An Evaluation of Biophilic Design in the Khoo Teck Puat ......Biophilic Design has been explored, to create environments, that; rather than focus on the properties of a building, allow

An Evaluation of Biophilic Design in the Khoo Teck Puat Hospital,

Singapore and the Queen Elizabeth Hospital, Birmingham.

Charlotte Rose Cridland

S15106729

BA Art and Design (Hons)

Introduction

This text gives an analytical overview of the concept and popularization of Biophilic Design; a

method of reconnecting occupants with nature in the built-up environment. This has been

integrated in the case study of: Khoo Teck Puat Hospital, Singapore (KTPH). The aims and

impacts, of integration combined with occupants’ opinions and feedback, leads the discussion

and forms the proposal of Biophilic Design’s potential, to be applied in the Queen Elizabeth

Hospital, Birmingham (QEHB). Biophilic Design is explained with reference to; research and data.

Image source: https://living-future.org/biophilic/case-studies/award-winner-khoo-teck-puat-hospital/

Caption: Fig 1. Courtesy of Khoo Teck Puat Hospital, Singapore (2019)

Citation: International Living Future Insititute (2019) Healing Through Nature Khoo Teck Puat Hospital. Available at: https://living-future.org/biophilic/case-studies/award-winner-khoo-teck-puat-hospital/ [Accessed 30/12/2019].

An introduction to Biophilic Design

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The origin of Biophilia, comes from two meanings, firstly life (Bio-) then a love for a specific thing

(-philia). This became popularized by Erich Fromm, German psychologist and philosopher in the

1960’s (Merriam-Webster 2020). The idea was later developed and brought to public attention by

American biologist, Edward O. Wilson, in the late 1900's, stating his belief in existence is through

emotive human affiliation with other life forms (Wilson 1997:165). Further explaining, that humans

require a better understanding of their necessary relationship to nature, is because they have

become consumed by modern technological advances. Nemitz (2000:7) expedites this further by

stating that vegetation is, at the same time, both familiar yet alien. Humans are aware of the

existence of nature, but it is often disregarded. Especially, as there is also the belief that society

has deviated from nature with ‘loss of biodiversity’ (Almusaed 2011:173). Therefore, Biophilia as

part of an emerging modernistic design between nature and structure, it restates and reinforces

the importance, of human connections with nature and highlights the spaces in which the concept

can be understood and respected.

Conceptualization of Biophilic Design is considered a way of reconnecting occupants to the

amalgamation of both urban structure and nature. It works by strategically incorporating natural

elements and implementing them in an architectural environment, directly and indirectly. This has

been shown to increase productivity and to support elevation in mental health and well-being

(Heath 2016). Biophilic Design has emerged as a result of expanding urbanism and perceived

human disconnection, from natural process and through urban rather than rural dwelling (Heath

2016).

Exploring how occupants can re-engage with essential parts of the natural environment, for

example: light, plants, water, fresh air and sound, Heath (2016) discusses how Biophilia aims to

strengthen human-nature relationships. By creating spaces that become more engaging and

productive, with access to landscape views, welcoming in natural light, and through forms of

nature that are indirect, such as: textural materials on both walls and flooring I.e. (cladding and

timber). This potentially generates stronger natural links in the environments, where people live

and work. Biophilic Design has been explored, to create environments, that; rather than focus on

the properties of a building, allow there to be a perspective which is solely human-centered

(Robbins 2017). Additional study shows, that Rocca (2007) proposes that the user, or the

observer, of a particular work, must be able to take on the status of ‘inhabitant’, in order to allow

the space, whether temporary or fixed to be experienced fully.

An Introduction to Case Study 1: Khoo Teck Puat Hospital, Singapore

In consideration of a human-centered approach to building design, Kellert (2018) confers that

Biophilia informs developers and designers, not just about what they should do in terms of

approach, but rather the importance of Biophilia, to each of us every day. It is necessary, to clarify

exactly what is meant by the term ‘importance’ in reference to Biophilic Design. The concept

demands that architects and planners embrace the spirit and intentions of the design as a Biophilic

process; a process that considers exactly what humans need in a space to feel calm and

comforted. Information collated from the 2010 build of the Khoo Teck Puat Hospital, Singapore,

presents points on: the integration of Biophilia. These include specific place-based relationships,

the evolvement of human-nature relationships and lessons learned through the process of the

build (International Living Future Institute 2019). All of which are deemed as necessary

requirements to fulfill human needs, but essentially to highlight how nature being carefully worked

and integrated in a space is thought to have positive, mental and physical effects.

