Hospital Architecture in China

---- Through Comparison between Chinese and Nordic Hospital Design

MASTER THESIS
Jing Ju

Examiner: Peter Frst

Tutor: Christine Hammarling

Department of Architecture
Chalmers University of Technology
Gothenburg, Sweden

Spring 2015
 ABSTRACT
ABSTRACT

With a large population, China is under great demands of hospital construction. However, the hospital design in China is
facing several problems, such as large scale, formalism and de-humanization. In this case, the thesis aims to solve
these problems so as to improve the practice of hospital design in China.

In the thesis, Chinese healthcare background is introduced by comparing with Nordic countries. The main problem of
hospital design in China is investigated. A series of solution on how to reduce size and height of a hospital, avoid
formalism and be humanization is learned through literature and case study in Nordic countries.

Finally, a conceptual proposal of a Chinese hospital is made as an application of the study into Chinese condition, which
not only improves the original proposal, but also solves the problems as is stated above effectively.

KEY WORDS: Hospital design; China; Nordic countries; size and height; improve treatment performance; adapt to
future; humanization; healthcare background; literature and case study; conceptual proposal

1
 CONTENTS
ABSTRACT 1
CONTENTS 2
STRUCTURE3 Part 4 Conceptual Proposal 30
4.1 Site background 31
Part 1 Current Healthcare Background in China 4 4.2 Concept 34
1.1 Population and health cost 5 4.3 Design process 35
1.2 Health insurance system 6 4.4 Rendering 36
1.3 Demand of hospital construction 7 4.5 Reduce size and height 39
4.6 Avoid Formalism 41
Part 2 The Problem of Hospital Design in China 8 4.7 Humanization 47
2.1 Large size and height 9 4.8 Site plan 52
2.2 Formalism 11 4.9 Floor plan 53
2.3 De-humanization 12 4.10 Model 58

Part 3 Literature and Case Study of Nordic Countries 13 CONCLUSION 59

3.1 Healthcare background 14 DISCUSSION 60
3.2 Reduce size and height 15 REFERENCES 61
3.3 Avoid formalism 18 FIGURES 62
3.4 Humanization 22 APPENDIX 65

2
 STRUCTURE
STRUCTURE

Current Healthcare background in China

Hospital design in China Study from Nordic countries

Literature study

Limited Autonomy

Case study

3
PART 1 Current Healthcare Background in China

1
Current Healthcare background in China

Hospital design in China Study from Nordic countries

Literature study

Limited Autonomy

Case study

4
1.1 Population and Healthcost

1.11.1 Population
Population andand Health
Health Cost
Cost
China
China is very
is very different
different fromfrom Sweden,
Sweden, it hasit has a large
a large population
population of proximately
of proximately 1,344,920,000
1,344,920,000 people,
people, hundred
hundred times
times bigger
bigger thanthan
Sweden,
Sweden, but but
the the expenditure
expenditure on healthcare
on healthcare is is much
much lessless
thanthan Sweden.
Sweden. Despite
Despite such
such a a disparity,
disparity, theythey
are are facing
facing a a same
same
problem of being an aging society.
problem of being an aging society. [1]
[1]

FromFrom healthcare
healthcare statistics
statistics comparison
comparison between
between China
China andand Sweden,
Sweden, we can
we can havehave a clear
a clear picture
picture about
about the the current
current Chinese
Chinese
situation.
situation. (Fig.1)
(Fig.1)

Sweden
Sweden
2000 2011
2000 2011

Total Population(000s)
Total Population(000s)
Median age(years)
Median age(years)
Aged under 15(%)
Aged under 15(%)
Aged over 60(%)
Aged over 60(%)
Annual growth rate(%)
Annual growth rate(%)
GDP/Head(US$)
GDP/Head(US$)
Health of GDP(%)
Health of GDP(%)
Health cost/Head(US$)
Health cost/Head(US$)
Government cost(%)
Government cost(%)
Private cost(%)
Private cost(%)

5
Fig 1 Healthcare statistics comparison between China and Sweden (Author: Jing Ju, based on WHO report, 2010)
1.2 Health Insurance System

1.2 Health Insurance System

The current health insurance system in China is facing several problems. Firstly, it is divided into different group of people who
pay differently for the health cost, which leads to a disparity especially between urban employees and rural farmers. Besides,
most resources are centralized in the designated hospital which is operated by the government because of the planned economy,
which leads to the abandon of the township hospital. Thirdly, the lack of government investment on healthcare leads to a heavy
burden of personal cost. [2]

The renovation of Chinese health insurance system may have the enlightenment about equality, market economy and government
responsibility by looking into Swedish social insurance system. [3] (Fig.2)

CHINA SWEDEN

Government Employee Farmer

Population in Sweden
official in urban area in rural area
Income taxes Income taxes Cooperative foundation taxes Income taxes Employer payroll fee

National Government 90% Enterprise 50% Community + National Regional National Social
Individual 10% Individual 50% Individual Government County Council Insurance Board

Designated hospital Free to Mixed

choose hospital
payment

Pay by personal insurance card; certain projects with own expense Pay in advance, then be recoverable by the insurance company

Government expenditure: 30.4% Public expenditure: 81.6%

Social expenditure: 34.7% Private expenditure: 18.4%
Private expenditure: 34.9%

6
Fig 2 Health insurance system comparison between China and Sweden (Author: Jing Ju, based on reference 2.3.)
1.3 Demand of Hospital Construction

1.3 Demand of Hospital Construction

As China grows stronger, the number of hospital construction has increased rapidly in the last 50 years. According the
government statistics, there are 23,170 hospitals (including 13,384 general hospitals) built in China in 2012. [4]

Sweden, however, has gradually decreased the hospital construction year by year. Till now, the resource of hospital in China has
come up with the number in Sweden. In 2010, there are 2.73 hospital bed per thousand population in Sweden, and 3.57 hospital
bed per thousand population in China. (Fig 3)

Number of general hospital (Per million population) Number of total hospital bed (Per thousand population)
16 Number of general hospital (Per million population) 16 Number of total hospital bed (Per thousand population)
16 16
12 12
12 12
8 8
8 8
4 4
4 4
0 0
1980 1985 1990 1995 2000 2003 1960 1970 1980 1990 2000 2010
0 0
1980 1985 China1990 1995
Sweden 2000 2003 1960 1970 China1980 1990
Sweden 2000 2010
China Sweden China Sweden

7
Fig 3 Comparison of hospital construction between China and Sweden in last 50 years (Author: Jing Ju, based on OECD health data.)
PART 2 The Problem of Hospital Design in China

Current Healthcare background in China

2
Hospital design in China Learn from developed countries

Literature study

Limited Problem Autonomy

Case study

8
2.1 Large Size and Height

2.1 Large Size and Height

Situation:
Because of the large population, hospital design in China tends to make the hospital very big so as to receive more patients.
Many projects in recent years designed hospital with over thousands beds, and even make hospital a medical city. (Fig 5)
4)

Disadvantage:
Such a big hospital will result to a long walking distances for patient and staff. Meanwhile, the medical city which makes
itself isolated from city context highlights its identity of being a hospital with abnormal life.

Hospital in Shanxi, 1300 beds Hospital in Shenzhen, 2000 beds

9
Fig 4 Size of hospital design. (Source: Baidu Image)
2.1 Large Size and Height

2.1 Large Size and Height

Situation:
Because of the limited land use with growing population, hospital design in China tends to make it high-rises. Especially in
the big city like Shanghai, many projects extend the hospital vertically to over 100 meters with a centralized layout. (Fig 5)

Disadvantage:
Such a skyscraper with a large transportation core make patients wait a long time for the elevators and delay the treatment.
Besides, the high located ward damages patients feeling for away from nature.

