How can the rehabilitation clinic anticipate to the different phases of rehabilitation?

Transcription

1 Reflection P4 Tom Bleijswijk Graduation studio The Healthy Environment, the Architecture of the Interior Mentors: Eireen Schreurs & Mechthild Stuhlmacher Building Technology mentor: Maarten Meijs Board of Examiners delegate: Frank Schnater

2 This report describes and reflects on the relation between research and design in my graduation project for the studio The Healthy Environment. The studio is part of the chair the Architecture of the Interior. The specific approach towards designing in the Interior studio will be explained and compared with my own graduation project. The discussed graduation project is a Rehabilitation clinic for patients with a Spinal Cord Injury (SCI) in Amsterdam Noord. Besides the design studio adjacent Studio Specific Research was given to link the research with my design. 1. The relationship between research and design Before the design studio even started, the assignment of the course Studio Specific Research 1 was to make a short movie about a Health Care Project. Although the project wasn t a rehabilitation center, it had some general interesting outcomes related to Health care architecture. By spending a day like a patient, interviewing them and observing the processes, user-based information was required which could not have been required by only studying pictures or drawings. Among others, this information included the organization, the representation and materialization of the projects. The movie clarified the meaning and importance of user-perspective research as a start for my own design project. When the design project started, a comprehensive research is carried out for the research seminar Studio Specific Research 2. This research focused on the users of the rehabilitation clinic and resulted in three reports. The first report 1 exist out of general information about Spinal Cord Injury and rehabilitation centers: what does it mean, what are the implications for the patient and the building? The information was mainly based on literature and gave me a theoretical understanding of SCI and how rehabilitation centers work. For SCI patients, a rehabilitation center should be a transition place between the hospital and daily life. The goal of rehabilitation centers is to facilitate the patients to function independently and help them to get back into society as soon as possible. In the centers there is more and more focus on outpatient treatment, because there are less complete SCI and the treatment of the condition gets better and better. The rehabilitation of SCI patients doesn t purely focus on the physical aspect. On the contrary, the mental rehabilitation is just as important. Research points out that, patients in the rehabilitation process are dealing with different coping styles like the acceptance of their condition, restoring their self-esteem and reintegration in the society. Therefore, the clinic must take into account the diversity and individuality of patients. This resulted in one of the research questions for my design: How can the rehabilitation clinic anticipate to the different phases of rehabilitation? An important aspect to incorporate in the design is that patients have different needs in different rehabilitation phases. Therefore, each patient should have the possibility to choose, whether they want privacy or social interaction with the public life. The program and the organization of the project have been adjusted accordingly. From the beginning, I was fascinated in creating several gardens in the design. They play an important part in the spatial organization, but also in the rehabilitation process. The different functions of the project are divided around three gardens each with their own atmosphere, level of privacy and use. - The most private therapy garden is surrounded by mental care functions as spiritual rooms, contemplation spaces and psychologists. The garden cannot be entered by patients, but serves as a place of rest. This part of the building stimulates the mental rehabilitation of the patient were they can find calm peaceful private places to think, but also have private meetings with professionals and patients to talk about their condition. 1 Bleijswijk, Vereisten voor het ontwerp van een dwarslaesie revalidatiekliniek, 2015

