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Why hospital design matters: A narrative review of built environments research relevant to stroke care

Julie bernhardt.

1 Stroke, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia

Ruby Lipson-Smith

Aaron davis, marcus white.

2 Centre for Design Innovation, Swinburne University of Technology, Hawthorne, Australia

Heidi Zeeman

3 Menzies Health Institute Queensland, Griffith University, Brisbane, Australia

Natalie Pitt

4 Silver Thomas Hanley (STH) Health Architecture, Australia

Michelle Shannon

Maria crotty.

5 Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia

Leonid Churilov

6 Melbourne Medical School, University of Melbourne, Parkville, Australia

7 School of Education, Health and Social Studies, University of Dalarna, Falun, Sweden

Healthcare facilities are among the most expensive buildings to construct, maintain, and operate. How building design can best support healthcare services, staff, and patients is important to consider. In this narrative review, we outline why the healthcare environment matters and describe areas of research focus and current built environment evidence that supports healthcare in general and stroke care in particular. Ward configuration, corridor design, and staff station placements can all impact care provision, staff and patient behavior. Contrary to many new ward design approaches, single-bed rooms are neither uniformly favored, nor strongly evidence-based, for people with stroke. Green spaces are important both for staff (helping to reduce stress and errors), patients and relatives, although access to, and awareness of, these and other communal spaces is often poor. Built environment research specific to stroke is limited but increasing, and we highlight emerging collaborative multistakeholder partnerships (Living Labs) contributing to this evidence base. We believe that involving engaged and informed clinicians in design and research will help shape better hospitals of the future.

Introduction

Imagine (re-)designing the very hospital you work in. What would you design differently? What would you change, to benefit you, your patients, and their families? What evidence might help guide those design decisions?

Healthcare facilities are among the most expensive buildings to construct, maintain, and operate. 1 Once built, hospitals remain in service for decades and are difficult to modify. With stakes this high, considering how building design best supports healthcare services is important. In this narrative review, we outline why the built environment matters, with particular focus on stroke care. We also discuss challenges inherent in designing healthcare environments, undertaking research and evaluating completed architecture.

The planning and design process for new healthcare environments is incredibly complex, but, in general, it occurs in three overlapping stages: (1) the planning stage in which the healthcare provider describes the users’ needs, model of care, and clinical program in a functional brief that summarizes the requirements for the new hospital; (2) the design stage in which these requirements are interpreted by architects to develop an initial concept which is then refined to a more detailed design; and (3) the delivery stage in which the building is constructed. The extent to which hospital staff and patients are included at each stage of this process can vary significantly between projects. 2

Healthcare professionals have long advocated for design features thought to benefit health and well-being, such as natural light, ventilation, and space between patients—for example, the circular hospital design proposed by the physician Antoine Petit 3 and long “Nightingale wards” proposed by Florence Nightingale. 4 Hospital design is now informed by a process termed “evidence-based design” (EBD), in which research evidence is used alongside other considerations such as the healthcare context, budget, and architects’ experience, to inform the design of the healthcare built environment. 5 , 6 In this context, the “healthcare built environment” encompasses: (1) the physical construction (layout, room dimensions, doors and window placement, outdoor and community access, etc.), (2) ambient features (noise, air quality, light, temperature, etc.), and (3) interior design (furniture, signage, equipment, artwork, etc.). 7 Analogous to evidence-based clinical practice, hospitals designed following best research evidence garnered from EBD processes have better safety, patient outcomes, staff retention, and operation costs. 8 , 9 The Center for Health Design, established in 1993 to advance EBD, now maintains a repository of over 5,000 articles on healthcare design ( https://www.healthdesign.org ).

The field is growing; however, many healthcare contexts, including stroke, have a limited built environment evidence base. 10 Establishing geographically organized stroke units has been an important focus 11 ; however, these studies rarely address specifics of the built environment, and we know little about optimal stroke unit design. Stroke clinical guidelines rarely mention the built environment nor provide guidance on how the environment might best support care. There are currently no stroke care-specific building standards, nor standardized checklists to evaluate the quality of these environments. 12

Why is the built environment neglected? Clinicians may identify as knowing less about how the environment might influence patient care or staff well-being. They may also feel uninformed about the design process and how to contribute their clinical expertise to influence decision-making. To begin to address these gaps, our objectives for this review were: (1) to introduce readers to healthcare built environment research and (2) to highlight evidence that underpins acute, subacute, or rehabilitation stroke care facility design. This review is in three parts:

• Overview of healthcare built environment research;
• Stroke care built environment evidence; and
• Planning and design of new healthcare environments: Challenges and opportunities.

We include research from recent, relevant systematic reviews, other evidence summaries, and selected qualitative and mixed-methods research focusing on healthcare environments and design. Healthcare environments are complex and context-specific, with many interdependent variables that can rarely be isolated. This complex system does not readily lend itself to highly controlled experimental research designs in real-life settings. 13 Qualitative methods, such as case studies and pre- and post-occupancy evaluations (before and after a redesign or redevelopment), are common. With research still developing, heterogeneity exists in research designs, outcomes, environments, populations, and theoretical frameworks employed. 14 Hence, robust summary evidence derived from meta-analyses is lacking.

Healthcare built environment research

Research is dominated by studies conducted in acute environments such as emergency, surgery, and intensive care units (ICUs) ( Figure 1 ). 6 , 15 , 16 Older people, including those in dementia care, are frequently studied post-acute populations. 17

The volume of built environment research conducted in different healthcare settings. Circle size indicates the number of published research articles based on systematic literature review in preparation 18 and articles listed in the Centre for Healthcare Design research repository. Pink circles represent all built environment research, and the dark gray circles indicate stroke-specific research. (The aerial sketch in this image has been adapted with permission from Architectus + HDR.)