Huashan hospital, Shanghai, 2003 Ruijin hospital, Shanghai,2003 Zhongshan hospital , Shanghai, 2004
21F 22F 22F

10
Fig 5 Height of hospital design (Source: Baidu Image)
2.2 Formalism

2.2 Formalism
Situation:
Since the condition that most clients of the hospital project are from local government, they are willing to focus more on the
eye catching aspect so as to make their effort visible, the hospital project thus tends to be in a pursuit of formalism such as
6)
streamline, high-tech facade or a traditional Chinese roof. (Fig 7)

Disadvantage:
Such a face job leads to an over investment on facade while have no benefit for the treatment performances. Moreover, the
particular form of the hospital make it impossible for the functional change in the future.

Hospital in Jinan, Streamline Hospital in Suzhou, Chinessness

11
Fig 6 Formalism in hospital design. (Source: Baidu Image)
2.3 De-humanization

2.3 De-humanization
Situation:
Chinese hospital looks like an operated machine which only care about the symptom of decease, but lack of considering
8)
patients as individuals and care about their feelings. (Fig 7)

Disadvantage:
The hospital with little consideration of the healing environment not only damages patients feeling, but also affects the staff
effectiveness.

Waiting corridor with little consideration about healing environment Multi-bed ward

12
Fig 7 De-humanization in hospital design. (Source: Baidu Image)
PART 3 Literature and Case Study of Nordic Countries

Current Healthcare background in China

3
Hospital design in China Study from Nordic countries

Literature study

Limited Autonomy

Case study

13
3.1 Healthcare Background
3.1 Healthcare Background
3.1 Healthcare Background
Healthcare renovation in Scandinavia
Healthcare renovation in Scandinavia
Scandinavia healthcare planning has been heavily influenced by political and economic changes that have created strong
Scandinavia
pressure healthcare
to reduce planning
the cost has beenwhile
of healthcare heavily influenced
improving by political
its quality. and economic
In 1991, changes
a Stockholm Modelthat have as
is made created strong
an economic
pressure to reduce increase
control meanwhile the cost of
thehealthcare
freedom ofwhile improving
choice its quality.
for the patient. In 1991,
[5] (Fig 8) a Stockholm Model is made as an economic
control meanwhile increase the freedom of choice for the patient. [5] (Fig 9)
The outcome of the renovation turned out to be a driving factor for improving the hospital. On one hand, it makes hospital a
The outcome of the
patient-oriented renovation
hospital since turned
patientsoutaretogiven
be a driving
power tofactor for improving
express their desirethewith
hospital.
moneyOn one hand,
follows them.it On
makes hospital
the other a it
hand,
patient-oriented hospital
makes hospital more since patients
efficiently arehave
since they giventopower to express
compete theirother
with each desire with
in an money
open follows
market them.patients.
to attract On the other hand, it
makes hospital more efficiently since they have to compete with each other in an open market to attract patients.

Compete with each other

Hospital A Hospital B

Sweden Government

Patient
Jamtland Stockholm Uppsala
County County County
Council Council Council Free of choice

Hospital D Hospital C

Reduce cost on healthcare Divide to 21 county councils The Stockholm Model: internal market economy

14
Fig 8 Healthcare renovation in Scandinavia (Author: Jing Ju, based on reference 5)
3.2 Reduce Size and Height
3.2 Reduce size and height
3.2 Reduce size and height
Network of small scale hospital
Network of small scale hospital
As communication network improved, portable technology will be more universally distributed. Such development
will strengthen the trend towards
As communication homecare
network andportable
improved, ambulance-care.
technologyThe
willeffect willuniversally
be more be a globaldistributed.
reduction inSuch
largedevelopment
acute
hospitals.will
[6] (Fig 9)
strengthen the trend towards homecare and ambulance-care. The effect will be a global reduction in large acute
hospitals. [6] (Fig 10)

Patient
Hotel

Psychiatry
Laboratory

Home Portable technology General & Acute Portable technology Ambulance

Hospital care
care

Pharmacy Office Clinic

Core Hospital

Core Hospital network

Oversea
treatment

Hospital network

15
Fig 9 Network of small scale hospital. (Author: Jing Ju, based on reference 6)
3.2 Reduce Size and Height
3.2 Reduce size and height
Limited height

There is abundant evidence shows that high buildings actually will damage peoples mind and feelings. They wreck the open
spaces near them, and they damage light and air and view. Therefore, most buildings shall have a four-storey limit. [7]

The four-storey height makes people on the ground as well as the one inside the building feel secure. The higher the building
is, the more frightening people will feel. It is said that the hospital should not be taller than the highest tree. (Fig 10)

Frightening

Secure

20-floor height

16
Fig 10 Limited height of the hospital (Author: Jing Ju, based on reference 7)
3.2 Reduce Size and Height
3.2 Reduce size and height
3.2 Reduce size and height
Take account of city context
Take account of city context

StStOlavs
OlavsHospital,
Hospital,Norway
Norway

Architectureis isananautonomous
Architecture autonomouslanguage
languagethat thathashasa collective
a collectivememory
memoryof ofform,
form,which
whichis isembedded
embeddedin inthethehistory
historyof ofthethecity.
city.
WeWeshould
shouldavoid
avoidbeing
beingnostalgic
nostalgicor orbased
basedononform
formalone,
alone,butbutfocus
focusononimproving
improvingtreatment
treatmentperformance
performanceandandadaptadapttotonew new
conditions.
conditions.

In InStStOlavs
OlavsHospital,
Hospital,thethehospital
hospitalis isdivided
dividedinto
intoseveral
severalblocks
blocksbasedbasedonona city
a citygrid,
grid,which
whichmakes
makeshospital
hospitalwell
wellintegrated
integratedwith
with
urbanlife,
urban life,meanwhile
meanwhilegivesgiveseasy
easyaccess
accessfromfromevery
everystreet.
street.(Fig(Fig11)12)

Hospital

Hospital scale followed the city grid

City

17
Fig 11 City size of St Olavs Hospital, Norway (Author: Jing Ju, based on reference 5)
3.3 Avoid Formalism
3.3 Avoid Formalism
Improve treatment performance

Akershus University Hospital, Oslo

The main idea of the Akershus University Hospital is that treatment, offices, outpatient and bed wards are planned as a clinical
unit which close to each other on the same floor. The hospital consists of several clinical unit which is organized according to
different disease. As a result, the treatment performance become more efficiently. (Fig 12)

Ward & outpatient

Treatment Office

Ward & outpatient

18
Fig 12 Improve treatment performance, Akershus University Hospital, Oslo (Source from C.F.MOLLER Architects, 2008)
3.3 Avoid Formalism
3.3 Avoid Formalism

3.3 Avoid
Adapt Formalism
to future conditions

Adapt to future conditions

McMaster Health Sciences Center
McMaster Health Sciences Center
Due to the fact that the medical technology nowadays is changing rapidly, we have to thinking long term for the flexibility and
adaptability
Due to the factofthat
the the
hospital design.
medical technology nowadays is changing rapidly, we have to thinking long term for the flexibility and
adaptability of the hospital design.
The McMaster Type is designed with rectangular forms which try to standardize different functions. In each module, the
vertical
The shaftsType
McMaster are isondesigned
the cornerwith
of the outside wall
rectangular formsforwhich
services [5] (Fig 13)
try to standardize different functions. In each module, the
vertical shafts are on the corner of the outside wall for services [5] (Fig 13)

Main corridor links to all courtyards

Main corridor links to all individual modules

19
Fig 13 Modular design of McMaster Health Sciences Center (Author: Jing Ju, based on reference 5)
3.3 Avoid Formalism
3.3 Avoid Formalism
Adapt to future conditions

New Karolinska Hospital, Sweden

The New Karolinska Hospital is called the max-flexible hospital. Based on a general structure system, the hospital can be
organized in many different ways, so that it will not be locked into any specific use and can be as up-to-date as possible when
moving in occurs.

