In Singapore, plans are underway to build one of the most sustainable hospitals in the world. The effort is driven largely by a S$3 billion government initiative to develop the country into the healthcare hub of Asia. As in the United States, major drivers include a surge in the aging population, longer life expectancies and anticipated population growth. But the country’s equatorial climate gives new meaning and importance to the role of sustainable design in the healthcare industry.

Khoo Teck Puat (KTP) Hospital, a 550-bed new generation acute general care hospital located in the northern region of Singapore, is a product of the sustainable design movement. The 102,245-square-meter hospital is being designed as a “hassle-free” hospital — centered on patient needs and wants — and a model of energy efficient design. The design unites building, site and healing mission in an environment that’s as much about sustainability as it is about wellness and community outreach.

A Breath of Fresh Air

In a country where temperatures hover around 80 degrees Fahrenheit year round, climate is a primary consideration in building design. Reducing temperatures and wringing humidity out of the hot, humid air can be cost-prohibitive in a country that imports almost 100 percent of its energy. Careful building orientation, exterior detailing and interior planning can greatly reduce air conditioning needs and costs. At KTP Hospital, the goal is to reach a 50 percent reduction in energy use compared to existing Singapore hospitals, which currently use 3.26 MegaWattHours per month per bed on average.

Major hospital departments are arranged along indoor/outdoor single-loaded corridors which open to daylight and gardens. This linear clustering allows for future expansion while simplifying orientation and wayfinding. Sun shades and wide over-hangs mitigate the amount of light and heat allowed into the corridors. Air-conditioned portions of the building, such as operating rooms or laboratories, will be co-located to minimize their external surfaces and heat gain. Family and visitor areas, such as balconies and circulation routes, are designed to be naturally ventilated. Green roofs, green walls and landscaping will also be used to help lower heat gain. A blend of horizontal and angled screens and louvres on the patient wards provide privacy, keep out driving rain during the monsoon season and allow fresh air to circulate.

Hospital in a Garden

KTP Hospital’s new location on Yishun Pond will allow hospital staff to extend their vision beyond the property, merging wellness programs and landscape redevelopment into a unique community asset. The hospital is “adopting” Yishun Pond, collaborating with other agencies to manage the water reserve, create continuity with the hospital’s interior gardens and strengthen connections to the surrounding neighborhoods.

The pond and garden also act as an orientation device and wayfinding feature for hospital patients and visitors. With views or access to the garden at all elevator cores and major department entries within the hospital, visitors will have a constant reference to determine their location. Designed to resemble a tropical rain forest, the lakeside portion of the garden is oriented so that the tall trees and foliage will block low sun angles into the hospital.

“Hanging gardens” may have been invented in Babylon, but 21st century Singapore encourages them to bring nature along as this “Garden City” grows ever upward. The hospital’s gardens will extend vertically with varied themes according to location and adjacent uses. In addition to the main garden on the first floor, the hospital will provide lush respites on floors B1, 4, 5 and 7. The garden below grade separates into smaller intimate spaces to foster reflection for the ambulatory surgery and radiation therapy patients. On the fourth floor, the garden will serve patient areas and an inpatient child care center. A sensory garden for geriatric and dementia patients resides one floor above between the two nursing towers. On floor 7, a “resus” nursery — to rejuvenate indoor plants needing fresh air — and a gathering space for evening events stand atop the pavilion roof.

Designed as an important community resource for wellness as well as healthcare, the hospital plans to incorporate the nearby Yishun Pond into its healthcare initiative. Benefiting from expert landscape architecture, the lakeside will be redeveloped with walkways and activity spaces for visitors and patients while continuing its role as a storm relief/retention pond. Recycled rainwater and graywater systems mirror the hospital’s self-sufficient design and complete the wellness loop when fed back to the landscaping.

The Healing Power of Going Green

In this ‘eco-hospital’, green design also marks a shift in medical attitude from treatment to prevention. A “Healthy Living” zone — complete with a wellness center and rehabilitation suite — complements the hospital’s connection to the outdoors.

Family and patient gathering lounges are open to the outdoors but under cover and shielded from the elements. In the patient rooms, a design premium is placed on orienting the rooms to maximize the island’s natural breezes and move the air efficiently through the rooms. Ventilating grilles between six and 28 inches above the floor maximize the cross-ventilation. As Singapore discovered after the SARS epidemic in 2003, natural ventilation is also an effective way to control potentially deadly communicable diseases.

Maximizing daylighting is a critical part of the energy reduction challenge. Exterior corridors will be naturally lit a majority of the time and most of the corridors have windows that open back into the interior departments creating light shelves and bouncing light deep into the interior.

Studies show that a connection to the environment speeds healing time and reduces patient stress in healthcare environments. In a country like Singapore that boasts a favorable climate and long-established sustainable design practices, the choice to create an “eco-hospital” seems natural.

PROJECT TEAM

MINISTRY OF HEALTH, SINGAPORE
ALEXANDRA HOSPITAL, SINGAPORE
HILLIER WORLDWIDE ARCHITECTURE
CPG CONSULTANTS, PTE LTD
PM LINK, PTE LTD
CENTER FOR TOTAL BUILDING PERFORMANCE, PTE LTD

PROJECT STATS

PROJECT COST: S$400 MILLION
PROJECT AREA: 102,245 SQUARE METERS