In this section, we introduce three topics relevant to most healthcare contexts: (1) design of internal spaces; (2) outdoor spaces; and (3) ambient features including light, noise, and air quality (with particular focus on infection control).

Internal spaces

The design of internal spaces, such as ward configuration, corridor design, and nurse station placements (centralized vs. decentralized), can influence patient visibility, safety, teamwork, distances staff walk in a shift, and time spent providing direct care to patients. 10 For example, open-plan, larger convex spaces can lead to greater patient visibility, and corridor width impacts staff circulation, informal communication, and teamwork. 19 In ICU, designs with centralized nurse stations and visibility of most patient rooms from that location are increasingly being replaced with decentralized nurses’ stations, arguably without strong evidence. 19 In emergency departments, with similar critical visibility requirements for teamwork and patient monitoring, some authors argue that physically separated zones or “pods” are neither efficient nor safe. 20 Decentralized nursing stations can lead to more patient room visits by staff. 21 , 22 This highlights current uncertainties.

The layout of hospital spaces and line of sight influences patient and visitor orientation and their ability to find their way around (“wayfinding”). 23 Signs, information boards, and “landmarks” (artwork, furniture, views, etc.) are typical wayfinding elements. 24 , 25 Inadequate wayfinding leads to delays in accessing services or finding people or places, associated stress, and higher staff burden as they provide directions for lost individuals. 25 While some standards exist, wayfinding is often not optimized in healthcare. 26

The proportion of single versus multiple(two or more)-bed rooms is a prominent ward design consideration. There is evidence that single rooms can support staff/patient communication, privacy, infection control, and noise reduction, but they are also associated with patient isolation and increased falls risk. 27 This evidence is, however, of mixed quality, limited to certain populations, with neutral and/or contrary results. 27 A higher proportion of single rooms generally results in longer corridors, longer staff walking distances, perceived decrease in patient visibility due to compromised sightlines, and higher construction and cleaning costs. 28 The inherent trade-offs will be different in every healthcare context. Less controversial is location of sinks and hand sanitizers; highly visible and standardized positioning promotes more consistent use. 29 , 30

Outdoor spaces

Hospital gardens were historically commonplace 31 ; however, less priority has been given to green space over time. Access to the outdoors and time in nature has been linked to stress reduction, improved physical symptoms, and emotional well-being in many healthcare settings. 32 Views of nature have been linked to reduced length of stay. 33 Good hospital garden design principles include creating opportunities for exercise, exploration, socialization, and to engage with and escape in nature. 32 Surprisingly, patients and visitors are often not aware of hospital gardens, and proactive approaches to increasing patient and family use of gardens have been recommended. 34 Usually conceptualized as spaces for patients and visitors, staff are often their primary users. 32 Outdoor spaces can be restorative for hospital staff, helping to reduce stress and improve attention, which may improve patient care and staff retention. 35

Ambient features

Ambient features, such as light and noise, can impact patient well-being and comfort, sleep, and communication with staff. 36 , 37 Light and noise also impact staff well-being and attention 38 and contribute to medication errors and other safety concerns. 39

Air quality is important for both comfort and infection control. Infection control is particularly prioritized in acute environments and is receiving deserved attention in the COVID-19 pandemic. A recent review of COVID-19 transmission showed that spatial configuration can affect patient density and thereby transmission. 40 Optimized systems for heating, ventilation, and air conditioning (HVAC) can filter microparticles such as viruses. Different HVAC systems also affect humidity, airflow velocities, air pressure—all important for exposure to active aerosols. Window ventilation, daylight, and electric UV light are recommended to aid disinfecting surfaces and use of surface materials that affect pathogen survival. 40

Stroke care built environment evidence

In this section, we outline how the built environment can influence important outcomes such as: (1) evidence-based stroke care, including rehabilitation; (2) efficiency of stroke care, staff processes, and communication; and (3) patient safety and well-being. The evidence-base specific to stroke care is small. 41 In Figure 2 , we summarize the design features and how they may influence a range of outcomes including patient and staff behavior. This should be considered illustrative rather than exhaustive. Where possible, we draw directly from stroke or brain injury-specific evidence, supplementing evidence from other populations where relevant.

A summary of the evidence specific to stroke care environments. Dotted lines = a hypothesis, garnered from research in other populations; thin lines = limited evidence, < 3 studies; thick lines = moderate evidence, ≥ 3 studies, based on systematic literature review. 41

Evidence-based practice including rehabilitation

We found no stroke-specific research to underpin built environment recommendations for optimal delivery of either time-critical acute stroke treatments or evidence-based care, including rehabilitation. Guidelines recommend early commencement of both structured and incidental physical, cognitive, and social activity for all stroke patients, 42 , 43 although recommended levels vary. Patients in both acute and subacute environments spend most of their day alone and inactive in their bedroom. 44 , 45 While we can hypothesize that providing “draw-them-out” features on a ward may improve activity and engagement, evidence is limited. These features may include green spaces and indoor communal (social) spaces. Unfortunately, communal spaces, when present, often appear to be underutilized in both acute 46 and rehabilitation environments. 47 Many factors may influence whether patients use communal spaces, including not knowing they exist or where to find them, difficulty accessing them without help, or feeling they don’t have permission to use them. 48 In a Norwegian study across 11 stroke units with communal areas, patients were more active and spent less time in their bedroom in units where meals were served in the communal area. 49 Providing resources (games, music, books) in personalized activity packs and in communal spaces (“environmental enrichment”), with the aim to improve physical, social, and cognitive activity, has recently been tested in acute and subacute settings with mixed results. 50 – 52 Importantly, this approach relies on staff to encourage use and engagement, rather than embedding activity opportunities into the building itself. Hallways and circulation spaces are generally underrecognized as providing spaces for incidental activity and interaction. 53

