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SAFHE/CEASA 2011 - Open Building for Healthcare Facilities: Lessons from the INO Hospital, Bern, Switzerland
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SAFHE/CEASA 2011 - Open Building for Healthcare Facilities: Lessons from the INO Hospital, Bern, Switzerland



Amira Osman presents lessons learned from the construction of the INO Hospital in Bern, Switzerland using "open building" practices. Presented at the SAFHE/CEASA 2011 conference in Johannesburg, South ...

Amira Osman presents lessons learned from the construction of the INO Hospital in Bern, Switzerland using "open building" practices. Presented at the SAFHE/CEASA 2011 conference in Johannesburg, South Africa.



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SAFHE/CEASA 2011 - Open Building for Healthcare Facilities: Lessons from the INO Hospital, Bern, Switzerland SAFHE/CEASA 2011 - Open Building for Healthcare Facilities: Lessons from the INO Hospital, Bern, Switzerland Presentation Transcript

  • Open Building for Healthcare Facilities: Lessons from the INO Hospital, Bern, SwitzerlandAmira OsmanCSIR Built Environment, South Africa
  • • Would you buy a car if the tires were moulded to the wheel rims, and the wheel rims welded to the chassis? • The first time your car needs a tire change, you would have to destroy the entire vehicle – although it still drives perfectly well – to make it fit for the road. • This procedure has always been followed in the construction sector. Cables are sometimes buried into concrete load- bearing ceilings. • When you need to replace them you have to destroy the intact building fabric. • • GEISER•"Spaghetti junction"
  • dynamic societies require agile architecture.two alternatives face clients with dynamic requirements:•scrap and build practices•stock maintenance practicesthe later is called “open building” among somepractitioners internationally
  • life cycle of a building•a building is never quite finished•it changes over time.different service lives of the individualcomponents of a buildingwhere different components are interconnected and interdependentan assembly of elements can only reach theage of its shortest-living component.•parts must not be physically connected in a way that causes destruction when one part or theother is removed or replaced•this notion of separation or “disentanglement” contradicts the usual conventions of theplanning and construction process. GEISER
  • Introduction of Technical Systems into Building Construction1800 1850 1900 1950 2000 Kendall Wood Frame Construction Steel Frame Construction Concrete Frame/Slab/Column 1840s piped water supply 1875 vented trap 1890 flush toilet 1880 public sewer systems PIPED 1890 natural gas for heating/cooking SYSTEMS 1920 fire sprinkler systems gas for illum 1880 steam heat 1925 hydronic heating 1935 ducted heating DUCTED 1935 air conditioning systems SYSTEMS 1920 mechanical ventilation 1890 electrical power cabling CABLED 1890 data cabling SYSTEMS 1950 cable television 1950 security systems ERA OF ENTANGLEMENT SEARCH FOR DISENTANGLEMENT ERA OF OPEN BUILDING
  • GEISER/KENDALLINO Hospital, Bern, SwitzerlandInsel University HospitalManaged by the Canton Bern Building Department“After many conventionally procured buildings, they realized that it is impossible to design a projectbased on a fixed program of requirements because the program inevitably changes in response tonew medical procedures, new regulations, and new market and insurance conditions.”
  • each year, certain events prevented them from fixing the program:•new medical procedures were introduced•a new head of surgery was hired who had new staffing, space, andequipment requirements•the market for services changed•new regulations were introduced•a paediatric facility was scheduled to be expanded•and so on.....
  • problems of changedistributed design and construction responsibilitiesthe INO is the first known project to apply these principlesrigorously in healthcare architecture•sets a new standard for adaptable medical facilities•offers an alternative paradigm for meeting critical needs in the field of healthcare architecture
  • the group adopted an entirely new planning process recommended by Urs Hettich, architect anddirector of the Canton Bern Building Departmentlong-term utility value•the ability to optimize adaptability in the face of changes in technical, social, or politicalcircumstances•such facilities are too dynamic and cannot be planned and built as if they areprogrammatically staticrather, the “whole” emerges over time, incrementally
  • a competition was held to select adesign/building firm for three distinct "levels“•the primary level, intended to last 100 years•the secondary level, intended to be useful for 20-plus years•the tertiary level intended for 5 to 10 years
  • managing complexity •Primary system fixed: •Secondary system adjustable: •Tertiary system flexible: COMPOSITE •Site logistics •Interior walls •Furniture SYSTEM •Building envelope •Floor covering •Mechanical equipment •Structure system •Ceilings •Hospital supplies •Interior logistics•Primary system fixed: •Secondary system adjustable: •Tertiary system flexible: COMPOSITE•Electronics •Equipment for head offices •Ports for apparatus SYSTEM•Location of head offices •Installations •Room for specific installations•Installation structure •Illumination
  • •primary system determines the structure and establishes conditions for the other systems•the interfaces are exactly defined•independence of lower-level (secondary and tertiary) systems •typical floor of primary system •8.4m x 8.4m structural grid •a structural grid with square “punch-thru” opportunities in the concrete slab on each floor, in the center of each structural bay
