Hospital architectures are very complex infrastructures that have evolved over time to be able to respond to the social, economic and medical needs of the ever-changing societies. These infrastructures are very complex also because they represent the space in which multiple interests converge. Around the health structures gravitate different figures and each of them has different ways of perceiving the surrounding environment and its state of quality based on the variables that characterize them. A well-designed hospital must be able to meet the needs of every category of people with whom it comes into contact. In the 80s several studies introduced the Evidence-Based Design Method, a theoretical model that merges architectural design with the scientific research method. Subsequently, thanks to the great attention paid to sustainability issues, methodologies and tools were developed for assessing the quality of built environments, some of which find application in health architecture. The purpose of this research is to investigate the ability of health architecture to concretely influence the overall health status of those who live and meet the building. Starting from a selection of the most used evaluation tools, through inclusion and exclusion criteria and a review of the existing literature, the selected tools have been compared to each other in order to better understand which categories are most frequently dealt with in the most recent instruments and which of them are more suitable and current to the needs of the Italian population. The categories have been grouped into Main Topics and, among these, Perceptive Wellbeing, Risks and Security and Mindfulness Education are the issues to work on to improve the quality of healthcare facilities in Italy. The analysis conducted allowed to identify a list of new criteria and indicators capable of implementing the only tool for assessing the quality of health architecture found in Italy. The tool, revised in the form of questionnaires, was applied in an Italian case study: the ASST Grande Ospedale Metropolitano Niguarda in Milan. In order to make a comparison, two pavilions of the Lombard structure (Block North of 2014 and Block DEA of 2002) have been identified as target of the survey. The questionnaires have been submitted to the various stakeholders (patients, visitors, carers, medical / nursing staff / healthcare assistants, Technical Office) in order to highlight the different needs between them. The results obtained were then compared with each other according to three criteria. The first comparison is between the results of the North Block and the DEA Block. The second comparison, on the other hand, compares the opinions collected by the staff and those gathered by patients on the most emblematic case study. Finally, the third comparison provides a system for the way in which users perceive certain elements within the structure and the results from a more conscious reading of the architectural space made by experts (Architect and representatives of the Technical Office). Based on the considerations emerging from the comparisons, meta-project strategies are established aiming to provide intervention guidelines for qualitatively efficient planning that meet the needs of the various stakeholders who live in the architectural healthcare space.
Le architetture ospedaliere sono infrastrutture molto complesse che si sono evolute nel tempo per poter rispondere alle istanze sociali economiche e mediche delle società in continua trasformazione. Queste infrastrutture sono molto complesse anche perchè rappresentano lo spazio in cui molteplici interessi convergono. Attorno alle strutture sanitarie gravitano diverse figure e ognuna di loro ha differenti modi di percepire l’ambiente circostante e il suo stato di qualità in base alle variabili che le caratterizzano. Un ospedale ben concepito deve essere in grado di soddisfare le esigenze di ogni categoria di persone con le quali entra in contatto. Negli anni ‘80 diversi studi hanno introdotto l’Evidence-Based Design Method, un modello teorico che fonde la progettazione architettonica con il metodo di ricerca scientifico. Successivamente, anche grazie alla grande attenzione ai temi della sostenibilità, sono stati sviluppati metodologie e strumenti per la valutazione delle qualità degli ambienti costruiti, alcune delle quali trovano particolare applicazione nelle architetture per la salute. Lo scopo di questa ricerca consiste nell’indagare sulla capacità dell’architettura sanitaria di infIuenzare concretamente lo stato di salute complessivo di coloro che vivono e entrano in contatto con l’edificio. Partendo da una selezione degli strumenti di valutazione più utilizzati, attraverso criteri di inclusione ed esclusione e una revisione della letteratura esistente, gli strumenti selezionati sono stati confrontati tra loro per poter comprendere meglio quali sono le categorie che vengono trattate maggiormente negli strumenti più recenti e quali di esse risultano essere più adatte e attuali rispetto alle esigenze della popolazione italiana. Le categorie sono state raggruppate in Main Topic e, tra questi, il Benessere percettivo, i Rischi e la sicurezza e l’Educazione alla consapevolezza risultano essere le tematiche sulle