The KTPH is a development situated in a dense urban environment, Yishun in Singapore,

covering approximately 3.4 hectares of land, consisting of 761 beds (Khoo Teck Puat Hospital

National Healthcare Group 2019). Considering the urban environment, the KTPH occupies, the

level of greenery, horizontal and vertical, in comparison to the size of the structure is roughly four

times the size of the building. 40% of this green space is open to public access (International

Living Future Institute 2019). The KTPH has not just achieved positive levels of extensive

greenery, it has also obtained many awards and recognition since its opening in 2010. Awards

have been given based on the hospital’s design, build and through maintaining areas which are

environmentally friendly. A few examples being: 1st prize SIA-NParks Skyrise Greenery Award

(2010), Platinum Singapore Health Award (2012), Global Healthy Workplace Award (2013) and

2017 Stephen R. Kellert Biophilic Design Award (Khoo Teck Puat Hospital National Healthcare

Group 2019).

The intentions of the design are to provide patients with a hassle-free approach to care, whilst

being surrounded by garden views. Volunteers and organizations that partnered with the KTPH;

dedicated their time to the gardens, so that patients could fully embrace the experience of a multi-

sensory environment, key features being; sound, sight, scent and touch (National Parks Board

2018). Nemitz (2000:8) states that, plants can be experienced fully in positive contexts as they

delight, adorn and provide nourishment.

The delivery of care provided from the staff to the patients at KTPH consist of; daily ward rounds.

Administration of medicine is included in the routine rounds, as well as meals and patient checks

prior to bedtime. Doctors are on a 24-hour call-in schedule, in case any patient requires urgent

medical care (Khoo Teck Puat Hospital National Healthcare Group 2019). Nurses and clinicians

will use specified pathways in order to communicate patient diagnosis, to reduce delays but also

to enhance the level of care received by patients. Care pathways are thought out sequences that

maintain order of instruction, to provide fast and effective treatment (Rosique 2020).

Image source: https://living-future.org/biophilic/case-studies/award-winner-khoo-teck-puat-

hospital/

Caption: Fig 2. Courtesy of Khoo Teck Puat Hospital, Singapore (2019).

Citation: International Living Future Insititute (2019) Healing Through Nature Khoo Teck Puat

Hospital. Available at: https://living-future.org/biophilic/case-studies/award-winner-khoo-teck-

puat-hospital/ [Accessed 30/12/2019].

The Integration of Biophilic Design in the KTPH

Kellert (2018:25) argues that nature as an experience, means direct contact with naturalistic

properties, such as: light, air, water, plants, animals, landscapes, weather, views of nature, the

outdoors and fire. Nemitz (2000:8) discusses similar views, stating that the characteristics of

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vegetation, are to stimulate the senses in multiple ways. Through; scents, odors, shapes and

structure. Considering these characteristics, it is thought that sight is no doubt one of the most

important human senses. The eyes gather and collate information from the environment, which

is then processed and creates reactions, to enable the occupant to feel either content or

melancholic. (Smart Vision Labs 2017).

The KTPH commends itself on introducing natural light to their patients based on the positioning

of the build and how it faces North in the shape of a 'V'. The configuration, was designed by RMJM

Hillier in partnership with CPG Architect Consultants, consisting of three building blocks, that

overlook a central courtyard (National Parks Board 2018). Retaining a balance between

accessible light, airflow and surrounding landscape views with reduced possibility of rainfall and

intense light entry (International Living Future Institute 2019). Additional to these naturalistic

properties, each floor has been extensively equipped with greenery. This allows every individual

who walks through the hospital, to be directly exposed to forest-like environments and to have

views of nature, at every angle that they situate themselves in. Nemitz (2000:7) discusses how

the sight of vegetation can often have a stimulating, palpable response on the skin, describing

vegetation as ‘the fur that covers the body of landscape’.

With this is mind, each garden has aims of being conducive as well as engaging. The KTPH

considered an educational approach to the integration of the gardens, applying compelling

themes that cater for a variety of patient needs. Examples are the species of plants as well as

edible fruit and vegetables. The range of colours, scents and flavours, present a multi-sensory

appeal to patients, visitors and staff (National Parks Board 2018). Staff must also take vital control

in one of the gardens, located near the Geriatric clinic. This is provided for the needs of Dementia

patients; staff are required to continually ensure patient safety whilst ensuring patient satisfaction

and enjoyment of the green surroundings (International Living Future Institute 2019).