The building is designed with a general floor-to-floor height and a general load capacity so that the equipment such as X-rays
and surgeries can be moved to any where in the building. The various type rooms are based on a modular network of 9*9m,
which can meet the demand of possible functional change in the future.[8] (Fig 14)

General room section Single patient room ICU open area

20
Fig 14 General room design of New Karolinska Hospital, Sweden. (Source: from reference 8)
3.3 Avoid Formalism
3.3 Avoid Formalism
Adapt to future conditions

Automatic storage technology

In the future, the traditional storage room maybe replaced by automatic storage system, which have already been used in
used incountries
many many countries in the
in the field field of healthcare.
of healthcare. Such a can
Such a system system can maximum
maximum use ofonspace
use of space on a minimal
a minimal footprint,footprint,
and also reduce
and risk
the alsoofreduce the in
infection risktheofhospital.
infectionBesides,
in the hospital. Besides,
the flexible the with
storage flexible storagesystem
a modular with a modular systemtocandifferent
can be adapted be needs.
adapted to different needs. (Fig 15)

21
Fig 15 Automatic storage technology (Source: from Kardex Remstar)
3.4 Humanization

3.4 Be Humanization
Patient-focused Hospital
St Olavs Hospital, Norway

In the traditional nursing organization, the patients are moved to specialties and function units. Much time is spent in
transportation between different units, such as operation, laboratory, wards etc.

The principle of a patient-focused hospital is that the resources are allocated to the patients. In this way, the total
transportation of the patients can be reduced. Another advantage is that the individual patient will be in contact with a
minimal number of staff which reduce mistakes in medication. [5] (Fig 15)
16)

Spec A Spec B
Spec A Patient Patient Spec B
Doctor

Too much transportation Patient

Nurse

Spec D Patient Patient Spec C

Spec D Spec C

Traditional/functional organization of medical activities Patient-focused organization of medical activities

22
Fig 16 Different organization of medical activities. (Source: from reference 5)
3.4 Humanization

3.4 Be Humanization
Patient-focused Hospital
St Olavs Hospital, Norway

St Olavs Hospital has a decentralized organization with six clinical centers. These centers are based on a specialty and the
associated patient groups. i.e. Women/child center or heart/lung center. Each clinical center is given a high degree of self-
sufficiency that traffic of patients and staff between the centers can be minimized. (Fig 17)
16)

Associated patient group

Female/ Mobility Heart/lung Gastro Psychiatry Neuro

children
center center center center center
center 1 2 3 4 5 6 8
9

1
Patient hotel 7 7
Staff center 8 6 2
Laboratory center 10
9
5 11
Supply center 10 3

Emergency center 11 4

Organization model in diagram Organization model on master plan

23
Fig 17 Organization model of St Olavs Hospital, Norway. (Source: from reference 5)
3.4 Humanization
3.4 Be Humanization
Patient-focused Hospital
St Olavs Hospital, Norway

All the clinics have wards, polyclinics for investigation and treatment, day surgery with an operating department, special
laboratories and premises for teaching and research, offices, and dining room, so that the decentralized center will be self
sufficient for different associated patients. The neuro center is taken as an example to describe as follows:

Plan 1 contains general functions such as main entrance, reception, polyclinics, day surgery and canteen. Plan 2 contains
teaching, research, examination, conference rooms and offices. Plan 3 and 4 contain ward spaces for treatment and
18)
operations. The underground level contains technical space, storage and culvert. (Fig 17)

Poly
clinic
Poly clinic ward
ward
Main entrance Canteen
ward Ward
Lobby Poly clinic To patient hotel
Surgery Office ICU Treatment To patient hotel
Ambulance Main entrance Lobby Surgery Poly clinic
Poly clinic Tech Tech Auditorium

Poly clinic

To female/child center

Ground Floor Plan of Neuro Center Section from the main entrance of Neuro Center

24
Fig 18 Floor plan and section of Neuro center in St Olavs Hospital, Norway. (Source: arkitektur n . 05 . 2007)
3.4 Humanization
3.4 Be Humanization
Sociality

Dayroom/dining room

Day room/dining room is very pleasant for patient to have social life and communicate with hospital staff, because it is a place
where five senses can be stimulated in the same time, like the taste and smell of food, nice eye view and appealing music.
The day room/dining room is better to have a close connection with the main entrance, courtyard and staff area, so that it can
be frequently used. (Fig 19)
18)

Dining Courtyard
room

Main entrance

A pleasant dining room benefits for social life in hospital Dining room has a good connection with main entrance and courtyard

25
Fig 19 Dining room in St Olavs hospital, Norway. (Source: arkitektur n . 05 . 2007)
3.4 Humanization
3.4 Be Humanization
Safety

Nursing Organization Nursing Layout

In traditional round nursing system, the nursing work is
divided into functions according to the conveyor belt
principle, which result to too many staff dealing with
one patient. It is difficult for the patients to know whom
they should turn for help. However, in the pair nursing
system, one nurse and an assistant nurse work together,
and there is a marked division of responsibility for a
group of patients.
The overview of the whole ward from the nurse station will
increase the patients feeling of security. For this reason,
there should not be more than one entrance. A good
sense of control is particularly important at night and on
weekends when the staffing is low. It is easier to achieve
a good sense of control with planning solutions that have
a single or an L-shaped corridors. (Fig 20)
19)

7 pat
10 patients 10 patients

2-pat 4-pat 4-pat 1 1 4-pat 4-pat 7 pat

1 nurse 1 nurse 7 pat 7 pat

1 ass. nurse 1 ass. nurse

Nurse station
Utility room
Head nurse Doctor Dining room
Entrance
Decentralized team station

Nursing organization in Narrokoping hospital, Sweden Nursing layout in Narrokoping hospital, Sweden

26
Fig 20 Nursing organization and nursing layout in Narrokoping hospital, Sweden. (Author: Jing Ju, based on reference 5)
3.4 Humanization
3.4 Be Humanization
Privacy

Three-patient room

The traditional planning of 3- The beds are placed at right

patient room put all three beds angles to each other. This
in a row on one side, which enable each patient to have
makes the patient in the middle a corner of his own. It is
far too exposed. easy for staff and relatives
to talk to patients.
The bed in the middle is not
allowed to use curtains during The bay windows introduce
the day since this cuts out the more light and offer a
daylight to the bed by the pleasant place to sit and
corridor. chat. (Fig 21)

3-patient room in Halmstad Hospital, Sweden 3-patient room in Kalmar Hospital, Sweden

27
Fig 21 Different three-patient room arrangement in Halmstad Hospital and Kalmar Hospital, Sweden. (Source: from reference 5)
3.4 Humanization
3.4 Be Humanization
Human Contact

The traditional nurse station with glazed window is not good for An open nurse station designed with varying levels is good for patients
contact with patients and visitors. in wheelchairs to have eye contact with nurse and staff. (Fig 22)

Nurse station in Vanda hospital, Finland Nurse station in St Olavs Hospital, Norway

28
Fig 22 Different nurse station in Vanda Hospital, Finland and St Olavs Hospital, Norway. (Author: Jing Ju, based on reference 5)
3.4 Humanization
3.4 Be Humanization
Feel of Nature

Vision
Vision is the sense that often gives us the first impression of the surrounding. Exposure
to daylight is effective in reducing depression and improving mood. Proper daylight
conditions also increase day time alertness, and fostering better sleep quality.

