Is This the Hospital of the Future?
Words by Daniel Simons
When we think about hospitals, we imagine disease, pathology and suffering. Hospitals are a product of the industrial revolution, inspired by the factory model to be functional, sterile and efficient. What if they could be better? What if instead of treating sickness, hospitals embraced salutogenics and treated the whole person? What could the utopian hospital of the future look like? The team at OMA believe they have the answers. They believe the hospital of the future is everywhere. The hospital of the future is now.
Saulutogenic design?
In contrast to the pathogenic model, which is based on treating disease and illness, salutogenics is strength-based and focuses on supporting humans’ innate ability to create mental and physical wellbeing, especially in times of stress. It invites us to focus on factors that keep us well and calls for an environment that stimulates the mind to create pleasure, satisfaction and enjoyment.
The theory of salutogenesis was introduced by sociologist Aaron Antonovsky in 1979. Antonovsky was fascinated by the survival of prisoners in the camps of World War 2. He believed that what distinguished the survivors from those who perished was their sense of comprehension and meaning.
Antonovsky’s research led him to invent the concept of ‘coherence’. According to Antonovsky, our sense of coherence is made up of how much we understand a situation, how manageable we believe that situation to be and how we find meaning in our individual experiences. Things that enhance coherence are typically salutogenic. According to Antonovsky, our sense of coherence can impact how quickly we heal, or how precipitously we decline.
The theory of salutogenics can be applied to any building or environment. It suggests that all design should be human-centred and maximise comprehensibility, manageability and meaningfulness. In the world of work, salutogenic design can enhance mental and physical wellbeing and improve productivity. In healthcare, salutogenic design can better patient outcomes.
What does a salutogenic hospital look like?
When we design a zoo, we go to great lengths to ensure that each animal’s habitat is as conducive to their wellbeing as possible. Architects, designers, biologists, landscape architects and animal psychologists all collaborate to painstakingly create a space that accurately mimics the animal’s natural environment. So why wouldn’t we do the same for humans in a hospital?
A hospital that embodies salutogenic principles stimulates and empowers its inhabitants and fosters a sense of social and psychological wellbeing. It is designed to include things that make people feel better about themselves and their environment: good lighting, aesthetic design, access to daylight, nature, art, and symbolic or spiritual objects.
Well-designed hospitals also empower the patients to have control over their surroundings, allowing them to adjust the noise, light, airflow and temperature as much as possible and giving them control over how and when they can seek social interaction or solitude.
Salutogenic hospitals create attractive and inviting spaces that nurture social interactions and social support as well as areas that allow for personal rejuvenation and private conversations.
Paying attention to these universal human needs helps to reduce anxiety and promotes positive emotions.
Is this the hospital of the future?
In a recent talk entitled ‘Healthcare of the Future’, OMA’s Reinier de Graaf shared his perplexity about the hospital of today. “I think it is very very curious that if you consider that the main task of a hospital is to care for people, the environments they generate don’t seem to care about…people.” It was a paradox de Graaf wanted to remedy, so when he was invited to create a vision for a project in Qatar, he made sure the person came first.
The Masterplan for the Al Daayan Health District in Doha, Qatar by OMA and British engineering consultancy firm Buro Happold shows us what is possible when salutogenics, human-centred design and sustainability come together.
Their vision for the Health District is set on a 1.3 million square metre plot and uses low cost, cross-shaped modular units that are prefabricated on site. The ability to quickly assemble, expand and adapt the structure was inspired by military hospitals used at times of war and natural disasters.
The centrepiece of the sprawling design is a two-storey building that combines a teaching hospital, a women and children’s hospital and a diagnostics centre. The clinical facilities are all on the first floor, while the bed wards are on the ground floor. This design reduces the need for elevator use and gives the convalescing patients a more direct view of the structures’ many healing gardens – an architectural feature that is central to Islamic medical architecture. The 30 garden courtyards are accessed from the rooms via a shaded gallery, allowing the hospital to combine its sterile, hygienic and infection-free environment with the worlds of nature, romance and pleasure.
Environmental considerations were also essential to de Graaf, who is heavily involved in sustainability and energy planning, having contributed to the European Climate Foundation’s Roadmap 2050: A Practical Guide to a Prosperous, Low-Carbon Europe and WWF’s Energy Report. The Health District Masterplan includes a high-tech farm that supplies food and medicinal plants. The hospital also produces its own energy via its solar farm, allowing it to function autonomously. All supporting facilities are connected to the hospital by an automated underground circulation system.
The modular units are all built on site, at a low cost, and with very little reliance on global supply chains. Because they are 3D printed, they can incorporate a wide variety of aesthetically pleasing designs. As OMA puts it, “3D-printing allows for endless variations in the design of the facades, reintroducing ornament in an architectural typology usually characterised by austerity.”
The modules allow for the hospital to be constantly updated and expanded at minimal cost and with reduced resources, meaning that the structure can be scaled up or down while remaining operational. “Architects have long aimed to provide the hospital with a final solution. This proposal starts from the opposite end: viewing the hospital as the type of building that is forever under construction, as an organism for which space and time must be considered equally,” says de Graaf.
Could de Graaf and OMA have dreamed up the hospital of the future?