At their base level, healthcare buildings are where people go to regain and/or maintain their health. Ambulatory care facilities are used for physician’s visits or tests, hospitals for more serious issues and rehabilitation or long-term care facilities for the road to recovery. As designers, we often have the intention to have these facilities go beyond their functionalities in design, but, unfortunately, most projects fail to emerge as vital community hubs.
To truly elevate our healthcare buildings and establish them within communities, we need to think of them as “fourth places.” The concept is akin to “third places,” or spaces between home and work where we interact with other individuals (a coffee shop, say). Therefore, fourth places should support gatherings, but also inclusiveness. There strangers from all backgrounds and views should be able to gather for social interactions in public or semi-public spaces.
Rethinking the Connections
As a visual person, I used to see the ideal healthcare system as a hub-and-spoke model, with the hospital being the hub and the spokes being all of the ambulatory buildings and services. Since then it’s become more of a spiderweb to me, one that overlays a community. As the lines between healthcare, education, retail, and hospitality blur more and more, the types of buildings providing services that improve public health expands, and the relationships between the buildings become more amplified through their connections. This makes the web considerably more complicated, but also significantly stronger.
Building types might serve multiple functions with the common purpose of improving and contributing to community health. For example, hospitals could become destinations for more than medical reasons if public parks are incorporated into their design. Gyms could be connected to hospitals, not only as places to exercise and socialize but for rehabilitation, while hospital restaurants might provide a gathering place for nutrition and education. In this fourth-place approach to design, the lines that previously differentiated these types of settings begin to disappear thanks to connection and common purpose.
We’ve already seen this occur in other sectors, such as grocery stores that sell clothing and housewares, farmers markets set up in transit hubs, and airports with shops that rival retail malls. Though the healthcare has been traditionally slow to change, this is not the norm now. Yet, the idea of hospitals serving communities isn’t new, either, so as we think about designing the next generation of healthcare facilities for the next 50 years, we need to ensure they do.
Another version of this article previously appeared in Healthcare Design.