SUSTAINABLE HOSPITAL DESIGN
Rethinking hospital design for a sustainable future
With climate change being combated on many fronts, Professor Stefano Capolongo, director of the Architecture, Built Environment and Construction Engineering Department, and Scientific coordinator of the Design & Health Lab and JRP Healthcare Infrastructures, at Politecnico di Milano, discusses the re-thinking and implementation of practices in the construction industry – which is one of the biggest contributors to climate change. He also considers how medical facilities can be designed and built to be more sustainable through the ‘Next Generation Hospital’.
The evolution of global healthcare models requires a profound rethinking of healthcare infrastructures as an opportunity to interpret the multiple instances that are transforming contemporary paradigms at a social, economic, and environmental level. The global challenges of our time – such as ageing population, inclusive design, Artificial Intelligence, and climate change and urbanisation, may find synthesis and balance in the ‘architectural project’, which has precise sustainable objectives, both in terms of individual projects and on a system level. The recently concluded United Nations
Conference on Climate Change (COP28) saw a unique moment in history, with 123 countries signing a declaration to ‘put health at the centre of climate action’, and support the development of climate- resilient, sustainable, and equitable health systems. In line with the so-called ‘One Health’ approach, sustainability, and practical actions to tackle climate change, are strictly related to health. Climate change is a global phenomenon
that countries around the world are seeking to address – due to its negative impact on the natural environment and, consequently, on humankind. It has been identified ‘as potentially the greatest health challenge of the twenty-first century’,1 as it contributes to the increase in non- communicable diseases (NCDs), and facilitates the spread of new infectious diseases, which in turn devastate the healthcare sector and its infrastructure. By causing an increase in both recurrence, and harshness of, extreme weather events, climate change also exerts a direct negative impact on health, provoking injury and illnesses. Rising air pollution alters the patterns of vector-, food- and waterborne diseases, and global warming also has mediated effects on social and human systems – including malnutrition, occupational heat stress, and mental illness, as well as increasing the rate of population displacement. This, in turn,
72 Health Estate Journal September 2024
Figure 1: The Karolinska University Hospital, Huddinge.
slows economic growth, and further increases poverty. The effects of global warming are particularly relevant to the most vulnerable populations, such as those with pre-existing medical conditions, the poor, children, and the elderly. They have also been found to affect the middle- and low-income populations.2
A form of social architecture The hospital is the social architecture that best interprets these transformations. It accompanies significant demographic, technological, and epidemiological evolutions, and condenses them in a key physical space, contributing to global health through the creation of healthier, more efficient, and comfortable systems. The hospital is a ‘city within the city’,
where multiple functions are co-located in a single but complex infrastructure experienced by users with different, and sometimes conflicting, needs. Against this backdrop, it is important to duly
consider how sustainable such a facility is; doing so tends to highlight how the previous obsessive focus on widespread technological solutions, rather than a human-orientated approach, the lack of significant investment, and remarkable managerial complexity, have contributed to a slowdown in the research on the architectural, morpho-typological, and construction aspects of these infrastructures. In particular, given an optimal lifecycle of around 50 years, it is estimated that the majority of European hospitals are obsolete and poorly suited to contemporary organisational models. This obsolescence arises from the inability of excessively rigid organisations to promptly support the changes necessary in the light of evolving processes and technologies, which also contribute to an increase in the net design and construction time. The need to keep up with rapid innovation while complying with stringent safety, hygiene, and system
White Arkitekter and Tengbom / Fredrik Sweger
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