It is the architect's responsibility to protect the public's health, safety, and welfare. Ironically, healthcare facilities, whose programs focus on those elements, often seem to fall short of those basic design standards. The evolution of healthcare practices has brought us to a stage of design that focuses on the machine rather than the patient. This shift has created stripped, unwelcoming, and unnatural healthcare environments that have proven to negatively impact the health and well-being of facilities' patients. Dialysis treatment facilities, whose medical procedures rely so heavily on machines, are an even more extreme condition of this imbalance. In an effort to raise awareness of this problem and reinvigorate architectural design that actually promotes healthy environments, I chose to explore the idea of "design that heals". Through the conscientious integration of nature, light, and color, this project redefines the priorities of a healthcare facility and takes a holistic and sustainable approach to design that better cares for the patients and enlivens the community. The proposed program pairs a dialysis clinic with a community nutrition center which helps address the causes of kidney disease at the source. Located in an underserved Anacostia neighborhood, the people-focused building provides nutrition education, food production and healthcare services. Taking inspiration from the filtration process of dialysis, the building aims to celebrate and expose its own water circulation systems, mirroring the beautiful, yet chaotic, systems within the human body. / Master of Architecture / This thesis explores how the architectural design of healthcare facilities impacts the health and well-being of the building’s occupants. Healing requires a holistic support system that provides for the patients physically, psychologically, and socially. Therefore, the environments which are designed to support this healing must be in tune with those needs and cater to each those factors. “Design that Heals” applies this holistic design strategy to a dialysis treatment facility, a branch of healthcare whose design is often overlooked and underserved. This research reveals specific environmental elements that can be improved upon through design in order to create spaces that better support healing, including the integration of natural light, nature, artwork, social support, increased patient control and decreased noise levels. This proposed treatment facility, which acts as an example for the design of future clinics, illustrates the application of these design strategies, creating a facility that actually supports the welfare and healing of the building’s occupants.

O rápido avanço da tecnologia médica e as alterações no perfil dos usuários demandam novas configurações da prestação de serviços e, consequentemente, novos espaços, aptos a suportar e contribuir com a realização das novas atividades. Este trabalho traz o mapeamento do processo de projeto para intervenções em edifícios de saúde, dos pontos de vista teórico e prático, e um modelo genérico do processo de projeto destas intervenções. O objetivo foi estudar métodos que favoreçam e facilitem a atualização contínua dos edifícios de saúde existentes devido à grande complexidade que envolve estes projetos. O método foi estruturado em levantamento e análise de dados. O levantamento contou com revisão bibliográfica, entrevistas e um estudo de caso numa empresa de projetos de arquitetura para saúde com vasta experiência no setor. Na análise de dados, as informações foram cruzadas e foi elaborado o modelo genérico, que serve de base para o desenvolvimento de projetos de intervenções em edifícios de saúde, podendo ser adequado para as peculiaridades de cada caso. O modelo, que abrange desde o início do processo de projeto até o acompanhamento do uso, é composto por cinco macrofases, divididas em fases e sub-fases, e contempla as diferentes relações entre elas, caracterizando o processo de um modo geral como cíclico, mas pontuando possibilidades de interrupção e retrocesso. São também apresentadas as interfaces entre os diversos agentes do processo em cada uma das macrofases e entre macrofases distintas. / The fast advance of medical technology and changes in user profiles require new configurations of service delivery and, consequently, new spaces, able to support and contribute to the implementation of new activities. This research presents the mapping of the design process for interventions in healthcare buildings, both from the standpoint of theory and current practice, and a generic model of the design process for these interventions. The aim was to study methods to encourage and facilitate continuous upgrading of existing healthcare buildings, due to high complexity involved in these designs. The method was structured in data collection and data analysis. The data collection was composed by literature review, interviews and a case study in a company of healthcare design with extensive experience. In data analysis, data were crossed and the generic model was developed, which can be the basis for the design development and can be suitable for the peculiarities of each case. Ranging from the beginning of the process to monitoring of use, the model consists of five macrofases divided into phases and sub-phases, and includes the various relationships between them, characterizing the process as cyclical generally, but with chances of break and retreat. We also present the interfaces between the different actors of the process in each macrophases and between different ones.

