The Architecture of New Hospitals - review

What should be the guiding principles of the design of new hospitals? How can these buildings embrace rapid change in clinical practice and available technologies, while supporting humane care in a healing environment? Is there a special place for beauty in hospital design?

These are some of the questions addressed by the well-known healthcare architect Collin L. Beers in a chapter titled The Architecture of New Hospitals: Complex yet Simple and Beautiful , part of the 2019 publication ‘The Modern Hospital: Patients Centered, Disease Based, Research Oriented, Technology Driven’.

Beginning with a brief guide to the history of hospital design and the factors that have traditionally influenced the shape and nature of these buildings, the author swiftly moves to his central thesis: that the increasing complexity of hospitals (functional, organisational and technological) is in itself a strong argument for simplicity of design. The analogy here is that of the art gallery, where any number of diverse and complex art works are housed in a highly flexible space where simplicity of architectural design is paramount. Along the way, Beers makes some intriguing points. He points out that the dictum ‘form follows function’ has often been misused in the case of healthcare buildings, in that ‘function’ has been misinterpreted as referring to the tools and processes of healthcare, rather than “the healing arts practiced by compassionate people for the benefit of people”. And he includes a nice illustration (from a speech by Winston Churchill about the post-war rebuilding of the UK’s House of Commons parliament building) of the tendency of many decision-makers to approve building designs which match the needs of the past, not those of the future.

Using the device of dictionary definitions, Beers argues that simplicity in hospital design should be an overarching goal, particularly in the case of whole building, green field projects, because this principle encourages us to avoid extraneous elements and distractions; make use of standardised features, modularity and mass production; focus on environments which are, in their unadorned state, easier to clean and maintain; promote way-finding for patients, visitors and staff; and enable acuity and technology-adaptable environments.

Beers’ turns to the issue of beauty at the end of this chapter, offering his view that there is some obligation for hospitals - public buildings, often paid for by citizen taxes or philanthropic giving - to explicitly aim for beauty in their design and construction. He is sensitive to local context and public expectations, but suggests that there are some general principles which contribute to this aim - successful integration with surrounding landscapes, clarity and rhythm in the main structural elements and sensitivity to potential future changes - can elements be added or removed without adversely affecting the original visual impact?

The chapter ends with an appeal to anyone involved in developing future hospital infrastructure to consider the interaction of complexity of processes and simplicity of design, to look for existing exemplars of where this nexus is well or poorly handled, and to offer up the resulting conclusions for consideration in the design process.

I found this chapter to be refreshing and well-argued. Much of the material will be familiar to healthcare architects and hospital planners, but it’s very helpful to see it presented with clarity and concision. The closing ‘Challenge’ section is certainly a welcome call-to-arms. The chapter can be downloaded (at a cost) from the SpringerLink website, where you also have the option (at even greater cost!) of purchasing the entire book in print or e-book formats.