The building that cares

Dutch architect firm, Mecanoo, is internationally known for projects like the train station in Delft, the library in Birmingham and the Manchester Technical University campus. Until recently, healthcare buildings were not on Mecanoo’s list of successful projects. That changed when Mecanoo received the assignment to build a new medical centre in the Dutch city, Zaandam. For architect Ryan van Kanten it was an opportunity to put himself on the map with Mecanoo, as a non-typical hospital architect. Klaartje Til visited the Mecanoo office in Delft to interview Ryan van Kanten, the architect who thinks it is only logical that a building should have caring qualities.

by Klaartje Til

I will come straight to the point. Can a building have caring qualities?
Yes, I think so, but only when the building is seen as a whole. Mecanoo tries to do this. Right from the start of the design process we look for ways to give people in the building a better feeling. It turned out very well with our project for the Zaans Medical Centre. They did not want the new building to be a classic example of a hospital building. They didn’t decide to go for a typical hospital architect, and wanted something different. Mecanoo had not designed a hospital before. Still, they came to us, because they wanted something different.

What makes the Zaans Medical Centre so different from other hospitals?
Our idea was that this building should not have the appearance of a hospital. You should not have the feeling that you are entering a hospital. When designing a hospital you must take into account practical things like: easy to clean, and security first. For the Zaans Medical Centre it wasn’t any different, because those are the requirements. But in our design these appear not as obviously. We designed it more as a public building that rather gives visitors the feeling of standing in a theatre lobby, than in a hospital.

What makes a hospital building caring?
In our design for the Zaans Medical Centre we tried to avoid stress moments. People are reluctant to go the hospital. They have to because they are ill or need care. Just before entering the hospital they already have a certain level of stress. People also have a lot of stress when they sit in the waiting room, just before they are called in by a doctor. An architect can think of ways that positively distract them to reduce the stress. For the Zaans Medical Centre we choose to work with graphic art. Together with the designers of the Silo Studio in The Hague, a graphic art design was created that showed drawings on the walls. The drawings show people directions but they also add a feeling of astonishment to the building. The visitor enters a public hall that is three levels high and they experience surprise because of an enormous drawing of a human body. The drawing refers to medical science. But if you look closer, you will see things that characterise the Zaanstreek (the region that surrounds the city of Zaandam), like traditional houses and elements of shipbuilding. This is a funny distraction. The first impression is: “Look, what is this extraordinary drawing?” And not: “Oh, there is the bell and there is the waiting room where I have to be at a specified time.”

As an architect, do you think in terms of these themes?
I think strongly in terms of orientation and daylight. People must immediately understand where they are and where they have to go. I think it is important that an architect ensures that at the entrance of a building people see daylight, both at their right and left side. They should notice immediately where the elevator is, and understand immediately how the building is put together. Daylight is a must. My rule of thumb is: never create a waiting room that has no daylight. You must be able to experience the weather when you are inside the building. It reassures and eases the feeling of stress. Daylight also helps orientation. Sometimes we cannot avoid making an indoor hallway. Then we make sure that there will be an outside view at the end of the hallway, so people always walk towards daylight. If that is not possible, we will take care that at the end of the hallway there will be an orientation point with a lot of artificial light. There should always be a focal point at the destination towards which someone walks.

As an architect, how do you explore these aspects, when designing a building like the Zaans Medical Centre?
By talking a lot with the people who will work in the new hospital: the nurses, the doctors, the social workers, the volunteers. They are all experts who have a lot of information from their experience. During the design process we talked very intensively for two years, with different user groups. For healthcare projects, it is especially important to listen to the users.

Does colour play an important role in the design of a health care building?
When choosing a colour, for example when finishing floors, walls and ceilings, you have to consider a good balance of stimulants. It should not be too boring, so not only white. But too exuberant is not good either. When designing a nursing home for elderly people, these are pitfalls to be aware of.

What pitfalls?
For a large floor with a rubber or marmoleum finish, it is better to create an even-colour. Not a finish with a dark patch suddenly popping up. People who cannot see well, or people who have difficulties interpreting stimulants, would think that they are about to fall into a hole. People who suffer from dementia are also quite sensitive to that. With bright primary colours you can make mistakes. People who suffer from dementia do not know how to deal with those colours.

So be careful with bright primary colours?
That is correct. In nursing homes you often see a lot of pastel colours. They are softer and easier for people to understand. Furthermore, creating contrast in the design is important. A white door in a white frame in a white wall, is difficult for people suffering from dementia. They often have difficulty in understanding that it is a door. It is better to have the frame in a darker colour so that they know: “That’s where I need to walk.”

Does location play an important role in the caring qualities of a building? Zaans Medical Centre is near a busy motorway.
The Zaans Medical Centre is at the end of the A7 motorway from Purmerend to Zaandam. The location was a given. They own the ground there and we can’t change that. The original commission was to create a hospital on the location that is exactly opposite where the new centre is located now. Plus, a parking facility was to be created at the front side of the hospital, facing the city. During the competition we immediately told them: “We want to turn it around.” The hospital should face the city so you immediately enter the hospital coming from the city and not from the motorway. The hospital building presents itself to Zaandam and looks away, so to speak, from the motorway.

Was it important for you and your team to turn the hospital away from the noise?
Certainly. Our design also has a clear kink. It has a simple form. Strictly speaking it is a long-drawn indoor street surrounded with building space. This makes it an all-sided building. It doesn’t have a front or a backside. By creating a kink facing the city, we tried to create a feeling of welcome, a gesture showing that this is where I have to be. It is simple in structure but it works.

And what happened to the surroundings of the new hospital building?
The current hospital was demolished. A new residential area will be built on that spot. That will transform the hospital from an institution at the skirts of the city, to a building that is integrated in a residential quarter. It will be integrated in society so to speak. The ultimate goal for a hospital is no longer to be seen as an institutional building, a fortress where you have to pass through a gate to get there. No, the hospital is just part of society.

What trends are expected regarding the caring qualities of a building?
I expect the institutional character of a hospital will disappear. I think we will see less and less of the large hospital, where you first have to drive to a parking place and then enter the building. Healthcare will be integrated more in the normal street scene. The healthcare building will develop into a sort of shop. There will always be a central building with operating rooms and intensive care. These don’t fit in a shop. But around these central rooms is a layer with nursing rooms and out-patient clinics. Why create all this into a large institute? For the caring character of a building you need to make the building easily accessible so that entering a hospital is less stressful. It is not about individual colours or materials, but about the whole appearance of the building. If you look at a nursing home from the sixties for example, you will immediately notice that it is a nursing home. I don’t think that is a good thing. You shouldn’t have the feeling that you live in a nursing home, but in a residential building, that happens to have the care that you need.

Photography: Mecanoo/Thijs Wolzak