  • Primary Systemthe presentation requirements for the primary system were very open for thecompetitors except for the gross building area•layout scenarios were not required•competitors did not receive space-planning templatesit was up to the competitors to show the quality of their “open building”
  • The primary system•service life of approximately 50 to 100 years•a long-term investment and unchangeablethe primary system will accommodate various secondary systems in different cycles duringits service lifethe primary system mainly comprises the following elements:•-external site conditions site access, public utilities•-load-bearing structures vertical and horizontal support structures•-outer building structure facade, roofs•-building services structure installation structure: concept of the technical access and location of the central control rooms
  • •fixed mechanical systems risers are placed in each quadrant.•fixed vertical circulation points3.6m square “punch-through” opportunities: holes in the “swiss cheese"
  • •the primary system is, in effect, a low-techbuilding for a high-tech content •Phase 1 of primary system •West façade, showing double skin
  • Interior view of the top floor of the empty primary system, showing skylights, openings for light-wells to the floor below. Precast columns with four sleeves at the base of each column for possible vertical drainage piping.Also visible is the inner layer of thedouble skin envelope, showingoperable wooden windows.
  • The competition for the secondary system, likewise international and anonymous, was decided in1998.independent and logical conceptthe project managers demanded solutions for distribution of mechanical services and layoutscenarios as well, showing typical patient paths•The competitors for the secondary system received documentation of the primary system•They also received the layout templates of the existing hospitaldemonstrate—with drawings—how their proposed fit-out systems could bedeployed according to a range of programmatic scenarios withinthe given base building(at that point already under construction).
  • the secondary system - with a service life of approximately 15 to 50 years - is a medium-terminvestment and adaptablesubsequent install-ability, disassembly and reassembly are the key focal points for thissystem levelthe secondary system mainly comprises the following elements:• -Finishing work interior walls, finish floors, ceilings• -Building services installations central control rooms and technical access• -Internal personnel, patient and materials movement vertical and horizontal• access, transport systems
  • The tertiary system - with a service life of approximately 5 to 15 years - is a short-terminvestment that can be changed without any major structural work. It is subject to rapid change andis least predictable. The tertiary system mainly comprises the following elements:• -Medical equipment• -Fittings, furnitureAfter an international preselection process for the tertiary system in 2000, the "HWPPlanungsgesellschaft" from Stuttgart, Germany, was commissioned with the planning and•acquisition of the tertiary system.
  • In OB, the built environment is considered in terms of who makes the decisions about its design(physical and spatial articulation): groups and individuals that may intervene and in what way•A democratic process in decision making has resonance in SA•Participation is not always restricted to involving people in the early decision making process –(Dewar: participation is not about asking people what they want as people’s expectationsare experientially determined)•Participation should also be in the form of spaces and architectural forms thatallow continued interaction, appropriation and re-interpretation by the usersthroughout the lifetime of the buildingThe built environment can be seen as a number of levels were different people have CONTROL interms of their ability to make decisions – spreading that control among the different stakeholdersand allowing more people to have a say in their environment is at the heart of an inclusive process:this has TECHNICAL IMPLICATIONS as these levels may then also relate to the degree oftechnical skill needed for the different components of a building – thus having an inclusive processwith many different levels of skill accommodated for
  • By understanding the environment in terms of “different levels of control” one is able todesign buildings in such a way were the architect might have complete control at onelevel of the building while allowing for more fluid and variated responses at other levels:HAMDI REFFERES TO THIS AS A CONTRAST BETWEEN EMERGENCE ANDPLANNING:“places that happen and happen to work – places that are designed and don’t”Open Building is about with different components of the built environment and clearlyseparating between them.•Some components have a longer life span than others•If change is required in the short life component – the long life component must not becompromised in the process
  • This is how old cities are ordered•there are permanent aspects of the city that give itcharacter and permanence•while the second level fabric may undergo constantchange and adaptationThus achieving relevance and rendering thesecities sustainable – as some OB practitionerswould say – this is the quality that makes citiesand buildings lovable
  • Most cities have developed, spreadTunis medina out, declined, renewed in parts, refocused their sense of place and have become multi-nucleated. In all of this, the city is an example of a fine-grained “living fabric.” No single party—private or public—controls the whole. Only a few owners (universities, medical centers, large corporate organizations, and governmental units being the most prominent) are large-scale. Even in these cases, internal control is hierarchically structured. •HABRAKEN
  • INO Hospital, Bern, Switzerland