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DANILO HOSPITAL

Location: Montenegro, Cetinje
Project type: Hospital
Employer: Montenegro Ministry of Environment and Urbanization
Project year: 2024
Construction area: 1800 m²
Land area: 472 m²
Status: International Competition

Architectural Team:
Kemal Bal, Nil Bıçak, Erol Kalmaz, Büşra Yavuz

Landscape Design: Studiobems

LIGHT AND HEALING

 

BEFORE THE SUBJECT, REGARDING THE SITE

The competition area constitutes the southeast boundary of the "Danilo I" Cetinje General Hospital campus, encompassing the former Children's Hospital and 27 trees. The old Children's Hospital, constructed in 1872, currently stands in a disused state. Surrounded by 27 trees, 16 of which fall within protected areas, the structure faces the parking area to the north, overlooking the hospital campus, and the service courtyard housing technical units. To the east, there is a rocky topography ascending to the level of the P1 road, while 15 meters to the south, residential structures are situated. The rear garden, nestled between residential plots, the old hospital structure, and the rocky topography, is open to consideration as a serene landscape area where the daily life of the new hospital can unfold.

 

TO THE GARDEN, IN THE GARDEN, FROM THE GARDEN

The starting point of the design is to create a structure where the soothing joy of nature is felt from within at all times, aiming to contribute to the healing process. The necessity of service use (parking and technical facilities) on the entrance facade, the dense tree coverage along the northern facade, and the inability of the hospital program to create a courtyard inside directed the design to achieve this goal in the central section where the entrance and circulation cores would be located. The positioning of the extensive landscape area behind the structure nurtured the intention to extend the entrance axis towards this hidden rear garden. Approaching the hospital while looking at the "garden" behind it, feeling like being in an inner "garden" with transparent facades, gallery voids, and landscape elements extending up to the roof in the entrance foyer, and departing by passing through the serene "garden" that beckons you along the interior circulation. Diluting the boundaries between outdoor and indoor spaces, thereby inviting nature inside and connecting the life inside to the outdoors.

 

SPATIAL ORGANIZATION

For the entrance scenario of the 44m-long structure, a central expansion zone close to the center was considered. This axis divides the structure into two reasonable lengths (20m and 17m). The width of 10m allows for a room/corridor/room system of 4+2+4m. In compliance with fire safety standards, escape stairs were placed in the 20m and 17m wings. The positioning and distance of the two stairs were arranged to be alternative to each other and at a minimum distance of 14m. The concept of front-middle-rear garden permeability mentioned in the previous paragraph guided these layout studies. Transparent material was used to limit the permeable space between the two building masses on the rear garden facade, accommodating patient and stretcher elevators. Nurse stations and waiting areas, which do not need to be enclosed, were also resolved in the direction facing the entrance void. The corridor ends on the ground floor in both wings and on the first floor in the 20m wing were left open towards the landscape. This way, the densely enclosed spaces in the high wings were refreshed with open and bright spaces in the central area.

 

FACADE ARRANGEMENT

In the facade design, a sense of rhythm takes precedence. After placing deep elements on the structural axes that will remain unchanged over time, voids and openings required for each space were organized further back. It was anticipated that this approach would allow for interior changes over time. While rhythmic opacities emphasizing light-shadow changes dominate the structure's two wings, a tranquil alternation of excitement/order and freedom is brought one after the other in the central part with a cohesive transparent facade character. Just like life itself.

 

FUNCTIONAL LAYOUT

Considering that clinics are units where patients are admitted, diagnosed, and directed for necessary tests, their placement on the ground floor and first floor was given importance. Radiology services were located on B1; central laboratories were resolved on the 2nd floor. In the sectional plane, diagnostic units were placed between examination units to achieve minimal internal circulation.

 

Orthopedics, internal medicine, urology, and gastroenterology, which share a common nursing station, were placed close to each other on the ground floor. Two 4-bed rooms for observations in the orthopedics and internal medicine departments were resolved at both ends of the ground floor, facing the rear garden facade. Gynecology, Neonatology, and Neurology were located on the short wing of the 1st floor, and KKB, Ophthalmology, and Dermatology were positioned on the long wing.

