“We shape our buildings, and afterwards our buildings shape us.” —Winston Churchill
Hospital design is going through a transformation worldwide. Architects and project owners are intentionally designing hospital environments with a focus on comfort and wellbeing to aid patient recovery and employee wellness.
This makes them some of the most challenging large-scale projects worldwide. Besides being contemporary and innovative, they must continue to provide critical life-saving functions as they always have.
In the southwest region of Norway, an NOK 1.8 billion hospital in Haugesund is being developed and renovated for similar reasons. Slated to open in 2020, Bygghaugesund2020 (or Haugesund Hospital) will provide the region with much-needed advanced treatment options, like new emergency and psychiatric care, surgery, intensive care and postoperative recovery, and an obstetrics/perinatology ward.
Strong client input, big joint venture
Helse Fonna (HF), healthcare provider in Norway’s southwest, faced ever-increasing operational and maintenance costs at Haugesund Hospital, and decided it was overdue for an upgrade. After inviting suggestions from almost 200 employees in a 2013 survey, they finished feasibility studies in programming, location, budget, and construction planning with design stakeholders in early 2015.
Five firms won the contract in a joint venture proposal during the public procurement phase. Managed by OEC Gruppen AS, the project has two main design partners, Momentum Arkitekter AS in Oslo and local partner Vikanes Bungum Arkitekter in Haugesund. SWECO Norge AS serve as engineering consultants, providing structural, electrical, ventilation, and landscape design to the project. Bygganalyse AS are cost-estimation subcontractors.
They used HF’s inputs to inform a stronger, more inclusive design intent, from programming to furnishing and installations. Erik Kverndal, partner at Momentum Architects, welcomes public participation and believes that hospital design engages the public’s interest in remarkable ways because of how fundamental hospitals are to human life and the right to healthcare.
[They] are hugely important; people in towns and regions are all interested and fight for their local hospitals. In many ways, hospitals are today’s cathedrals.”
—Erik Kverndal, partner at Momentum Architects.
Developing the city center
Situated downtown, the hospital is flanked by Stord/Haugesund University College, a few blocks away from the town’s beloved City Hall. The upgrade is part of a series of major investments that hope to position the city as an attractive destination for skilled professionals.
“Building this hospital . . . helps to develop both the city and the city center, and provides energy to our entire organization. I am proud of all the employees and users who have participated in the work,” says CEO of Helse Fonna HF, Olav Klausen, of the survey and initial phases of the project.
As both a renovation and new construction, 25,000 square meters will expand the hospital’s west and south blocks and 19,000 square meters will house the newly planned building.
During conceptualization, the Momentum team paid attention to these important considerations in building design: generality, elasticity, and flexibility. They are part of a prevailing Norwegian philosophy that describes a building’s physical measures and adaptability1, and mean the following:
- Generality—a building can be used for several purposes without changing core properties.
- Elasticity—may be morphed into smaller or larger areas as required.
- Flexibility—should offer reconfiguration options in diverse ways.
At Haugesund Hospital, all of these were carefully considered and designed for. In fact, they make use of an additional adaptability measure—extendibility—in the old structure by rebuilding a part of it in renovation.
Designing beyond constraints
A hospital can have super-specialized yet highly-varied programming. Multiple stakeholders and consultants provide their expert input from the start. Two departments like labs and surgery can be on the same floor but require completely different ventilation and temperature controls. Logistics like elevators, conveyors, chutes, and waste material need separate but special handling2.
Despite these constraints, they must be adaptable. With stringent regulations and formal oversight, high levels of coordination between all parties responsible for project delivery are required.
And yet, Momentum incorporated two exciting features in hospital design and delivery on Bygghaugesund2020:
One of the main challenges is designing sustainably for the Nordic climate. The country additionally has strict climate, energy, and thermal regulations. Still, Momentum aims for energy positive design in all its projects and is behind the first 100% passive hospital design project of its kind in Norway, the New Kirkenes Hospital.
Haugesund’s new building is planned according to principles of the “Green Hospital” initiative, with passive warming and cooling features. They chose steel and concrete to comply with regulatory and environmental standards, but will install these with a low carbon footprint.
Differing floor heights meet at the intersection of existing and new structures, creating unique junctions with natural sunlight and citywide views. The use of renewable energy and sustainable materials is a key factor in their work, asserts Erik.