There is limited stroke-specific research about the value or harm of single- versus multiple-bed rooms. A higher proportion of single rooms may be associated with lower levels of patient activity in acute stroke. 54 , 55 A systematic review of single- versus multiple-bed rooms in older people and those with neurological disorders found potential benefits (e.g. infection control, patient satisfaction) and harms (e.g. falls, isolation) with single rooms. 56 In rehabilitation facilities with a high proportion of single rooms, patients emphasize the importance of communal areas. 57 Further work is needed to identify and test how modifications to layout and communal and circulations spaces could enhance patient engagement, activity, and optimal care provision.

Efficiency of care, staff processes, and communication

Interprofessional communication and teamwork between physicians, nurses, and allied health professionals supports best practice stroke care. 11 Shared staff spaces support team communication and collaboration, enabling better understanding of patient needs, and greater knowledge about other team roles. 58 , 59

Therapy spaces are often discrete locations (e.g. gym, occupational therapy rooms), rather than being holistic, context-based environments that reflect the connectivity and continuity necessary for rehabilitation and transition beyond discharge. 60 , 61 Separation of clinical and therapy spaces can impact staff travel time, patient practice and activity, and even clinical decision-making. For example, Blennerhassett et al. 47 found that patients spent less time engaged in physical activity and more time in corridors when the ward was located further from the gym, on a separate floor. This also impacted wheelchair use and patient travel time. 47 Inaccessible therapy spaces can also change therapists’ intervention choices. 62

Safety and well-being

Falls are common after stroke, 63 yet the relationship between the built environment and falls is largely unexplored. The presence of a fellow patient (multiple-bed room) may help reduce falls, especially for older patients with neurological injury. 56 , 64 Roommates play an important role in monitoring the physical and mental health of others in stroke rehabilitation. 48 Stroke patients often experience loneliness when in hospital, 65 , 66 and some patients will choose a shared room over the privacy of a single room. 57 Sleep is important for recovery. Unsurprisingly, visual and aural privacy is less in multiple-bed rooms. However, noise traveling between corridors and bedrooms and lack of dedicated staff spaces for confidential conversations are also important. 48

Planning and design of new healthcare environments: Challenges and opportunities

Healthcare environments research and design is a multistakeholder endeavor involving government, healthcare providers, managers, clinical staff, patients, architects, quantity surveyors, construction companies, building managers, etc. This collaborative process can be challenging, 67 , 68 considering interdisciplinary differences in knowledge and approaches. 69 The complexity of hospital procurement and the fact that design and construction processes are foreign to many healthcare professionals adds further challenge. Clinicians often do not understand what the “user group” consultation process is supposed to achieve, and their involvement may be inconsistent throughout the design process, which limits their contribution to the process and ability to influence decisions. 67 While collaboration between architects and healthcare professionals is not new, 70 limited evidence informs current consultation processes. 67 , 71 High-quality healthcare environments are produced when shared decision-making and collaboration happens across healthcare, construction, and architecture to create designs based on evidence and end-users’ perspectives. 69

A number of research approaches are suggested to facilitate this collaboration, including participatory design, co-design, and Living Labs. 2 , 72 , 73 Over many years, our team has built partnerships between healthcare environment practitioners, clinicians, researchers, and people living with stroke, which have served to create a common understanding of the barriers and opportunities for redesigning and optimizing stroke care environments. With the creation of the Neuroscience Optimized Virtual Living Lab (NOVELL) for stroke rehabilitation redesign ( www.novellredesign.com ), we are working to develop new models for stakeholder engagement and research, and to contribute new evidence to stroke rehabilitation design.

In addition to collaboration challenges, research is infrequently embedded in the planning and design of new healthcare environments, and leaders in EBD have long called for appropriately funded, transparent, and freely available evaluations of completed buildings. 74 – 76 Given the cost of constructing and running healthcare buildings, the absence, or non-disclosure, of evaluations to determine whether desired outcomes were met is concerning. 77 , 78 Hospital design and construction is underpinned by technical and generic building guidelines and standards that differ within and between countries. The degree to which these standards are “evidence-informed” varies. In stakeholder consultations, understanding what is evidence-based and what is open to change can be difficult. Design innovation is essential if hospital buildings are to respond to new healthcare models or processes. For example, the recent COVID-19 induced surge in utilization of telehealth and other e-health technologies for rehabilitation, other treatment, and communication with people with stroke has implications for healthcare design, increasing demand for spaces for videoconferencing, equipment storage, and potential changes to waiting rooms and on-site consultation spaces. 79 , 80 Future design considerations for stroke recovery should also extend to the home environment. 81

The built environment matters. It can impact healthcare delivery and patient and staff outcomes. An evidence base is growing in some areas of healthcare design, while others require significant further research. The potential for both hospital and health services design innovation is strong. By continuing to build this evidence base, EBD can complement architectural processes to deliver high-performing healthcare assets. Involving engaged and informed clinicians in built environment design and research will help shape hospitals of the future.

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: NOVELL is funded by the Felton Bequest and the University of Melbourne. Julie Bernhardt is funded by an NHMRC Research Fellowship (1154904). The Florey Institute of Neuroscience and Mental Health acknowledges support from the Victorian government and in particular funding from the Operational Infrastructure Support Grant.

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Architectural evaluation of healthcare facilities: a comprehensive review and implications for building design.