Os hospitais possuem estruturas físicas complexas, e projetá-los não é uma tarefa fácil. A dificuldade aumenta se o profissional não tiver disponíveis ferramentas de gerenciamento de escopo as quais auxiliariam a interconexão dos inúmeros profissionais de áreas de conhecimentos distintos, das normatizações vigentes, das atividades da unidade hospitalar, dos fluxos a serem respeitados, da variedade de elementos construtivos e das constantes inovações tecnológicas e assistenciais. O problema identificado é a baixa adoção de processos de gerenciamento de escopo em projetos de arquitetura para saúde. O presente trabalho teve como objetivo modelar um processo de gerenciamento de escopo para a aplicação em projetos de arquitetura para saúde. Como metodologia, fez-se o estudo de literatura técnico-científica. Como resultado deste trabalho, apresentou-se um processo de gerenciamento de escopo para projetos de arquitetura para saúde (GEPAS), para que se torne uma ferramenta de gestão destinada a arquitetos, gestores de escopo, gerentes de projetos e administradores e, com isso, contribuir para que diminua o número de falhas decorrentes da ausência de controle das informações de projetos / Hospitals are complex physical structures and design them is not an easy task. The difficulty increases with the lack of projects scope management tools, which would help interconnect the many professionals in different areas of knowledge, current regulations, hospital unit activities, flows to be considered, variety of constructive elements and the constant technological and healthcare assistance innovations. The problem identified is the low adoption rate of project scope management processes in healthcare architecture projects. The present thesis had an objective to introduce a process of scope management for applications in healthcare architecture projects. The study of technical-scientific literature was the methodology adopted for the current thesis. As a result of this effort, a process of scope management for healthcare architecture projects (GEPAS) was introduced. It should become a management tool aimed at architects, project scope managers, project managers and administrators and with that, contribute to minimize the number of failures due to the lack of control of information in projects

Os hospitais possuem estruturas físicas complexas, e projetá-los não é uma tarefa fácil. A dificuldade aumenta se o profissional não tiver disponíveis ferramentas de gerenciamento de escopo as quais auxiliariam a interconexão dos inúmeros profissionais de áreas de conhecimentos distintos, das normatizações vigentes, das atividades da unidade hospitalar, dos fluxos a serem respeitados, da variedade de elementos construtivos e das constantes inovações tecnológicas e assistenciais. O problema identificado é a baixa adoção de processos de gerenciamento de escopo em projetos de arquitetura para saúde. O presente trabalho teve como objetivo modelar um processo de gerenciamento de escopo para a aplicação em projetos de arquitetura para saúde. Como metodologia, fez-se o estudo de literatura técnico-científica. Como resultado deste trabalho, apresentou-se um processo de gerenciamento de escopo para projetos de arquitetura para saúde (GEPAS), para que se torne uma ferramenta de gestão destinada a arquitetos, gestores de escopo, gerentes de projetos e administradores e, com isso, contribuir para que diminua o número de falhas decorrentes da ausência de controle das informações de projetos / Hospitals are complex physical structures and design them is not an easy task. The difficulty increases with the lack of projects scope management tools, which would help interconnect the many professionals in different areas of knowledge, current regulations, hospital unit activities, flows to be considered, variety of constructive elements and the constant technological and healthcare assistance innovations. The problem identified is the low adoption rate of project scope management processes in healthcare architecture projects. The present thesis had an objective to introduce a process of scope management for applications in healthcare architecture projects. The study of technical-scientific literature was the methodology adopted for the current thesis. As a result of this effort, a process of scope management for healthcare architecture projects (GEPAS) was introduced. It should become a management tool aimed at architects, project scope managers, project managers and administrators and with that, contribute to minimize the number of failures due to the lack of control of information in projects

O rápido avanço da tecnologia médica e as alterações no perfil dos usuários demandam novas configurações da prestação de serviços e, consequentemente, novos espaços, aptos a suportar e contribuir com a realização das novas atividades. Este trabalho traz o mapeamento do processo de projeto para intervenções em edifícios de saúde, dos pontos de vista teórico e prático, e um modelo genérico do processo de projeto destas intervenções. O objetivo foi estudar métodos que favoreçam e facilitem a atualização contínua dos edifícios de saúde existentes devido à grande complexidade que envolve estes projetos. O método foi estruturado em levantamento e análise de dados. O levantamento contou com revisão bibliográfica, entrevistas e um estudo de caso numa empresa de projetos de arquitetura para saúde com vasta experiência no setor. Na análise de dados, as informações foram cruzadas e foi elaborado o modelo genérico, que serve de base para o desenvolvimento de projetos de intervenções em edifícios de saúde, podendo ser adequado para as peculiaridades de cada caso. O modelo, que abrange desde o início do processo de projeto até o acompanhamento do uso, é composto por cinco macrofases, divididas em fases e sub-fases, e contempla as diferentes relações entre elas, caracterizando o processo de um modo geral como cíclico, mas pontuando possibilidades de interrupção e retrocesso. São também apresentadas as interfaces entre os diversos agentes do processo em cada uma das macrofases e entre macrofases distintas. / The fast advance of medical technology and changes in user profiles require new configurations of service delivery and, consequently, new spaces, able to support and contribute to the implementation of new activities. This research presents the mapping of the design process for interventions in healthcare buildings, both from the standpoint of theory and current practice, and a generic model of the design process for these interventions. The aim was to study methods to encourage and facilitate continuous upgrading of existing healthcare buildings, due to high complexity involved in these designs. The method was structured in data collection and data analysis. The data collection was composed by literature review, interviews and a case study in a company of healthcare design with extensive experience. In data analysis, data were crossed and the generic model was developed, which can be the basis for the design development and can be suitable for the peculiarities of each case. Ranging from the beginning of the process to monitoring of use, the model consists of five macrofases divided into phases and sub-phases, and includes the various relationships between them, characterizing the process as cyclical generally, but with chances of break and retreat. We also present the interfaces between the different actors of the process in each macrophases and between different ones.

