The recent Pandemic Covid-19 has swept lives like dust from the floor. It’s never enough to show sympathy and gratitude to the families of the victims of the surge of coronavirus while we can never fill the gaps of their loss. Covid-19 made us believe that life is uncertain and we cannot predict what the next second can bring to us. Surprisingly, this is not just one global surge that happened, but it had a long queue above it with numerous other pandemics that arrived at a similar pace. The world is full of problems with Climate risks, Epidemics, Geological risk, human-oriented risks, war, disaster risks, etc., to cope and mitigate possible disruptors they may cause. These risks hit all sectors of urban living and healthcare is the one that highlights their presence for resilience. Resilience is the ability to respond, endure and adapt or return to the risk. Across the globe, immense changes in resilient designs are recorded with healthcare facilities on the leading panel because any risk first is challenged by the healthcare facilities and their interlinked sectors. Healthcare architecture holds a plea to build future-proof hospitals, so that not only diagnosis helps people, the architectural facilities themselves should work against the risk.
Healthcare resilience is the system’s capacity to adapt or limit to the changes of the facility and its building services and mitigate the services from damage while contributing to adopting new functions of recovery. If there is any fire or earthquake in a building or near the region, you can’t tell the patients to move out of the building because they need electric supply, mechanical supply, and human resources to successfully rescue themselves and the equipment like ventilators and medicine as well from the building. Resiliency for hospital building is a long process of strategic design and functionality within the service planning of the structure. The plan for resilience in healthcare facilities can be divided into levels and degrees of emergency, as shown in the figure.
After understanding the level of risk preparedness and degree of emergency, we can also move ahead with the steps in the risk assessment index for low, medium, or high-risk areas provided by WHO on a note to spread awareness for healthcare resilience. The steps involved in this preparedness list focus on deep and strategic time for site planning, structure, built form, MEP Services, Facility Management, O&M, and capacity building.
Apart from the resiliency of hospitals from natural or human-made risks, we still hold the stereotype of the hospital as a service-oriented building only. Today, where all building typologies face typological cannibalism, hospitals are also transforming from service-oriented concrete jungles to carts rolling on biophilic principles. The conceptual changes to hospital design are to make hospital buildings pleasant enough by incorporating elements of nature and techniques of biophilia. Hospitals are shifting their core ideology from treating the ill to the overall health and well-being of the community. Accounting biophilic principles in design, whether on a small or large scale, using materials like stone, or highlighting green areas in hospitals addressing indoor gardens for well-being, peace, and tranquility of patients and staff. Biophilic design proven reports of lower anxiety levels and speedy recovery of patients supported by the biophilic design strategies in healthcare infrastructure. Biophilic principles for healthcare architecture incorporate good ventilation, use of natural materials, optimization of natural light, sound-absorbing materials, and green spill-out gardens. Resilient design in hospitals talks about long-term vision and benefits for nature and people simultaneously by reducing energy consumption and integrating passive strategies from the initial design stages. One appropriate example of this could be, The Ostra Hospital and psychiatric facility, Sweden, which follows a similar theme of resilience with a long-term vision incorporating biophilic principles reflected in space planning and interiors.
The design and planning of the hospital is an initiative against the strict environment planning of psychiatric healthcare units. The designers of the hospital planning focused on the free and open environment of the healthcare units as the environment vitally affects patients’ recovery. The entrance leads you to the entry hall of 3-story height connecting to the common hall area for patients to meet and greet family and friends. Apart from the fact that the building design is yet secluded and unicentric, the patient activities arranged with the courtyard and a passageway overlooking all three stories help patients interact among themselves and with the sky. The biophilic principles of Complexity and order, visual connection to nature, and dynamic and diffused light refuge are amalgamated well in care units with no staff card requirement yet secure gardens with green enclosures from windows. The design intends for patients’ care and recovery through nature.
Resilience in healthcare architecture is subject to the need and problem-specific to the context and typology of service provided concerning the location. Resilience could be against natural disasters or adverse mental health conditions. Designers must think about the threats before they head for conceptualization in every healthcare facility to attain resiliency right from the core.
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