The art painting in the room plays an important role for patients to sense nature. The
representational nature paintings containing human figures and harmless animals such
as bird are preferred over counterparts that are somewhat abstract. [9]

Hearing Bird
Mimic pleasant nature sounds, such as birds and water, can be used as a therapeutic
tool in order to enhance well-being and distracting patients from stressful symptoms. [9]

Taste
Sunlight Water
The taste is closely connected to the sense of smell. The smell of flower evokes its
sweet taste. By drinking cool water, it can stimulates its aroma of mint.

Smell
The various type of smell such as the fresh leaves and fragrant flowers in the air can
recall good memories, and reduce pain from the patient.

Touch Greenery Flower

Touch is a tactile sense. The sense of touch helps us to orientate ourselves and to feel
the limits between our bodies and the environment. Through touch, we feel warm or cold,
hard or soft. It also help transmitting information for blind when touching. [9] (Fig 23)

29
Fig 23 EBD in healing environment. (Author: Jing Ju, based on reference 9)
 PART 4 Conceptual Proposal

Current Healthcare background in China

4
Hospital design in China Learn from developed countries

Literature study

Limited Design Autonomy

Case study

30
4.1 Site Background

4.1 Site Background

Shanxi Province Taiyuan City Yingze District

The site is the People's Hospital in Shanxi, which is located

in center of Shanxi Province in China. It is the biggest
general hospital in Shanxi province, serving for a population
of 4,277,700 inhabitants in Taiyuan City.

The hospital has undergone several changes since first

constructed in 1953. Today, however, the hospital is in need
of an upgrade to meet the new technology advancements and SITE
demands with healthcare. [10]

31
Fig 24 Site background. (Source: Baidu Map)
4.1 Site Background

Problem of existing hospital

Arbitrary extension within the site Disoriented main hall Long corridor with no light and little waiting area

Hospital area: 56 000 sqm

Acute care (Hot floor): the patient in emergency; 2 000 sqm
Inpatient care: the patient in bed; 21 000 sqm
Outpatient care: the patient visit and treatment; 15 000 sqm
Medical service: laboratory and research etc. 12 000 sqm
Technical service (-1F): supply, kitchen etc. 6 000 sqm
Staff area: 67 000 sqm
Staff dormitory, administration and dining 67 000 sqm

The layout is a series of individual buildings, with its own function

and has no connection with each other. People have to take much
time on transportation.

32
Fig 25 Problem of existing hospital (Author: Jing Ju, based on reference 10)
4.1 Site Background

Problem of original proposal

The new high-rise casts a big shadow on the existing People waiting for elevators in the centralized The multi-bed ward has little concern about
ward; Elliptical form unsuitable for functional change transportation core the healing environment.

Hospital area: 73 600 sqm

Acute care (Hot floor): the patient in emergency; 8 000 sqm
Inpatient care: the patient in bed; 29 000 sqm
Outpatient care: the patient visit and treatment; 12 600 sqm
Medical service: laboratory and research etc. 13 000 sqm
Technical service (-1F): supply, kitchen etc. 11 000 sqm
Staff area: 63 000 sqm
Staff dormitory, administration and dining 63 000 sqm

The original proposal has a centralized layout with ward on the top,
which result to large transportation and make the ward far away
from the nature.

33
Fig 26 Problem of original proposal (Author: Jing Ju, based on reference 10)
4.2 Concept

4.3 Concept

SIZE HEIGHT FORMALISM HUMANIZATION

Hospital

City

Small scale Close to nature Improve treatment performance Healing environment

Connection to city Horizontal expansion Adapt to future condition Way finding

34
Fig 27 Concept (Author: Jing Ju)
4.3 Design Process

1. Original Plan 2. Keep and demolish old buildings 3. Add new buildings according to city grid

4. Inner corridors connect with all buildings 5. Create orientation center and pulic pathway for easy way finding 6. Frame courtyard along the pathway

35
Fig 28 Design process (Author: Jing Ju)
4.4 Rendering

36
Fig 29 Birdview (Author: Jing Ju)
4.4 Rendering

37
Fig 30 Interior of orientation center (Author: Jing Ju)
4.4 Rendering

38
Fig 31 Public corridor between out-patient department and in-patient department (Author: Jing Ju)
4.5 Reduce Size and Height

City context

Main entrance
Old city
The three main flow which come from old city, bus terminal and
Bus Train station train station, take about 30min to the site by public
terminal
transportation. They mainly use the street along the southern
Patient hotel
edge of the hospital area which is suitable for having a main
entrance.

Patient hotel
The location of the patient hotel is better to be in the east of
City transportation analysis the site which has a close connection both with the hospital
and the train station, so as to facilitate patients and relatives
from afar.

Medical university Hospital

Hospital
Hospital Hospital network
Due to the influence of the medical university, many hospitals
Hospital
are distributed within the district, which makes the hospital
Hospital
network possible in the future, and result to a decrease the
hospital scale on the basis of communication technology.
City hospital network analysis

39
Fig 32 City Context (Author: Jing Ju)
4.5 Reduce Size and Height

Surrounding

Bus stop

N N N

Greenage
Psychiatry

Residential
Ward

Patient hotel Patient hotel

School

N N N

40
Fig 33 Surrounding (Author: Jing Ju)
4.6 Avoid Formalism

4.6 Hospital Organization

Improve
4.6 treament
Hospital performance: Hospital Organization
Organization
Patient perspective of the hospital organization
Patient perspective of the hospital organization
The design is a decentralized organization with six clinical centers and an orientation center for easy way-finding. These
centers are isbased
The design on a specialty
a decentralized and the associated
organization patientcenters
with six clinical groups.and
Each
an clinical center
orientation provides
center mainway-finding.
for easy entrance, public
These
functions,
centers areoutpatient
based on adepartment, wards,
specialty and office and sub-emergency,
the associated whichclinical
patient groups. Each is givencenter
a highprovides
degree of self-sufficiency.
main entrance, public
functions, outpatient department, wards, office and sub-emergency, which is given a high degree of self-sufficiency.
Associated patient group

Associated patient group

6
Heart/lung Female/ Mobility Gastro Neuro Psychiatry
center children
center 2
center center center center 6
Heart/lung1 Female/ 5
Mobility3 Gastro 4 Neuro 5 6
Psychiatry
center children
center 2
center center center center
1 3 4 5 6 5
11
4
1
Reception and primary care center 7 11
4
10 9 17 3
Emergencyand
Reception center
primary care center 7
8 12
10 9 7 3
Emergency
Laboratory center 8 2
8
9 12

Laboratory 8 2
Staff centercenter 9
10
Staff
Supplycenter
center 10
11
Supply center
Patient hotel 11
12
Patient hotel 12

41
Fig 34 Hospital organization (Author: Jing Ju, based on reference 5)
4.6 Avoid Formalism

Improve treatement performance: Hospital layout

Car entrance

Pedestrian entrance

Logistics entrance

Ambulance flow
Logistics flow
Car flow

Ambulance parking

Truck parking
Entrance square
Temporary car parking
Ambulance entrance Pedestrian entrance Car entrance Car entrance
Pedestrian entrance Entrance of underground parking

