Healthcare architecture in metamorphosis--observations in Hong Kong's heuristic experience.

Healthcare Architecture in Hong Kong is in an on-going process of metamorphosis in response to the social, economical and technological developments in the territory. In the process of transformation, universal problems like obsolescence, growth and expansion, and advances in science and technology as well as problems unique to Hong Kong like population growth, scarcity in land supply and high density development all call for special solutions. With the turn of the century, new forces of change have also begun to take shape, and in anticipation of the hyper-turbulent changes ahead, we need to shift our paradigm to allow revolutionary new perspectives and innovate, shape and create the future healing space which is sustainable, adaptable, flexible and humane.

The multifunctional therapy room of the future: image guidance, interdisciplinarity, integration and impact on patient pathways.

With few exceptions the interventional rooms of the present are either imaging suites or sterile operating rooms. Their users are restricted to either percutaneous procedures or to two-staged image-guided surgery without intra-operative imaging control. Since interventional therapy of the future will be minimally invasive and since minimally invasive therapy is essentially image-guided therapy, a new physical place for these activities has to be devised: the multifunctional therapy room of the future integrates sophisticated imaging and image guidance modalities together with advanced surgical and life-support equipment in a sterile environment [1, 2, 3]. Even given a high degree of integration, this will be a complex and costly piece of medical technology. These two factors--complexity and cost-- require interdisciplinary technological and medical collaboration to bring it into existence, distribute its cost and maximize usage and medical benefit. Yet another dimension of multifunctionality will be introduced and a significant impact on the care of vitally threatened patients will be exerted by using this room not only for elective image-guided therapy but also for emergent one-stop diagnosis and treatment. Motivation, technology, implementation strategies and funding of this image-guided, integrated and interdisciplinary therapy room, as well as a comprehensive approach combining emergency care and elective computer-assisted therapy (CAT), are discussed in this paper.

Children in hospital: a design question.

Holistic medicine is the global trend in medical care. It involves not only the highest possible standard of diagnosis and treatment, but also designing the whole experience of being ill and that of hospitalization. In such a frame, planning and designing for children has to be considered in such a way that a child will be helped to withstand the effects of illness, the separation from home and family and the entrance into an unusual, unfamiliar and strange world. Although the wellbeing and happiness of children in hospital is the concern of the nursing staff and of the parents, many other factors have to be satisfied also. A young ill child who has to be treated in hospital has to adjust to a number of environmental and treatment conditions which may be upsetting and may have far-reaching effects. Because of all these, much effort has been made, over the last fifty years, to develop planning and design aspects, which will make a child's life in hospital less unnatural. Furthermore, it will reduce the unavoidable and inevitable discomfort, disease, pain and misery experienced by children. These aspects include avoidance of admission of children into hospital whenever possible, operations on a daily basis, unrestricted visits, encouraging of parents to visit or to stay with their children, the provision of suitable playing facilities, materials, equipment etc. This paper will seek to explore and develop: a change in philosophy in child care, its influence on the various types of facilities, the importance of the family, the psychological needs as design factors such as security, social contacts, personal space, movement, comfort, independence, outdoor spaces and others. Factors relating to design parameters and standards will also be explored. The meaning and importance of scale is highlighted since it is felt that children are not miniature adults, but individuals with their own particular capacities.

1997 construction & design survey.

Managed care might seem to be putting a damper on healthcare construction, but in fact it's one of several industry changes creating opportunities for architectural and design firms. One example of a trend toward making surroundings as pleasant as possible is the west campus expansion at East Texas Medical Center in Tyler (left). Designed and built by Ellerbe Becket and completed in 1995, the project, including a nine-story medical office building, features artwork and rooftop gardens.