Published on : October 22, 2010

Sustainable Healthcare Design in the Middle East: Al Mafraq Hospital

Sustainable Healthcare Design in the Middle East: Al Mafraq Hospital

Al Mafraq Hospital is a state-of-the-art healthcare facility that promotes sustainability and wellness as an integral part of the healing environment.

Located in the central region of Abu Dhabi, the newly designed hospital is carefully situated on a prominent site directly adjacent to the existing Al Mafraq Hospital. The site offers an opportunity to express the client’s desire to have visible and timeless architectural presence set in the midst of the Al Mafraq community. The new hospital complex boasts a striking contemporary style defined by four distinctive patient towers and a glass enclosed horizontal podium containing clinical program elements.

The 272,000-square-meter, 750-bed replacement hospital and outpatient clinic offers an enhanced and comprehensive patient care program extending excellent urgent care and general medical services. Patients and visitors to the hospital are greeted by an inviting glass enclosed lobby concourse. The lobby concourse space is flooded with natural light and offers hotel-like lounging spaces and private and dignified patient reception areas. Way-finding is incorporated into the design fabric of the building through elegant sculptural elements and water features that orient visitors to the patient towers’ elevator lobbies. Easy access to the outpatient clinic is offered from the main hospital lobby through an enclosed pedestrian bridge. Carefully planned and located for privacy and comfort, the Women’s and Children’s Pavilion features a separate entrance and tower dedicated to specialty services for mothers and children.

Each of the four towers contains no more than 30 single rooms per floor, complemented by comfortable and modern nursing stations and patient control centers. Spacious corridors lead to private and comfortably sized rooms designed for patient and visitor comfort and privacy. All rooms feature large windows and ample natural light. VIP floors for patients requiring special privacy and attention offer dignified and comfortable suites and surroundings.

The new hospital will provide urgent care services with an expanded emergency department and critical care services. Flexibility is a key component of the facility, allowing for expansion of the departments with minimum disruption. In addition to rooftop gardens and the latest energy conservation devices, the entire medical center complex is designed for sustainability and maximum energy savings.

Sustainable Strategies

A collaborative effort among Burt Hill’s architects and engineers, the client, and Abu Dhabi stakeholders led to hospital’s thoughtful design, which incorporates key sustainable strategies including building orientation, storm water management, water conservation, reduction of annual energy consumption, and indoor environment and air quality. The building features sustainable materials, and is sited within a landscape with a substantial component of indigenous desert plantings. In accordance with the Abu Dhabi 2030 plan, Al Mafraq Hospital has utilized the principles in the Estidama and the Pearl Rating System, which is a checklist of sustainable requirements similar to the LEED rating system.

The project has been designed in parallel with the Al Mafraq Community master plan and incorporates public transportation and other amenities for hospital visitors and employees via future connectivity to the Abu Dhabi 2030 master plan and Capital District. The master plan design successfully integrates New Urbanist principles and carefully considers the placement of Al Mafraq Hospital while accommodating complex patterns of circulation necessary for the facility. Moreover, the plan’s land use program includes space for a variety of related medical programs, and provides appropriate facilities and pathways to those staff and employees who wish to ride their bicycles to work to reduce the single-occupancy vehicle traffic to the building.

Landscape and Water Usage

The site and landscape strategy for the project incorporates a sustainable planting and design approach through created wadi-scapes, which have both ecological and economical advantages. Existing on-site wetlands have been retained and new ones created with native marsh grasses. These wadi landforms collect and deliver seasonal drainage water to locations where it can filter back into the water table. The wadi-scape and preserved wetland areas also help to support and nourish natural habitat for local wildlife. The extensive planting areas, which have significant areas of sand and wadi gravel, help to reduce the overall heat island effect, and overall water demand while providing an indigenous landscape.

The planting layout and species selection was designed in tandem with the irrigation system to maximize the available water resource by using technologies such as flow sensors, weather sensors, soil moisture sensors, soil additive to increase water retention in soils, and drip irrigation for maximum water efficiency. Over 350 cubic meters of Treated Sewage Effluent and grey water, which is separated from sewage produced daily from the hospital, will be directly used to irrigate the landscape, providing all of the required water needs. No potable water is used for irrigation.

