Zeidler Partnership Architects (ZPA) has completed the design of a 340-bed, 600,000-square-foot Diagnostic Imaging and Surgical Procedures hospital—Assuta Medical Center—located in the northern greenbelt of Tel Aviv's high-technology district. It is being constructed in two stages, with the proposed opening date for the first phase being November 2008. Designing a healthcare facility in the international field required a deep understanding of the site and the local culture to comprehend the nature of a hospital 10,000 miles away from ZPA's offices in Toronto.

Before undertaking the design process, ZPA investigated the issues involved from three directions: nature of the site, nature of the client, and the nature of the facility. These three aspects provided ZPA the tools to design a hospital that will grow from the roots of the country and the society.

Nature of the site

The site (figure 1) fronts Hayarkon Park to the south, while to the north, the long rectangular site borders on Habarzel Street, a newly developed high-tech zone for the city. Hayarkon Park meanders through Tel Aviv starting from the Mediterranean Sea and going east to the mountains. One design goal was to find a way to provide a connection from the street to the park and city beyond. The second major challenge was that the site was part of a pre-existing two-phase commercial development. Phase I, an office complex, had already been built, while Phase II, the hospital site proper, had previously been excavated with all the foundations in place to receive another office complex. The hospital had to be designed to work with these foundations.

The Assuta Medical Center site fronts Hayarkon Park to the south and borders on Habarzel Street to the north, a newly developed high-tech zone for the city

Nature of the client

The client group consists of an insurance company that will manage the hospital, providing both the medical and nonmedical services, and the development company, which would not only construct but also own the building. Working with this unique joint venture has had a profound influence on the design process and on the nature of the building.

Nature of the facility

The Assuta Medical Center's main services are invasive and noninvasive, diagnostic and procedural. They include outpatient and inpatient facilities, with 20 Operating Rooms, 40 ICU beds, 300 acute care beds, Imaging, Catheter Labs, Radiation Therapy, and 25 Dialysis Positions. The facility is designed to provide uniquely available acute care with the use of sophisticated equipment. The aim was to have these qualities reflected in the image of the building.

The combination of the client group, the facility, and the site (with the particular challenge of the pre-existing construction), all combined with the procedural/diagnostic hospital program to allow development of a unique design appropriate to this facility. It was decided that to achieve the goals of the client group, accommodate the programmatic needs of the hospital, and respond to the site conditions a variety of tools would be used to enable the client group to make informed decisions at each step of the design process.

The design process

The design process began with a charette of five individual architects within ZPA. Each developed a scheme over three weeks to present to the client. The five schemes were then reduced to three choices.

Stage two began with further development of the three chosen schemes, with each team presenting its design using sketches, physical models, and other drawings as appropriate to convey both the practicality of the program and the vision of the design. This became a thread that ran through the whole process: how to convey the sense of place and vision of the building while still addressing the practical realities of the medical clinic. The client group, in turn, appreciated the combination of presentation media, which enabled them to make decisions in a timely fashion.

Stage three of the process saw the final scheme chosen for development. The massing model (figure 2) and a series of watercolor sketches (figure 3) further explored several concepts that influenced the design direction.

The early massing model for Assuta Medical Center

One of several watercolor sketches made of Assuta Medical Center by Tarek El-Khatib

Design concept

The long plan of the hospital is cut through on the north-south axis (perpendicular to the park) in two places, creating public spaces that link the street with the park (figure 4). A large atrium (figure 5) was created between these two links, forming a U-shape, with the bottom of the U facing the park. This public space forms the main circulation spine of the building both horizontally and vertically. This loop works as the orientation mechanism for the hospital, forming an essential connection from one end of the building to the other. An angled cut in the bottom mass (figure 6) directs the circulation from the east plaza to the main entrance of the building in the center of the block. This cantilevered mass not only encourages people to move towards the entrance, but also provides essential shelter as they make their way from the plaza into the building.

The long plan of the hospital is cut through on the north-south axis in two places, creating public spaces that link the street with the park

A large atrium was created, forming a U-shape, with the bottom of the U facing the park

An angled cut in the bottom mass directs the circulation from the east plaza to the main entrance of the building in the center of the block

The building mass (figure 7) is composed of two bodies, a lighter white mass resting on heavy reddish brown mass, giving the sense of massive sculpted boulders anchoring the building to the site. This composition recalls the image of a Mediterranean village, with white houses on a heavy mountain base. The red stone base—with public spaces that appear as large slots in the boulders—continues inside the building and is inspired by the passageways of dense rock in the walkways of Petra, Jordan. This four-story plinth contains all the outpatient clinical and procedural services.

The building mass is composed of two bodies, a lighter white mass resting on a heavy reddish brown mass

One of the many functions of this plinth unique to Israel is that it must also serve as a bomb shelter. Here the windows are much smaller, in contrast to the lighter mass on top of the plinth. At specific points along the plinth are boxes clad in dark bronze aluminum that punctuate the regular rhythm of the windows.

The much lighter white mass will contain the more private hospital wards of inpatient services. The many windows of the hospital rooms punctuate the skin of this mass. There is a layering between the identical windows with the stone pattern and detailing, creating a secondary, falling rhythm that tempers the long rectangular volumes.

Between these two masses is an interstitial space accommodating the building's mechanical services. This significantly reduces the need for mechanical space on the roof, as the ducts run from the middle of the building both up and down. This also frees up more floor space for programmatic functions. On top of the bottom mass, at the level of the interstitial space, is a roof garden that provides a green space for patients on the top floors who are unable to travel down to the park below.

Along the south façade, directly across from the park, is a four-floor glass wall that allows the patients to maintain a connection with nature. The inspiration for this wall was the image of a “Mahrabieh” (an Arabic screen generally made of wood that provides necessary screening from the sun). These screens help to block and fragment light as it enters a space. This glass wall will be fritted in large patterns ranging from translucent to 30-80% opacity. The frit is dark brown, giving the sense of a magnificently large screen. The screen is pierced with the chapel box, which is floating in the air halfway up the atrium between the interior and the park. It is intended that this chapel be a nondenominational spiritual place for all three of the major religions of Israel.

Conclusions

The building has been under construction on the site for the last three years. During this time, we have received validation that the three original milestones established at the beginning of the design process for this project have successfully related to the site, culture, and medical system in Israel. The main challenge of long-distance design was met by establishing a rigorous process that, in effect, collapsed the distance. HD

Zeidler Partnership Architects is working in association with Moore Architects, Ltd.,: and M. Brestovisky Architects, Tel Aviv, Israel, on the Assuta project. The team for Zeidler included Tarek El-Khatib, Senior Partner/Design; Alan Munn, Senior Partner/Administration; Amos Caspi, Senior Associate/Project Architect. Other project team members include Eythan Chetrit, Client Project Manager/M. Iuclea & Co./Tel Aviv, and Andrew S. Mazurek, Functional & Space Programmer/Metis Advisory Group, Ltd./Chicago.

For further information, contact Tarek El-Khatib at telkhatib@zeidlerpartnership.com or Amos Caspi at acaspi@zeidlerpartnership.com. To comment on this article, visit http://healthcaredesi.wpengine.com.