Higgins also points out that it’s important to separate the service cir-
culation stream. “You need to make sure that the service entries are dif- ferent from your other entries so you’re not having goods delivered into your emergency ward. You down want garbage brought through patient corridors,” he says. Khemakhem adds: “Another design mistake is inadequate wall pro-
tection in areas where you have a lot of traffic moving back and forth, such as carts and beds. This will contribute to the life cycle of the building and also protect the building from being damaged in a short period of time.” Higgins believes that the most serious engineering mistake is a “lack
of resilience in mechanical and electrical engineering infrastructure”. He adds: “The prevention of a single point of failure is incredibly important – you need to make sure that if there is an issue you don’t lose power or emergency services. “For example, operating theatre ventilation should not come from a single
source from a central location. There should be individual mechanical venti- lation plants with a very strong clinical resilience. That way, if one ventilation plant goes down there are still four or five to work with. Not only does this have the potential to save lives, it is also makes financial sense as the hospital will always be able to charge for services in the operating theatre.”
Healthcare architects and designers try to create a wellness feel by providing open spaces, family areas, and court- yards. Design can have a big impact on patient wellbeing
5 Al Ain Hospital 6 City Hospital, Dubai 7 RAK Hospital , Ras Al Khaimah
THE NEED FOR SENSITIVITY
Khemakhem highlights the increasing awareness of green issues in the region, and says: “Sustain- ability is now a key consideration, especially in the UAE. It’s not responsible to design something in the Middle East without being sensitive to the environment. The first thing we look at is how we can make the spaces comfortable, without using a lot of air-conditioning.” He adds that LEED accreditation is the “next step” when it comes to sustainable healthcare
design. “We would love to design a hospital here that is LEED-certified. We’ve done it in the US and it’s certainly do-able here, but it has to be initiated by the client. “In time I think every building that we design here will have to be LEED compliant. It’s always
harder in healthcare facilities because there are so many things to address. I don’t think that Platinum status is achievable but Gold and Silver are within reach.” Higgins says that it’s an extra challenge to create LEED-compliant healthcare facilities due to the fact that they are “24-hour buildings which are constantly consuming energy”. But he points out that Abu Dhabi’s upcoming Cleveland Clinic, by Mubadala and Aldar, is aiming for LEED accreditation. It’s not just the environment that needs a sensitive approach – the local customs and requirements
demand attention. Khemakhem explains: “You have to have separate waiting areas for men and women and screens in some areas. “In this region, if someone is in hospital then their entire family would want to go and visit them.
So we have to make sure that there is enough space for the visitors, and in some cases you need to allow for people staying overnight, perhaps in the patient’s room.” He also reveals that most of the hospitals that AECOM has designed in this region have ‘executive’
suites to cater for royal in-patients. “Essentially they’re VIP areas which are aggressively marketed at royalty. In the case of the The City Hospital in Dubai the suites on the top level and are accessed via designated elevators. It’s a similar concept to a hotel – there’s one single room with an adjoining room for family, or a whole suite which is a combination of around four rooms. “If these facilities prevent people from going abroad for healthcare then they will be a great success because it means that the healthcare standards will improve further.”
BRIDGING THE GAP
Higgins believes that the regional standard of hospital design is improving and adds: “The existing facilities were built on an ad hoc basis without a detailed consideration of modern design guidelines. However the new facilities coming on stream will be far better. Over the next two years or three years I think we’ll see facilities grow towards western standards. “The introduction of mandatory healthcare insurance for expatriates in Dubai and Abu Dhabi has brought
money into the sector which is allowing standards to be raised and more modern facilities to be built. “It’s an emerging market here, and the healthcare infrastructure has a long way to go, but there’s
a terrific opportunity to fill the gaps in the market.” Khemakhem points out that the region is looking to the US as the benchmark. “There is a lot of
focus on what the US is doing. Abu Dhabi Municipality has stated that all new facilities need to comply with the American Institute of Architects (AIA) healthcare standards, as well as the International Building Code (IBC). For us it’s just like designing a facility back in the US. “As well as the UAE and Qatar, we’ve seen a lot of recent activity in Saudi Arabia. Saudi also wants
to bring its healthcare facilities up to international standards, specifically American standards.” Khemakhem believes that hospital developers in the Middle East are aware of the benefits of
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quality design. “I have worked on four projects in the Middle East and the awareness is almost as high as in the US. They want to push the bar and have state-of-the art-facilities to create a great environment for the patients.” Yet he adds that the bar needs to be constantly readjusted: “With healthcare design there is no
limit for improvement because so much is involved – medical equipment constantly changes, as does building technology. In addition, medical treatments are changing – now some hospitals are catering for alternative medicine and providing spas within them.” Higgins concurs, and concludes that flexibility in design is crucial, especially in the Middle East.
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“The sector is evolving all the time – technological advances are a daily occurrence. Bed wards need to cater for increases and decreases in demand in clinical requirements. In the Middle East we have an ageing population, in which the life expectancy is climbing. Flexibility is crucial and we must design facilities that can accommodate change. That’s the challenge for healthcare planners and designers today.”
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