Main traffic road Range of underground parking

Car and pedestrian entrance Car flow

Pulic pathway
Pulic courtyard

Out-patient courtyard
Main flow
In-patient courtyard
Secondary flow

Pedestrian flow Public passage and greenage

42
Fig 35 Hospital layout (Author: Jing Ju)
4.6 Avoid Formalism
Level 5-11.
Improve treatment performance: Program and flow Ward Ward

Ward
Level 5-6.
Ward

Ward
Helipad

OPD
OPD Ward
Laboratory
OPD

Emergency Ward
OPD Level 4.
Ward
OPD

Ward

Supply
OPD
OPD Ward
Laboratory
OPD
Emergency Ward
OPD Level 3.
Ward
OPD

Ward

Supply
OPD
Laboratory OPD Ward
Sub-emergency
Orientation OPD
Emergency Ward
OPD
Level 2.
Ward
OPD Sub-emergency
Wind Main activities Sun orientation Nature green Ward

Supply OPD
Ward
Laboratory
Sub-emergency Acute
OPD
Orientation
Emergency OPD
Ward
OPD

Ward
OPD Sub-emergency Out patient Level 1.
Ward
Main idea of clinical cluster In patient

Staff flow Ambulance flow

Emergency halll OPD department Ward Patient flow Parking

Office
Underground
Treatment Parking
Lobby Visitor flow Pharmacy/cafe Sub-emergency Visitor flow Emergency flow
Pre-OP Storage Level B1.

Post-OP OP theater OPD department Ward

Emgerncy function and flow Clinical cluster function and flow Exploded axo
43
Fig 36 Program and flow (Author: Jing Ju)
4.6 Avoid Formalism

Improve treatment performance: Program comparison

The area analysis shows that the new proposal mainly expands its functions in the acute care and outpatient
department, while decreasing the size of ward unit in comparing with the original proposal. Other functions such as
medical service and technical service remains the same as the existing hospital.

The total hospital area is 69 000sqm, bigger than the existing hospital (56 000sqm) and a bit smaller than the original
proposal (73 600sqm).

40
000sqm

30 29

24
21 Existing hospital
20
20
Original project
15 New proposal
12.6 13
12 12
11 11
10 8
6 6

0
Acute care Inpatient care Out patient care Medical service Technical service

44
Fig 37 Program analysis (Author: Jing Ju, based on reference 10)
4.6 Avoid Formalism

Improve treatment performance: Construction process

1. Original hospital 2. Build new ward and new supply center 3. Build new outpatient department

Legend
Emergency center
Ward
Outpatient department
Laboratory center
Supply center
Public pathway

4. Build new emergency and laboratory center 5. Move emergency to build the outpatient department;
Build orientation center and public pathway
45
Fig 38 Construction process (Author: Jing Ju)
4.6 Avoid Formalism

Adapt to future: Flexible room arrangement

50000 50000
4000 5700 5700 7500 7500 7500 7500 4000 4000 5700 5700 7500 7500 7500 7500 4000

6000
6000

6000
6000

15000
15000

15000
3000
15000
3000

3000
3000

6000
6000

6000
6000
4000 5700 5700 7500 7500 7500 7500 4000 4000 5700 5700 7500 7500 7500 7500 4000
50000 50000

Out patient department with double corridors In patient department with 3-pat room and single-pat room

50000 50000
4000 5700 5700 7500 7500 7500 7500 4000 4000 5700 5700 7500 7500 7500 7500 4000

6000
6000

6000
6000

15000
15000

15000
3000
15000
3000

3000
3000

6000
6000

6000
6000

4000 5700 5700 7500 7500 7500 7500 4000 4000 5700 5700 7500 7500 7500 7500 4000
50000 50000

Out patient department with single corridor Laboratory department

46
Fig 39 Flexible room arrangement (Author: Jing Ju)
4.7 Humanization

Way finding: Comparison of enclosed square

The enclosed square makes entrance space very important so as to guide people into the hospital. A large enclosed square
with a narrow entrance wont be easily noticed from the outside, meanwhile the emergency and laboratory building surround it
The enclosed square makes entrance space very important so as to guide people into the hospital. A large enclosed square
makes the square less used by the public. If enlarge the entrance and locate an orientation center in the middle which has a
with a narrow entrance wont be easily noticed from the outside, meanwhile the emergency and laboratory building surround it
good connection with all the buildings will benefit for easy way finding.
makes the square less used by the public. If enlarge the entrance and locate an orientation center in the middle which has a
good connection with all the buildings will benefit for easy way finding.

Narrow entrance with large enclosed square Enlarge entrance connects with orientation center

47
Fig 40 Comparison of enclosed square (Author: Jing Ju)
4.7 Humanization
Way finding: Comparison of main entrance
The front of main entrance
The front of main entrance
The front of main entrance
The front of main entrance
Fig 41 Comparison of main entrance (Author: Jing Ju)
Original main entrance
The orientation center is hidden from the street, which
makes patient difficult to find the entrance.
Street view of main entrance
Bottom overhead main entrance
The bottom overhead structure of the original building
makes the orientation center recognizable from the
street perspective, however still a bit confusing.
Street view of main entrance
Tall entrance
The tall ceiling makes the entrance distinctive and
offers a public space in the front, however, the nice
form has little benefit for the performance.
Street view of main entrance
Low entrance
The low entrance is easy for patient to recognize from
the street and follow the way to the orientation center,
meanwhile gives importance to the old building.
Street view of main entrance
48
4.7 Humanization

Way finding: Path towards entrance

The tallest existing building

People will easily notice the tallest existing building from
afar and guide their way to the hospital.

Horizontal space corridor

When people follow the way and arrive at the main entrance,
they will see a horizontal space corridor which indicate them
to pass through.

Two paths for patient

When people get to the central square, they can either go to
the orientation center on the left to know which building to go
if come for the first time , or go directly to the decentralized
clinical center on the right.

49
Fig 42 Path towards entrance (Author: Jing Ju)
4.7 Humanization

Patient needs: Ward layout

Safety: Single corridor with nurse station near the entrance Sociality: Dining room close to entance, nurse station and courtyard

Safety: decentralized team station with each responsible for 9 patients Automatic storage system: decentralized storage close to team station and patient room

50
Fig 43 Ward layout (Author: Jing Ju)
4.7 Humanization

Patient needs: Three-patient room

Wardrobe next to patient with bed height Each patient has a family zone at its own coner All facilities hidden backward to the patient

A triangle coummunication relationship among patients Look through from the entrance Access to nature from bay window and balcony

51
Fig 44 Three-patient room (Author: Jing Ju)
 In-patient flow

4.8 Site Plan 1:1000 6F

Out-patient flow Neuro Center

Ward
4F
Underground parking

Neuro Center
OPD
Sub-Emergency

3F

Logistics Supply Center Reception

6F
4F Gastro Center
Gastro Center Ward
11F
OPD
Heart and Lung Center

Reception

4F
Orientation and
Primary care Center 6F
4F Mobility Center
Laboratory Mobility Center Ward
Center OPD
Staff Area

Ambulance
Reception Sub-Emergency
Underground parking
4F

Emergency Center
Space Corridor 2F Female and Children Center 4F Female and Children Center 6F
OPD (Out patient department) Ward

Emergency Main entrance In-patient flow

52
Fig 45 Site plan (Author: Jing Ju)
4.9 Floor Plan 1:1000 In-patient flow

Ward
OPD
Out-patient flow 12
Sub-emergency
3
Supply
9 5
OPD Ward 1
OPD

OPD Ward 4 11
Laboratory 13
Underground parking
Sub-emergency 4 7
1
Emergency
Entrance OPD Ward

