Healthcare International

The winning scheme for a new hospital in Denmark by WHR Architects, in association with KHR Arkitekter and Arup International, reflects a respect for its 100-year-old historical context in Copenhagen while offering Danish health care an infusion of American healthcare design.  

Anthony Haas, WHR principal, said the Danish government launched a healthcare campaign years ago to bring high quality care to their citizens. They sought international best practices for new methods to deliver health care and wanted to apply those lessons for a blended solution. The capital region of Denmark’s vision to provide world-class health care included a 2020 hospital and psychiatry plan to provide a framework for the development of the region’s healthcare services into the future that also stipulated funding. 

They sought innovative ideas and creativity to improve and rebuild 30- to 40-year-old facilities. When Haas met Adam Tier Jacobsen, a Danish architect, at a healthcare conference five years ago, a relationship began that reached a crescendo with this competition. Jacobsen was part of a delegation touring the U.S. to better understand this country’s healthcare delivery.

“Danish competitions are timely and expensive. Teams we faced were fierce,” says Haas. “To win it is very exciting. It’s an opportunity to explore and grow and to better understand what we have to deal with to improve the health of patients. We have assembled a great team.”

The intense international competition included jurors focused on proposals addressing four main tasks: architecture, functionality, sustainability, and economy. The competition was outlined in a 150-page brief citing the site’s national historic significance, environmental principles and patient strategies, planning and traffic, and hospital functions for somatic and psychiatric needs, as well as technological and structural needs, implementation, energy and water consumption, and operation.

Stage One of the juried invitation-only competition was from April to August 2014; a shortlist of three teams was then extracted to advance to Stage Two in early 2015. By November 2015, Proposal 73416 — the consortium of KHR, WHR, and Arup — was announced as the winning team. 

WHR, a national healthcare firm with offices in Houston, Dallas, Raleigh, New York, and Copenhagen, has completed various major projects for Houston Methodist, St. Luke’s, and Memorial Hermann in the Texas Medical Center and Houston suburbs. When the delegation from Denmark visited Houston, WHR was able to give them tours of 11 million square feet of projects in a concentrated hub that highlights innovative advances to create healing architecture.

“While the Danish government maintains a high quality standard of health care to all Danish citizens, unfortunately there has not been any major new hospital development in the last 30 to 40 years,” says WHR associate Sara Shumbera. “As a result, many of their facilities are aging rapidly, and since they have not completed any significant renovation projects, Danish health care’s architectural expertise is also in turn very limited. Although healthcare is run differently between our two countries, the Danish visitors liked the Texas Medical Center’s attention to the patient experience, privacy, safety, high outcomes, and especially liked the flexible and adaptive design solutions.”

In contrast, in the Danish facilities most patient rooms are semi-private, each accommodating two to three patients. The team also saw in the existing Danish facilities a lack of efficiency and flexibility due to little prior planning for what healthcare architects now know is the inevitability of future growth. “These facilities may have been robust in the past but are not capable of adapting to changes, challenges, and advancements in the current global healthcare industry,” says Shumbera.

WHR’s hybrid proposal comingles and merges medical treatment typologies of both cultures with six new brick and glass towers coupled with four connecting gallery spaces in a park campus. The Bispebjerg (pronounced “Bish-bee-beer”) Somatic Hospital is projected to be a $240 million project and will be phased into an existing medical campus to include private single patient rooms, an emergency department, and diagnostic and treatment facilities. The Medical campus has several other projects under design and construction, including a 

psychiatric hospital, a laboratory/logistics building and a recently completed parking garage.

The bed towers are designed with gallery spaces to reduce the number of elevators and amount of public circulation and to function as a lobby access point that receives natural light from internal courtyards. 

“We design our hospitals to feel more like home. That gives the patient warm, refreshing, and soothing feelings,” says Haas. “You always feel best when you are in the security of your home. In Copenhagen, the hospital public spaces feel stark and open, and as we go further, we will see whether we can add warmth and influence that.” 

Because of its geographic location, Denmark has long, bright summers and equally long, dark winter days with relatively cool temperatures and rain. Given these conditions, the design team tried to create hospital spaces that amplified sunlight, efficiently maximized face time with patients with less circulation/stretched-out facilities, and integrated the concept of private rooms into the Danish socialized medical system. (Denmark provides health care for all of its citizens at no cost. Individuals are assigned to hospital zones similar to school zones.) 

The proposal includes “Wintergardens” for park views, art installations, and engagement with nature. The built structures open to many courtyards that give access to natural light, including a lower-level parking garage/drop-off zone with a dramatic light well puncturing the space with a planted courtyard tree.

Blending the outside and inside is a difficult challenge given a hospital’s complex mechanical ducting needs, but the team has not shied from the request. “Everyone can see the gardens. This way people will not look back at the machine,” says Shumbera. “It really is a hospital in a park.”

Programmatically, the hospital departments are organized to ascend though the towers, starting with mechanical/utilities and linens in the basement; emergency and surgery on the ground floor; and ICU, offices, and clinics on the lobby level. The higher levels are for individual patient rooms, with nurses’ stations positioned to be visible to all the stepped rooms. The rooms include large windows with views, as well as beds positioned to allow patients to look into the corridor. The new rooms also include French balconies with doors that have grates for fresh air.

Another strategy for making the building more open for its users includes raising the site to greet visitors with translucency. As they make connections through the glass walkways between the bed towers there are views of the park and surrounding historic buildings. The steps allow visitors to climb up and down the courtyards and experience the natural setting.

The team is currently in the beginning phases of collecting user process data and room-by-room components. They are meeting with various physicians and clinicians to understand and identify how the new design accommodates and adapts to healthcare delivery. In addition to solving the architecture and engineering challenges, they want the architecture to supplement new operational ideas. The project includes various phases, and WHR’s team is mainly based in Denmark, with strong connections to the Houston office. 

“The intent of the consortium was never to design a new American hospital for Copenhagen but to fuse the best healthcare practices from Denmark, the United States, and around the world,” says Shumbera.

The diverse makeup of the WHR, KHR, and Arup team includes architects and engineers from America, Denmark, Germany, Spain, Turkey, Ireland, Italy, and Sweden using today’s technology to work across time zones and languages. “The rewarding part of this experience and this project is the cultural intervention and understanding how international healthcare works, which we hope will not only breed new ideas in Denmark but also help us change our work in Texas,” says Haas.

Florence Tang, Assoc. AIA, is a design professional and journalist based in Houston. 

This article was originally published in the March/April 2016 issue of Texas Architect.