A presente dissertação tem por objetivo estudar o patrimônio arquitetônico do Instituto Butantan, localizado na cidade de São Paulo. Esse Instituto, fundado em 1901 para produção de imunobiológicos, e que se notabilizou mundialmente pela pesquisa em ofidismo, instalou-se em um campus de pesquisa no qual cientistas e arquitetos criaram, durante o último século, um conjunto de elementos arquitetônicos, urbanísticos e paisagísticos relevantes do ponto de vista não só científico, mas também histórico e patrimonial, dentro do contexto recente de valorização do patrimônio arquitetônico da saúde. Mais especificamente, pretende-se analisar também como tem se dado a preservação deste importante acervo arquitetônico, já reconhecido e tombado pelo órgão estadual (Condephaat) e municipal (Conpresp) de proteção do patrimônio cultural. A partir de levantamentos da história, do espaço construído e das normativas dessa instituição, analisou-se em que medida as ações reservacionistas que incidiram sobre esse patrimônio seguiram as recomendações da Carta de Veneza (1964), documento internacional em vigor que estabelece os princípios básicos que devem fundamentar quaisquer intervenções no patrimônio cultural, e da Teoria da Restauração, de Cesare Brandi (1963), um dos textos-base nesse campo. Para tanto, foram consultadas principalmente fontes primárias do acervo documental e iconográfico do Instituto, fontes secundárias pertinentes e depoimentos de frequentadores desse campus. / This research intends to study the architectural heritage of the Instituto Butantan, in the city of São Paulo. This institute, founded in 1901 for the production of immunobiologicals, has garnered world-recognition for its research on ophidism and is located in a research campus where scientists and architects created a set of architectonic, urban and landscape elements during the last century. This set is relevant not only for its scientific importance, but also due to its historical and heritage significance, given the recent context of valuation of healthcare architecture. Furthermore, this research analyses how this architectural heritage has been preserved, since it has already been recognized and listed by the state and municipal departments of protection of cultural heritage. Based on surveys on the institution\'s history, its built space and its regulations, it was analyzed the extent to which actions toward such heritage have followed the recommendations from the Venice Charter (1964), an international document that establishes the basic principles to support interventions on cultural heritage, and the Theory of Restoration, by Cesare Brandi (1963), a reference text in this field. For such, primary sources from the Institute\'s document and image collection were consulted, as well as pertinent secondary sources, and statements from users of the campus.

China is engaged in the largest healthcare construction program in history, expecting to build more than 2,000 hospitals and a large number of healthcare facilities at all scale over the next few years. This once-in-a-lifetime construction boom provides a valuable opportunity to rethink Chinese hospital design, and especially to consider how to design modern hospitals that are effective and efficient in delivering care, and are responsive to the cultural needs of the Chinese people as well. This dissertation seeks to rigorously define these issues and develop metrics that link design to key healthcare processes. This study uses a range of concepts and analysis tools drawn from cross-culture organizational communications, evidence-based design, space syntax and other research traditions. This thesis develops and refines metrics for four main drivers of nursing unit design: space economy, staff efficiency, natural light and cultural preferences for communication. Communication among Chinese healthcare workers is strongly influenced by cultural preferences for patterns of authority and decision-making reflected in organizational culture and rooted in Confucian principles of hierarchical social structure (Dengji), social network (Guanxi) and face (Mianzi). While the dissertation builds on a longstanding tradition of research focusing on healthcare space economy and staff efficiency, new measures for cultural preferences are proposed and tested. Based on emerging theories of cross-cultural organizational communication by Hofstede and other scholars, and space syntax, this study particularly explores how cultural preferences for face-to-face communication are reflected in the design of Chinese nursing units. Based on the proposed metrics, the dissertation analyzes six pairs of Chinese and US nursing units, matched on layout type. While the Chinese nursing units appear Western, deeper quantitative analysis of their layouts reveals significant national differences in the application of unit typologies in China when compared to those in the U.S. It shows that Chinese hospital design is rooted in cultural preferences such as for positive energy (qi) based on Fengshui theory, and in Confucian principles of hierarchy, social networking and face.

