In spite of its status as a first-tier city, Shanghai has not been universally recognized as a leader in the delivery of healthcare services, and is often eclipsed by cities such as Singapore and Hong Kong—both key centers for global medical tourism. In an effort to position Shanghai as a world-class medical destination, the Chinese government launched a design competition challenging architects across the globe to create a blueprint for a new international medical city that would not only attract medical tourists, but also entice expatriates and Chinese nationals alike.
An innovative rethinking of the conventional hospital campus secured GS&P first place in the global competition and ultimately the commission to master plan the new state-of-the-art medical complex.
“The shared facility was an essential piece of the master plan,” says Kevin Kim, GS&P senior vice president and principal-in-charge on the project. “We expressly designed it to be the core support facility for the hospitals and specialty clinics located on the campus. It was the very first piece we designed because it’s the central hub that all the surrounding facilities will physically connect to.
“The project was essentially the culmination of our involvement with the client that began with a feasibility study for the campus. We were then selected to develop the master plan as a result of winning the design competition. After we’d completed the master plan, we were awarded the contract for two of the medical city’s buildings. One was Huashan Hospital, and the other was the shared facility.”
A world-first, the 947,805-square-foot, eight-story support facility will serve as the centralized distribution point for all logistical, clinical and public support services for the campus’s hospitals and specialty clinics.
“The functionality of this shared facility truly makes it one-of-a-kind,” says Kim. “I’m not aware of any other building that combines this variety of supporting services and then connects to different hospitals with different ownership.”
The shared facility’s medical program includes clinical and pathology laboratories; pharmacy (retail/storage); clinic/MOB; and sterilization services. Food, retail, laundry, supply storage, materials management and IT support services—all responding to the needs of the campus’s inpatient and outpatient facilities—will also be provided via the facility.
“The idea behind the shared facility was to enable the hospitals and clinics to share vital resources and technologies,” explains Kim. “By centralizing so many key services, especially the most expensive modalities such as imaging, the support facility will significantly reduce unnecessary duplication of basic services, and also lower operational costs for the individual hospitals and clinics.
“Another element that makes it unique is the fact that it was designed on four corners so it can receive connecting sky bridges from any direction. When we were developing the master plan, the locations of many of the buildings were still to be determined. So we came up with the concept of putting four cylinders on the four corners of the building, which would make it possible to receive a connecting sky bridge from any direction within that cylinder surface.”
Creating an Iconic Landmark
To successfully accommodate the needs of the medical center’s various hospitals and clinics, the shared facility had to measure nearly one million square feet. Due to its size and scope, the design team was tasked with fitting the building on a constricted site at the center of the complex, while at the same time creating a facility that had a strong visual connection to the surrounding landscape. To achieve this, the team developed the shared facility as a sloped building with numerous functions located below grade to minimize congestion without compromising functionality. Several key elements were incorporated into the design in order to promote the building’s connection with the landscape, including a green roof, terraced rooftop gardens and a large central glass atrium.
“Before this project, the campus itself was designed to be a civic landmark,” says GS&P project team member Sejin Kim, “and at that point the shared facility was embedded into the entire design. Now, it’s a separate project and a separate building. One of the owner’s key goals was to make the facility really stand out because it’s the anchor at the heart of the campus. So we explored several different design concepts in order to create the iconic appearance they were searching for.”
“If you look at the original master plan, the shared facility was initially conceived as a long, stretching hill, gently rising toward the center of the campus,” explains Kevin Kim. “Everything was underneath it, and the ‘arms’ beneath the hill were reaching out and holding the surrounding hospitals. That’s how the connection was made. It really didn’t look much like a building.
“However, we had to make some major adjustments to the master plan when the government determined it was more practical to divide the land and sell the site to each hospital. Because of this, the boundary for the facility became much more limited, and we had to adjust our design accordingly. Instead of the roof contiguously expanding out to touch the other hospitals, we used sky bridges to connect one hospital to another. We still wanted the facility to look like it was rising out of the landscape because we’d been charged with creating an iconic building that would become a landmark for the city. So we managed to maintain the original design concept by giving the building a sloping green roof and a terraced façade, which reinforces the idea that the building is rising out of the earth.”
With four hospitals and a number of specialty clinics connecting to the building from different angles, the design team was tasked with finding an alternative to housing operational support in the back of the shared facility. This needed to be achieved while maintaining strict separation between materials, patient and public circulations in a facility that will eventually house an estimated 18,000 workers and thousands of patients. To meet this challenge, the team layered circulation patterns vertically, placing patient circulation on the building’s upper floors, public circulation on the facility’s main level, and service and supply circulation belowground.
