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Freedom and the Cage
Spurred by ideals of individual liberty that took hold in the Western world in the late nineteenth century, psychiatrists and public officials sought to reinvent asylums as large-scale, totally designed institutions that offered a level of freedom and normality impossible in the outside world. This volume explores the \"caged freedom\" that this new psychiatric ethos represented by analyzing seven such buildings established in the Austro-Hungarian monarchy between the late 1890s and World War I. In the last two decades of the Habsburg Empire, architects of asylums began to abandon traditional corridor-based plans in favor of looser formations of connected villas, echoing through design the urban- and freedom-oriented impulse of the progressive architecture of the time. Leslie Topp considers the paradoxical position of designs that promoted an illusion of freedom even as they exercised careful social and spatial control over patients. In addition to discussing the physical and social aspects of these institutions, Topp shows how the commissioned buildings were symptomatic of larger cultural changes and of the modern asylum's straining against its ideological anchorage in a premodern past of \"unenlightened\" restraint on human liberty. Working at the intersection of the history of architecture and the history of psychiatry, Freedom and the Cage broadens our understanding of the complexity and fluidity of modern architecture's engagement with the state, with social and medical projects, and with mental health, psychiatry, and psychology.
eBook
Design Criteria of Shelter Hospitals in Response to Biological Accidents: A Systematic Review
The appropriate response to mass causality biological events requires well-established preparedness and providing a surge capacity. In such a situation, a practical solution is to convert large public venues into shelter hospitals. Due to the lack of a guideline for the transformation of a large public center into a hospital, the present study collected the design criteria for the transformation of public buildings into shelter hospitals in response to biological events such as epidemics or mass causality biological accidents.
The keywords were searched in Scopus, Web of Science, and PubMed databases until November 2021. This systematic review was conducted using terms related to mass causality biological accidents, shelter hospitals, and design criteria.
Of 1802 extracted articles, duplicates (
= 280) and unrelated publications (
= 1342) were left out in the initial evaluation. Among 180 remained papers, 29 records satisfied our criteria after reviewing abstracts and full texts. Most of the included studies were related to the transformation of public venues into hospitals in response to the coronavirus disease 2019 (COVID-19) pandemic. The investigated themes included site selection, layout and structure, waste and wastewater management, ventilation, communication, food and medicine delivery, humanitarians and social supports, post-treatment care, and Management measures.
In summary, large public venues are highly recommended alternatives for surge capacity in response to mass causality biological accidents. However, the main challenges for using these centers are the provision of basic requirements such as water and electricity, ventilation, and available space.
Journal Article
Advancing evidence-based healthcare facility design: a systematic literature review
Healthcare facility design is a complex process that brings together diverse stakeholders and ideally aligns operational, environmental, experiential, clinical, and organizational objectives. The challenges inherent in facility design arise from the dynamic and complex nature of healthcare itself, and the growing accountability to the quadruple aims of enhancing patient experience, improving population health, reducing costs, and improving staff work life. Many healthcare systems and design practitioners are adopting an evidence-based approach to facility design, defined broadly as basing decisions about the built environment on credible and rigorous research and linking facility design to quality outcomes. Studies focused on architectural options and concepts in the evidence-based design literature have largely employed observation, surveys, post-occupancy study, space syntax analysis, or have been retrospective in nature. Fewer studies have explored layout optimization frameworks, healthcare layout modeling, applications of artificial intelligence, and layout robustness. These operations research/operations management approaches are highly valuable methods to inform healthcare facility design process in its earliest stages and measure performance in quantitative terms, yet they are currently underutilized. A primary objective of this paper is to begin to bridge this gap. This systematic review summarizes 65 evidence-based research studies related to facility layout and planning concepts published from 2008 through 2018, and categorizes them by methodology, area of focus, typology, and metrics of interest. The review identifies gaps in the existing literature and proposes solutions to advance evidence-based healthcare facility design. This work is the first of its kind to review the facility design literature across the disciplines of evidence-based healthcare design research, healthcare systems engineering, and operations research/operations management. The review suggests areas for future study that will enhance evidence-based healthcare facility designs through the integration of operations research and management science methods.
Journal Article
Fable Hospital 2.0: The Business Case for Building Better Health Care Facilities
Evidence shows that changes in the architecture, design, and decor of health care facilities can improve patient care and in the long run reduce expenses. These essays detail the state of the research, look inside two hospitals that put some of these innovations into practice, and consider how design fits into the moral mission ofhealth care.
Journal Article
Architecture and the modern hospital : Nosokomeion to Hygeia
\"More than any other building type in the twentieth century, the hospital was connected to transformations in the health of populations and expectations of lifespan. From the scale of public health to the level of the individual, the architecture of the modern hospital has reshaped knowledge about health and disease and perceptions of bodily integrity and security. However, the rich and genuinely global architectural history of these hospitals is poorly understood and largely forgotten. This book explores the rapid evolution of hospital design in the twentieth century, analysing the ways in which architects and other specialists re-imagined the modern hospital. It examines how the vast expansion of medical institutions over the course of the century was enabled by new approaches to architectural design and it highlights the emerging political conviction that physical health would become the cornerstone of human welfare\"-- Provided by publisher.
Book
Evidence-Based and Value-Based Decision Making About Healthcare Design
Objective:
This study describes a vision and framework that can facilitate the implementation of evidence-based design (EBD), scientific knowledge base into the process of the design, construction, and operation of healthcare facilities and clarify the related safety and quality outcomes for the stakeholders. The proposed framework pairs EBD with value-driven decision making and aims to improve communication among stakeholders by providing a common analytical language.
Background:
Recent EBD research indicates that the design and operation of healthcare facilities contribute to an organization’s operational success by improving safety, quality, and efficiency. However, because little information is available about the financial returns of evidence-based investments, such investments are readily eliminated during the capital-investment decision-making process.
Method:
To model the proposed framework, we used engineering economy tools to evaluate the return on investments in six successful cases, identified by a literature review, in which facility design and operation interventions resulted in reductions in hospital-acquired infections, patient falls, staff injuries, and patient anxiety.
Results:
In the evidence-based cases, calculated net present values, internal rates of return, and payback periods indicated that the long-term benefits of interventions substantially outweighed the intervention costs. This article explained a framework to develop a research-based and value-based communication language on specific interventions along the planning, design and construction, operation, and evaluation stages.
Conclusions:
Evidence-based and value-based design frameworks can be applied to communicate the life-cycle costs and savings of EBD interventions to stakeholders, thereby contributing to more informed decision makings and the optimization of healthcare infrastructures.
Journal Article