We spoke with the PMMT Arquitectura studio, recently awarded the A + award for healthcare architecture, thanks to the parametric design of the Manta Hospital, in Ecuador.
Humanity faces the unknown once again. Although the phrase may seem contradictory, it is still true, since it is not the first time that we have faced a pandemic. However, it is the first time that we do it on such a large international scale. Covid-19 is putting our health services in check and, although we are now in full battle, we must consider how to deal with a similar situation in the future.
A new healthcare architecture
We set our sights and our expectations on hospital architecture professionals. Specifically, we talk about the future of hospitals with PMMT Arquitectura, a Barcelona company with 25 years of experience and which boasts values committed to the health and well-being of people, through its specialization in healthcare architecture, having as main tools innovation and research in this field.
In November 2019 they received the A + award for the best Sanitary Architecture project by the Manta Hospital, in Ecuador. This hospital that was built in just over a year with criteria that could help us imagine a post-covid future, such as hyperflexibility in its uses thanks to the parameterization of the parts and systems of the building, what they call parametric design. The hospital is located in the province of Manabí, where in 2016 an earthquake destroyed the old health center. Because of this we decided to speak with PMMT Arquitectura about the future of hospital construction and design.
The collapse of hospitals must be stopped
The Luxonomist: Can Hospital Design Be Improved to Fight the Pandemic? How?
PMMT: From an architectural point of view, we believe that solutions must be found that help de-stress health systems, which are currently on the brink of their capacity, and that are prepared to face possible outbreaks of this pandemic or others that may arise. hold the future. From our point of view, many of the solutions seen today, such as field hospitals or inflatable units, are systems that act on the surface of the problem, but cannot solve the organizational collapse of the entire network. On the other hand, large rooms conditioned as hospitals, as they are structured within a single environment, it is not possible to treat the air or ventilation in a specialized way, by areas, so the viral load in these spaces can be very high.
These infrastructures do not facilitate the incorporation of all the necessary technologies nor do they create comfortable environments for patients and staff, a fundamental aspect in traumatic and highly stressful situations such as the current one. At PMMT we believe that the real challenge is to offer solutions in record time, but that can also act in the long term. In other words, supporting the health system not only in this crisis, but also in future ones.
Hospitals must respond to new needs
TL: Can current hospitals and health centers be reformed to adapt to new needs?
PMMT: Today’s hospitals are well designed to respond to the needs of our society in a generalized way, but not to respond to pandemics of this type. These situations place the centers at the organizational limit, which is why they end up functioning in a precarious way and, consequently, increasing the pressure and stress of the medical personnel who have to be at the forefront of these battles.
Larger and more technological hospitals have more response capacity, but the problem is not typological, but rather one of the system understood as a complex network. These pandemics destabilize and stress the health systems of any region or country, leading them to functional collapse due to the impossibility of meeting the demand for beds in a short period of time to treat the peaks of critical and semi-critical patients who need long periods of time. treatment and cure. We believe that the network must be rethought and completed and not so much the current hospitals. It is not about creating new specialized areas in our buildings that in a pandemic situation end up collapsing and turning health centers into monothematic ones.
New centers with technology and hyper-specialized
TL: What improvements would you propose to deal with this pandemic or another?
PMMT: The watchwords are: flexibility, adaptability to change and technology. The unstoppable globalization creates uncertainty about the cycles of pandemics or natural disasters to which we are going to be subjected, so it is necessary to design new healthcare typologies that add to the current ones with a high level of specialization and flexibility, at the same time as the security of the entire current network is improved.
We believe that the solution is not the field or emergency hospitals that may be necessary from time to time, but that end up chronicizing precariousness. In addition, these spaces do not allow freeing the system since they depend on it to a great extent. The solution is to generate new highly technological infrastructures that can function as large hyper-specialized centers or a large ICU with hundreds of beds, with all the guarantees for doctors and patients.
These hospitals, which we could call special contingencies, could be located near the large health centers in the country. The objective would be to optimize the available resources and concentrate, as far as possible, all the cases derived from the pandemic.
The goal is for the rest of the network to be able to function as normally as possible. In periods of absence of major epidemics or catastrophes of any kind, they would continue to function in combination. They would do it as research or specialty centers with small adaptations of the equipment.
Design is important too
TL: Are design and comfort at odds with the efficiency of a hospital? Is the comfort / efficiency ratio high in terms of economic expense?
PMMT: Hospital environments have evolved very rapidly in recent decades, thanks to the continuous development of technological and scientific applications in the healthcare field, both in the field of diagnosis and treatment. This improvement that apparently could only bring advantages for users, doctors and patients, has led us to a wide implementation of technology in these environments. Something that has led us to design excessively technical, cold and aseptic spaces.
For years, more and more experts have warned of the importance of a suitable environment to speed up the healing processes. For example, having natural light or planning the necessary spaces for each type of activity. This can help patients’ health status improve more quickly. In addition, it can also reduce medical errors and facilitate communication between medical personnel, patients and companions.
The important thing is the people, not the diseases
There are multiple and very diverse factors that an architect can influence to generate more comfortable and efficient spaces. In most cases, these options, when developed in the design phase, will not entail an extra cost compared to any other proposal. It will simply be a matter of the designer taking into account a set of criteria and conditions when designing these spaces.
The comfort / efficiency ratio is achieved by making a holistic approach to health, approaching the patient in an integral way, healing him on a physical, but also intellectual, occupational, spiritual, emotional and social level, placing the person at the center of attention. That is, we must focus on curing people, not diseases.
In the future post Covid-19 many things may or may not change in our daily habits, but what we have to be crystal clear is that many things must change in our hospital management and, specifically, in the morphology and use of our buildings. Luckily there are professionals who seem to anticipate our needs.