“In order to make this multi-functional complex work at the highest level, clear separation between patient, staff and public channels was critical. So we came up with a vertical and horizontal circulation system that fully addresses those issues,” says Kevin Kim. “We limited public circulation to the main level of the facility, along with food service, retail, conference spaces and other public amenities, which are all accessible from the outdoor park at street level. The patients will easily be able to circulate between the facility and the surrounding hospitals and clinics via sky bridges on the building’s upper floors, and won’t have to go outside just to get to another building.”
Far away from patients and the general public, all shared supply services within the facility will be centrally stored and distributed via a network of subterranean roads and tunnels that run beneath the building.
“The last thing an international hospital wants to contend with is large trucks and materials going in and out,” says GS&P senior architect and project team member David Stewart. “They’re not going to make any money that way either. So the perfect solution was to put the central distribution facility on the basement level. We also located storage, mechanical functions, operational support and parking below grade, which can all be accessed via underground roads and tunnels. There’s almost as much circulation and activities going on below ground as there is above.”
Green Building Design
When envisioning this international medical city of the future, the GS&P team designed the complex to be one of the world’s most energy-efficient healthcare campuses. This eco-friendly approach was underscored in the design of the shared facility, where particular emphasis was placed on creating a sustainable building that would not only maximize natural resources, but also minimize energy consumption.
“The green roof was a big part of the sustainable philosophies we designed into the building,” says Kevin Kim. “The city of Shanghai is really encouraging green roof ideas because they promote cleaner air and lower the overall city temperature as there are so many paved areas. The city will actually pay 30 percent toward the cost of a green roof, and we’ve taken full advantage of that.”
In conjunction with the expansive green roof, an enhanced building envelope and high-efficiency mechanical equipment will offset almost half of the building’s carbon footprint. Additionally, a double skin façade consisting of two glazed skins with solar shading devices will provide a higher insulating value for the building’s exterior envelope while mitigating solar gain, decreasing cooling loads and permitting natural ventilation. To create shaded park areas and allow for natural light, the slope of the building was oriented and designed based on specific sun angles. Planted roofs will act as building insulation systems and also assist with stormwater management.
In keeping with the project’s green building and energy-saving goals, the design team was tasked with creating an atrium space that could be comfortably heated and cooled without incurring huge energy costs. The team designed the atrium to face north in order to minimize heat gain and provide natural sun shading. Passive heating and cooling systems will be used to condition the building’s first floor as opposed to the entire space. This innovative design strategy will reduce both the costs and energy required to ventilate the space. Other sustainable design strategies include maximizing daylighting; total energy cogeneration; geothermal heat exchangers; and solar collection.
Shanghai New Hongqiao International Medical Center’s shared facility represents a revolutionary new model in healthcare delivery. By centralizing multiple resources and technologies, the striking centerpiece will significantly reduce unnecessary expenses for the campus’s inpatient and outpatient facilities, and give patients and hospital staff easier access to technologies that might otherwise prove cost-prohibitive for an individual hospital. The groundbreaking facility will also maximize capital investment to lower barriers to entry for future hospitals and specialty clinics, helping the international campus attract top-tier medical talent—and subsequently medical tourists—from around the world.
“This shared support facility is going to make it much easier for a new hospital to build on campus because they won’t have to build a full-range hospital in order to be operational; and that’s what the Shanghai government wanted,” says Kevin Kim. “It will also make it easier for the public to get outpatient-based treatment. In China, an outpatient facility is always a part of the main hospital, so you need to go through the hospital system just to get to these clinics, which are typically overcrowded and have a lengthy registration process. The way we’ve designed this facility, it will be a quick in and out when patients come for imaging or lab services.”
“At the end of the day, it’s all about innovating how you provide healthcare,” adds Stewart. “When you look at this campus and its shared facility, which serves as the public centerpiece, they’re essentially saying that Shanghai can provide better healthcare than anywhere else—and in a better environment. It’s a huge drawcard that will ultimately see people from other provinces and countries seeking their healthcare in that city.
“The shared facility is a totally unique project,” continues Stewart, “and it’s been incredibly exciting to be a part of it because it’s never been done before—and that’s the kind of thing you can typically only dream about as an architect.”