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A Room with a View and a Breeze

Aerial view map of project which occupies a long, narrow site between two busy highways
The project occupies a long, narrow site between two busy highways and included the creation of a new street to connect the highways and provide an access point to the hospital. © Studio 505/HOK/CPG

The Ng Teng Fong General Hospital under construction in Singapore features an innovative design to increase natural ventilation and abundant plants to bolster healing.

March 25, 2014—The architects and engineers who designed the Ng Teng Fong General Hospital, under construction in the Jurong District of Singapore, faced a challenge that would have been unusual for a similar project in the United States: they needed to design the facility to maximize natural ventilation.

The stunning facility is 18 stories high, with approximately 1.3 million sq ft of acute care space, and can accommodate as many as 1,100 patients. Approximately 20 percent of the hospital’s beds are in private, air-conditioned rooms, which carry a price premium. But—as is the custom in public hospitals in Singapore—80 percent of patient beds are in shared rooms or wards with no air-conditioning. Patients are kept cool in the tropical environment by ceiling fans and the flow of air through the windows.

“Singapore is right on the equator. It’s hot and muggy and the same every day. The whole idea of our design was to enhance natural ventilation [and] to build a building that includes nature going up the façade,” says William Roger, AIA, ACHA, a senior vice president and the director of healthcare projects in the San Francisco office of design firm HOK. HOK was the design architect on the project. Singapore’s CPG Corporation was the architect and engineer of record. Studio 505, in Melbourne, Australia, collaborated with the team on the handsome façade and assisted in the layout of the nursing wards.

Aerial view rendering of the Ng Teng Fong General Hospital

The patient rooms in the central acute care hospital are arranged
in a radial array to enhance natural ventilation. Abundant greenery
was part of the design from the beginning. © Studio 505/HOK/CPG

To increase ventilation, the team developed a novel approach to the wards, which are customarily large square rooms with beds along each wall. Instead, the team arranged each of six beds canted out from a sawtooth headwall, creating a radial array of bed units, each with its own window.

“You can think of them as sails, up in the air, trying to catch the breeze,” Roger says. “There are two of these units per floor, and they are connected by a large center core that has shared support, the lifts, the stairs, and support rooms and conference rooms that are air-conditioned for the staff.” 

The team developed and refined this radial concept utilizing Building Information Modeling (BIM) software. They also built a full scale model of a unit. The BIM model helped the team with energy efficiency strategies and natural lighting elements that earned the project platinum status in Singapore’s Greenmark program.

The hospital is actually three separate key components, the largest being the acute care hospital. Also included are a large, outpatient clinic and a long-term care facility. The different components are linked on several levels. Singapore is seeking to reduce the length of patient hospital stays and the attached long-term care facility addresses that concern.

“They call it twinning,” Roger says. “They team up a community hospital, which is longer term care, with an acute care hospital, which is more of a typical public hospital.” He notes that several other hospitals in various stages of development will employ this concept. “They are really beefing up their health care infrastructure in Singapore.”

Illustration of canitlevered planters which hold abundant greenery

Cantilevered planters hold abundant greenery, which helps filter the
air, attenuate street noise, and provide peaceful, natural views for
patients. © Studio 505/HOK/CPG

The hospital is built on a pile foundation, with two basement levels and five floors on a regular grid of approximately 9 m square. The sixth level is a transfer floor for the levels above, which contain the radial wards. The structural system is cast in place concrete with some interior walls employing concrete masonry units. Metal studs and drywall are uncommon in Singapore, where mold is a pressing concern.

Key elements of the façade design are abundant living plants, which occupy small cantilevered decks outside patient rooms as well as many areas of the roofs. The team selected a combination of hardy plants. About one third of the plants are permanently planted and will be maintained in place. The remaining two-thirds are part of an exchange system whereby failing plants can be removed, replaced, and nursed back to health in a central location. Some of the roof areas function as gardens for patients and staff.

“We had the vegetation on the building from day one,” Roger notes. “We think it has multiple purposes. We think [the plants] filter some of the air. They also help with the acoustical attenuation of the noise from the streets below. And they are also nice to look at.” Some studies have indicated that exposure to nature actually enhances healing, he notes. 

Rendering which shows the hospital that is actually three separate key components, connected on several levels

The hospital is actually three separate key components,
connected on several levels. The largest, an acute care hospital,
is in the center, surrounded by an outpatient clinic and a long-term
care facility. © Studio 505/HOK/CPG

The project sits on a long, narrow site 130 m wide and approximately 500 m long between two busy highways. The project included the construction of a new street linking the two highways and providing an access point to the facility and belowground loading bays.

Although the site constraints placed challenges on the design team, Roger notes that it resulted in a facility with horizontal separation of the three components that actually will improve the function. He likens it to an airport arrival area where customers can clearly discern the appropriate location for their visit.

The project was expedited by Singapore’s Ministry of Health in the immediate aftermath of the financial crisis in 2008.

“When the downturn hit the planet, the government there did the same thing the U.S. did in terms of trying to bring shovel-ready projects onboard,” Roger notes. “The difference being that the nine ministers sat around a table, decided what to do, and did it the next day. And also the difference was they had more than $600 billion in the bank, instead of having to borrow the money to do it.” 

The acute care component of the project is set to open in December, followed by the clinic in early 2015, and the long-term care facility in late 2015.



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