Modern Material Solutions Applied in Pediatric Facilities

S t r e s z c z e n i e Wraz z pojawieniem się w naukach medycznych dbałości o kondycję psychiczną pacjenta ukształtowały się nowe tendencje w formowaniu układów funkcjonalnych budynków służby zdrowia. Bardzo ważną cechą staje się aranżacja wnętrz współgrająca z funkcją medyczną. Otwiera to nowe możliwości dla architektury obiektów ochrony zdrowia. Pozytywny wpływ architektury na samopoczucie użytkownika jest bardzo istotny w przypadku medycznych jednostek zajmujących się opieką nad najmłodszymi pacjentami. Dla dzieci kontakt z przychodniami i szpitalami oznacza stres związany z separacją od rodziny i środowiska domowego oraz strach przed procedurami medycznymi, które powodują ból. Odpowiednio ukształtowana przestrzeń umożliwia redukcję negatywnych przeżyć związanych z przebywaniem w placówce leczniczej. Warto przyjrzeć się architekturze szpitali dla dzieci oraz oferowanym współcześnie rozwiązaniom materiałowym, które umożliwiając spełnienie wymaganych norm higieniczno-sanitarnych, jednocześnie pozwalają na realizację śmiałych wizji projektantów pediatrycznych placówek medycznych. K e y w o r d s : Architecture; Material solutions; Health care facilities design; Hospital; Pediatrics. 2/2018 A R C H I T E C T U R E C I V I L E N G I N E E R I N G E N V I R O N M E N T 13 A R C H I T E C T U R E C I V I L E N G I N E E R I N G E N V I R O N M E N T The Si les ian Univers i ty of Technology No. 2/2018 d o i : 1 0 . 2 1 3 0 7 / A C E E 2 0 1 8 0 1 8 A . G ę b c z y ń s k a J a n o w i c z , B . K o n a r z e w s k a architectural solutions. The second part of the paper presents material solutions that can be used as individual wall barriers arrangement in medical facilities. Moreover, the paper discusses the Polish guidelines for the selection of building materials suitable for interior arrangements of this type of units. A hospital is a traumatic place for children. Regardless of the situation, whether the youngest patients had prior experiences with staying at a medical facility, or if it is their first visit, the hospital is an environment associated with pain and fear, implying a potential separation from family as well as remoteness from the everyday habitat. The youngest patients are considered to be a difficult group for the staff since their fear of medical procedures causes violent reactions that make it impossible to conduct tests or treatments properly. A prolonged child’s hospitalization is detrimental to its mental state and could result in the so-called hospital disease, which significantly impairs its further physical and mental development [1]. A number of studies conducted in the 1970s have proved the existing form of health care architecture to result in an increased stress in children [2]. Not only among the youngest patients do the overwhelming objects’ scale, labyrinths of corridors, sterility of rooms, coupled with the dreaded medical technology infrastructure, cause unpleasant associations. Designers of medical units oriented on providing children with medical services currently have the opportunity and the design tools to create a less volatile environment. Research conducted under the popular trend basing the design on the obtained evidence – evidence-based design – has proved the properly structured interior design to be able to facilitate children’s healing process, reduce stress associated with hospitalization, and thereby indirectly support parents and medical staff [3, 4]. A new, youngest-oriented, architectural design trend correlated with hospitals has been implemented for more than two decades which has been indicated by numerous monograph studies presenting the most famous investments of this type [3, 5, 6]. Objects’ masses, material solutions, and spatial arrangements are created to meet children’s perception. Designers arranging medical interiors, lobbies, doctor’s offices or treatment rooms are aware of the special requirements of the youngest users. The latest medical knowledge in combination with the knowledge of the child’s psyche is used to create space in which the process of treating small patients can be conducted most effectively. The proper, i.e. least stressful, impact of the medical space is influenced by, among others, the access of natural light to rooms, the introduction of green areas within the premises of hospital facilities, as well as the interior design and the associated choice of finishing materials and their coloring, together with the equipment created in accordance with the guidelines of the contemporary art. The quality of the surrounding in which the patient resides affects the course of the healing procedure. Scientific research carried out on hospital wards has proven unmatched interiors to cause anxiety disorders in patients and reduction of the proper immune system functioning, resulting in increased doses of pharmaceuticals [7]. The rooms are designed in a way that allows for a round-the-clock parents’ stay – regardless of the patient’s age, in order to ensure the sense of security of the youngest. There are special areas in the admission room and in the corridors, which allow families to calmly wait for medical procedures, whereas play areas have lower suspended ceilings. The results of social relations’ observations taking place in urban space inspired the implementation of such solutions. Being applied at the hospital, they become an added value [8]. The architecture of hospitals, clinics, and doctors’ offices (especially those designed in the period of modernism) is determined by functional requirements. Additionally the aspects of medical technology are evidently the leading, if not the only, factor determining its conception. Nevertheless, designers, with their years of experience and research, are aware of the importance of feelings and emotions experienced by patients in contact with a medical facility. The formula of the formed environment affects the healing process and convalescence. The holistic medicine’s approach to healing is currently spread at a much larger scale in pediatric objects, than in different facilities of other medical specialties. European Charter for Children in Hospital formed in 1988 by the British National Association for the Welfare of Children in Hospital – NAWCH – states: “Children shall have full opportunity for play, recreation and education suited to their age and condition and shall be in an environment designed, furnished, staffed and equipped to meet their needs”. 1.1. First impression: facade and entrance zone A building’s facade is the first element to be seen from a long distance. Designers of modern hospitals, with the achievements of building materials’ technology, can create original object’s coatings of any color 14 A R C H I T E C T U R E C I V I L E N G I N E E R I N G E N V I R O N M E N T 2/2018 M O D E R N M A T E R I A L S O L U T I O N S A P P L I E D I N P E D I A T R I C F A C I L I T I E S or specific texture, that are also visible at night due to media animation. Such facades have been realized, among others, in London (Richard Desmond Children’s Eye Center), Florida (The University of Florida Health Shands Children’s Hospital) and also in Parma (The Children’s Hospital “Pietro Barilla”). The aforesaid designs are based on additional, double glazed facades using mass-colored glass or metal oxide-coated glass, which incorporate light installations to create projections after dark. Most of these coatings are equipped with an original, colorful facade detail also acting as sun blinds, served by vertical or horizontal so-called brise soleil, movable or fixed panels of steel mesh or perforated metal plate [9]. The aesthetics borrowed from kindergartens, playgrounds and department stores, i.e. public facilities that children deal with on daily basis, is introduced also to hospitals and clinics. Transformation of the spatial formula begins already in the outer zone – the entrance area. It is shaped similarly to the public space, which does not arouse any negative connotations in the youngest. The details attracting a child’s interest are often used. They include, inter alia, art installations similar to those located on playgrounds. The scale of the main entrance is adapted to children’s perception. Canopies above the doors lower the entrance zone and eliminate the intimidation resulting from contact with the monumental mass of the hospital (Fig. 1, 2). Everything is created in such a way as to interest children, distract their attention, and facilitate their entry into the medical world. 1.2. Hospital’s activity center: admission room and registration Additional visual surprises are installed upon entering the hospital, in the main hall, so that the attention of the small patient is not focused exclusively on future examinations and treatments. The search for such solutions resulted in a trend focusing the spatial layout of the hospital on the inner atrium or lobby. In larger objects, a child and its guardians must undergo a registration process within the admission room before they reach the medical zone. The registration point is usually in the lobby – in the space, which resembles the market of a small town. In a metaphorical sense it is a heart of the hospital – its peculiar showcase. It combines various patient-dedicated functions – from administrative issues related to hospitalization to commercial services with shops, pharmacy and restaurants. At the end of the twentieth century many objects were formed in such a way. Hospital’s atria are particularly popular in North America. The Hospital for Sick Children building in Toronto is, according to literature, a prototype for such distribution of a medical unit [2]. Drawing inspiration from popular resolutions of public spaces, designers from Zeidler Roberts Partnership A R C H I T E C T U R E 2 /2018 A R C H I T E C T U R E C I V I L E N G I N E E R I N G E N V I R O N M E N T 15 a Figure 1. The main entrance is reminiscent of kindergarten