With its low-rise profile, attractive courtyard gardens and modular construction, the proposed Al Daayan Health District in Qatar offers a stark contrast to hospitals that many residents in the Gulf — or other parts of the world — will be familiar with.
The plan for the 1.3-million-square-metre site near Doha is ambitious, but designers suggest it could become a regional standard in the future.
There are no tower blocks, medicinal plants are grown on-site and the facility can generate its own energy as well as deal with its own waste.
And it will be built by robots using 3D printing.
Commissioned by Hamad Medical Corporation (HMC), a Qatari hospital operator, the master plan for Al Daayan Health District, unveiled in late 2021, is the work of Dutch architectural practice OMA and British engineering company Buro Happold.
In its brief to the architects, HMC said its existing infrastructure lacked space, did not have the capacity for current and future demand, and was “a major barrier to clinical service transformation”.
Speaking earlier this year at a healthcare conference in Berlin, Reinier de Graaf, the partner at OMA overseeing the project, suggested that hospital design, in general, was in need of a shake-up.
“When 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. You see this impenetrable fortress,” he said.
Many contemporary hospitals are, Mr De Graaf said, large, anonymous, ugly and distant from the people they are built to serve.
“It’s fair to say that it’s probably largely the fault of hospitals that people dislike modern architecture, because they represent the worst of modern architecture,” he added.
The Qatari hospital is envisaged as having 1,400 beds, with patients staying on the first floor, while the ground floor is used for consultation rooms and other services. Machines located underground, meanwhile, are involved in keeping the hospital running.
High-rise hospitals outdated
Postwar hospital towers are often “very grim”, but from around the late 1970s and early 1980s, at least in North America and Europe, a greater focus developed on “patient-centred care”, said Annmarie Adams, an architect and researcher at McGill University in Montreal, Canada, who has written extensively on hospital design.
“Hospitals came to look like shopping malls or airports or hotels. They looked more like fantasy buildings or buildings that offered some escape,” Ms Adams said.
These post-1980s hospitals are often brighter and more colourful, with a large atrium or a “main street concept”, and a focus on circulation.
“Many of these post-1980 hospitals are low rise. Few floors. They’re flat. We have a new one in Montreal. It looks like a Toys R Us. Each pavilion is a different colour, it’s in different blocks,” she said.
“There’s this urgency to normalise medicine, to just make it feel like a regular place to go. That comes out of our fear of serious illness and this idea that many of these institutions are starting to look alike. That’s not really new — that’s since the 1980s.”
Mr De Graaf said the beds in the planned hospital “hug” the courtyards, creating an appealing, natural environment. This is something that, research has shown, helps patients recover faster.
“If you look out of the hospital into green, there’s research that shows you need fewer painkillers and you go home fewer days after an operation,” said Marie Strid, a healthcare architecture specialist at Chalmers University of Technology in Gothenburg, Sweden.
“It’s very important to have something green outside instead of a brick wall.
“At the Erasmus hospital in Rotterdam, they have put in a roof garden because it’s a high-rise hospital. That’s another example. Hospital designers know we have to look out of the window at something.”
In a modern-day echo of physic gardens — herb gardens containing medicinal plants that were popular in Europe from the late medieval period onward — the hospital could have its own garden to produce the substances used in a number of drugs.
Other trends in hospital design and function have led to hospitals becoming places where people go for “daycare”, meaning they are in and out without staying overnight, Dr Strid said. There has also been a trend towards more specialised facilities with “better knowledge and experience” and research capability.
They are being transformed by technology, with operating theatres tending to increase in size to house equipment.
Technology is changing how hospitals are designed
OMA says the hospital — the first it has designed — is conceived not as a building, but as a system, being made of modules produced on-site that allow the hospital to be increased or reduced in size while remaining operational.
Thanks to 3D printing, which is increasingly being used in construction, each module could be different, with its own unique ornamentation.
Flexibility could help it cope with a trend OMA has identified in which the lifespan of hospitals appears to be falling over time. Some built in the second half of the 20th century have lasted only about 25 years, OMA said, compared to more than double that for facilities constructed early in the century.
Ms Adams said that even some earlier hospitals had flexibility in mind, such as the McMaster University Medical Centre in Hamilton, Ontario, Canada.
Dating back half a century, it was designed with the idea that a fifth floor could be built on it, although this never happened.
“There’s a real obsession with flexibility. You just don’t know what you’re going to need,” Ms Adams said.
“The engineers designed [the McMaster hospital] so additional floors could be added on the top, but that was never really done. The building came to be seen as obsolete before its potential was reached.”
OMA suggests its planned facility, using the latest technology that makes it easy to expand, is instead a model for the hospital of the future.