Public account hot search content Read to the end of the article to view
Text / Zhang Yawei Architect of the Fourth Design Institute of CITIC Architectural Design and Research Institute Co., Ltd
Acute and critical emergency medicine is an important part of the research of modern emergency medical service system, and the seamless integration of pre-hospital and in-hospital rescue is very important for improving and improving the medical treatment effect of acute and critical illness, and further reducing critical mortality and disability rate. This paper takes the Liuzhou Public Health Emergency Center and the Critical Care Center as an example, combined with the arrangement of specific pre-hospital traffic streamline medical units, organizes complex medical processes, promotes each other's functions, multi-compounds, links the emergency life chain, and builds a health community that combines man, nature and healing.
keyword
Critical care pre-hospital treatment streamline
Healthy community Anti-epidemic transformation
Project background
Critical care medicine (CCM) was founded in the 1970s and 1980s and is an important part of the research of the modern emergency medical service system (EMSS). How to improve and improve the medical treatment effect of acute and critical diseases, especially the emergency medical treatment effect at the scene of pre-hospital emergencies, and further reduce the critical mortality rate and disability rate are still a worldwide problem. In the covid-19 pandemic that spreads around the world in 2020, intensive care ICU treatment has always been a decisive battleground to save critically ill COVID-19 patients. At present, the ratio of beds in the intensive care ICU of most hospitals in China is 2% to 4%, there is a problem of too low ratio, insufficient number of beds, universal expansion of ICU bed ratio is not realistic and economical, the formulation of regional health planning, rational allocation of resources, overall development of emergency undertakings is very important.
Liuzhou Public Health Emergency Center and Critical Care Center, located in the Northern Ecological New Area of Liuzhou City, are the first batch of general hospitals designed and built in Liuzhou City after the new crown pneumonia epidemic with "small outpatient, large treatment" as the planning positioning.
Aerial view of the hospital sideways
The Liuzhou North Ecological New Area, where the project is located, is the first ecologically themed urban new area in Guangxi, and in addition to meeting the normal medical facilities required for the rapid development of the new area, it also needs to play a role in further improving the level of medical assistance in Liuzhou city and strengthening the construction of major epidemic treatment bases. The critical care center is biased towards emergency treatment, mainly for daily emergency treatment and emergency medical treatment of mass casualties in Liuzhou and even in guizhong area; the public health emergency center is mainly in response to public health emergencies, such as this epidemic, in addition to the conventional configuration of the infectious disease building, the inpatient building will also be designed according to the standard of "combination of epidemic and epidemic".
Medical planning
General hospital, critical care center, public health emergency center trinity, three functions superimposed on a hospital, can be vividly understood as a critical care emergency as a specialty of the "combination of epidemic" general hospital, in the domestic has not seen such a scale precedent, the design needs the hospital to participate in the front, together with the stability of the function planning: five major emergency centers (chest pain center, stroke center, trauma center, critical maternal treatment center, critical newborn treatment center), over-allocation of ICU center, Regular outpatient clinics for the surrounding citizens, infectious disease buildings, and inpatient buildings for the combination of epidemics. The medical planning link is preceded by the creation of the plan, so as to clarify the design goals, conditions and constraints, summarize similar functional domestic and foreign cases, broaden the horizon, gather sand into a tower, summarize the advanced design concept, and put forward a more flexible, diversified and complementary, and highly efficient program logic.
Plan the design
The architectural plan cuts the chassis of a large building into small and medium-sized unit communities that meet the human scale, so that the large and long process becomes small and specialized, combined with the design of the surrounding landscape belt, the overall layout presents the morphological distribution of the checkerboard grid. The square tower releases more faces overlooking the wetland landscape, and the four square towers are arranged diagonally in pairs, opening up the green landscape corridor on the south side. The core of the campus planning lies in the selection of facing, entering and exiting and the planning of the guarantee system, after comprehensively considering the road grade, emergency flow line, surrounding plot attributes, and epidemic conversion, the design will place the door emergency emergency comprehensive building on the southernmost side, with the largest width along the street, using the design mode of traffic buildings, in front of the main entrance on the south side, the 120 emergency vehicles will be channelized and diverted to avoid traffic interweaving and congestion; the north side is arranged in the first and second phases of the hospital building, visiting the flow line north into the north and exiting the north, reducing the traffic pressure of the main entrance As for the east side of the land, the impact value of the infectious disease building and the sewage exit is close to the secondary road, and the impact value on the surrounding area is reduced to the minimum; the scientific research administrative building is located in the southwest corner of the land, and the diagonal layout of the tower of the hospital building is staggered, releasing more aspects overlooking the wetland landscape.