1. Introduction

Addressing demographic shifts and healthcare challenges through architectural innovation, 2. materials and methods, analysis of evaluation methods for healthcare facilities’ review, 3.1. architectural and design guidelines for healthcare institutions, 3.2. user experience and satisfaction in healthcare institutions, 3.3. sustainability and health in healthcare institutions, 4. discussion, 4.1. contextualization and interpretation, 4.2. comparison with previous research, 4.3. implications—integrated healthcare architecture framework (ihaf).

• Inclusive design process: IHAF’s inclusive design process ensures that the voices of all stakeholders are heard and integrated. This approach leads to creating spaces that are not just architecturally sound but also empathetic to the needs of patients, healthcare workers, and visitors. It fosters a collaborative design environment, resulting in more effective and user-friendly healthcare facilities.
• Adaptive and flexible spaces: The emphasis on adaptive and flexible spaces allows healthcare facilities to remain relevant and functional in the face of rapid technological advancements and changing healthcare demands. This component ensures that healthcare architecture is not static but evolves, accommodating new treatments, technologies, and patient care models.
• Patient-centric design: By prioritizing patient-centric design, IHAF ensures that healthcare facilities are not just places for treatment but also spaces that promote healing and well-being. This aspect of the framework focuses on creating a supportive and comforting environment for patients, which is crucial for their recovery and overall experience.
• Staff efficiency and well-being: Recognizing the critical role of healthcare staff, IHAF places equal importance on designing spaces that enhance staff efficiency and well-being. Efficiently designed workspaces can significantly reduce stress and burnout among healthcare professionals, leading to improved patient care and staff satisfaction.
• Eco-friendly practices: IHAF’s commitment to eco-friendly practices ensures that healthcare facilities contribute positively to the environment. This approach aligns with global sustainability goals and can lead to cost savings in the long run through the efficient use of resources.
• Green spaces: Integrating green spaces within healthcare settings under IHAF enhances the aesthetic appeal and provides therapeutic benefits to patients and staff. These spaces serve as areas for relaxation and respite, contributing to the overall healing environment.

4.4. Assessing IHAF against Existing Approaches

• Existing approaches: Traditionally, healthcare architecture has focused on functional and operational efficiency, adhering to standard architectural guidelines and regulations. These approaches often prioritize technical and operational aspects, sometimes overlooking the diverse needs of end-users [ 26 ].
• IHAF: The IHAF introduces an inclusive design process, actively involving patients, healthcare workers, and architects. This approach ensures that facilities are operationally efficient and cater to all stakeholders’ diverse needs. The IHAF’s emphasis on adaptability accommodates evolving technologies and patient needs, marking a significant shift from traditional, more rigid design methodologies [ 29 , 37 ].
• Existing approaches: Conventional designs often prioritize operational efficiency and cost-effectiveness, compromising patient comfort and staff well-being. The focus is typically on the physical layout and technical aspects, with less consideration for the experiential aspects of the users [ 28 ].
• IHAF: Places a strong emphasis on patient-centric design, ensuring facilities are functional, comforting, and stress-reducing. The IHAF equally values the well-being of healthcare staff, advocating for efficient and positive work environments. This holistic approach to design under the IHAF contrasts sharply with the more practical focus of traditional methods [ 27 , 30 ].
• Existing approaches: Sustainability in traditional healthcare architecture often comes as an afterthought, focusing primarily on energy efficiency and operational cost reduction. While these are important aspects, they only encompass part of the spectrum of sustainability [ 35 , 36 ].
• IHAF: Integrates eco-friendly practices and green spaces as fundamental components of the design process. This comprehensive approach to sustainability extends beyond mere energy efficiency, encompassing a broader environmental perspective that includes patient and staff well-being, offering a more holistic approach to sustainable healthcare architecture [ 33 , 38 ].

4.5. Empirical Insights from Evidence-Based Hospital Room Design

4.6. limitations and recommendations for future research, 5. conclusions, author contributions, data availability statement, conflicts of interest.

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Jaušovec, M.; Gabrovec, B. Architectural Evaluation of Healthcare Facilities: A Comprehensive Review and Implications for Building Design. Buildings 2023 , 13 , 2926. https://doi.org/10.3390/buildings13122926

Jaušovec M, Gabrovec B. Architectural Evaluation of Healthcare Facilities: A Comprehensive Review and Implications for Building Design. Buildings . 2023; 13(12):2926. https://doi.org/10.3390/buildings13122926

Jaušovec, Marko, and Branko Gabrovec. 2023. "Architectural Evaluation of Healthcare Facilities: A Comprehensive Review and Implications for Building Design" Buildings 13, no. 12: 2926. https://doi.org/10.3390/buildings13122926

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The hospital of the future: rethinking architectural design to enable new patient-centered treatment concepts

• Original Article
• Published: 15 December 2021
• Volume 17 , pages 1177–1187, ( 2022 )

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• Carlos Amato 1 ,
• Leslie McCanne 1 ,
• Chengyuan Yang 1 ,
• Daniel Ostler 2 ,
• Osman Ratib 3 ,
• Dirk Wilhelm 2 , 4 &
• Lukas Bernhard   ORCID: orcid.org/0000-0002-9729-8928 2  

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Today’s hospitals are designed as collections of individual departments, with limited communication and collaboration between medical sub-specialties. Patients are constantly being moved between different places, which is detrimental for patient experience, overall efficiency and capacity. Instead, we argue that care should be brought to the patient, not vice versa, and thus propose a novel hospital architecture concept that we refer to as Patient Hub . It envisions a truly patient-centered, department-less facility, in which all critical functions occur in the same building and on the same floor.