quali lavorare per un miglioramento della qualità delle strutture sanitarie in Italia. L’analisi condotta ha permesso di individuare una lista di nuovi criteri e indicatori capaci di implementare l’unico strumento di valutazione della qualità delle architetture sanitarie riscontrato in ambito italiano. Il tool, revisionato sotto forma di questionari, è stato applicato in un caso studio italiano: l’ASST Grande Ospedale Metropolitano Niguarda di Milano. Per poter fare un confronto, all’interno della struttura lombarda vengono individuati due padiglioni (Blocco Nord del 2014 e Blocco DEA del 2002) sui quali attuare l’indagine. I questionari vengono somministrati ai diversi stakeholder (pazienti, visitatori, accompagnatori, personale medico/infermieristico/OSS, Ufficio Tecnico) per poter evidenziare le diverse esigenze tra essi. I risultati ottenuti sono stati poi confrontati tra loro secondo tre criteri. Il primo confronto è tra i risultati del Blocco Nord e del Blocco DEA. Il secondo confronto invece paragona le opinioni raccolte dal personale e quelle raccolte dai pazienti sul caso studio più emblematico. Il terzo confronto infine mette a sistema il modo in cui vengono percepiti dagli utenti determinati elementi all’interno della struttura e i risultati scaturiti da una lettura più consapevole dello spazio architettonico da parte di esperti (Architetto e referenti dell’Ufficio Tecnico). Sulla base delle considerazioni emerse dai confronti vengono stabilite delle strategie metaprogettuali che mirano a fornire delle linee guida di intervento per una progettazione qualitativamente efficiente e rispondente alle necessità dei diversi stakeholder che vivono lo spazio architettonico sanitario.
Evidence-based hospital design. Percezione della qualità degli spazi
ZUCCHETTI, MARTINA
2018/2019
Abstract
Hospital architectures are very complex infrastructures that have evolved over time to be able to respond to the social, economic and medical needs of the ever-changing societies. These infrastructures are very complex also because they represent the space in which multiple interests converge. Around the health structures gravitate different figures and each of them has different ways of perceiving the surrounding environment and its state of quality based on the variables that characterize them. A well-designed hospital must be able to meet the needs of every category of people with whom it comes into contact. In the 80s several studies introduced the Evidence-Based Design Method, a theoretical model that merges architectural design with the scientific research method. Subsequently, thanks to the great attention paid to sustainability issues, methodologies and tools were developed for assessing the quality of built environments, some of which find application in health architecture. The purpose of this research is to investigate the ability of health architecture to concretely influence the overall health status of those who live and meet the building. Starting from a selection of the most used evaluation tools, through inclusion and exclusion criteria and a review of the existing literature, the selected tools have been compared to each other in order to better understand which categories are most frequently dealt with in the most recent instruments and which of them are more suitable and current to the needs of the Italian population. The categories have been grouped into Main Topics and, among these, Perceptive Wellbeing, Risks and Security and Mindfulness Education are the issues to work on to improve the quality of healthcare facilities in Italy. The analysis conducted allowed to identify a list of new criteria and indicators capable of implementing the only tool for assessing the quality of health architecture found in Italy. The tool, revised in the form of questionnaires, was applied in an Italian case study: the ASST Grande Ospedale Metropolitano Niguarda in Milan. In order to make a comparison, two pavilions of the Lombard structure (Block North of 2014 and Block DEA of 2002) have been identified as target of the survey. The questionnaires have been submitted to the various stakeholders (patients, visitors, carers, medical / nursing staff / healthcare assistants, Technical Office) in order to highlight the different needs between them. The results obtained were then compared with each other according to three criteria. The first comparison is between the results of the North Block and the DEA Block. The second comparison, on the other hand, compares the opinions collected by the staff and those gathered by patients on the most emblematic case study. Finally, the third comparison provides a system for the way in which users perceive certain elements within the structure and the results from a more conscious reading of the architectural space made by experts (Architect and representatives of the Technical Office). Based on the considerations emerging from the comparisons, meta-project strategies are established aiming to provide intervention guidelines for qualitatively efficient planning that meet the needs of the various stakeholders who live in the architectural healthcare space.| File | Dimensione | Formato | |
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https://hdl.handle.net/10589/147667