Challenges in Design for Tall Hospitals in Hong Kong and Salutogenic Outcome VIVIEN W. L. MAK P&T A RCHITECTS A N D ENGINEERS LT D.
Background
Density & height 1,100 square kilometres of land 7.24 million population Photo by Coolbie Re
Density & height Land population density 6,690 people per square kilometre District of highest density Mong Kok 130,000 people per square kilometre Photo by Coolbie Re
Density & height Hong Kong has the most skyscrapers in the world, with 8000 buildings more than 14 floors, almost double of New York. Photo by Coolbie Re
Landscape & site 75% of Hong Kong is rural, comprising hills, woodlands and coastline. Landscape is hilly and mountainous with steep slopes. Photo by Coolbie Re
Landscape & site Some sites exhibit more challenging geography and irregular shapes than others. Site of Gleneagles Hong Kong Hospital
Private hospitals in geographically challenging sites Canossa Hospital Hong Kong Adventist Hospital Hong Kong Baptist Hospital Hong Kong Sanatorium & Hospital Matilda & War Memorial Hospital Tsuen Wan Adventist Hospital & more
Public hospitals in geographically challenging sites Queen Mary Hospital Kwai Chung Hospital Princess Margaret Hospital Haven of Hope Hospital United Christian Hospital Pamela Youde Nethersole Eastern Hospital & more
Queen Mary Hospital Established in 1937 1400 beds Managed by Hospital Authority of Hong Kong Teaching hospital of the University of Hong Kong
Queen Mary Hospital Major expansion in 1955 and 1983 Block K, Queen Mary Hospital
Two tallest hospital buildings in Asia Which are the tallest in the world? 1 st Guy s Hospital, London (148.65m, 34F) 2 nd Hong Kong Sanatorium Hospital (148.5m, 38F) 3 rd O Quinn Medical Tower at St. Luke s Hospital, Houston (145.3m, 29F) 2 nd tallest in Asia - Block K, Queen Mary Hospital, Pokfulam Tallest in Asia - Hong Kong Sanatorium & Hospital, Happy Valley 4 th tallest in the World 28 stories Building height 137 metres 2 nd tallest in the World 38 stories Building height 148.5 metres
Private Hospitals in Hong Kong Canossa Hospital Hong Kong Adventist Hospital Hong Kong Sanatorium & Hospital Matilda & War Memorial Hospital St. Paul s Hospital Evangel Hospital Hong Kong Baptist Hospital Precious Blood Hospital St. Teresa s Hospital Union Hospital Tsuen Wan Adventist Hospital Gleneagles Hong Kong Hospital
Most of the private hospitals were established by foreign missionaries or independent groups from late 18 th to early 19 th century to serve the community s needs. Some started as orphanage, nursing homes or sanatoriums, others were small hospitals serving about 20 beds in the beginning.
Hospital buildings were purpose-built or altered from existing buildings. St. Paul s Hospital, for example, adapted a cotton mill and began services in 1918. The original cotton mill building is still in use today. St. Paul s Hospital, 1960
Hillside establishments A number of private hospitals are situated on the hills, commanding fascinating views and bound by a limited plot of land that used to comfortably accommodate services to fulfill their missions in the early days. British Military Hospital Tsuen Wan Adventist Hospital
Tsuen Wan Adventist Hospital 1990 S 1960 S NOW
Hong Kong Adventist Hospital 1960S NOW
Public Hospitals in Hong Kong that were founded since the latter half of the 19 th century tend to be situated in relatively flat sites. Queen Elizabeth Hospital, 1964 & today Prince of Wales Hospital, 1984 & today
New public hospitals that were founded in the past few decades are usually situated in flat sites and have less problems in dealing with topography. Pok Oi Hospital Tai Po Hospital Tsueng Kwan O Hospital Hong Kong Eye Hospital
Challenges in Design of Tall Hospitals
Tall Hospitals High density and patient volume would consistently challenge hospitals of this city of growing and ageing population. Limitation in land supply pushes both public and private hospitals in Hong Kong to maximize development potential of their given sites. Several hospitals have resulted in becoming TALL. St. Paul s Hospital
3 NEW PRIVATE HOSPITAL BUILDINGS IN HONG KONG
The Challenge of Structures for TALL HOSPITALS Tall buildings in Hong Kong challenge structural & geotechnical design in catering for WIND LOADS. Hospital layout planning would need to make peace with sizeable columns and beams.
Basements may become necessary due to other planning parameters such as HEIGHT RESTRICTIONS. The Challenge of Structures for TALL HOSPITALS Hospital layout to allow space for basement walls, temporary working space and installations, and retaining walls when slopes are dealt with. Attention to be paid in waterproofing Radiology and Oncology departments which tend to be sunken underground. Best solution is to place major equipment away from the basement walls.
Substructure works may be carried out in an independent contract in advance of the Superstructure works to gain time. The Challenge of Time for TALL HOSPITALS Time for obtaining government submissions and unknown underground conditions may prolong project programme. *Pay attention to the interface between the two contracts, especially if the substructure works include excavation and basement construction. E.g. Concreting bunkers and radiation test Resolve building services coordination ahead of time to settle required builder s works. Early submission of combined services drawings and wall elevations required. Weather tightness of external walls to be achieved as early as possible to enable interior works.