14
1
11
Logistics 2 8
1. Traffic Space
2. Lobby
3. Ward
4. Poly clinic
5. Treatment 9 5
12
6. Emergency 1
7. Operation theater 5 1 11 3
12 9
8. Imaging diagnosis 1
4 13
9. Office 1 11 2
10.Research Laboratory
11.Storage 4
13
12.Dayroom /Dining room
13.Consulting room
14.Shop /Pharmacy /Cafe
14
2
11
1

4 9 5
11 1
1
3
2 4 12
10
2

8
12
Ambulance
14
2
7 Underground parking
1 6
9

8 13
11 2 4 13
1 11 1
7 1
9 12 5 3

Emergency Main entrance In-patient flow 53

Fig 46 Ground floor plan (Author: Jing Ju)
4.9 Floor Plan 1:1000

Ward
OPD
12
Roof garden
3
Supply
5
OPD Ward 9 1
OPD

OPD Ward 4 11
Laboratory 13
Roof garden 4
1
Emergency
Roof garden OPD Ward

1
11
1. Traffic Space
2. Lobby
3. Ward
4. Poly clinic
5. Treatment 9 5
12
6. Emergency 1
7. Operation theater 5 11 3
12 9 1
8. Imaging diagnosis 1
4 13
9. Office 1 11
10.Research Laboratory
11.Storage 4
13
12.Dayroom /Dining room
13.Consulting room
14.Shop /Pharmacy /Cafe

11
1

4 9 5
11 1
1 3
4 12
10

12

1
9

8 13
11 2 4 13
11 1
1
7 1
9 12 5 3

54
Fig 47 Third floor plan (Author: Jing Ju)
4.9 Floor Plan 1:400

50000
4000 5700 5700 7500 7500 7500 7500 4000

Storage Storage Staff Staff Staff Staff Staff Staff Treatment Treatment

6000

6000
Reception Poly Poly Poly Poly Reception

15000

15000
Storage Storage

3000

3000
clinic clinic clinic clinic

6000

6000
Waiting Poly Poly Poly Poly Consulting room Treatment
area clinic clinic clinic clinic

4000 5700 5700 7500 7500 7500 7500 4000

50000

Out patient department (Double corridor)

50000
4000 5700 5700 7500 7500 7500 7500 4000

Storage Storage Poly-clinic Poly-clinic Poly-clinic Poly-clinic Poly-clinic

Staff Staff Treatment Treatment
6000

6000
Storage

Waiting area Waiting area

15000

15000
3000

3000
Consulting room Reception
6000

6000
Poly-clinic Poly-clinic Poly-clinic

4000 5700 5700 7500 7500 7500 7500 4000

50000

Out patient department (single corridor)

55
Fig 48 Floor plan of out-patient department (Author: Jing Ju)
4.9 Floor Plan 1:400

50000
4000 5700 5700 7500 7500 7500 7500 4000

1-pat 1-pat 1-pat 1-pat 1-pat 1-pat

Nurse station

6000

6000
Dencentralized station Dencentralized station

15000

15000
3000

3000
Dayroom 3-pat 3-pat 3-pat 3-pat

6000

6000
4000 5700 5700 7500 7500 7500 7500 4000
50000

Ward Unit

50000
4000 5700 5700 7500 7500 7500 7500 4000

Dayroom Dayroom Office Office Office Office Office Office Office Office Storage
6000

6000
15000

15000
3000

3000
Laboratory
6000

6000
4000 5700 5700 7500 7500 7500 7500 4000
50000

Laboratory department

56
Fig 49 Floor plan of in-patient and laboratory department (Author: Jing Ju)
4.9 Floor Plan 1:100

5600
7500

Toilet

6000
6000

6000

6000
3-PAT Room 1-PAT Room Toilet

Bay window Balcony Bay window Balcony

7500
5600

Three-patient room Single-patient room

57
Fig 50 Floor plan of patient room (Author: Jing Ju)
4.10 Model

58
Fig 51 Model photo (Photographer: Jing Ju)
 CONCLUSION
Research
Research
Design (Application of research)
Design (Application of research)

China (Problem) Nordic countries (Solution) Exiting hospital (Problem) Conceptual Proposal(Solution)

Large size and height Network of small scale hospital Over 1000 beds Hospital network in the city: 500 beds in ward; 300 beds in patient hotel

Height limited 100m height 4-storey in outpatient department; 6-storey in ward buildings

Formalism Integrate with city context Inflexible form Start from city analyze and follow the city grid

Improve treatment performance Outpatient, offices and ward close to each other on the same floor

Modular and general design Modular building with flexible room arrangement

Automatic storage technology Use automatic storage technology instead of traditional storage room

De-humanization Patient-oriented hospital Disoriented main hall Decentralized organization with six clinical centers and an orientation center

Sociality-Dining room Long corridor without waiting area Dining facing south closes to courtyard, patient room and public corridor

Safety-Nursing organization and Large and centralized Decentralized team station with every nurse takes care of 9 patients;
nursing layout transportation core L-shaped and single corridor with a nurse station located in the center

Privacy-Three patient room Multi-bed ward without Every patient has a corner of its own, share with a bay window and a balcony
healing environment

Human Contact-Nurse station Open nurse station with varying levels benefits patients in wheelchairs

EBD in healing environment Nature and visual art in public area

59
Fig 52 Conclusion (Author: Jing Ju)
 DISCUSSION

The starting point of this thesis is the healthcare studio which I participated for designing a general hospital in Sweden last
semester. This is the first time for me to design a hospital. In order to get familiar with the hospital design, we made a study
trip to St Olavs Hospital, where I was greatly impressed with its large differences in comparing with Chinese hospitals. So I
started to make reflection during the hospital design, and learned a lot about the theory of hospital design which I thought
can be introduced into China.

Through the thesis I made further understanding about the hospital design, especially in the aspect of humanization which I
think can be further developed.

The thesis provides a perspective to look into the hospital design by comparing with different countries. It offers a big
background which even refers to politics, while ends with a practical proposal in an architectural way.

The thesis is suitable for most of the situation in China, however, in some special cases, it may asks for different solutions on
hospital design. For example, some big cities with strong urban context and land limit may not fit with a small scale hospital.
A high rise which has solved the elevator problem can be a nice solution since its compact structure makes everything
closely located in distance.

After all, the thesis offers a different view in Chinese hospital design by investigating the problem and solving it through
learning experience from Nordic countries. I hope that the thesis can help people get inspired and give rise to further insight
regarding this topic.

60
 REFERENCES

[1] World Health Organization. World health statistics 2010. World Health Organization, 2010.
[2] Zhichao Liu. The renovation of social insurance system in Sweden which gives the enlightenment to China. Shanxi
Univeristy, 2013.
[3] Anell, Anders. Swedish healthcare under pressure. Health economics, 2005.
[4] National health statistics yearbook of the Peoples Republic of China, 2013.
Available at: http://www.nhfpc.gov.cn/htmlfiles/zwgkzt/ptjnj/year2013/index2013.html
[5] A Dilani. Design and care in hospital planning. Karolinska Institutet. 1999.
[6] Dyro, Joseph. Clinical engineering handbook. Academic Press, 2004.
[7] Alexander, Christopher, S. Ishikawa, and M. Silverstein. Pattern Languages. Center for Environmental Structure 2,1977.
[8] Stockholm County Council. New Karolinska Solna, Memorandum of information. Stockholm, 2008.
[9] Ulrich, Roger S., et al. A Review of the Research Literature on Evidence-Based Healthcare Design. HERD: Health Environments
Research & Design Journal, 2008.
[10] Donghui Qi. Research into the Strategy of the Integrated Construction Design of General Hospital. Tsinghua University, 2004.

