Duke Medical School is now operating in Singapore. The Mayo Clinic has opened a new campus in Dubai. And Harvard has forged an alliance for a for-profit hospital in India. Top quality medicine is now a global product and traditional centers of excellence such as Houston, Chicago and Philadelphia are competing for physicians and patients with well-funded emerging medical complexes in Asia and the Middle East.
But is it business-as-usual? Are the facilities and the people who run them designed, funded and operated the same way as in North America? The answer is yes, and no — design for medical innovation around the globe is in many ways the same, but with sometimes subtle adjustments that tune this international product to the needs, preferences and pre-occupations of the local situation.
Do these exotic healthcare projects hold interest for us here in North America? The answer is yes; current replacement hospital, medical school, research laboratory and healthcare campus development projects in Singapore are providing lessons in sustainability, communicable disease response, practice re-organization, and design for staffing that we are applying to our work in Alabama, North Carolina and New Jersey.
Sustainability and energy conservation are now mainstream concerns to healthcare providers around the world. In the United States, the United States Green Building Council is preparing a specialized rating program for healthcare facilities. Sustainable design inspiration doesn't just come from a guidebook; location, weather and energy availability are often driving factors in sustainable projects abroad.
As an island nation whose only significant natural resource is its people, Singapore prioritizes energy efficiency as a key element in its national defense strategy. Singapore has created its own version of Leadership in Energy and Environmental Design called GreenMark; the national government actively encourages developers and designers toward sustainable designs. The 400,000-sq.-ft. Yong Loo Lin School of Medicine at the National University of Singapore will achieve Green Mark Gold through a combination of passive and active design features, including a high-performance exterior envelope, air handling units with heat recovery, locally-produced sustainable materials and finishes, water conserving toilet fixtures and naturally ventilated circulation spaces between shaded exterior arcades and air-conditioned functional spaces.
Applying these lessons at home, Duke University Medical School's new research building does double-duty as a high-tech advanced laboratory designed to Leadership in Energy and Environmental Design Silver status. The Medical Science Research Building II isn't your average green building. The five-story, 160,000-sq.-ft. laboratory facility implements sustainable building practices that conserve energy, minimize waste and utilize environmentally friendly building materials — an effort to counteract the notoriously high energy usage of typical laboratory buildings. By using a wide range of sustainable systems and materials, MSRB-II uses 35 percent less energy than a similar lab building — enough to power 100 average sized homes for a year — saving the university more than $200,000 annually.
Communicable disease response
Preventing the accidental transmittance of communicable diseases or infection in the course of operations is a major liability and economic concern for administrators, physicians and insurers. Policies and prevention can only go so far; how can design assist?