ABSTRACT
Nowadays, we are getting increasingly aware of the close relationship between environment and health. The built environment is becoming a consciously understood source of illness (or bad health) or, on the contrary, a resource for improving the health status of people. But how to design it is by far a more complex matter. For this reason we need to gain a better understanding of what we are able (or willing) to achieve through the design of the environment and how we can achieve it.
Current research supports the fact that hospitalized patients, experience physical as well as high psychological distress. It can be hypothesized that these patients are influenced at least in part by the design of the “healing space” and its effect on the relation of hospital environment and personal perception of health. Besides the medical and psychological treatment that we offer to patients and their families, their environment can become one of the adaptive and positive elements for patients and their families in their long trajectory of illness.
Creating environmental conditions that can improve people’s health in their everyday life and can re-generate it when it is compromised by illness, is a broad and complex issue. In order to do this we need proper design as well ass decision-making strategies. Through the design of healthcare facilities environment we can influence - both in a positive or negative way – the determinants of health or disease. Interior design, artwork integration and aesthetic issues are key aspects of the more general problem of the health promotion through the design of the physical environment.

The lecture will deal with such problems through the introduction of innovative ideas and advanced architectural solutions

ABSTRACT
Architecture environmental design and comfort conditions in Maternity wards
The Paper presents the results of the research made for a doctorate thesis of 2007, developed on different aspects related to the environmental human comfort in the hospital areas to give birth. The research took place in 6 Maternity centres of Río de Janeiro in Brasil.. The methodology was based on quantitative and qualitative data on the physical conditions and on the perception of users , patients and staff, about environment comfort
Measurements were made on temperature, relative humidity, noise, lighting, using electronic equipment under normal conditions according to the state of the art technology, taking into account the ethics components approved by the Ethics Commission of each centre. The noise and HVAC data measured were out of allowed limits and were the main cause of insatisfaction.
The conclusions are that the architecture professionals can significantly contribute, in a multidisciplinary design team, to improve the quality of the environment in the new Maternities ,based on the expectative of users.

ABSTRACT
Therapeutic gardens in the Hospital of Culiacán.

The therapeutic garden can be defined as a space as well as a process. It is a meeting point of Medicine and Design. For a patient , family or staff to spend a huge number of hours in a hospital can be a stressing experience. To have the possibility of acces to a garden decreases the stress and improve the health of the patient. The objective of this project is based on the importance for patients, family and staff of using the gardens for rehabilitation, and psychological support, within the healing process
The first phase has started occupying the available open spaces inside the Hospital of Culiacan, between departments of Surgery, Wards, Gynaecology, Internal Medicine, where it is possible to use about 1.600m2. In this first phase the investigation has been oriented to the diagnosis of the above mentioned specialities, in order to understand the pathologies involved and symptoms affecting the patients from the physiological and psychological side, as well as their capacity of movement and need of amusement
Moreover , a large number of patients , with a stage of more than 60 days , need to walk everyday about 15 to 20 minutes, and make exercises of breathing and other activities for relaxing and playing, reading , and simply talking each other.
All these activities being developed at the gardens are a positive contribution of the environment design to the healing process

ABSTRACT
New site for the University Hospital of S. Vicente de Paul at Rio Negro . Colombia

With architectural, technical and operational characteristics, for an innovative proposal. The cultural change where the patient is more and more aware of his rights and of his illness, implies a change in the way of the health assistance, centered in the patient and his family. Access to the most modern therapies not available in other health centres of the region, with the innovation as the central axis of competence and incorporating strategies of knowledge management and information technologies application
A Hospital with modern design , for a long time useful life, a main reference in the area
With friendly environment and efficient energy installations, following ecological standards . First Green Hospital (certified LEED) and with global quality standards that qualify it as a first class category by the Joint Commission.
With automated processes for control and monitoring in a Communications Network based on IP Protocol , used for image transmission PACS ,patient records, security watching, communications , BMS, logistics , etc
With specialized Clinical Centres accessible outside. With separation of technical and administrative areas , for exclusive people circulation pathways.
With common areas for visitors where to meet any required service or attention ( food, shoping, pharmacy, information, worship, and others.

ABSTRACT
Construction of Hospital del Este in the province of Tucumán Argentina

The Ministerio de Salud of Argentina with financial support from Spain within the frame of cooperation Spain / Argentina ,called for bids for the Project of a General Hospital ( with emphasis in Maternity ) to be built in the East of Tucuman
The Project presented in this paper was awarded by Project and Price to the UTE integrating Argentinean and Spanish companies ,to Eductrade for medical equipment, automatic systems, and maintenance Program and to BM3 as construction company. The Project team was selected by professional qualification and outstanding design.