"Blue Wave Flying Rainbow, Oasis of Life", located in the Liuzhou Public Health Emergency Center and Critical Care Center on the bank of the wetland park, the main entrance has the arch intention of life neon in both plane and shape, and the first aid, hospitalization, and scientific research administration are distributed around the shared medical skills of the central gate emergency and emergency comprehensive building, showing the harmony of the combination of man, nature and healing. This "flying rainbow" is a vivid portrayal of the long bridge lying on the wave and the double road in the form of the building, and it also means the tough growth that has endured wind and rain and established the rainbow as a covenant.
Functional analysis
Traffic design
Traffic planning and design make full use of the surrounding municipal road network, organize emergency, hospitalization, visitation, logistics, office, dirt collection of their respective traffic flow lines, so that it "fast and slow separation, to hair separation, functional separation", especially emergency emergency flow line ground-air coordination, functional contact is convenient, 24 hours rain or shine. The efficiency of emergency response was critical to the project, and the design of the peacetime and wartime combination must be fully considered. The "combination of epidemic prevention" area is fully designed from the overall planning, architectural design, and mechanical and electrical system configuration, and meets the needs of rapid conversion and epidemic treatment during the epidemic under the premise of meeting the requirements of usual medical services.
Integration of pre-hospital and in-hospital rescue
"Small outpatient, large treatment", the emergency center as the core medical function of the project, must ensure the function and streamline of the simple and efficient, the five major emergency centers (chest pain center, stroke center, trauma center, critical maternal treatment center, critical newborn treatment center) in the use of the process can not be equal amount, chest pain center, stroke center function is similar, the number of visits is large, can support independent operation; trauma center, critical maternal treatment center, critical newborn treatment center Audience group is small, independent operation is not realistic Combined with the actual use needs of the hospital, the design combines these three centers with the emergency department to set up a large emergency center to integrate medical resources and improve the work efficiency of medical staff.
The emergency center is set on the first floor of the door emergency comprehensive building, the emergency traffic adopts the airport-style channelization diversion, coordinates the pre-hospital rescue mechanism, shortens the response time, pre-position 120 pre-hospital pre-diagnosis, ensures the 24-hour smooth flow of 120 emergency vehicles, smoothly connects the underground parking area and the canalized drop-off island, the main entrance canopy provides an all-weather wind and rain-free environment, guarantees the emergency flow line, facilitates the arrival of emergency patients, and the front entrance canopy can also provide outdoor wind-free temporary treatment places when there is a major accident and a large number of injured people.
Combine planes
The south side of the first floor of the interior connects the emergency centers through the long "medical corridor", which is the main structure of the overall architectural space logic, and the functional areas are organized through the four-storey high "corridor", which implies the logical relationship within the hospital and forms a unique entrance image together with the entrance canopy. The foyer reserves sufficient buffer space for treatment, the functions of medical guidance, registration, and medicine collection are unfolded along the border order, and the "medical corridor" is relatively independent and closely linked, becoming an important space for organizing patient treatment, the 10m wide medical street is convenient and efficient, the medical unit introduces a rich form of green courtyard, provides ventilation and lighting, provides a pleasant waiting experience for waiting patients, medical care, and patients have their own independent channels in each medical unit, achieving the effect of patient-centered, efficiency priority, doctor-patient triage, for patients, Visitors and hospital staff create a comfortable environment for seeking medical treatment and working.
In addition to the emergency centers, there are imaging departments closely related to stroke and chest pain on the first floor, so that CT, MRI, hybrid operating rooms and emergency centers are seamlessly connected; the second floor functions are routine medical configurations, including outpatient clinics, functional examination departments, ultrasound departments, endoscopy departments and central examinations; the intensive care ICU ward center is set on the third floor, which is connected with the surgical ladder set up in the first emergency center, and the number of ICU beds is configured according to 12% of the total number of beds; the four layer functions are: operating room, pathology department, and blood transfusion department. The functions of each floor are unfolded along the order of the "medical corridor", relatively independent and closely linked, becoming an important space for organizing patient visits, and the medical passage connects the north side of the inpatient building and the outpatient emergency medical technology complex, so that large-scale medical skills can be shared, and at the same time, the health consultation, banks, convenience stores, light meals, beauty salons, flower shops, bookstores, cafes, children's entertainment and other facilities on each floor and contact space make up for the healthy life elements that have been neglected by the hospital.