To demonstrate the feasibility and benefits of our concept, we selected an exemplary patient scenario and used 3D software to simulate resulting workflows for both the Patient Hub and a traditional hospital based on a generic hospital template by Kaiser-Permanente.

According to our workflow simulations, the Patient Hub model effectively eliminates waiting and transfer times, drastically simplifies wayfinding, reduces overall traveling distances by 54%, reduces elevator runs by 78% and improves access to quality views from 67 to 100% for patient rooms, from 0 to 100% for exam rooms and from 0 to 38% for corridors. In addition, the interaction of related medical fields is improved while maintaining the quality of care and the relationship between patients and caregivers.

With the Patient Hub concept, we aim at rethinking traditional hospital layouts. We were able to demonstrate, alas on a proof-of-concept basis, that it is indeed feasible to place the patient at the very center of operations, while increasing overall efficiency and capacity at the same time and maintaining the quality of care.

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Current healthcare systems around the world are characterized by the organizational principles of segmentation and separation of medical specialties. They are structured into departments and facilities which offer the best service in their respective field but are not properly coordinated or tightly linked to the rest of the healthcare ecosystem. Consequently, today’s hospitals seem more a collection of different “departments” and medical fields than a fully integrated cooperative and service-oriented facility. Each department uses its own workflow schemes or standard operative procedures (SOP), employs specially trained personnel, and runs its medical service in well-circumscribed and precisely defined structures and areas. Communication between disciplines is often limited to the absolute minimum necessary for coordination tasks, e.g., regarding forwarding of relevant patient information and time scheduling of examinations or interventions.

The current system requires patients to step from doctor to doctor and from department to department to collect the jigsaw puzzle pieces of their disease. It is a serious drawback of current hospital structures that patients often need to tell their medical history and symptoms over and over again to the medical staff of different disciplines and subspecialties. The request and scheduling of different diagnostic examinations across departments are often confined to a very succinct standard requisition, neglecting the exchange of any additional patient-specific information (e.g., the anatomical reconstruction after gastric surgery in case of a postoperative CT scan to rule out complications). This data that are essential for appropriate programming and interpretation of diagnostic procedures is often non-accessible to the physician performing the exams. We call this “incremental care” and in this traditional model, the patient is constantly moved around to receive care (Fig.  1 depicts an exemplary traditional patient’s pathway). While some of these issues could be addressed by optimizing the clinical communication and data storage infrastructure, we believe that by means of architectural choices it becomes possible to further benefit and simplify the necessary workflows and to reduce the amount of required technology.

Traditional Incremental “Patient to Care” flow: the patient is constantly being moved between departments, typically starting from clinical reception, followed by examinations, diagnostics, treatments, ward stays and other way stations. Due to the highly fragmented structure, a direct access of external parties, especially academia and industry, is aggravated

Current hospitals are organized around well-separated specialized clinics and expert units, which all by themselves are perfectly tuned for economically optimized and efficient use of their dedicated infrastructure (e.g., the operating room in surgery or the MRI in radiology) and make efforts to reduce the cost of personnel wherever possible. Profit has become the main driver of healthcare and everything else including patient satisfaction and even quality of care often comes as a second priority. However, financial profit is generally not assessed on a global scale of patient management services but rather on the level of subsystems and specialized services, with a focus on separated profit centers which results in higher global costs rather than reducing them due to inefficient coordination and consolidation of clinical pathways. “Service-oriented” care units refer more to medical services (or equipment) and teams providing dedicated care, rather than to patient-centered care facilities. This often results in inefficient workflows such as excessive and unnecessary time spent in waiting rooms, which is becoming prevalent in large facilities.

Although system optimization works well for a specialized and restricted field, e.g., a department or a single facility, the entire healthcare system has grown enormously toward becoming rigid, not-adaptive, and slow. It is not designed for the active prevention of disease, but for mere reaction in case an adverse health event or development arises. This approach entails that the patient suffers more overall, since diseases are allowed to develop and manifest themselves before they are finally diagnosed and treatment can be started. At the same time, the burden for clinical care facilities increases as well, since treatments become more complex and result in longer durations of stay. The preventive approach has been advocated for quite some time now [ 1 ] and its benefits have become very obvious during the recent Covid-19 pandemic [ 2 ].

Although “interdisciplinary care” and “overarching approach” represent typical buzzwords of modern treatment concepts, the integration of involved clinical disciplines remains on a low level. One notable exception is acute trauma or emergency management where any active action is focused on the patient and collaboration is crucial to handling critically vital situations. The growing field of emergency medicine could serve as a model for a more global paradigm shift, as an example of healthcare delivery that is, above all, patient-centered. In such a context, interdisciplinary communication is highly standardized involving all persons and services required for well-protocoled patient management scenarios. Services are brought to the patient, and not vice versa, and anything and everybody involved is geared to facilitate a fast and comprehensive treatment. It has been shown that the patient-centered multidisciplinary approach, at least for acute trauma, can save lives and is superior to traditional concepts [ 3 ]. So, one might ask whether such an approach could also be beneficial for other indications or even for general care? And if so, will this new concept maintain the current standard of care and the relationship between caregivers and patients?

As a central building block for addressing the issues described in the previous we present our new hospital concept that we refer to as Patient Hub . It envisions a truly patient-centered, department-less facility, where all the critical functions occur on one floor. While our idea is not intended to solve all of today’s hospital design flaws (and we are fully aware that one solution will never fit all models), we aim at providing concepts and tools to help re-think traditional designs.