In December of 2019, the city of Wuhan in China reported an outbreak of a high number of pneumoniacases (Bassareo, 2020). The SARS-CoV-2 Virus (severe acute respiratory syndrome coronavirus 2)started to cause disturbance in societal functions, eventually leading to anomalous infection controlmeasures. Covid-19 was believed to have appeared in Sweden on 31st January and on the 9th ofMarch, it was confirmed in the Stockholm Region (Roden, 2020). Historically, pandemics have struckhumanity numerous times before, yet the virus proved that the modern world was still not prepared. Patients had to be accommodated in hospital corridors, general wards, and makeshift hospitals.Currently, the way of dealing with the virus is to admit patients into negative pressure isolation rooms.Negative pressure isolation rooms eliminate the airborne infectious particles, unlike regular emergencyrooms. Thus isolation rooms within alternative arrangements could offer a bigger space capacitywithout placing the burden on a municipality. Our thesis sheds light on disadvantages within temporary health facility solutions used during theCoronavirus pandemic. The project proposes an alternate strategy for dealing with sudden massdemand of hospital patient beds for quarantine units. This strategy involves a permanent buildingplanning, which is prepared in advance to limit the time for shifting space. In addition, multiple interiorfittings are prefabricated, easy to install as well as transport. By proposing a building with a floor planfor a primary office usage, the building could be transformed for a secondary usage as an infectiousdisease clinic in case of serious health threats to the modern welfare society. / I december 2019 rapporterade staden Wuhan i Kina ett utbrott av ett stort antal lunginflammationfall (Bassareo, 2020). SARS-CoV-2-viruset (allvarligt akut respiratoriskt syndrom-coronavirus 2) börjadeorsaka störningar i samhällsfunktionerna och ledde så småningom till avvikande åtgärder förinfektionskontroll. Covid-19 tros ha dykt upp i Sverige den 31 januari och den 9 mars bekräftades det iStockholmsregionen (Roden, 2020). Historiskt sett har pandemier drabbat mänskligheten flera gångertidigare, ändå bevisade viruset att den moderna världen fortfarande inte var beredd. Patienterna fick bo på sjukhuskorridorer, allmänna avdelningar och provisoriska sjukhus. För närvarandeär sättet att hantera viruset på att ta in patienter i negativ tryck isoleringsrum. Isoleringsrum med negativttryck eliminerar de luftburna smittsamma partiklarna, till skillnad från vanliga akutrum. Således kanisoleringsrum inom alternativa arrangemang erbjuda en större utrymmes kapacitet utan att belastaen kommun. Vår avhandling belyser nackdelar med tillfälliga sjukvårds lösningar som används under Coronaviruspandemin. Projektet föreslår en alternativ strategi för att hantera plötslig mass efterfrågan på sjukhuspatientsängar för karantän avdelningar. Denna strategi innebär en permanent byggnadsplanering,som är förberett i förväg för att limitera tiden det tar att skifta ett utrymme. Dessutom är flerainredningsdetaljer prefabricerade, lätta att installera och transportera. Genom att föreslå enbyggnad med en planlösning för en primär kontorsanvändning kan byggnaden omvandlas till ensekundär användning som är en infektionsklinik, i händelse av allvarliga hälsorisker mot det modernavälfärdssamhället.

The objective of the diploma thesis is the new building of Cancer Prevention Centre, first of its kind in the Czech Republic. The site is located on steep terrain of the south hillside of Žlutý kopec in Brno, which is a part of Masaryk Oncological Hospital complex. The aim of the Cancer Prevention Centre is to attract the citizens’ attention and invite them to undergo a preventive medical check-up with the potential to save hundreds of lives every year. The project takes this fact in consideration and strives to find ways leading not only towards establishing new relationship between the building and the public, but also towards connecting the city centre and nearby by residential area with the hospital complex. The three volumes of the buildings create a dynamic composition and therefore complete the characteristic development of Masaryk Oncological Centre. The main concept however revolves around the motive of instability, balance and journey which are all linked to tumour diseases.