"Zero demolition and reform" to reduce the epidemic and convert the inpatient building
The construction of "anti-epidemic combination" wards is already a trend in China, but how to achieve rapid, effective and practical conversion, how to learn the actual use experience of the conversion ward in the epidemic situation, and how to combine the practical needs of medical staff on the front line are problems that designers must think about and solve.
Different from the conventional strip and tower inpatient buildings, taking into account the phased construction of the first and second phases of inpatient buildings, and in order to ensure that the inpatient buildings can achieve the "zero demolition and reform" epidemic conversion, after referring to many domestic and foreign inpatient building cases and multi-party design arrangements, we will set the plane length-to-width ratio of the inpatient building in a golden ratio, and the functional distribution is in the "worker" font: the central part is the medical area, the nurse station is located in the core part of the ward, the nursing flow line is shortened to the greatest extent, and the central medical area is converted into a sanitary passage area during wartime. The interference with daily functions is greatly reduced; the single-storey inpatient unit is equipped with 50 beds, the north and south wards are divided, the south side has the best sunshine and landscape orientation, the entire face width is all set up as wards, the ward contains triple rooms, double rooms and barrier-free ward suites to meet the needs of all levels, and the hidden drying space ensures the integrity of the façade; the northwest as a patient, visiting elevator and equipment room area, the public elevator hall directly faces the medical area, which is convenient for management; the northeast as a medical entrance and doctor's office area, relatively independent.
In the streamline design, the patient elevator, the medical elevator, and the dirt elevator are set up separately to meet the requirements of the use of clean and decontaminate flow, and there is a surgical ladder. Vertical traffic and horizontal corridors are used to effectively distinguish between patients with various diseases, visits, administration and cleansing streamlines.
The function highlights the combination of peacetime and wartime, drawing on the relevant experience of Wuhan's anti-epidemic, and the standard unit of wartime hospitalization can be quickly and instantly converted without dismantling and modifying. The northeast medical entrance and doctor's office area are used as clean areas, and the central medical area is used to complete the sanitation of the polluted area and the semi-polluted area to ensure the safe and convenient use of medical personnel in wartime.
Inpatient plane - usually
Hospitalization plane - epidemic time
Link First Aid Life Chain
Hospital building because of its complex functional needs and streamlined organization, compared to other buildings more rational, functional trinity of Liuzhou City Public Health Emergency Center and Critical Care Center is more so, it carries the responsibility and hope for life, but the hospital is not only the simple use of machines, with the development of society and medical model change, modern hospitals gradually to a highly complex community center transformation, modern hospitals in advanced science and technology, convenient processes at the same time need more warmth, At this time, design and planning play a very important role in coordination, so as to achieve the harmony of form and the unity of functional flow.
Acute critical care, public health emergency, Liuzhou Public Health Emergency Center and Critical Care Center on the one hand to organize a complex medical process, functions promote each other, multi-compound, link emergency life chain; "blue wave flying rainbow, life oasis", on the other hand, it provides a green sunshine life scene, like a rainbow of the broad hall canopy, inpatient visits of the boulevard, intensive sharing of healing garden, podium roof of the sky garden, pleasant and transparent medical corridor, Together, these constitute an oasis of life with rich layers, and build a healthy community that combines man, nature and healing.
A little perspective view of the hospital
Close-up lateral renderings
heavy
pound
invite
please
Gather in Wuhan on March 18-20, 2022 to enjoy cherry blossoms. If you want to further understand the classic cases of health community and hospital construction combined with peace and urgency, welcome to register for the "Academic Exchange of Medical Construction Integration Alliance and Hospital Wisdom Construction and Environmental Space Quality Improvement Summit Forum" sponsored by Hubei Medical Construction Integration Alliance, Zhuyitai and CITIC Architectural Design and Research Institute Co., Ltd.
Scan the code online to complete the registration
Contact
| Park Lihua | 18910389967 |
| Sun Xuemiao | 18773187870 |
END
Hot search content
| In-depth coverage | Hand surgery room | Domestic cases | Foreign cases |
| Hu Guoqing Classroom | Medical construction vane | Doctor's Word | Big coffee sharing |
| Youth medical circles | Logistics system | Medical elderly care | Enterprise style |
| Medical construction in the Greater Bay Area | Infectious disease hospital | Green Hospital | Anti-epidemic handbook |
| Washing system | Hospital logistics | Medical imaging | Ward space |