COVID-19 revealed enormous shortcomings in the healthcare system. Its current state, in a great deal brought about by the neoliberal views of the XX and XXI centuries, poses a challenge to care provision. Research explores the limitations of Evidence-Based Design (EBD) and emphasizes the need for a more holistic approach to creating care architecture spaces. The theoretical framework delves into the historical context of hospital architecture, its technologicalization, and the influence of neoliberalism. It critiques the dominance of evidence-based medicine in design and proposes a feminist perspective that values cultural and local practices. The methodological positioning involves a qualitative examination of social relations and experiential aspects, utilizing space syntax and user observations. The research aims to contribute to a broader discourse on healthcare architecture, considering both rationalistic and affective perspectives, through historical and contemporary case studies. Examples like Hotel Dieu de Beaune, Hospital Simon Ruiz in Medina del Campo, Bimaristan al Qalwun in Cairo, and Hof van Wauw in den Haag form the historical part of the case studies whereas the modern set is represented by Maggie’s Center in West London, Rehab Clinic in Basel, Kinderspital in Zurich and Sanatorium in Paimio. To further investigate the healthcare environment extensive conversations were performed with hospital staff and patients, with the focus on daily routines, opinions about the space and working systems but also feelings and emotions.
This exploration calls for more humane aspects of hospital architecture, highlighting principles like collectivity, orientation, and equality. It underscores the significance of signs of care, the delicate balance between isolation and connection, and the role of hospitals in caring for their external environment. Direct connections and the dual nature of hospitals as both homes and institutions are explored, along with the dynamic interplay between formal and informal elements. The work advocates choice-driven design, offering flexibility. Furthermore, it confirms the importance of nature. It concludes by referencing Florence Nightingale's timeless principles, emphasizing their continued relevance and proven historical effectiveness in creating compassionate and functional healthcare environments.
Furthermore, these principles were explored in the design part in the form of the design for the Infectious Diseases Hospital at Haringvliet in Rotterdam. The project aims at caring not only for patients but also for staff, visitors, and the public by offering each group prescribed earlier qualities.