Three green roof gardens overcome the limitation of ground-level space. This was an important client-request to help with patient recovery and employee stress, so the architects took the opportunity to provide spectacular views of the city and the sea.
Prefab manufacturing & industrialized construction
Momentum successfully completed Kirkenes Hospital using prefab assembly, transporting built rooms from Germany 3000 kms north to the Arctic circle. They are currently exploring similar possibilities at Haugesund, either as flat-packed, component assembly or full-section production of building elements for the facade and technical installations.
When construction begins, these will be cast then transported to the site just in time, shaving weeks off of project delivery time.
Hospital design apart, urban context adds concerns like public rights-of-way, lack of space, listed historic buildings, and strict city codes to the mix. When combined with dual renovation and new construction plans in an in-use structure already, the plot thickens. The project partners foresee time and cost overruns because of decanting (the process of rehousing people and departments) when construction begins.
Coordinating a large interdisciplinary team in separate locations during the design phase was yet another challenge, for which Momentum relied on Building Information Modeling (BIM).
Moving to BIM
Momentum Arkitekter has always encouraged team members to reach out and work collaboratively across disciplines. It also emphasizes the use of technology for faster, more efficient project delivery.
From the outset, it was their aim to build Haugesund Hospital entirely in Revit. They were counting on the power of technology to develop the best design solutions. Equally important to them was the ability to leverage BIM collaboration for faster information flows and easier communication.
Momentum oversees design coordination for both new programming and renovation at Haugesund Hospital. Between Momentum and local partner Vikanes Bungum Arkitekter, the two firms have divided design responsibilities. They separately but concurrently work on segments of the central model like facade, interiors, etc.
Not quite the right start to design collaboration
Momentum began using Revit Server on most projects when they first moved to BIM. While it is a viable multi-user co-authoring solution for one office, it did not work for the Haugesund Hospital project. It was cumbersome to setup and maintain on a Wide Area Network (WAN), with latency issues when uploading changes to the main model. Additionally, they found that it was not intuitive to setup or use.
They then tried ProjectWise, the AEC collaboration software from Bentley, but latency and user management issues made it unfavorable. It was difficult to borrow elements from the Revit model, which added to compatibility issues and workflow interruptions.
Using BIM collaboration tools
Hans-Christoph Schultz is an architect and BIM manager at Momentum Architects, managing team collaboration, file-coordination and verification of model integrity. He says prior weekly meetings or emails to exchange model files and resolve issues would unnecessarily extend because of overlaps or omissions caused by delay in workflow. Long email exchanges would bury important change requests, making collaboration inconvenient and time-consuming.
With BIM collaboration tools Collaboration for Revit and BIM 360 Team, that quickly changed. They were able to work together in real-time, communicate directly in the same model, and manage files easily in one project location.
Cloud worksharing in Revit
They could co-author the same Revit model using cloud-based worksharing service Collaboration for Revit that allows remote multi-user co-authoring in Revit. Sending messages in real-time using the Communicator tool while in the model proved indispensable. They checked in before syncing or releasing changes to ensure that any concurrent work was not lost.
Seventeen architects in both design teams used Collaboration for Revit. Eight engineers and landscape architects from SWECO worked on structure, MEP, HVAC, and landscape design in the same model.
Almost 40 stakeholders from all firms were able to access design progress in the software, on demand.
Easy BIM file-sharing
Twenty-five users were in the project’s BIM 360 Team hub, a design file-sharing software made specifically for the industry. It made managing user permissions and files easy for Hans-Christoph. All users could view the main Revit model in a seamless user experience directly in a web browser or mobile app.
Additionally, they invited collaborators from partner firms Vikanes Bungum, SWECO, and project management group OEC to view design files and follow project progress in the team hub.
All collaborators could share design choices, exchange important messages, and provide technical feedback during design review.
Tools like these will make our lives easier in the future. We believe in technology and BIM and its ability to facilitate closer collaboration and coordination across all disciplines, to optimize our projects for better design adaptations, technical solutions, and for time and cost savings. This is all to the benefit of our clients, partners, and our own work as architects.”
—Hans-Christoph Schultz, Architect & BIM Manager at Momentum Architects.
Watch Erik Kverndal and Hans-Christoph explain how design collaboration in the cloud created significant efficiencies on the Haugesund Hospital project:
- Blyth, A., & Worthington, J. (2010). Managing the Brief For Better Design. New York, NY: Routledge.
- Hospital, Whole Building Design Guide