Image source: https://www.greenroofs.com/projects/khoo-teck-puat-hospital-ktph/

Caption: Fig 3. Courtesy of National Parks Board and Greenroofs.com, Khoo Teck Puat

Hospital, Singapore (2019).

Citation: Greenroofs.com (2019) Khoo Teck Puat Hospital (KTPH). Available at:

https://www.greenroofs.com/projects/khoo-teck-puat-hospital-ktph/ [Accessed 30/12/2019].

Image source: https://www.rmjm.com/portfolio/khoo-teck-puat-hospital-singapore/

Caption: Fig 4. RMJM Khoo Teck Puat Hospital, Singapore (2019)

Citation: RMJM (2019) Khoo Teck Puat Hospital. Available at:

https://www.rmjm.com/portfolio/khoo-teck-puat-hospital-singapore/ [Accessed 30/12/2019].

https://www.greenroofs.com/projects/khoo-teck-puat-hospital-ktph/https://www.greenroofs.com/projects/khoo-teck-puat-hospital-ktph/https://www.rmjm.com/portfolio/khoo-teck-puat-hospital-singapore/https://www.rmjm.com/portfolio/khoo-teck-puat-hospital-singapore/

Both sustainable and environmental principles were carefully considered in the planning of plant

integration. Singapore, has a tropical climate as it is situated in Southeast Asia, located close to

the earth's equator. There is ample amount of rainfall, uniformed warm temperatures and high

humidity all year, with very little month by month weather variations (Meteorological Service

Singapore 2020). Therefore, an estimated 70% of the plants are known to be indigenous, easing

the access of maintenance and cost. There is also a rooftop farm located at KTPH, consisting of

over 130 vegetable plots and fruit trees. It is believed that around 50 different varieties of the food

sources grown on this farm are edible and are used in the hospital kitchen. Examples of the

edibles are; corn, okra, kale, papayas, bananas and apples (National Parks Board 2018). An

educational benefit of organically grown food produce, is created for both visitors and patients,

who are less aware of where their food has been sourced from. Especially in such an urban

environment, the opportunity exists to learn more about locally sourced produce.

Another Biophilic Design feature that was considered in the planning, was the pre-existing Yishun

water pond. The ground that the KTPH is situated, sits near the pond, with water flowing through

the central courtyard. Almusaed (2011:39) discusses, that understanding architecture

sustainability, means working with, not against nature, by avoiding damage to nature systems. In

respect of energy efficiency, sustainability and reduction in carbon footprint, the water from the

pond is irrigated and treated, prior to the usage of any landscape needs. Sensors have also been

integrated to control and regulate the levels of water used, preventing any waste (Khoo Teck Puat

Hospital National Healthcare Group 2020). Beneficial to patients, is the movement of water,

starting at Level 1 in the central courtyard, where it then descends a waterfall in the basement,

giving an illusion to its viewers, that the water has been directly drawn in from Yishun pond. The

breezes that skim over Yishun pond are maximized for the use of natural ventilation, in wards that

are subsidized. This is said to generate an enhancement of patient comfort, due to the retained

balance of Yishun’s tropical climate and prevailing winds (International Living Future Institute

2019). Additional research suggests that areas such as; the hospital lobby and corridors deemed

for public access, gain enough wind speed to reduce the reliance or need of mechanical

ventilation, saving on energy costs (International Living Future Institute 2019).

Image source: https://living-future.org/biophilic/case-studies/award-winner-khoo-teck-puat-hospital/

Caption: Fig 5. Courtesy of Khoo Teck Puat Hospital, Singapore (2019).

Citation: International Living Future Insititute (2019) Healing Through Nature Khoo Teck Puat Hospital. Available at: https://living-future.org/biophilic/case-studies/award-winner-khoo-teck-puat-hospital/ [Accessed 30/12/2019].

Image source: https://www.ktph.com.sg/main/explore_ktph_pages/228/designed_for_comfort

Caption: Fig 6. Khoo Teck Puat Hospital, Singapore, Wards (2020).

