John Bendix, Building Project Director, Herlev Hospital. Changes in Scandinavian healthcare sector - oppportunities for Finnish companies. Finpro seminar materials 19.4.2012.

1. Herlev hospital
Copenhagen area

2. Parlament has desided
to spend 6.000 mio €
The conditions:
An Emergency guidline has to be followed
Closing off smaller hospitals
20-25 % have to be used on medical equipment.
The construkion cost must be max 4800 €/m2.
The running cost has to be cut with 6 - 8 %
Some standard of sizes has to be met.
ex. Ambulatori 245/7 og single bedroom 33-40 Norge 23-32 m2
The ideas has to be exchange with other regions

3. HERLEV
320 mio €
Ålborg
Bispebjerg
450 mio €
420 mio €
Viborg
160 mio € Rigshosp.
260 mio €
Gødstrup
Hvidovre
450 mio €
200 mio €
Skejby Hillerød
900 mio € 500 mio €
Kolding Sct Hans
130 mio € 80 mio €
Køge
Åbenrå 570 mio €
180 mio €
Odense Slagelse
900 mio € 200 mio €

4. Herlev hospital
Main hospital in Copenhagen area.
• 500.000 inhabitants
• 22 somatic specialties
• 4500 employees
• Extraordinary architecture extraordinary

5. Future capacities
■ Number of beds will be reduced by
1,7 % a year - 35 m2 pr. bed
■ Ambulatorie activity increces by 3% a year
■ All surgery rooms has to be active
- 245 days and 7 hours pr day
■ Acute and elektive funktions has to be
separated. - lower running cost
■ Focus on research and education
New construction = 57000 m2

6. How should the patient see the new hospital ?
Clinical functions:
■ Close relations to the GP.
■ All kind of specialist all hours.
■ Single bedrooms
(lower infection rate, confidentiality, support from relatives)
■ Efficiency in treatment.

7. How should the patient see the new hospital ?
Building:
■ Healing architecture
Safety
Green areal for relaxation
Integrated art.
■ Wayfinding
Intuitive understanding
■ Sustainability
■ Innovation and new technology
■ Evidensbaseret design

8. Project competition
Winning project
finished 2017
architects Henning Larsen
(Made the Copenhagen operhouse)

9. Services
Existing Elective
Siteplan Existing
beds
Parking
Underground
Emergency + Acute Children
Heliport + Parking
Waste Water treatment

10. Profile
New Building

11. Main Entrance

12. Gardens in round buildings

13. We want the newest
Designing a new hospital
Building a new hospital
Designing a new hospital
Hospital in operation
To be safe you learn from
the former (8 years old) design
taking experiences and evidence
into consideration (Safe)
It must be an active
decisition whether
Year 1 3 6 you should go more
or less safe
Getting experiences and design evidence
Day to day small steps of innovation
Conceptual innovation
More seldom conceptual ones
takes place (not so safe)
How clearly are you exposed to succes or failure ?..

14. An example – centralized dispence of medicin
Prediction 8 years ago:
It will be possible in 8 year time to:
Secure the right quantity of medicin given at the right time
Avoid inappropriate interaction between food and medicin
Create talks between docters and pharmacists
……….
Introducing a centralized system for dispence of medicin
But first should be invented:
New equipment – new IT solution – new distribution system
The invention did not go as fast as expected
Headline in newspaper should be:
Great experiences has been gained in … project,
and it will help others.

15. Dilemmas
Evidence Balance Innovation

16. Balances
Healing architecture
Healing architecture - a political request/demand
Construction cost Running cost:
Increase: Increase :
Lots of windows Energy
A huge entrance hall Maintenance
…….
Decrease :
Short stay in hospital
No Rehospitalization

17. Balances
Sustainability
Sustainability - a political request/demand
Construction cost Running cost:
Increase : Increase :
Investments with a long Maintenance, costly to repair
return of investment and renew.
Technical equipment with
high complexity Decrease :
……. Energy
Renewable energy
(country level)
Disposal

18. Balances
How do we design for the future ?
Safe Unsafe
Evidence based design Innovation
Best practise Predict something
Predict the unpredictable
Newspaper headlines
Congratulations:
Newspaper headlines You has build a modern and
Congratulations: upto-date hospital
You kept the budget,
timeshedules and quality. But you did spend too much
money, you finished 2 years
But you build an old fashion too later and there is a lot of
and out-dated hospital problems with
the new technics introduced.

19. How to deal with the unpredictable
Flexibility
Easy changes of walls,
easy changes in the technical installations.
Elasticity
Easy to make an extra floor,
easy to make building extentions
Generalization
Easy to use offices as an ambulatorie
Easy to turn a patient-hotel into a ward

20. Use of consultants
Employed in hospitals are ”project managers”.
What we need is:
Specialist (heads) (analyze, plan, design …)
Manpower (hands) (drawings, field investigations …)
The need will vary during the project periode.

21. Thanks