://is.muni.cz/el/1423/jaro2014/HEN597/um/47510652/Ulrich_1984.pdf.) Since then, the field has developed significantly. However, biophilic hospital design requires more than just siting a building in a remote leafy locale. As Yannick Joye noted, the buildings and the surrounding urban environment also need to reflect biophilic principles. See Joye, Y. (2007). Architectural lessons from environmental psychology: The case of biophilic architecture. Review of General Psychology, 11(4), 305- 328.


² Another important dimension of hospital design, especially acute in the developing world, is the provision of essential standards of water, sanitation, hygiene, and health care waste management and cleaning (known by the acronym WASH). These must be provided by the infrastructure supplying the hospital, as an integral part of the hospital planning, and the urban planning around it. But as this Global Baseline Report from the World Health Organization and UNICEF makes clear, too many places do not have adequate standards. And it is an urgent priority now to provide them. See https://washdata.org/sites/default/files/documents/reports/2019-04/JMP-2019-wash-in-hcf.pdf



Mehaffy, M. et al. (2020). HOSPITAL (pattern). In A New Pattern Language for Growing Regions. The Dalles: Sustasis Press. Available at https://pattern-language.wiki/.../Hospital



SECTION I:

PATTERNS OF SCALE


1. REGIONAL PATTERNS

Define the large-scale spatial organization…

1.1. POLYCENTRIC REGION

1.2. BLUE-GREEN NETWORK

1.3. MOBILITY CORRIDOR

1.4. 400M THROUGH STREET NETWORK

2. URBAN PATTERNS

Establish essential urban characteristics…

2.1. WALKABLE MULTI-MOBILITY

2.2. LEVEL CITY

2.3. PUBLIC SPACE SYSTEM

2.4. BIOPHILIC URBANISM

3. STREET PATTERNS

Identify and allocate street types…

3.1. URBAN GREENWAY

3.2. MULTI-WAY BOULEVARD

3.3. AVENUE

3.4. SHARED SPACE LANE

4. NEIGHBORHOOD PATTERNS

Define neighborhood-scale elements…

4.1. STREET AS CENTER

4.2. PEDESTRIAN SANCTUARY

4.3. NEIGHBORHOOD SQUARE

4.4. NEIGHBORHOOD PARK

5. SPECIAL USE PATTERNS

Integrate unique urban elements with care…

5.1. SCHOOL CAMPUS

5.2. MARKET CENTER

5.3. INDUSTRIAL AREA

5.4. HOSPITAL

6. PUBLIC SPACE PATTERNS

Establish the character of the crucial public realm…

6.1. PLACE NETWORK

6.2. WALKABLE STREETSCAPE

6.3. MOVABLE SEATING

6.4. CAPILLARY PATHWAY

7. BLOCK AND PLOT PATTERNS

Lay out the detailed structure of property lines…

7.1. SMALL BLOCKS

7.2. PERIMETER BLOCK

7.3. SMALL PLOTS

7.4. MID-BLOCK ALLEY

8. STREETSCAPE PATTERNS

Configure the street as a welcoming place…

8.1. STREET AS ROOM

8.2. TERMINATED VISTA

8.3. STREET TREES

8.4. STREET FURNISHINGS

9. BUILDING PATTERNS

Lay out appropriate urban buildings…

9.1. PERIMETER BUILDING

9.2. ARCADE BUILDING

9.3. COURTYARD BUILDING

9.4. ROW BUILDING

10. BUILDING EDGE PATTERNS

Create interior and exterior connectivity…

10.1. INDOOR-OUTDOOR AMBIGUITY

10.2. CIRCULATION NETWORK

10.3. LAYERED ZONES

10.4. PASSAGEWAY VIEW



SECTION II:

PATTERNS OF MULTIPLE SCALE


11. GEOMETRIC PATTERNS

Build in coherent geometries at all scales…

11.1. LOCAL SYMMETRY

11.2. SMALL GROUPS OF ELEMENTS

11.3. FRACTAL PATTERN

11.4. FRAMING

12. AFFORDANCE PATTERNS

Build in user capacity to shape the environment…

12.1. HANDLES

12.2. CO-PRODUCTION

12.3. FRIENDLY SURFACES

12.4. MALLEABILITY

13. RETROFIT PATTERNS

Revitalize and improve existing urban assets …

13.1. SLUM UPGRADE

13.2. SPRAWL RETROFIT

13.3. URBAN REGENERATION

13.4. URBAN CONSOLIDATION

14. INFORMAL GROWTH PATTERNS

Accommodate “bottom-up” urban growth…

14.1. LAND TENURE

14.2. UTILITIES FIRST

14.3. DATA WITH THE PEOPLE

14.4. INCREMENTAL SELF-BUILD

15. CONSTRUCTION PATTERNS

Use the building process to enrich the result…

15.1. DESIGN-BUILD ADAPTATION

15.2. HUMAN-SCALE DETAIL

15.3. CONSTRUCTION ORNAMENT

15.4. COMPLEX MATERIALS



SECTION III:

PATTERNS OF PROCESS


16. IMPLEMENTATION TOOL PATTERNS

Use tools to achieve successful results…

16.1. FORM-BASED CODE

16.2. ENTITLEMENT STREAMLINING

16.3. NEIGHBORHOOD PLANNING CENTER

16.4. COMMUNITY MOCKUP

17. PROJECT ECONOMICS PATTERNS

Create flows of money that support urban quality…

17.1. TAX-INCREMENT FINANCING

17.2. LAND VALUE CAPTURE

17.3. EXTERNALITY VALUATION

17.4. ECONOMIES OF PLACE AND DIFFERENTIATION

18. PLACE GOVERNANCE PATTERNS

Processes for making and managing places…

18.1. SUBSIDIARITY

18.2. POLYCENTRIC GOVERNANCE

18.3. PUBLIC-PRIVATE PLACE MANAGEMENT

18.4. INFORMAL STEWARDSHIP

19. AFFORDABILITY PATTERNS

Build in affordability for all incomes…

19.1. INTEGRATED AFFORDABILITY

19.2. COMMUNITY LAND TRUST

19.3. MULTI-FAMILY INFILL

19.4. SPECULATION TAX

20. NEW TECHNOLOGY PATTERNS

Integrate new systems without damaging old ones…

20.1. SMART AV SYSTEM

20.2. RESPONSIVE TRANSPORTATION NETWORK COMPANY

20.3. AUGMENTED REALITY DESIGN

20.4. CITIZEN DATA