The building of 13.400 m2 includes 132 beds hospital ward, with 6 ICU for adults and 20 ICU for children, Services of Diagnostic and Treatment, Complementary areas, Logistics and Administration. The Project was developed in one Ground Floor and one First Floor, in a functional layout for hospital units, patios, and horizontal and vertical circulation paths.

The objectives were basically
- Good ambient conditions , lighting, ventilation, outside views , comfort,
- Sustainability , Reliability and easy Maintenance
- Improved thermal insulation and sun protection , due the subtropical climate

ABSTRACT
Light hospitals . New requirements in healthcare
In some Healthcare Systems has been developed a new concept of Health Centre we name Light Hospital. It is based on the functionality of processes oriented to patient needs and associated services.
The paper describes the main characteristics of this Centre , its infrastructure and its organization, as well as the different approaches in several countries , as Scotland, Portugal, and various autonomies in Spain, Andalusia and Catalonia
The Light Hospital is a resource supporting the activity of the Hospital of Reference for acute patients, From this perspective, the management , administration, organization and healthcare processes depend from its Reference General Hospital.
The objective of the Light Hospital is to be a Centre of High Resolution , very near to the population, assisting in therapeutics processes and diagnosis, and ambulatory surgery without beds. This model is configured as a flexible resource, adapted to the specific requirements of a particular area with a specific functional plan.
From the functional and architectural point of view it is designed as a horizontal modular building, with different functional areas within a net of interrelations , in a balance of its correct connection to people and to reference hospital, allowing a multidisciplinary assistance in critical healthcare processes

AMBULATORY CARE STEPS AHEAD

Author: Leslie Welch – HLM Architects, UK

ABSTRACT


The concept of ambulatory care is not new when viewed from an international perspective, but its application in the UK has resulted in new models of elective care in terms of consultation, diagnostic, and treatment procedures. These constitute 90% of the non-emergency workload traditionally undertaken in district general hospitals. Recent developments have illustrated a significant trend towards providing emergency facilities within an ACAD setting, and a noticeable relaxation of traditional demarcations between primary and secondary activities, conceived to create a more holistic, local service while retaining strong network links to the wider health economy.
The resulting models of care and their impact on contemporary building design are well illustrated in a series of innovative healthcare projects:

OPTIMUM DESIGN ESSENTIAL FOR DYALISIS CENTRES

Authors : Manuel Alvarado and MarceloFattorini. Argentina

ABSTRACT

In the early 1990s the National Medical Care company arrived in Argentina to broaden its Dyalisis Centres Network. introducing new technologies and procedures. Later , Fresenius Medical Care from Germany, took it over and started managing this Centre Network all over the world. The Design, Construction, and Management of a network of outpatient dyalisis centres in the period 1994 – 2008 are subjects examined in this article.

Abstract The positioning of technical premises: "key elements" of the architectural and technical design of a hospital

Author Louis Roessel, chief engineer at the University Hospitals of Strasbourg

The presentation aims to provide a few elements for consideration, to be integrated in the planning and design stage of hospital equipment (new construction or renovation of existing premises). This covers:
• a summary of indispensable technical connections for the operation of a hospital (energy, transport, communications, etc.)
• a reminder of provisions and restrictions relating to law, regulations, standards and economics, with an impact on the type and positioning of technical connections and premises.
• interaction between hospital and technical functions within the structure.
the integration of considerations relating to the maintenance and replacement of installations at end-of-life, in view of past and future technological developments.

Abstract : Logistics within a hospital architecture
Author :Dominique Troesch, chief engineer at the University Hospitals of Strasbourg

Hospital logistics cover all incoming and outgoing material flows. These flows require the availability of large surface areas in close relation with the required future organization.
When preparing the detailed planning specifications, the planner contacts the many entities which, within a hospital, manage segments of the logistic's system, generally without the support of a referral agent with a global vision of the general concept required by the establishment.
This means that the initial organization must frequently adapt to the available surface area and configuration of the premises, rather than the other way round, reducing effectiveness substantially.
This report will list the different flows and the surface areas dedicated to logistics. Percentages will be established on the basis of a new building used for operations to highlight the fraction of premises used for logistics. This presentation will also include an analysis of consequences subsequent to errors and/or undersizing.