 

While central laboratories were resolved on the 3rd floor, blood collection, nursing station, and waiting area were placed close to the central space with abundant daylight from two directions. Thus, by keeping patient entry in a specific section of the floor, efficient operation of laboratory services free from patient circulation was aimed. The needs of the Radiology personnel for restrooms/rest areas/locker rooms on the B1 floor were considered along with the rest program of the Laboratory personnel on that floor. Waste disposal (3.10) and cleaning room (3.19) in the laboratory program were placed on the B1 floor.

 

Radiology units were placed on the B1 floor. The waiting area and admission area serving units with patient access, such as ultrasound, mammography, and X-ray, were positioned directly opposite the elevator and stairwell. The use of transparent elevator voids aimed to provide a partial view of the rear garden and exposure to daylight.

 

Patient restrooms were stacked on floors close to entrance and waiting areas for shaft continuity and ease of patient access. Radiology and Laboratory staff restrooms were resolved on the 2nd floor, adjacent to the staff rest area.

 

LANDSCAPE DESIGN

The aim of landscape design is to create environmentally friendly, sustainable, high-quality public green spaces, and a rehabilitated forest area. The project has evaluated the landscape as an experiential learning strategy.

 

The most important elements determining the landscape character are topography and existing plant life. Various themed gardens have been created in the design, referring to the natural landscape formation in Cetinje and its surroundings. The goal is to create a constantly changing rich landscape experience in every season, ranging from a medicinal plant garden to a garden with healing herbs, and clusters adorned with aromatic species.

 

The ecosystem created with existing and new plant life, along with rainwater harvesting, will enrich the landscape culture of the hospital complex and provide a resting place for patients and their families. A natural and tranquil garden has been designed with a pathway winding among existing trees, preserving them.

 

The objectives of the landscaping strategy are to rehabilitate existing trees while preserving them, create a natural landscape with low-maintenance local species, nourish the soil using rainwater, and enrich landscape culture with rehabilitative themed gardens.

 

Some of the plant species used in the area include Salvia officinalis, Lilium candidum, Mentha spicata, Camellia japonica, Lavandula spica, Myrtus communis, Pistacia lentiscus, Rosa canina, Viola sp., Satureja montana, Rosmarinus officinalis, Vitex agnus-castus.

 

STRUCTURAL SYSTEM DESIGN

Due to advantages such as the possibility of underground construction, cost-effectiveness, fire safety, acoustics, etc., reinforced concrete was preferred for the structural system. Reinforced concrete shear walls required for seismic loads of the structure were designed around the fire stairs and at the four corners of the building. The short facade of 10m was designed with two intervals of 4+6m. The long side, after crossing a single opening of 7m in the central part, was divided into a maximum of 6m intervals, respecting the boundaries of reinforced concrete walls.

 

Steel was chosen for the roof structure due to its lightweight and ease of implementation. For the regular placement of steel roof beams, the 2nd-floor reinforced concrete vertical elements were finished with a concrete perimeter beam.

 

The perimeter of the basement was surrounded by reinforced concrete walls due to soil load. A raft foundation type was preferred for the building foundation. Depending on the ground characteristics before excavating the basement, mini piles or well foundation construction may be considered. Protection methods such as mini piles or well foundation construction will be applied for trees numbered 1, 2, 3, 4, and 11, which are within 2.5m of the structure. If the protection cannot be ensured for tree number 4, which is approximately 70 cm close to the basement boundary, it can be relocated to another area on the campus.

 

The structural system of the elevators in the central part was modeled as a more delicate section steel structure to keep the perspective as open as possible. This frame was connected to neighboring reinforced concrete walls to ensure structural integrity. The exact dimensions of the elements will be determined after static calculations.

 

FACADE MATERIALS

The facade design of the new hospital, which is one floor higher than the old Children's Hospital, pays homage to the existing structure. The first two floors, in reference to the historical significance of the existing building (constructed in 1872), feature brick. The additional floor is finished with wood to suit the small scale of the structure. On the long facades, the eaves cast shadows on the facade, and the area below the eaves is clad in wood, emphasizing the material transition with the 2nd floor.

 

Brick is detailed as "cladding brick - 15mm" with mechanical assembly due to reasons such as insulation without thermal bridging, ease of application, and cost.

 

Wood surfaces are considered as "natural wood film-coated compact laminate - 10mm" with mechanical assembly due to reasons such as suitability for outdoor conditions, ease of application, and cost.

