In the past, we’ve learned about hospital design in China from the surface only. It’s been perceived that design decisions are made based on social, cultural, and economic drivers—or, simply, based on how it’s always been done. In actuality, the reasons for design decisions are deeper. Hospital design in China is logical and pragmatic, and often based on passive green design.

For example, a few characteristics of such Chinese design approaches that you might be familiar with include:

  • Long, slender buildings that create a sense of light and air
  • Multiple buildings chosen rather than monolithic buildings
  • Façades and shading devices that direct sunlight
  • Buildings arranged to take advantage of wind direction
  • Operable windows that bring fresh air in and take old air out.

In the West, monolithic buildings are designed with a reliance on HVAC systems. This hasn’t been the design approach by China’s local design institutes now, nor will it be in the future. Why is this the case? First we must deeply understand how China is different.

Environmentally. China being the largest country in the world will eventually surpass the U.S. in the use of resources, so passive green design is in the best interest of China and the world. Natural light over artificial lighting is key to saving energy. Buildings are designed to be no more than 24 meters wide and, if wider, light wells are placed. An example of designing with natural light can be found in patient rooms, with at least 50 percent of patient rooms in Chinese hospitals required to face south.

Economically. In China, the design solution is to have multiple buildings as opposed to single structures to provide maximum natural ventilation and sunlight. Glass and steel on the exterior isn’t financially feasible due to the increased façade area, and concrete with solid insulation in-fill is often specified instead. Aesthetically beautiful hospitals can be designed with concrete.

For lifespan cost, the reliance on HVAC systems to manage air changes also isn’t realistic and will result in increased energy use compared to older hospitals. The green requirements in China require that less energy be used in new buildings than in existing ones.

Culturally. The use of nature as part of healing is inherent to Chinese healthcare. To that end, providing access to sunlight and fresh air through operable windows is important.

Socially. China’s hospitals are the largest in the world, with 1,000 beds the norm. Chinese hospital design is logical and pragmatic, but not austere. For example, paint can do wonders to a space, but expensive light fixtures and finishes aren’t an option. What is appreciated is natural light and views into gardens, which can enhance spaces and improve the experience of patients, visitors, and staff.

China is a major market for healthcare design, and it will become more important for firms to understand the customer. Clients are becoming more educated on good healthcare design and what is right for China. What China needs is not new ideas, but better ideas with an understanding to Chinese healthcare design.