Citation: Khoo Teck Puat Hospital National Healthcare Group (2020) Explore KTPH, Designed for Comfort. Available at: https://www.ktph.com.sg/main/explore_ktph_pages/228/designed_for_comfort [Accessed 10/01/2020].

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Post-Occupancy Feedback of KTPH

The Ministry of Health conduct an annual survey, based on patient satisfaction. In 2016 12, 467

patients had been asked to give feedback, based on Singapore’s hospitals, polyclinics and

specialist centers and the care and services they provide. 86% of responses were positive,

achieving categories; ‘good’ and ‘excellent’. The KTPH reached the top of the Ministry of Health’s

2016 survey list, with 91% positive patient satisfaction, this had increased by 5% since 2014, as

the rating was marked down at 86% (Kahlik 2016).

A POE (post-occupancy evaluation) was also conducted in 2016, on 200 individuals, comprised

of; staff, visitors and patients. The evaluation was based on an earlier approach to healthcare

focusing on the integration of greenery and water and how these features effect the user's well-

being (International Living Future Institute 2019). The feedback from the evaluation found that;

80% of people said that Singapore hospitals should invest in elements that offer blue-green

spaces and that 15% of the hospital visitors use the spaces for both social and recreational use

(International Living Future Institute 2019).

The success and benefits of integration consider the KTPH as part of broadened ecosystem.

Providing habitable green areas that have attracted several species of butterflies through

integration of the indigenous plants, it has been designed as ‘more than just a place of recovery’

(International Living Future Institute 2019).

An Introduction to Case Study 2: Queen Elizabeth Hospital, Birmingham

In the 1930’s, the old Queen Elizabeth Hospital was built, linking both the hospital and the

academics of medicine, together on one site. The design was to connect both science and

clinicians in order to provide the most effective and efficient patient treatment. (University

Hospitals Birmingham NHS Foundation Trust 2020). The rebuild of Birmingham's Queen

Elizabeth Hospital began construction in 2006 and reached completion in 2010. An estimated

£545 million, was invested. International law firm, Pinsent Masons secured the finance and acted

on behalf of the UHB Trust and the Birmingham and Solihull Mental Health Trust (Design Build

Network 2020). Facilitating, 1,213 beds, the QEHB’s aims of strategy are to maintain and prioritize

patients' needs first and foremost. Other aims that the QEHB closely consider are; purpose,

values, collaborative practice and visions on providing honesty, accountability, innovation and

respect (University Hospitals Birmingham NHS Foundation Trust 2020). In recognition of the work

and care provided by volunteers, charity support workers and staff in the UHB Trust, an awards

ceremony is held each year, called Building Healthier Lives, commending individuals on their

dedication to providing quality healthcare.

The aims of the hospital are; like the KTPH, in relation to the level of care which staff and

volunteers want to provide to their patients. However, both the design and architectural concepts

are very different in the two developments. The new QEHB underwent construction by Balfour

Beatty, with the design being created by BDP Architects. It consists of three pods which connect

through walkway access, each pod is truncated, sloping downwards toward the back of the build,

creating a donut-like shape, where wards and departments circulate round the center of an ‘open

top’ roof (Design Build Network 2020). As well as the hospital being designed to facilitate 1, 213

beds, new mental health units have been constructed on the hospital grounds, taking a definitive

and sensitive approach to patient care (Design Build Network 2020). The delivery of care provided

in the QEHB works on a basis of rotational shift pattern, this means that throughout the day, as

shift patterns change, the member of staff responsible for specific patients, will give a handover

of care plans so that patients are kept up to date with their plan and provides patients with an

opportunity to liaise and talk to staff about the treatment they are receiving (The Patient

Information Group 2019:14).

Image source: http://www.bdp.com/en/projects/p-z/Queen-Elizabeth-Hospital-Birmingham/

Caption: Fig 7. BDP, Queen Elizabeth Hospital, Birmingham (2018).

Citation: BDP (2018) Queen Elizabeth Hospital Birmingham. Available at:

http://www.bdp.com/en/projects/p-z/Queen-Elizabeth-Hospital-Birmingham/ [Accessed

10/01/2020]

Image source: https://www.uhb.nhs.uk/Images/NewHospital/PhotoGalleries/Construction79.jpg

Caption: Fig 8. Queen Elizabeth Hospital, Birmingham (2020).

Citation: University Hospitals Birmingham NHS Foundation Trust (2020) New hospital

construction photo gallery. Available at:

https://www.uhb.nhs.uk/Images/NewHospital/PhotoGalleries/Construction79.jpg [Accessed

10/01/2020].