Statutory Control on Tallness Development potential is limited by the control of building mass in view of visual and ventilation impact to the city otherwise. St. Paul s Hospital
CONTROL OF BUILDING HEIGHT AND MASS Statutory Control Challenges in planning and design for TALL HOSPITALS Restricting Building Mass Building Ordinance Chapter 123 controls maximum building height and plot ratio of different classes of sites. Restrictions on building height and floor area are also imposed in : (1) Outline Zoning Plans (OZP) (2) Lease documents Airport height restrictions vary at different locations of Hong Kong.
ST. PAUL S HOSPITAL The Challenge of Statutory Control Challenges in planning and design for TALL HOSPITALS The government revised the OZP of the zone of Hospital site to incorporate maximum building height for GIC sites in 2010. Building height restriction in OZP in the case of ST. PAUL S HOSPITAL It was said that the new tower of HK Sanatorium & Hospital might have raised public s concern on the height of institutional buildings.
The Challenge of Statutory Control Challenges in planning and design for TALL HOSPITALS Building height restriction in OZP in the case of ST. PAUL S HOSPITAL Plans for the hospital redevelopment had been long approved and construction was in progress at that time. Maximum height and Gross Floor Area imposed on the Hospital site was therefore capped at the approved level.
The Challenge of Statutory Control Challenges in planning and design for TALL HOSPITALS GLENEAGLES HONG KONG HOSPITAL Building height restriction in LEASE in the case of GLENEAGLES HONG KONG HOSPITAL The new land lease of Gleneagles Hong Kong Hospital specifies a maximum building height and gross floor area for the development based on the decision of the Town Planning Department.
TSUEN WAN ADVENTIST HOSPITAL The Challenge of Statutory Control Challenges in planning and design for TALL HOSPITALS In the case of TWAH, the exchanged land lease specified a maximum building height for both the new tower and its podium structure as per the neighbouring community s requirement. Building height restriction in LEASE in the case of TSUEN WAN ADVENTIST HOSPITAL Public consultation provides the neighbours of hospital sites a platform to negotiate their wishes.
Given the maximum building height, floor by floor heights had to be carefully considered and balanced among all departments based on the priority of needs. TWAH section extra 600mm for the top floor to accommodate rainwater drain pipes from roofs ward floors share the rest of the allowed height to achieve a floor height of about 4.2m operating theatre suites are provided with a floor height of 5m to achieve the clear headroom of 3m podium floors housing outpatient activities achieve a floor height of 4.5m
Vertical systems Challenges in planning and design of TALL HOSPITALS Within a tall structure, desirable work flow that is essential to the effective operation of a hospital needs the support of abundant and wellplanned VERTICAL TRANSPORTATION SYSTEMS.
The last thing a tall hospital wants -
X6 Vertical systems Challenges in planning and design of TALL HOSPITALS VERTICAL TRANSPORTATION Elevators should be adequate, strategically located, grouped and segregated. X8 x3 17 lifts to serve 26 floors Block B, St. Paul s Hospital
VERTICAL TRANSPORTATION Vertical systems Challenges in planning and design of TALL HOSPITALS 15 lifts to serve new 25 floors extension block Tsuen Wan Adventist Hospital X6 X5 x4
VERTICAL TRANSPORTATION Vertical systems Challenges in planning and design of TALL HOSPITALS X8 X6 x3 17 lifts to serve 9 floors Gleneagles Hong Kong Hospital
Vertical systems Challenges in planning and design of TALL HOSPITALS Additional transport systems such as escalators, dumbwaiters and pneumatic tube systems are commonly adopted. Special transport systems such as automated vehicles and vertical boxveyors would also be considered and installed in some hospitals. Boxveyor system at Block B, St. Paul s Hospital
VERTICAL BUILDING SERVICES Vertical Systems Challenges in planning and design of TALL HOSPITALS Adequate space shall be allowed for pipe ducts to house vertical pipe stacks and necessary air ducts that support a hygienic indoor environment. An efficient floor layout for a tall hospital should provide an optimized number of elevators and pipe ducts at logical locations, enhancing circulation and allowing convenient access for maintenance without potential disruption to the operation of the hospital. Pipe ducts at Block B St. Paul s Hospital
Trees & Tall Hospitals Building and landscape design for new hospitals and hospital redevelopment projects shall maximize opportunities for planting to create desirable and healthy environments for the community and building users. To ensure that the city is provided with a reasonable amount of trees and shrubs, there are also statutory requirements on the minimum provision of greenery and compensation of trees, should any on an existing site be removed due to a building development.
507 existing trees removed for hospital development Trees & Tall hospitals Gleneagles Hong Kong Hospital Existing trees on the green field site were all removed for hospital development.