The landscape strategy also incorporates many mature native and exotic trees and date palms relocated from with the greater hospital site to form the specimen trees for the new development.

Products and Materials

Evidence-based design was utilized during the design process as a means to measure the impact of all design and material solutions. Every element, from the use of anti-microbial paint to the effect of bathroom placement on slip and fall injury rates, was studied and analyzed to arrive at the optimal solution. Rapidly renewable and sustainable materials, including certified wood products for casework and wood wall paneling, linoleum flooring for corridors and patient rooms, acoustical ceiling tiles, gypsum wall board, ceramic tile walls and flooring, and carpet tiles in administrative areas, are used throughout the project.  Paint systems, sealants, and adhesives have been specified to reduce or eliminate volatile organic compound emissions in occupied spaces.

Energy

Extreme temperatures exceeding 50 degrees centigrade during the summer months challenge design teams to plan efficient mechanical cooling systems.

Smart decisions can be made early in the design process by understanding a site’s particular environmental attributes and through the utilization of energy modeling. For the Al Mafraq Hospital, energy modeling assisted in determining the ideal building orientation, the appropriate building envelope and sun-screening strategy, and the engineering for efficient MEP systems. In parallel with the energy modeling, lifecycle cost analysis was performed during the design process to evaluate go no go with systems with the client. The hospital incorporates many energy savings items, including roof mounted solar panels that provide 75 percent of the total power requirement for heating hot water.

Mechanical cooling systems for the project utilize a flexible and zoned VAV system where appropriate (90 percent of building HVAC system) to reduce volume of air supply and fan energy. Furthermore, a heat pipe system for infection control was designed to separate supply and exhaust air streams, which results in 50 percent energy recovery in exhaust air stream.

Computational Fluid Dynamic modeling was utilized in the design process for studying appropriate air flow in burn units and operating theaters, envelope wind pressure, and smoke management systems.

Culture

Most of the healthcare design programs in the Middle East are led by American standards, which are recognized as the best in the world. It is important for designers to define the spaces and proper environments within a facility, and to coordinate with the healthcare staff (i.e. doctors, nurses, and operators) to best meet their working needs. The aim is to adapt to the culture in this part of the world while incorporating innovation and improved practices from other parts of the world.

The planning and design of healthcare projects in the Middle East require sensitivity to certain cultural and religious aspects of the region. Project designs must address the need to provide appropriate and dignified spaces for prayer for both for the patient and the staff. Family-centered care has been a tradition of the region for centuries and the design of Al Mafraq Hospital allows this tradition to continue in a new international setting. The separation of males and females must be considered in all aspects of the design, including waiting areas, hospital wards, and recovery rooms. It is common for large families to accompany patients, which has a direct impact on the types of spaces and furniture considered for waiting areas. The patient room, which is the heart of any healthcare institution, is generous in size and incorporates caregiver zones unobstructed by the family zones. The room design recognizes the numerous users of the room: the patient, the medical staff, and the family. Architects and medical planners need to consider these cultural requirements in the early stages of programming and conceptual design as they have a major impact all aspects of the overall project.

The new Al Mafraq Hospital facility reflects the future of healthcare. The integration of outpatient and inpatient services provides the highest level of care and achieves economies of operations. This healthcare facility offers a new experience to medical staff and patients, as it will set the standard for modern healing environments in the Middle East.

About the Author

Erik has led the design and management of several award winning healthcare, corporate /commercial, and higher education projects in the Middle East and United States. His intuitive approach to design combines with a focus on interdisciplinary integration among architects, engineers, landscape architects, and interior designers resulting in rich project solutions. He is a leader in Sustainable Design in the Middle East, incorporating the Estidama Pearl Rating system as evident by the recent award of Best Sustainable Hospital in the Middle East for Al Mafraq Hospital in Abu Dhabi. Erik graduated with a Bachelor of Architecture degree from Kansas State University and received his architectural registration in New York State.