The potential of Biophilic Design at the QEHB

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Research shows the QEHB occupies approximately 137,000m2 of land (Design Build Network

2020). An estimated 16,000m2 of land surrounding the hospital, has been considered by the UHB

Trust, in conjunction with Birmingham and Solihull Mental Health NHS Foundation Trust, to create

a project beneficial to local communities. The aims are to enhance either habitats or food

production, that can be self-sustaining, but also bring together businesses, charities and

organizations (University Hospitals Birmingham NHS Foundation Trust 2014).

The 16,000m2 of unused land has been divided into 12 separate areas across the site, each

demonstrating its own focus. Further research shows that areas 1 and 2 have already gained

plant integration, comprising of both mature trees and fruit trees. Generosity from the QEHB

charity, presented a £5,000 grant, making this integration possible (University Hospitals

Birmingham NHS Foundation Trust (2020). The remaining 10 areas have been given a focus,

some of which closely consider the benefits of patient access. For example; area 3 plans to create

a pathway that weaves through trees generating shaded areas. This will reduce photosensitivity

to light, in patients who have undergone specific treatments, that still want to have access to fresh

air without the worry of direct exposure to sunlight (University Hospitals Birmingham NHS

Foundation Trust 2020).

Image source: https://www.uhb.nhs.uk/Downloads/pdf/CommunityOrchardAreaMap.pdf

Caption: Fig 9. Community Orchard Area Map (2020).

Citation: University Hospitals Birmingham NHS Foundation Trust (2020) About the Community Orchard and Gardens. Available at: https://www.uhb.nhs.uk/about-the-community-orchard-and-gardens.htm [Accessed 10/01/2019].

As well as the community orchard and gardens, the QEHB began creating a wildflower meadow

in 2014, situated on the east side of the hospital grounds. Partnered with Birmingham’s Wildlife

https://www.uhb.nhs.uk/Downloads/pdf/CommunityOrchardAreaMap.pdfhttps://www.uhb.nhs.uk/about-the-community-orchard-and-gardens.htmhttps://www.uhb.nhs.uk/about-the-community-orchard-and-gardens.htm

Trust the hope and aims of the meadow are; to improve biodiversity of the land attracting wildlife,

but also bringing together patients, staff, visitors and local communities (University Hospitals

Birmingham NHS Foundation Trust 2014). Another aim was to see the potential growth of; the

cuckooflower, cowslips plants, buttercups and orchids. Research conducted shows that these

species of plants are native to the United Kingdom; The cuckooflower tends to bloom through mid

to late spring or early in the summer and distinguishes itself as pale-lilac in colour, the name of

the flower links closely to that of the cuckoo bird, as typically the flower blossoms around time of

the bird call. The cowslip, also known to bloom in springtime, approximately around April and May

appear in clusters and are distinguished by being yellow in colour. Buttercups are like cowslips

with a close visual link, being yellow colour and obtaining a cup shape, however they are more

commonly recognized in the UK and they tend to appear in big patches on dampened grass areas

(Plantlife 2020). Orchids, however, are a lot rarer to find in the UK, but the species that tend to

flower are; the lady orchid, the fen orchid and the butterfly orchid (PlantlifeVideo 2018).

The belief that these plants were chosen for the wildflower meadow, is because native plants are

known to be self-sustaining and tend to thrive when they are scheduled to bloom based on

climate. This eases the access of maintenance, keeping costs to a minimum but with the benefit

of generating stronger natural links between humans and nature.

Image source: https://www.uhb.nhs.uk/news/new-wildflower-meadow-for-qehb.htm

Caption: Fig 10. Wilflower Meadow, QEHB (2014).

Citation: University Hospitals Birmingham NHS Foundation Trust (2014) New wildflower meadow for QEHB. Available at: https://www.uhb.nhs.uk/news/new-wildflower-meadow-for-qehb.htm [Accessed 10/01/2020].