 

The roof is finished with standing seam metal roofing, similar to what is used in other structures on the campus. Gray color is chosen, akin to the historical L building's roof at the northern end of the campus. Titanium alloyed zinc is selected for its high corrosion resistance.

 

INTERIOR MATERIALS

While the materials for the exterior are inspired by historical and sensory atmospheres, the interior is kept minimal. The focus inside is directed towards the landscape, and therefore, white tones of plaster/paint are chosen for the walls. Vinyl is used on the floor for hygiene and acoustic reasons. Suspended ceilings are considered as gypsum panels. The inner surface of the steel roof, for fire safety reasons, is covered with gypsum panels in a truss-like pattern. Aluminum windows with heat-insulating properties and electrostatically painted surfaces are used. The central part of the building, kept as transparent as possible, features a structural silicone aluminum facade system, leaving window mullions behind.

 

To maintain the perspective of the rear garden in the central space, elevator shaft surroundings and floor doors are enclosed with steel frames featuring glass bodies. Elevator cabins are opaque for the patient's privacy and sense of security, with stainless steel finishing on the interior surfaces.

 

The doors of the compartments are made of aluminum with hygienic wipeable wood laminate coating. Accessories and door kickplates are made of stainless steel. Technical rooms on the B1 floor and doors of the radiology unit are made of specially painted steel plates.

 

Ceramic tiles are chosen for wet spaces to ensure material continuity in walls and floors.

 

The entrance vestibule is kept low and designed with glass-to-glass junctions.

 

ECOLOGICAL ASPECT OF THE DESIGN

The first step towards energy efficiency in buildings is the appropriate site layout and an efficiently resolved architectural design in harmony with the physical environment. In this context, the aspects of architectural design that affect sustainable building economics will be discussed first, followed by intentions regarding energy-consuming equipment.

 

Daylighting

The long facades of the building are oriented in the northwest-southeast direction in the given layout. The entrance facade facing northwest is shaded by a series of tall trees. The southeast facade receives direct sunlight and is relatively shaded with fewer trees. The roof section is arranged to provide a band window on the southeast facade to support the daylight needs of the entrance facade. This allows the entrance lobby, illuminated by diffuse northern light, and the central spaces on the floors to be brightened by vibrant southern light. The overhang extending along the two long facades of the building is designed to protect the building facade from directional rain, and it is anticipated to contribute to daylight control on the southeast facade. Access to all spaces is provided from the facade (except for B1 spaces), aiming to minimize the use of artificial lighting during the day. Corridor ends are kept open on the ground and first floors, and on the second floor, maximizing the use of daylight is ensured with a skylight. It is anticipated that the waiting and admission area on the B1 floor, surrounded by transparent material in the elevator shafts, will be partially open to the rear garden perspective and receive daylight.

 

Solar energy will be converted into electrical energy using photovoltaic panels, which are expected to be placed along the southeast side of the pitched roof. For aesthetic reasons, with a 1m setback and excluding elevator towers, the area available for panel placement is approximately 150m².

 

A system for managing the automation of lighting systems and fixtures, especially in common areas, will be implemented. High-tech, energy-efficient fixtures will be preferred.

 

Clean Air

In all spaces (except for B1 spaces), at least one operable window to the external facade is designed. This allows mechanical ventilation systems to be operated at a minimum during the autumn and spring seasons. The ability to open corridor ends and automate the control of roof windows illuminating central spaces allows natural ventilation to be utilized in common areas to support mechanical systems.

 

Rainwater

Rainwater falling on the roof surface will be collected by rainwater channels at the eaves and transferred to buried modular water storage units in the landscaped area. The collected water will be used for toilet flushing and landscape irrigation. The slopes of the sidewalks will be designed to allow water to flow towards the landscaped areas. Permeable materials will be used on the walking paths around the building, allowing rainwater to infiltrate the soil.

 

Insulation

Isolation is crucial for passive climate control in buildings and to protect building elements from the deteriorating effects of environmental conditions. Therefore, water and heat insulation layers were included in all relevant sections of the structure (underground, behind mechanically assembled facades, and the roof). High-pressure resistance XPS boards are chosen for insulation around the basement, and stone wool mineral boards, advantageous for fire resistance, are preferred for the facade and roof. Necessary air circulation gaps in the facade and roof sections are defined in the system section. Thicknesses and densities will be determined after calculations.

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