We developed a novel, one-of-a-kind design concept for the hospital of the future. The envisioned facility is fully patient-centered and strives for a workflow-oriented design by clustering related functionalities and processes in defined hubs, all located on the same floor and in close proximity to each other. In order to demonstrate the effectiveness and added value of our proposed hospital architecture, we benchmarked this new concept against a traditional design. For that, we reconstructed both the Patient Hub and an exemplary traditional hospital layout using 3D simulation software and compared them with regard to workflow efficiency and patient satisfaction. For the initial analysis presented here, we chose a typical patient scenario based on a common real-world case.

The patient hub concept

Today’s hospital buildings are often fancier versions of the 1960s bed-tower-on-diagnostic-and-treatment podium model, with a lot of newer technology crammed inside. In accordance with the principle of decentralization, which is prevalent in many healthcare systems around the world [ 4 ], such environments are characterized by being divided into departments and individual silos, each possessing its own organizational structure (including permanent staff, assigned space and beds), optimized for operational and financial efficiency. The patient is moved around from place to place to receive care, instead of bringing the care and technology to the patient (e.g., infrastructure like CT or MRI is often inconveniently and remotely located in a different building, as illustrated by Fig.  2 ).

Functional stacking of (traditional) Template Hospital used for simulation comparison

In contrast, our Patient Hub concept is a radical departure from the way traditional hospitals are designed. It envisions a transformative “one of a kind” and truly patient-centered, department-less facility. We propose a highly centralized clinical layout, where all relevant medical fields of expertise are available within the same space surrounding the patient (see Figs.  3 and 4 ). They form clusters which contain functionalities of equal classes, as for example examination , out-patient care or administration . For the patient, the whole system has a single-entry point to simplify wayfinding and is designed to minimize patient movement. The centralized clinical layout brings together staff from all specialties to encourage clinical collaboration and care coordination, thereby stimulating health care performance [ 5 ]. Instead of facilities being distributed along the hospital, and most often on different levels or even buildings, the new design concept aims at achieving a logical and self-explaining layout by bringing together what belongs together. However, the vision of the Patient Hub encompasses much more than a traditional hospital: This new environment (or ecosystem) co-locates outpatient, inpatient, rehabilitation, wellness and prevention, ancillary support spaces, and industry (research and development) all under one roof. It is envisioned to be no longer just a site for the treatment of the sick but a health-oriented all-encompassing facility, which is achieved by implementing patient-centered structures and workflows as well as by an expansion of services to also incorporate prevention and wellness.

Re-imagined healthcare paradigm: changing from incremental “patient to care” approach toward a re-imagined “care to patient” approach

Concept diagram illustrating “all under one roof” collaborative Patient Hub concept

Instead of being department-oriented, the Patient Hub design follows a more functional approach. To avoid getting lost in the sub-channels of the system (different departments with specific ecosystems), the architecture is logically constructed and patient-centered. It features a single point of entry, and a central meet and commute “core” to which the relevant facilities (housing, examination, out-patient care, administration) are linked, just as the arms of a tree are joined to the trunk. For the reduction or even full avoidance of patient moves, the respective areas cluster the required functionalities on one site. This will be done irrespective of the affiliated department or responsibility. Instead of passing from the radiologic department in level A to cardiology in level D to complete the pre-operative check-up, the patent will now move from one to the other door, as depicted in Fig.  5 .

Re-imagined “Care to Patient” flow diagram indicating functional adjacency needed to deliver patient-centered care

By avoiding duplicating functionalities which today are replicated in every department (e.g., waiting rooms, registration area, observation area) the Patient-hub concept aims at saving space, simplifying patient pathways, and facilitating implementation and adaptation of new treatment concepts. While keeping this functional patient-hub design with all required functionalities being logically distributed on one floor, we envision different levels of the building to be adaptable to different patient needs and specialties, like surgery, medical treatment, rehabilitation, etc. (see Fig.  6 ).

Patient Hub functional stacking and 3D massing

Due to its horizontal layout and resulting space demands, the Patient Hub layout in its most essential form is best suited for freestanding greenfield hospitals. The hub floor of our current design requires an 8,000–9,000 square meter floor plate but can be scaled up and down depending on the number of beds and procedure space needed. Since a further increase of the horizontal expansion would start to contradict the goal of having a compact centralized hub with streamlined workflows and short routes, we instead propose to stack multiple independent Patient Hub units vertically. Thereby, it becomes possible to retain the compact size of each hub and keep all movements of a given patient on the same floor, while making more efficient use of the available building ground and increasing the overall capacity.

Patient scenario

Our exemplary scenario revolves around a patient being diagnosed for rectal cancer. First, the patient receives general examination and diagnostics according to current guidelines [ 6 ], which include endoscopy, pelvic MRI and CT. After physical examination, which, due to his age and existing comorbidities includes cardiologic assessment, the case is discussed in multidisciplinary consultations such as tumor conferences and the patient is scheduled for surgery. Preparation measures for surgery include obtaining the patient’s informed consent by the surgeon and anesthesia, as well as preoperative preparation such as bowel cleansing and blood tests. After the intervention, observation in the ICU is carried out for one day, before the patient is returned to the regular ward. In our scenario, an eventless postoperative course is observed, which is why only a chest x-ray is performed to examine the postoperative lung status. No other tests or assessment of anastomotic healing are undertaken. During the hospitalization, the patient has an interview with the surgeon, to discuss upon the results of surgery and eventually additional treatments, and another interview with the social worker to decide upon auxiliary measures. Finally, the patient is discharged from the clinic.

The case above describes a common situation that clinicians are dealing with regularly and is based on the organizational structure and standard operating procedures of a university hospital. We analyzed the necessary steps along this clinical pathway for a traditionally designed hospital. Even though we chose a complication-free course for our scenario, the resulting list of necessary steps contains 95 entries, many of which are describing a change of the patient’s location or time spent within various waiting rooms. Refer to Table 1 for an excerpt of this list.