3 - The larger mobility garden has a more open and friendly character and can be entered by the patients. This garden is surrounded with corridors and exercise spaces. It serves as an extension of the physical exercise spaces inside. The garden stimulates and challenges the patients to move around in the fresh air, working on their rehabilitation, confidence and self-esteem. - The largest meeting garden can be entered by both the patients and the public from the neighborhood and park. This garden is surrounded by the more public functions as the entrance hall, outpatient lounge, swimming pool, restaurant and the park. Here, patients can experience the normal life and prepare themselves to go back into the society. They can meet with their family in the restaurant, or have spontaneous encounters with people from the park. The connection with nature is stressed as an important element in the rehabilitation process. All the different spaces are connected with nature, either physically or visually. Sometimes spaces are located at the courtyard and sometimes facing the park, it depends on the function and the amount of privacy that is needed. The bedrooms for the inpatients requires more amount of privacy and are therefore located on the first floor. Though, some rooms have a private balcony and all have a great view over the greenery and activities in the park. Meeting places can be found on several places in the building in different scales of privacy but always connected with the outside. The different atmospheres throughout the whole building give patients the possibility to choose. They can make their own choice between contemplation, exercising or social encounters. This freedom makes the patient more independent and stimulates the general rehabilitation process. This idea of independency, stimulating and fastening up the rehabilitation process has my interest from the beginning of the project. Therefore, I further elaborated my research in the third report 2 with the following research question: How can the physical environment of the rehabilitation clinic stimulate patients to work on their rehabilitation (sport and exercise)? The research resulted in various interesting possible design solutions on the level of facilities, organization, routing and accessibility. Visual contact with other patients who work on their rehabilitation can be very motivating. The placements of the sport and exercise facilities can encourage patients to use them, even though they don t have therapy. To stimulate the patients to work on their rehabilitation outside the clinic, public sport facilities inside the clinic make them ready for real life. Also a complete wheelchair friendly design encourages patients to move around inside the clinic, while special places (inside and outside) can challenge them to deal with obstacles in real life. All these aspects are elaborated in the graduation project. 2. The relationship between the theme of the graduation lab and the subject/ case study chosen by the student within this framework (location/object) The theme of the graduation lab is healthcare and is called The Healthy Environment. This already reveals the goal for the graduation project; designing a healing environment for a healthcare program. A healing environment cannot only be created on the inside; the surroundings of the projects are just as important. The students could choose between several sites in Amsterdam Noord to place their healthcare project based on their chosen program. 2 Bleijswijk, Het stimuleren van sport en bewegen in een dwarslaesie revalidatiekliniek, 2015

4 The user-orientated research specified my type of program and location. The decisive factor for my design location was the versatility of the site Wingerdweg/Florapark. The second report of the Studio Specific Research 2 analyses this site and reveals possible positive and negative effects of the location of the Rehabilitation clinic on the patients 3. The rehabilitation clinic is located in Amsterdam Noord at the border of the Florapark and the neighborhood called the Volewijck. The green space of the park can contribute to a healing environment for the patients. Looking, smelling and using the greenery is a healing factor. The neighborhood on the other side gives the impression that the patients are still part of the normal community. The challenging part of the site is the existing building. The building has a monumental status, is less than 700m2 and has a strong symmetry in the plan and facades. The building is way too small for a rehabilitation clinic, so more square meters needed to be added. Because of the small-scale site and the monumental status of the building, the expanding of the building with new large building volumes and the implementation of the program needed to be realized with care. Additionally, the new building has to give something else back to the park, because the new design takes up a lot of space of the park. Apart from this, the municipality of Amsterdam Noord has developed a new vision of the Florapark to become a more dynamic park. This new Noorderpark designed by West 8, will be a new big metropolitan park with an important recreational and ecological route. This route will connect the pieces of park which are currently separated. This future recreational route will also run along the design location with the existing kindergarten. This gives the rehabilitation clinic the opportunity to become an important point on this route. This resulted in another research questions for my design: How can the rehabilitation clinic become a part of the existing structure and surroundings (including the new Noorderpark and recreational route)? In the design, the public meeting garden is connected to the recreational route on the park side. In the daytime, people from the neighborhood and the park can enter this garden to make contact with patients outside or inside in the restaurant. The more public spaces like the restaurant and café, fitness and workshop space are facing the route and the park. This ensures a more open and vivid façade and on the park side with several activities. In the evening the swimming pool, sports hall and fitness can be opened up to the public making it an active object in the park. In this way the rehabilitants are included in the society. The fact that the sport facilities can be used by the residents in the neighborhood has also a financial advantage, there these facilities are big investments. So both during the day and in the evening the building contributes to the vitality of the park. The building also provides space back to the park in another way. An amount of square meters, which is taken away from the park on ground floor, is given back on the roof of the building. Some of these roof terraces/gardens are also accessible for the public. In this way, the park is enjoying the building and the other way around. The new building volumes are connected with the existing building on the park side. By looking and analyzing the measurements, proportions, and materialization of the existing building new volumes are added in a subtle way. Even though the new added building masses are considerably larger than the existing building volume, because of the various building heights and proportions there arises a unity were the existing building becomes part of the larger structure. A closer study on the existing building resulted in an analysis on the structure, materials and atmosphere. The building is built in the Amsterdamse school style (brickwork) and has a typical jaren 30 interior plan and atmosphere. After the refurbishment, the interiors became light and fresh with a lot of plywood white walls and ceilings. This fascinated me and made me continuing this exterior and interior style in a contemporary way in my new design. The so called kamer en-suite is a typical architectural mean out of the 30 s and has become a theme in the interior plan of the rehabilitation center. This ensures a historical connection with the existing building, but also has a flexible advantage. Rooms can be closed off or opened up; it depends on the level of privacy that is needed. Furthermore the corridor of the existing building is 3 Bleijswijk, Locatie Wingerdweg 98/Florapark en de invloed op de revalidatiekliniek, 2015