A moderate amount of Biophilic Design features appears to be pre-existing, as the QEHB has

already begun integration of trees and plants transforming specific areas of land, to generate

stronger relationships between humans and nature. The issues surrounding the exterior plans

are; ease of access to patients who require bed rest, those who are bed bound and to those

who require wheelchair access, struggling to travel any length of distance. The potential of

Biophilic Design is required internally at the QEHB. Inadequate amounts of greenery are

displayed in Figure 12: Queen Elizbeth Hospital Birmingham (2018). This shows a panoramic-

like view that overlooks the center of one of the truncated pods. A natural element that appears

to have had some consideration in the planning is that of the ‘open roof’ design, projecting

natural sunlight that cascades down the tiles. Although aesthetic, the light only seems to reach

certain points on contact, before views become shadowed and darkened. To patients who are

situated on the upper levels of the hospital, they reap more benefit of the natural sunlight, in

comparison to patients, staffs and visitors that occupy the lower levels of the hospital, looking

out across the center of the pod, where natural light has become lost.

The white tiling on the outside of the building, also seems to have had some consideration, as

white is known to be reflective. Perception of the colour seen by an individual, based on

wavelength is an indicator of how much light is being reflected, it is believed that ‘white light’

consists of every wavelength on the energy spectrum, therefore meaning all of its wavelengths

are reflected, not absorbed (Deziel 2018). The importance of reflection transmits the light from

one surface to another. This aspect of design could be worked upon to increase the potential of

Biophilic Design, as natural light is part of an essential requirement for plant growth. The QEHB

could aim to apply planters that hang outside ward windows, with some of the native plants

discussed in the wildflower meadow, to give patients a direct view of nature that is low

maintenance, low cost, creates visual pleasure and what uses a source already integrated; light.

This would also benefit those who are not able to leave their bed, due to their specific treatments.

https://www.uhb.nhs.uk/news/new-wildflower-meadow-for-qehb.htmhttps://www.uhb.nhs.uk/news/new-wildflower-meadow-for-qehb.htmhttps://www.uhb.nhs.uk/news/new-wildflower-meadow-for-qehb.htm



Citation: BDP (2018) Queen Elizabeth Hospital Birmingham. Available at: http://www.bdp.com/en/projects/p-z/Queen-Elizabeth-Hospital-Birmingham/ [Accessed 10/01/2020].



Citation: BDP (2018) Queen Elizabeth Hospital Birmingham. Available at: http://www.bdp.com/en/projects/p-z/Queen-Elizabeth-Hospital-Birmingham/ [Accessed 10/01/2020].

Further research conducted into one of the QEHB wards, based on Figure 13: Queen Elizabeth

Hospital, Birmingham. Mail Online ©PA (2013) also displays the lack of naturalistic features

internally within QEHB wards. As a society, everything seems to be standardized and it is

http://www.bdp.com/en/projects/p-z/Queen-Elizabeth-Hospital-Birmingham/http://www.bdp.com/en/projects/p-z/Queen-Elizabeth-Hospital-Birmingham/http://www.bdp.com/en/projects/p-z/Queen-Elizabeth-Hospital-Birmingham/http://www.bdp.com/en/projects/p-z/Queen-Elizabeth-Hospital-Birmingham/

almost as if there is the constant pursuit to project cleanliness and sanitation that deters away

from the integration of nature and the natural environment. This presents almost too much of a

clinical feel and approach to the building. There is no denying the importance and

understanding of cleanliness and optimized hygiene levels in an environment specified for

patient treatment. However, this is where other principles can start to be considered, even in

ways of indirect connections to nature. This ward could provide patient’s with photographs or

images of natural landscapes, if there is no allowance of a landscape view out of the window.

Figure 6: Khoo Teck Puat Hospital, Singapore, Wards (2020) displays this approach, giving a

sense of calmness, tranquility and a place that feels rejuvenated. This approach would not

require any maintenance, and it would be of a low cost. A hospital bed is where patients are

expected to be relaxed and to feel comfort. The way the QEHB wards are displayed currently do

not give patients that option or the sense of ‘positive well-being'. The QEHB works with

University Hospitals Birmingham, an education led factor of the hospital, with this is mind the

QEHB could consider working with other areas of University faculties such as; Art, Design and

media to create images that are of local environments, giving patients an educational

opportunity as well as they urge for natural properties that the wards are screaming out for.

Image source: https://www.dailymail.co.uk/health/article-2296951/Farce-new-545m-NHS-Queen-Elizabeth-Hospital-Birmingham-SMALL.html

Caption: Fig 13. Queen Elizabeth Hospital, Birmingham. Mail Online ©PA (2013).