Workflow simulation

Using the 3D simulation software FlexSim Healthcare™ (FlexSim Software Products, Inc., Orem, Utah, USA), we developed dynamic models for comparing various quality measures between our two different hospital layouts. FlexSim Healthcare is a standalone healthcare simulation product aiming to model patient flows and other healthcare processes. It is designed to help healthcare organizations to evaluate different scenarios and validate them before they are implemented. For that, one or several architectural models can be created, followed by the definition of patient journeys. During execution of the simulation, FlexSim can monitor data contributing to patient satisfaction, including the total time spent, time spent for each treatment, time proportion of receiving care, travel distances, etc. It can also be used to analyze staff and equipment utilization rates and help to balance staff workload and amount of equipment.

Modelling of architectural layout

We selected Kaiser Anaheim hospital, a traditional hospital with a similar size, to be compared to the Patient Hub. The construction of this hospital was based on a generic “template” hospital plan developed and used by Kaiser-Permanente, the US largest non-profit Health Management Organization (HMO) (Fig. 7 ). This plan was developed when the organization was required to replace half of its hospital beds in California due to new seismic regulations and resulted in a prototypical hospital “template” that can be built on virtually any site, with few modifications [ 7 ], with a minimum of effort, lead time, and government review [ 8 ]. The design aimed at incorporating the best known clinical practices and design success stories and was optimized for a fast and efficient construction process [ 7 ]. Due to these characteristics, and a broad and successful implementation, we have selected this layout as the best comparison available today.

Simulations within FlexSim Healthcare for a traditional hospital (Kaiser-Permanente); a 2D overview floor plan; b 3D rendering of 2nd floor; the right parts of the images show the linear workflow used for the simulation

The second model (see Fig.  8 ) represents our Patient Hub, i.e., a hypothetical department-less hospital layout based on patient-centered care activities and concentrated on a single floor. Both buildings were modeled in FlexSim based on the floor plans. The model elements essential to this process were those affecting patient travel distance and waiting time, including vertical transportation, wall arrangement and the available medical equipment.

a 2D view of main Patient Hub floor showing diagnostic and treatment, outpatient, universal inpatient patient ward and patient experience / public / interdisciplinary coordination core blocks; b 3D rendering of Patient Hub floor within FlexSim environment; showing simulation workflow study to determine and test ideal functional adjacencies

Definition of patient treatment journey

After implementing the models, we defined the patient scenario (see previous section) and created a list of healthcare services that this patient needs to receive. We programed the full process based on this list, from patient first entering the hospital, walking to each exam rooms, receiving direct care (endoscopy, CT, MRI, surgery), receiving indirect care (observation rooms, patient ward), consultation and rehabilitation, and finally leaving the hospital.

Definition of staff and equipment

We assigned medical staff (doctors, nurses, technicians, etc.), medical equipment (CT, MRI etc.) and transit equipment (wheelchairs, gurneys, etc.) to the simulation models. For each model, 2 CT machines, 1 MRI machine, 1 ergometer, 4 gurneys and 4 wheelchairs were available. The patients were supervised by 4 Doctors of Medicine (MD) and 4 Registered Nurses (RN) per medical specialty. Numbers were based on the size of the functioning area (according to industry standards) and are the same for both models in order to not affect the simulation results. We programed the full process of staff providing direct and indirect care including escorting and monitoring patients.

Using FlexSim we simulated the whole process from entering the hospital to exiting, and monitored key statistics including travel distance, major milestones, treatment times, waiting times, time proportion, utilization rate for both patient and staff. For both scenarios, we simulated the arrival of three patients every half hour between 8am and 9:30am, which amounts to a total of nine patients.

Comparative parameters

For measuring the performance of the two models, we selected multiple parameters, with a high focus on improving the patient experience:

Waiting and Transfer Time

Travel Distance

Number of Elevator Runs

Access to Respite Spaces, Nature and Quality Views

The first parameter Waiting and Transfer Time is arguably the most relevant for patient experience, staff workload and overall efficiency alike. By decreasing this parameter, the overall duration of the hospital stay can be shortened and resting/recovery time for the patient (i.e., time spent in the ward) can be maximized. Furthermore, staff members are less overburdened and can potentially use the gain in time for other tasks or patients, thus improving staff satisfaction and economic interests of the hospital. Admittedly, reducing transfer times likewise can serve to increase the throughput of patients, however, we did not intend to improve on this measure.

The parameter Travel Distance refers to the length of the path that each single patient needs to travel during the hospital stay. We split this into the following three parts reflecting the different stages of the patient’s pathway: Endoscopy , CT  +  MRI  +  Cardiology and Anesthesia  +  OR  +  ICU . Decreasing travel distance is desirable since long transfers between distant departments are a burden for patient and personnel alike and extend the duration of hospital stays.

Wayfinding refers to the complexity of the patient’s traveling route within the hospital. A high number of turns, stop-and-go’s, transfers paired with rather chaotic paths and destinations scattered across different buildings indicate a poor performance with respect to this parameter. Short and infrequent transfers paired with simple and uncomplicated routes within the same building and on the same floor indicate a good performance. For our initial assessment, we interpreted the patient’s path as a graph and used the number of nodes and edges as an abstract measure of complexity. In addition, we considered the number of locations requiring signage as a more user-oriented parameter.