5 cladded with beautiful tiles, which are quite typical for the 30 s style. This tilework is elaborated further in the wet programs of the new design, where each department has different tiles. This makes the different departments recognizable but also easy to clean. Just as in the existing building, a lot of plywood is used on the interior but also on the ceiling of the new design, finished off with clean walls and floors making the atmosphere of the spaces fresh and vivid. 3. The relationship between the methodical line of approach of the graduation lab and the method chosen by the student in this framework The design studio was organized in such a way that the students were free to choose between several user groups (non-hospitalized health care) and several design locations. My personal interest in rehabilitation centers has several reasons. I know people who are involved in rehabilitation centers; both doctors and patients. Besides this, I think rehabilitation centers can be an inspiring and hopeful place for patients instead of a machine that makes people better. The site visits helped me to choose my final design location, as explained in the previous chapter. Within the graduation lab, several workshops where held to support the designing of the project. The patient room workshop; making a 1 to 20 model was very useful to get grip of scale and proportions. Also the garden workshop was very interesting in several ways. By designing a garden for a fellow student, new insights where found for the design of my colleague student, but also for my own design. In the end I wanted to elaborate this further, but unfortunately the design of the gardens moved a bit to the background. Next to the workshops, I used different research and design methods. The most useful research information is obtained by interviewing staff and patients of rehabilitation centers in the Netherlands. The guided tours through the rehabilitation gave a good insight into real practice. The interviews with patients and staff were crucial in my design process. This made me aware for who I was doing this graduation project, and stimulated me to design from user-perspective. Besides this, literature and reference projects are analyzed to determine my program and architectural ideas. An extensive analyses and site visit of the existing building helped me a lot to create an understanding how to deal with existing structures. For my other architectural ideas, I made different model studies for several purposes. On smaller scale to find a proper composition, on bigger scale to find the right proportions and atmosphere between different elements and materials. 4. The relationship between the project and the wider social context Nowadays most rehabilitation centers have a private character. The buildings are not accessible for the public and seem to look like hospitals. However, there are certain trends visible in rehabilitation centers. More often rehabilitation centers become more specialized and the focus of rehabilitation is shifting towards out-patient rehabilitation. Besides this, rehabilitation centers are looking for a new identity, with a more public character. These are just a few of the topics which are feeding the health care debate on how health care should be organized and represented. This graduation project joins this debate, by introducing a small stand-alone rehabilitation clinic for Spinal Cord Injury patients with a more public character. The clinic has a smaller amount of beds for the in-patients and the program of the center is more focused on outpatients with several sport facilities. A lot of these facilities can also be used by the public and together with the non-institutional outside appearance, the building has a more public character while the privacy of the patient is taken into account at all times. The fact that the building is standing in a park that will be very dynamic, makes the rehabilitation clinic an important element in the new Noorderpark. Together with the other elements in the new Noorderpark; a large new swimming pool (Noorderbad), outside pools and activity fields all connected by the new recreational route, the clinic becomes an integrated part of the Noorderpark. The rehabilitation clinic and Noorderpark contributes to a positive impact on the social cohesion and the representational image of the current problematic district.