Building for Change: Comparative Case Study of Hospital Architecture — Pilosof 2020

This study examines the effect of architectural design strategies on the adaptability of hospitals over time. Most hospitals are designed for highly specialized medical functions, which frequently conflicts with the need to design the hospital facility to accommodate the evolution and modification of functions over time. The need to design for a specific medical program while preparing for its future evolution can be met through various architectural design strategies. The study compares two hospital buildings with very similar configurations and medical programs but very different architectural design strategies: one was designed for an undetermined future medical function, and the other was designed for a specific medical function. The study analyzes and compares the two hospital buildings' design strategy, planning, design process, and construction by phases over the course of twelve years. The hospital's ability to make changes during the design, construction, and occupancy phases was constrained as a result of a design strategy tailored to a specific function. It was discovered that a systematic approach to system separation for an unknown function, as opposed to a "tailor-made" approach in the design for a specific function, supported a variety of evolving medical programs. Conclusions: Architectural design strategies developed early in the design process have a significant influence on the future evolution of the hospital facility. The disparate outcomes of the two projects illustrate the greater impact of healthcare policies, hospital organizational culture, and infrastructure funding models on the architecture and adaptability of hospitals.

Pilosof NP. Building for Change: Comparative Case Study of Hospital Architecture. HERD: Health Environments Research & Design Journal. 2021;14(1):47-60. doi:10.1177/1937586720927026