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- Could you briefly explain what the initial situation was for the renovation of the Privée Ward at Hirslanden Klinik Stephanshorn and what objectives the project aimed to achieve?
With the Hirslanden Group’s decision to close Hirslanden Klinik Am Rosenberg in Heiden, it became clear that Hirslanden Klinik Stephanshorn would need to accommodate more patients. In particular, the clinic lacked adequate private rooms. As part of a feasibility study for the renovation and extension of the hospital, we were able to demonstrate that the space becoming available on the 4th floor of the annex building could be used to meet the demand for a Privée Ward on a short-term, interim basis. The Privée Ward, with its nine rooms, serves as an extension of the existing inpatient ward on the 4th floor and can therefore be integrated very effectively into the existing hospital infrastructure, both operationally and logistically.
- What distinguishes a hospital renovation from a conventional construction or refurbishment project?
Depending on the use of a building, renovations and conversions involve different levels of complexity that need to be taken into account, particularly when the building remains operational throughout the construction process. Renovation work in a hospital places very high demands on both planning and execution. On the one hand, there are the operational requirements, which include workflows, supply and disposal routes, hygiene, and so on. On the other hand, there is the building’s infrastructure, including all building services – electrical systems, heating, ventilation, air conditioning, plumbing, medical gases, and so on – as well as the building’s structural integrity and its physical, acoustic and fire safety requirements. In practical terms, this means that, for example, the existing documentation for ventilation systems or electrical installations first needs to be reviewed and checked.
Unfortunately, the as-built documentation is often not fully up to date, as minor changes may have been made in the meantime. Wherever possible, this needs to be verified through on-site inspections and by looking into the suspended ceilings. This allows us to establish before construction begins which installations can be dismantled and how the new installations can be integrated into the existing system. We must never, for example, cut an electrical or ventilation line that is still supplying medical equipment in another area – the consequences could be fatal. In addition to all these aspects, it is of course also essential to ensure hygiene and safety at all times. With regard to hygiene, clear separation is required. The construction site must be a separate area, clearly segregated from hospital operations. This includes the delivery and disposal routes for the construction site, as well as the routes used by construction workers.
When it comes to safety, clear concepts are required that take the progress of the construction work into account. In particular, escape routes within the hospital and those on the construction site must be maintained at all times.
- How do you organise construction processes, material deliveries and the coordination of contractors when patients, medical staff and hospital operations all have to continue at the same time? What are the key factors?
I think communication is key here. Everyone working at the hospital needs to be informed about the renovation project and why it is necessary. It is important that everyone understands the objectives of the renovation, because only then, for example, can the nursing staff answer patients’ questions.
- What role do factors such as access routes, transport routes, working hours and noise levels play in a renovation project like this?
A very significant one. As mentioned earlier, the construction site needs to be a self-contained, separate area, and the transport routes should not cross with those used by the hospital.
Working hours and permitted noise windows need to be defined with the clinic in advance and strictly adhered to. During the renovation of three operating theatres with an adjacent sterilisation unit while the hospital remained fully operational, we had an alarm bell installed on the construction site, as two of the operating theatres were always in use. Whenever the surgical team activated the alarm, all construction work had to stop immediately. Fortunately, this only happened once.
- Where was particular sensitivity and attention to detail required? Were there situations where short-term adjustments became necessary? How were these handled?
Sensitivity and careful coordination are always required wherever interfaces between different areas or parties arise. In the case of the Privée Ward, for example, we had to drill through the floor slab into the 3rd floor to install the drainage pipes for the showers, which of course had to be fully accessible, and connect them to the existing downpipes. However, the 3rd floor is occupied by a medical practice that had to remain fully operational at all times. We therefore defined clear time windows for particularly noisy work and, at the same time, coordinated the interventions on the 3rd floor in a detailed day-by-day schedule.
- Does direct communication also extend to the patients?
No, there should be no direct communication between the planning team and patients. Communication with patients must always be handled through the client’s project management team or the hospital itself.
- How does the ongoing hospital operation influence architectural decisions and the design of the new spaces? Do you sometimes have to compromise?
It is less the ongoing hospital operation that influences the architectural decisions and more the existing spatial conditions of a renovation project. The annex building was constructed as a skeletal structure, meaning that we had an existing column grid but no load-bearing walls. This gave us the advantage of being able to remove all the existing walls and redesign the spaces based on the column and façade grid. As the walls were lightweight partitions, the resulting noise impact was also relatively low.
For the bathrooms, however, we had to remove the existing screed in the shower areas during the agreed time windows. We did have to make some compromises when it came to the ceiling heights. Since the floor-to-floor heights of the existing building were fixed, this had to be taken into account when coordinating the building services. The existing floor-to-floor height was already quite low, so we developed a concept in which the various building services could be routed with almost no intersections.
At the same time, new fire safety regulations had to be taken into account, particularly regarding fire stopping around wall penetrations. Ultimately, we had to install the ceiling in the corridor 5 cm lower than originally planned.
For more information about the project, click here.
Credit Michael Orlik
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