470 to be planted to compensate Trees & Tall hospitals Gleneagles Hong Kong Hospital Existing trees on the green field site were all removed for hospital development. Proposed Landscape Plan for Tree Compensation
VERTICAL GARDENS Trees & Tall hospitals With a compact site and height restriction, the permitted site coverage of building sites would be maximized to accommodate hospital functions. Area that remains available at pedestrian level for planting is limited. Vertical gardens become a common solution, bringing greenery onto terraces, balconies, roofs and building facades.
Trees & Tall hospitals Tsuen Wan Adventist Hospital Sky Garden as the receiving location of new trees for Tree Compensation
Challenges are: 1. Water-proofing planters 2. Treatment at Water-sensitive areas 3. Sunken planters 4. Access for maintenance 5. Selection of plants Pest, Allergy & Odour sensitivity Raised planters with double slabs Avoid placing planters above water-sensitive areas such as operating theatres, intensive care units and sterile stores. Sunken planters create more flexibility for the design of gardens, but would be in conflict with clear headroom required for the hospital function below, particularly when 1.2m soil depth is for compensating trees. Hospital operators shall be given designated access for watering and maintenance of plants. Vertical planting at locations with limited access requires automatic irrigation system and species that require minimal maintenance. Operators may be reluctant to provide plants in a hospital at all since bugs and pests may invited. Segregation, access control, low-maintenance species, and management would be some possible answers to this challenge. Plants with smells to be avoided near IVF centres.
Salutogenic Outcome 3 CASE STUDIES IN HONG KONG
ST. PAUL S HOSPITAL is an existing 358-beds hospital founded by the Sisters of St. Paul de Chartres in 1898. The hospital shall be expanded to provide state-of-art facilities for outpatients and 550 inpatient beds.
Project duration 2005-2018 3 phases of redevelopment & basement construction Changes in regulations, decisions & design St. Paul s Hospital Redevelopment Challenges 3-level basement adjacent to historic chapel Height & GFA limits imposed during execution Continuous operation of existing hospital during construction Old Block & Original Main Block
The project is carried out in 3 phases to maintain continuous operation of the Hospital. Two new high-rise hospital blocks have been built in the first two phases, including a 3-level basement for radiology and ancillary facilities. In Phase 3 an old block will be demolished and replaced with a landscaped area over a new basement extension to complete the master plan.
Located at the front of the campus, Block A provides preventive care services and special clinics. Hospital core services in Block B are grouped by outpatient services at the lowest zone for ease of access, surgical floors in the middle for efficiency, and inpatient floors at the top for security and privacy. Block A
Typical ward floor Block B, St. Paul s Hospital Classical golden rectangle applied in façade design
New garden after demolition of the Old Block
Approach to new hospital drop-off St. Paul s Hospital Redevelopment
HONG KONG ADVENTIST HOSPITAL TSUEN WAN was founded in 1964 by the Seventh Day Adventist Church and currently houses 120 beds. A new 25-storeys extension building will provide more comprehensive facilities for outpatients and 470 inpatient beds by late 2015. VIEW FROM NORTH
Tsuen Wan Adventist Hospital Extension Challenges Extremely tight site on a steep slope Continuous operation of existing hospital during construction Hindrance during public consultation for land exchange Fast track project programme with multiple contracts Height limits and clearance from neighbouring development TEMPORARY SHED
Well-being is realized and achieved through the building form, spatial articulation, layout planning, and the coherence of the interior design. ENTRANCE VIEW ENTRANCE VIEW VIEW FROM SOUTH
SKY GARDEN PLAN The Sky Garden is the key green feature of the new building. Allows cross ventilation and provides greenery to the neighbouring estates, and encourages visitors and staff to utilize daylight and engage in outdoors activities.
CHAPEL ENTRANCE LOBBY ADMISSION
GLENEAGLES HONG KONG HOSPITAL GHK is a joint venture project of Parkway Pantai Ltd and NWS Holdings Ltd with the collaboration of the LKS Faculty of Medicine of the University of Hong Kong. The 500 beds facility is due to be completed in January 2017.
Irregularly shaped sloped site possessed in 3 phases Railway track through the site Height and GFA limits Gleneagles Hong Kong Hospital Challenges 470 trees to be compensated for the 507 cut away 46 months from assignment of land to HOSPITAL OPERATION
The master plan and external design of the new hospital express curves and fluidity in a well-balanced approach to remain efficient in spatial planning, and to blend into the hillside environment.
Logical stacking and grouping of hospital functions enables intuitive way-finding. The two wings are linked with a bridge to enhance work flow and circulation. Patient wards strategically housed in two wings to maximize daylight and views Surgical suites, ICU and LDR in the heart Outpatients and preventive care at street level
Gardens are extensively provided to create a multi-level, green and active healing environment, supporting well-being of patients, visitors and hospital staff. Proposed podium gardens Gleneagles Hong Kong Hospital
A Relaxing Journey Comprehensible spaces for a stressfree journey begins with a spacious drop-off, a visible main entrance hall, and clear connectivity.
Staff canteen and doctors lounge providing comfortable and relaxing social spaces
Building tall Number of floors = Number of concreting cycles = Number of mistakes that may be repeated But also Chances to make better places
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