61
 FIGURES
Fig 1: Healthcare statistics comparison between China and Sweden (Author: Jing Ju, based on WHO report, 2010)
Fig 2: Health insurance system comparison between China and Sweden (Author: Jing Ju, based on reference 2.3.)
Fig 3: Comparison of hospital construction between China and Sweden in last 50 years (Author: Jing Ju, based on OECD health data.)
Fig 4: Size of hospital design. (Source: Baidu Image)
Fig 5: Height of hospital design (Source: Baidu Image)
Fig 6: Formalism in hospital design. (Source: Baidu Image)
Fig 7: De-humanization in hospital design. (Source: Baidu Image)
Fig 8: Healthcare renovation in Scandinavia (Author: Jing Ju, based on reference 5)
Fig 9: Network of small scale hospital. (Author: Jing Ju, based on reference 6)
Fig 10: Limited height of the hospital (Author: Jing Ju, based on reference 7)
Fig 11: City size of St Olavs Hospital, Norway (Author: Jing Ju, based on reference 5)
Fig 12: Improve treatment performance, Akershus University Hospital, Oslo (Source from C.F.MOLLER Architects, 2008)
Fig 13: Modular design of McMaster Health Sciences Center (Author: Jing Ju, based on reference 5)
Fig 14: General room design of New Karolinska Hospital, Sweden. (Source: from reference 8)
Fig 15: Automatic storage technology (Source: from Kardex Remstar)
Fig 16: Different organization of medical activities. (Source: from reference 5)
Fig 17: Organization model of St Olavs Hospital, Norway. (Source: from reference 5)
Fig 18: Floor plan and section of Neuro center in St Olavs Hospital, Norway. (Source: arkitektur n . 05 . 2007)
Fig 19: Dining room in St Olavs hospital, Norway. (Source: arkitektur n . 05 . 2007)
Fig 20: Nursing organization and nursing layout in Narrokoping hospital, Sweden. (Author: Jing Ju, based on reference 5)
62
 FIGURES
Fig 21: Different three-patient room arrangement in Halmstad Hospital and Kalmar Hospital, Sweden. (Source: from reference 5)
Fig 22: Different nurse station in Vanda Hospital, Finland and St Olavs Hospital, Norway. (Author: Jing Ju, based on reference 5)
Fig 23: EBD in healing environment. (Author: Jing Ju, based on reference 9)
Fig 24: Site background. (Source: Baidu Map)
Fig 25: Problem of existing hospital (Author: Jing Ju, based on reference 10)
Fig 26: Problem of original proposal (Author: Jing Ju, based on reference 10)
Fig 27: Concept (Author: Jing Ju)
Fig 28: Design process (Author: Jing Ju)
Fig 29: Birdview (Author: Jing Ju)
Fig 30: Interior of orientation center (Author: Jing Ju)
Fig 31: Public corridor between out-patient department and in-patient department (Author: Jing Ju)
Fig 32: City Context (Author: Jing Ju)
Fig 33: Surrounding (Author: Jing Ju)
Fig 34: Hospital organization (Author: Jing Ju, based on reference 5)
Fig 35: Hospital layout (Author: Jing Ju)
Fig 36: Program and flow (Author: Jing Ju)
Fig 37: Program analysis (Author: Jing Ju, based on reference 10)
Fig 38: Construction process (Author: Jing Ju)
Fig 39: Flexible room arrangement (Author: Jing Ju)
Fig 40: Comparison of enclosed square (Author: Jing Ju)
63
 FIGURES
Fig 41: Comparison of main entrance (Author: Jing Ju)
Fig 42: Path towards entrance (Author: Jing Ju)
Fig 43: Ward layout (Author: Jing Ju)
Fig 44: Three-patient room (Author: Jing Ju)
Fig 45: Site plan (Author: Jing Ju)
Fig 46: Ground floor plan (Author: Jing Ju)
Fig 47: Third floor plan (Author: Jing Ju)
Fig 48: Floor plan of out-patient department (Author: Jing Ju)
Fig 49: Floor plan of in-patient and laboratory department (Author: Jing Ju)
Fig 50: Floor plan of patient room (Author: Jing Ju)
Fig 51: Model photo (Photographer: Jing Ju)
Fig 52: Conclusion (Author: Jing Ju)

64
 APPENDIX
Schedule
First tutoring 2015.1.28 Mid term seminar 2015.3.19 Final seminar 2015.5.18 Public exhibition 2015.6.4

1 Current healthcare background in China

First tutoring: project plan; simple schedule; define limit on research
Working schedule and preliminary framework
Data collection: OECD/WHO/Chinese statistics; literature study in healthcare background
Diagram making: health cost; insurance system; construction and distribution; funding

2 Problem of hospital design in China

Second tutoring: discuss processing; recommend reference literature on Nordic hospitals
Literature and case study on Chinese hospital: problem of existing hospital; history of hospital architecture; regulations; latest project, etc.
Investigate main problems of hospital design in China: size and height; formalism; de-humanization
Choosing site for conceptual proposal: study existing site and original proposal

3 Literature and case study from Nordic countries

Third tutoring: define goal and conclusion; choose reference project for case study of Nordic hospital
Literature study on Nordic hospital: healthcare background; history of hospital architecture; adapt to future; EBD in healing environment, etc.
Case study on Nordic hospital: St Olavs Hospital(including study trip), new Karolinska hospital, Akershus hospital, etc.
Thinking of application in China
4 Conceptual proposal
Fourth and fifth tutoring: develop the main idea of the proposal
City analysis: history; geography; transportation; type of street; function of surrounding
Drawing and Model making: master plan; program and flow; floor plan; computer model; facade and section, etc.
Booklet making and presentation preparation

Part 1 Part 2 Part 3 Part 4

Finished Finished Finished Finished

65
 APPENDIX
Healthcare Background: Funding

In China, most general hospitals are state hospital which are funding by the government. With the renovation of Chinese
In China,
insurance system whichmost generalopen
gradually hospitals
to theare stateeconomy,
market hospital which
more and are funding by theenterprises
more private government.
areWith the renovation
encouraged to of Chinese
invest for theinsurance
hospital. system
[4] which gradually open to the market economy, more and more private enterprises are encouraged to
invest for the hospital. [4]
However, because the fact that the insurance system is only applied for the designated state hospital, and that most
resources areHowever, because
still allocated in the
the fact
statethat the insurance
hospital, system
most people are isstill
onlywilling
applied for tothethedesignated
to go staterather
state hospital hospital,
thanand
to that most
resources are still allocated in the state hospital, most people are still willing to go to the state hospital rather than to
the private hospital.
the private hospital.
20000
20000
16000 15483 15141 14900 14309 14051 13850
16000 15483 15141 14900 13534
14309 14051 13850 13534
12000
12000 State hospital
8437
7068 Non-state State hospital
8000
6240 8437 Hospital
8000 4952 5403 7068 Non-state Hospital
4102 6240
3220 4952 5403
4000
4102
4000 3220

0
2005 0 2006 2007 2008 2009 2010 2011
2005 2006 2007 2008 2009 2010 2011

66
Fig Tendency of state and non-state hospital construction on general hospital from 2005-2011 (Author: Jing Ju, based on reference 4.)
 APPENDIX
Healthcare Background: History of hospital architecture
Trends of hospital volume
History of Chinese hospital

