What should the hospital of the future be? 

Should it be merely an improvement on existing models, or should it be a fresh start, rethinking hospital design for the healthcare needs of tomorrow?  

Buro Happold, who is in an international design team with architect OMA, explored these questions for one of the leading healthcare organisations in the Middle East.  

An international, integrated consultancy of engineers, designers and advisers, Buro Happold worked on this extensive research project in parallel with a major healthcare district masterplan.  

While exploring a step change in the evolution of the hospital, a key achievement has been developing a prototype for the Hospital of the Future. 

Future thinking 

Step forward 20 years, and it’s easy to imagine a very different world. One that has changed significantly.  

Responding to the impact of developing technologies, and evolving demographic shifts, the shocks and stresses facing daily life, and adapting to climate change. 

But one key group of facilities in today’s cities that has not undergone a major conceptual design change in the last century is hospitals.  

Together with architect OMA and other collaborators, Buro Happold’s experts have created a prototype for the Hospital of the Future, which could redefine the future of hospital design. Image: Squint/Opera.

Agile design 

The report presents the design of a prototype that seeks to address the problems that hospitals face today.  

It considers how future hospitals may be redefined, from the first principles of design. 

The prototype reimagines hospital building design, deconstructing the established model, and reconceiving it to be more agile and resilient.  

Sallyanne Lewis, associate director in the structures team at Buro Happold, says: “We have tried to think beyond what happens in a hospital now, to what may be happening in the future. It’s about trying to imagine something that doesn’t exist yet.” 

Addressing challenges 

The report outlines a series of key drivers for change, including the acknowledgement that the healthcare needs of a population are not static and that the innovations in healthcare provision are accelerating as technology evolves. 

Many functions that were previously performed in hospitals can now be undertaken remotely.  

The prototype seeks to tackle these particular challenges to the design of hospital buildings by providing a super-adaptive model for the Hospital of the Future. 

Modularity can be achieved on different scales, from components such as columns, or panels through to volumetric, or whole rooms.

Built-in adaptability 

The design is inspired by field hospitals, which offer modular layouts that are adaptable to any given demands.  

In stark contrast to the traditional multi-storey stacked configuration of existing hospital facilities, the prototype would adopt a horizontal configuration. 

This is achieved by relocating hospitals out of city centres, to areas of lower land value.  

Here patients can benefit from being surrounded by a more rural or natural environment, while hospital facilities will have the space to expand and contract as required. 

Future incomplete

The Hospital of the Future will never be finished. It will be always growing, shrinking or morphing. Thus, the facilities within a hospital need never become obsolete, they can be perpetually updated. 

A fundamental enabler of this inherent adaptability is the way the prototype embraces modularity. It has been developed as a single kit of parts.  

Repetition and commonality at all scales permit these rapid transformations, meeting the live needs of the population that it is serving at that exact time. 

Modular by design 

Each module within this “kit of parts” can function independently as well as part of the whole.  

Buro Happold identified a series of typologies of space within a hospital, isolating the structural demands of each.  

Equipment-heavy and vibration-sensitive spaces such as MRI or CT scanning rooms were the most structurally onerous. Many other spaces, such as bed wards, could be designed to a highly efficient level of standardisation. This includes plug-and-play MEP systems, water and district energy supplies, power and data, and air and medical gasses. 

Rapid construction 

This industrialised prefabrication approach and standardised formation for each new module enable rapid construction with minimal site disruption, as well as ensuring factory-grade finishes. 

Lewis explains that the nature of the design also allows for all typologies of space structurally.  

A new module can be bolted on at any time and used for any purpose, with minimal disturbance to other hospital departments within the wider structure. 

“The nature of the design means that modules can be added on easily and the continuity of corridors and service runs is all there – you don’t have to adapt between the spaces,” she explains. 

The prototype provides an unprecedented level of resilience, driven by the need to prepare for the impacts of climate change, resource scarcity and geo-political uncertainty. Image: Squint/Opera.

On-site prefabrication 

To achieve this ongoing expansion and contraction as evolving needs demand, a “flying factory” is proposed, which will be a hub for on-site industrialised construction. 

It will be a controlled environment in which modules can be prefabricated and assembled, before they are moved to the construction site and installed.  

Once construction is complete (whether fully or partially), the Flying Factory will evolve into a maintenance hub – supporting upkeep, the adaptation of modules or ongoing expansion and contraction.  

Finally, at the end of the hospital’s life, the Flying Factory will be a hub in which modules can be disassembled and packaged up for reuse. This capability to reuse and recycle materials on site delivers benefits both in terms of cost savings and lowering the hospital’s carbon footprint. 

Throughout its life, the Flying Factory adapts and pivots to be a perpetually useful facility for the hospital. 

Shooting for the moon 

Lewis says: “The client’s brief was that while we should assume it would be put in the desert, we could put them all over the world or potentially even on the moon.”  

The challenge then was how to provide all the materials, all the construction and all the resources needed to build – how to prefabricate as much of the building as possible? 

“But what we really saw as a negative was the idea of building lots of prefabricated buildings and then transporting them across the world,” she adds. “This doesn’t feel like a good use of carbon. 

“If you could instead create a factory close to the site that you brought all your resources to and use as much as possible the resources that are local to the area in which you are building your hospital, it would be much more efficient.  

“In the desert, these local resources might be stone or sand. But if you were building it in Norway, it might be timber.” 

People at the core 

People, staff, patients and visitors are at the heart of the prototype.  

It is a hospital that delivers critical treatment in an efficient manner, supports comfort and promotes recovery. 

Embedded within these holistic design principles are the very latest technologies, which will provide a cutting-edge treatment and research environment that improves patient outcomes.  

By disrupting the traditional hospital model, Buro Happold has developed a prototype that is flexible, modular, pioneering and resilient.  

Lead consultant: OMA – research, urban design, architecture, project management, masterplan. 

Clinical architect: Henning Larson. 

Healthcare planners: ETL. 

Landscape design: Michel Desvigne Payagiste (MDP). 

Cost consultants: De Leeuw Group. 

Full acknowledgement and thanks go to www.burohappold.com for the information in this article. For more information, visit Hospital of the Future.