Step outside for a moment: the value of pedestrians in healthcare precincts

Michaela Sheahan, Researcher, HASSELL

Bump space, serendipitous encounters: whatever the label, the name of the game in healthcare design is connecting people. But the focus on internal collaboration has some unintended side effects: buildings get bigger, and people spend more time inside.

External space is shrinking as large clinical and research buildings bring teams closer together via soaring atria, internal streets, and sky-bridges. Good connections are vital to a well-functioning hospital, but as public realm diminishes, so does walkability and street activity. Nothing kills a precinct quite like a deserted street.

My research shows that as these precincts grow, two indicators of pedestrian activity – Walkscore and intersection density – decrease. The bigger a precinct becomes, the more difficult it is for people to walk around.

Large buildings and impermeable blocks obstruct pedestrians, and limiting land use to only healthcare decreases small business opportunities. If every nearby building is a health facility, people won’t go outside to grab lunch or drop into the bank. In Boston’s high density Longwood precinct an internal pedestrian network is being developed in response to traffic danger and a need to connect teams across buildings and streets. In Houston’s vast Texas Medical Center, the combination of a sky-walk system, a car-dependent location, and exclusive healthcare land-use leaves the footpaths empty. The meticulously landscaped gardens and public spaces are wasted.

Designers and administrators are working to overcome the barriers to vibrant precincts; high land costs and burgeoning healthcare space requirements limit opportunities. But modest initiatives in external space can deliver large benefits.

At the Gold Coast University Hospital, courtyards provide opportunities for fresh air and quiet conversation.  The Necker Hospital in Paris is replacing obsolete buildings with a park.  In Boston, small public spaces host musical performances to coax staff outside. In Melbourne’s Parkville, public seating has come a long way since the old wooden park bench, and at Sydney’s Westmead Hospital precinct, a new vision that prioritises walkability and community integration is just beginning.

These small acknowledgements of the importance of street level activity suggest a willingness to invest in public realm projects for the good of patients, staff and the community. High quality design of the spaces between buildings plays a crucial role in inviting everyone to step outside for a moment.

This research project was funded by the National Association of Women in Construction, and Cult Design. The full report can be accessed here: http://apo.org.au/node/53548

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