1229 Ancient hospital in Suzhou

Small building, long corridor, garden surroundings;
concerned about peoples feeling. 1917 Peking Union Medical College, Peking
Pavilion style; Western layout with traditional roof 2003 Ruijin hospital, Shanghai
Mega hospital
Mega hospital
Mega hospital
400 1300 1800 1820 1840 1860 1880 1900 1920 1940 1960 1980 2000 2020

400 BC The Asclepieion at Pergamo, Greece

Physical health importance: Exercise, sport facilities; 1865 the Royal Herbert Hospital, London 2013 St Olavs hospital, Norway
Psychiatry therapy: Usage of art and music Pavilion style; Sufficient light and ventilation; City block; patient-focused hospital
Corridor access to nature
1933 Hospital in Lille, France
Mega hospital

History of European hospital

Trends of hospital volume

67
Fig History of hospital architecture (Author: Jing Ju)
 APPENDIX
Improve treatment performance: Hospital flow
patient visits/day
Planned as a whole 10% - 20% emergency Patient by ambulance/helipad/foot/taxi
Swift
Leave
Emergency hall
Acute care PRE-OP POST-OP ICU Ward
Reception

Medical service Inpatient Patients

care Preparation Surgical Operation
allowed home
Consulting room
Outpatient Storage
care
Technical service

X-rays Laboratory
Patient hotel Patients and relatives from afar CT scanning Research and education

Overall flow Emergency flow

Kitchen Utility/Storage room

Laboratory
Research and education

Dining room Patient room

Patient by foot/bus/taxi (online appointment) Dayroom

Decentralized Nurse Station:

Diagnosis and Patient/visitor Reception
Clinic treatment: Clinic Patient hotel Secretary office/Toilet
Main entrance
X-ray/CT scanning Leave
Reception Humanization
Blood test
STAFF AREA: Drug storage Treatment room
Changing room Examination room
Office Consulting room
Counseling room
Doctor office
Safe and comfortable Dayroom

Outpatient flow Inpatient flow

68
Fig Hospital flow (Author: Jing Ju)
 APPENDIX
Reduce size and height: Hospital network

Ward

Hospital land area Hospital land area Commercial land area

Building a patient hotel can be a method to reduce the size and height of the ward. The patient hotel is designed for patients
who do not need to be in a nursing ward. It also opens to relatives and regular visitors. It is a hotel with basic nursing
facilities and nurses on hand 24hours. Thus, patient hotel can be built as a commercial building while has a close connection
with the hospital.

Overseas treatment

Treatment Home care

Based on a wide spread healthcare information technology, the hospital can be more decentralized such as community
hospital, home care, ambulance care and overseas treatment, which helps reduce the size of the hospital meanwhile enable
people to have a more private care with a shared medical network.
69
Fig Hospital network (Author: Jing Ju)
 APPENDIX
Humanization: Room design

Ceiling design
Pleasant form
Sound absorbing (noise reduce)
Light (daylight and artificial light)

Wall design
Low and horizontal window (wider view for patient when laying down in the bed)
Door opening (1300mm, opening direction)
Visual art present nature and human activities (not abstract art)
Sense of control (temperature, daylight)
Textile for touch (soft or hard, warm or cold)

Floor design
Even color (calm and peace)
Material: Anti-slippery
Easy cleaning (wall hang facilities, e.g. toilet seat)
Connect with balcony/courtyard

70
Fig Room design (Author: Jing Ju)
 Study trip APPENDIX

Every clinical center has its own identity Open reception easy for communication Staff in dayroom close to working place

St Olavs
Facilities hanging on top for easy cleaning Automatic guided vehicles (AGV) Tube which transmits samples to laboratory

Family zone in single patient room All facilities hidden backward to the patient Wardrobe next to patient with bed height Nature light with forest image
71
Fig Study trip (Photographer: Jing Ju)
 APPENDIX
Site background: Problem of original proposal

The ward plan have several design problems as is stated in the research. Firstly, the high rise leads to big transportation
core in The ward plan
the middle havenotseveral
which design
only cost problems
money as delay
but also is stated
the intreatment
the research. Firstly, the
performance. high risetheleads
Secondly, to big
curved walltransportation
makes
hospitalcore in the middle
inflexible which
for future not only
change. cost money
Besides, butplan
the floor alsohas
delay theconcerned
little treatment about
performance. Secondly, the such
healing environment, curvedas wall
longmakes
corridorhospital inflexible
with little waiting for
area,future change.nurse
centralized Besides, the and
station floormulti-bed
plan has ward
little without
concerned aboutzone,
family healing environment, such as long
corridor with little waiting area, centralized nurse station and multi-bed ward without family zone,

Long corridor
Long corridor

Large transportation core

Large transportation core
Centralized nurse station
Centralized nurse station

Multi-bed ward
Multi-bed ward

72
Fig Problem of original proposal (Author: Jing Ju, based on reference 10)
 APPENDIX
Site background: City context

History
Taiyuan City has a long history of over 2500 years. At first it is a small city, with a smaller town inside. The main traffic go
through the city from north to west. Later, it continues to expand to the south, and with its main transportation connects closely
with the site.

Geometry
Sine the city is sandwiched between two mountains, it always suffers a strong wind from north-west during the winter period.

Taiyuan City (982 BC) Taiyuan City (1912)

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Fig City context (Author: Jing Ju, based on research on the T-shaped crossing Pattern of traditional streets in Taiyuan. Lizhen Yi. 2011 )
 APPENDIX
Site background: City context

1
Street fabric (5m)
1 This old city have kept its special street fabric for over
3
2 2 2500 years, which is quite different from the modern
4 4
1
one (like a cross shape). The street in every block is
3 2
always discontinued and zigzag, which people can not
4 4 easily see through towards the endpoint of the road.
Such a pattern protects the city from suffering strong
wind and forms the microclimate.
1 4

Street fabric in city context

Four types of street

The I-shaped street has a broad eye view over the
1 I-shaped 2 T-shaped 3 L-shaped 4 Broken-line shaped main traffic road, without a main focus of eyesight.
The T-shaped street has a strong direction, with a
focus of a building on the endpoint. The L-shaped
street has a enclosed eye view, with a focus of a wall
on the endpoint. The broken-line shaped street
extends the space, with eye focus on every turning
point of the street.

Four types of street

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Fig City context (Author: Jing Ju, based on research on the T-shaped crossing Pattern of traditional streets in Taiyuan. Lizhen Yi. 2011 )
 APPENDIX
Conceptual proposal: Street in hospital

The I-shaped street in hospital offers a broad over view to the courtyard. The broken-line shaped street extends the space,
Thea I-shaped
with street
eye focus on the incourtyard
hospitalatoffers a broad over
the endpoint. Theseview to thenotcourtyard.
streets only haveThe broken-line
good shaped
relationship street
with the extends
nature, the space,
but also
with a eyeforfocus
beneficial easy on
waythe courtyard at the endpoint. These streets not only have good relationship with the nature, but also
finding.
beneficial for easy way finding.

I-shaped corridors in hospital Broken-line shaped corridors in hospital

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Fig Street in hospital (Author: Jing Ju)
Conceptual proposal: Sketches APPENDIX

2015.04.05. Conception of Master plan A 2015.04.05 Conception of Master plan B 2015.04.20 Hospital organization

Site Plan
2015.04.20 Hospital structure and flow 2015.04.20 Clinical center 2015.04.28 Development of floor plan

2015.04.28 Logistics and car parking 2015.04.28 Add a central orientation 2015.05.04 Flexible room arrangement 2015.05.04 Flexible room arrangement
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