Citation: Hodgekiss, A. and Mail Online (2013) Farce of the new £545m NHS hospital which is too SMALL: Flagship unit forced to re-open old wards at the site it replaced. Available at: https://www.dailymail.co.uk/health/article-2296951/Farce-new-545m-NHS-Queen-Elizabeth-Hospital-Birmingham-SMALL.html [Accessed 10/01/2020].

https://www.dailymail.co.uk/health/article-2296951/Farce-new-545m-NHS-Queen-Elizabeth-Hospital-Birmingham-SMALL.htmlhttps://www.dailymail.co.uk/health/article-2296951/Farce-new-545m-NHS-Queen-Elizabeth-Hospital-Birmingham-SMALL.htmlhttps://www.dailymail.co.uk/health/article-2296951/Farce-new-545m-NHS-Queen-Elizabeth-Hospital-Birmingham-SMALL.htmlhttps://www.dailymail.co.uk/health/article-2296951/Farce-new-545m-NHS-Queen-Elizabeth-Hospital-Birmingham-SMALL.html

Evaluation of research and data collection

Analyzing the research and data collected from the KTPH and the QEHB, highlights key points

regarding both pre-construction planning and design. The KTPH’s contingency had always been

to prioritize and thoroughly consider the integration of Biophilic Design features, solely as a

human-centered approach to healthcare design. Whereas, the QEHB’s aims were still based on

providing quality, efficient healthcare. Yet the design and architectural concepts, focused more

on compiling several different facilities with high-tech equipment, achieving NHS patient demands

and needs. University Hospitals Birmingham stated that they wanted to decrease lengths of

patient wait times, pre- and post-surgery and increase patient discharge to those who have

undergone surgery, within 23 hours post admission (University Hospitals Birmingham NHS

Foundation Trust 2012). This is said to prevent patients being in hospital, any longer than what is

needed.

However, credit to the QEHB must be embraced, as thematic of some plant, light, fresh air and

sound integration have been noticed, linking to features of Biophilic Design, without much

recognition. Although the plants have been seen to occupy external land surrounding the hospital

site, the thought and intentions of the design, should be praised as the QEHB has worked with

various trusts and organizations to put these plans in place, in order to strengthen human-nature

relationships. Native consideration of plants, like the KTPH was also considered when planning

the wildflower meadow, this is where it is important to note that Yishun, Singapore and Edgbaston,

United Kingdom both sustain different climates. Therefore, access to self-sustaining native plants

can allow other developments looking to integrate nature in a cost-effective way, to research and

study what plants native to them can provide some form of direct connection to nature for its

occupants. Having plants which can be self-sustaining also reduces cost and minimizes the

upkeep, but benefits those in the surroundings that they occupy, to be experienced and enjoyed

to their fullest potential. It is vital to say that the NHS is already under such high-pressured

demand to provide quality healthcare, therefore, the opportunity may not have existed if these

self-sustaining plans of native plants had not been thought of earlier on.

Other potentials, such as; sound was also considered by the QEHB as they wanted to strategically

grow the cuckooflower, said to be known, that when in bloom this occurs around the same time

the cuckoo bird calls. To those who can access the meadows, would benefit from this, as it is

such a divine, unique approach to enhancing habitats as well as bringing in other wildlife. The

QEHB, has the potential to apply more direct elements of nature, but the key is, that the existing

potential allows for development and improvement of integration.

Conclusion

To conclude the evaluation of Biophilic Design and its potential to be applied to the Queen

Elizabeth Hospital, Birmingham, shows that research supports an existing potential as well as a

future potential. With the process and concept having not been extensively considered in the

planning and design, the integration of Biophilia does not necessarily have to abide by each

strategic plan that the Khoo Teck Puat Hospital, Singapore had applied to its own construction. It

just notes that simple elements of sound, fresh air, and direct access to some form of plant growth

will undoubtedly elevate patient satisfaction. The QEHB has already distinguished naturalistic

features of; sunlight, sound, fresh air and external growth of vegetation to the hospital grounds. It

is key is to take these features and allow them to become more considered, more developed and

think about these in a way that focus become more human centered. This leads the text into a

final discussion on the future of Biophilic Design. It rests in the eyes of architects, designers,

planning consultants, finance trusts and ultimately the occupant to determine what generates

stronger human-nature relationships.

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Documents

An Evaluation of Biophilic Design in the Khoo Teck Puat ......Biophilic Design has been explored, to create environments, that; rather than focus on the properties of a building, allow