The Number of Elevator Runs is another measure for the complexity of patient transfers. Elevators often are bottlenecks within hospital buildings and contribute to elongated transfer times, which is disadvantageous from patient, staff and economic perspectives. Therefore, a low number of elevator runs indicates better performance. Furthermore, elevator operation typically accounts for 3 to 8% of the total energy consumption of a building [ 9 ]. Thus, a decrease can have a positive impact on the hospital’s CO 2 footprint.

Hospital stays can be associated with high mental stress or anxiety for many reasons, such as individual ailments and separation from the outside world and everyday life. The bleak, functional and sterile look that hospital interiors tend to have, may further amplify this effect. However, there is overwhelming evidence and research indicating that having frequent Access to Respite Spaces, Nature and Quality Views influence our health outcomes and help mitigate this problem [ 10 , 11 , 12 ]. To evaluate the performance of our models with regard to this parameter, we analyzed the number of patient rooms, examination rooms and corridors providing quality views to gardens surrounding or located in between hospital buildings.

Numeric results of the workflow simulations for the parameters and models explained in the Methods section are given in Table 2 .

Our results presented in the previous section are promising, since a considerable improvement for every selected parameter can be observed. We see this as a proof-of-concept of our ideas. However, we want to stress that the investigated scenario is only a first step toward proving the feasibility of the Patient Hub concept. Other patient scenarios and combinations of them will lead to even more complicated situations and workflows, where we believe the benefits of the new patient-centered layout will become even more obvious—due to the reduction of bottlenecks and resulting improvements of target parameters relevant for patient experience. Generally, we interpret the simulation results as evidence for the postulation that, as healthcare strategies are expected to evolve toward more ambulatory and short-term hospitalization, facilities should focus more on optimizing their workflows rather than maintaining the priority of traditional inpatient procedures of hospitalized patients. Our study also concludes that a patient experience measurement or scoring system should be formally included in all hospital design simulations, although the construction of such an integrated index is still pending and requires the involvement of experts from different fields.

Clearly, the proposed layout has not yet been fully implemented in the real world and thus may be prone to problems that cannot be identified using the proof-of-concept approach presented in the manuscript. As of now, a test pilot project with limited scale is under construction in Philadelphia, which will accommodate 150 beds. This test project will be a valuable source of insights regarding problems and limitations of the Patient Hub concept.

Still, there are limitations that we are already aware of, especially regarding the size of the Patient Hub. It is neither reasonable nor feasible to scale up a single floor facility indefinitely to accommodate for more and more patients. The strengths of the centralized layout would be mitigated by the huge size and the whole system would presumably become sluggish and less efficient. Also, the available building ground would not be used very efficiently, as compared to a multi-level building. A possible solution to this is the stacking of multiple patient hubs (e.g., with different specializations) on top of each other. However, this would mean that diagnosis and treatment services need to be duplicated, which has been done in the past, but is not preferred by most hospital operators due to financial concerns.

A further limitation is that an integration of the Patient Hub concept into existing facilities is not possible. Thus, it is exclusively applicable to new building projects.

As of now, the proposed concepts mainly focus on architectural design and a translation to the real world will certainly require many more building blocks, such as AI (notably workflow scheduling/optimization), big data (collection and processing of health data) and robotics (e.g., self-driving assistance systems). In particular, we envision the entire infrastructure, including technical devices, spaces and functional units to become adaptive and mobile. For example, a medical / surgical patient room could be utilized as an ICU site (Universal Room). Intervention rooms could be suitable for surgery, interventional radiology or cardiologic manipulations. CT scanners and other assistance systems could be designed as self-navigating systems, to move independently to desired locations.

While we plan to incorporate such considerations into future work, we advocate a very deliberate use of technology, governed by the paradigm of bringing care to the patient and not solely by economic interests. As argued before, the new patient-centered approach is expected to increase patient satisfaction, to reduce overall procedure times (if combined with an intelligent real-time scheduling and organization system) and to even be superior regarding infection prevention. Moreover, such an adaptive environment will most likely contribute to the physicians’ satisfaction as well as foster collaborative and interdisciplinary work. At the same time, it will allow for fast and easy adjustment of the entire system according to the current number of patients and the prevailing diseases they are suffering from (e.g., in case of a pandemic). As shown in Fig.  9 , we envision the Patient-Hub to behave according to an expanding core model, where all activities can be centralized during times of low demand (e.g., at night) and expanded by reactivating auxiliary areas from hibernation to deal with higher workloads. A centralized layout would facilitate such an expansion and retraction as opposed to a traditional layout where all core functionalities are distributed throughout the hospital.

Functional design changes from a distributed pattern to an expanding core concept

The Patient Hub Design maintains the patient–caregiver relationship and the principle of patient-centered care delivery by preserving core aspects of current hospitals such as wards and operating theaters, which, however, are functionally rearranged and smartly repositioned within the Patient Hub. This rearrangement not only improves patient experience but also the patient-related communication and collaboration of physicians, further improving workflow and information exchange.

We believe “departments” will no longer define the basic structure of a hospital. Instead, patient requirements and functionalities, such as “operative care,” “infectious disease recovery”, “conservative oncology” or “preventive care” will be brought into focus. By using this revised interpretation of interdisciplinary patient-centered care for our Patient Hub concept, we are able to improve patient and healthcare workers experience and satisfaction while maintaining the current standard of care.

Lastly, we do not believe that economic parameters are deteriorated by the patient-centered approach. On the contrary, our simulation results show significant increases in efficiency throughout the facility, with less required staff members and less time required per patient. Therefore, we expect our approach to not only be beneficial for patients and employees, but to be cost effective and economically reasonable at the same time.

We have presented our vision of a novel patient-centered department-less hospital design referred to as the Patient Hub. While the realization of this vision clearly requires disruptive change regarding many aspects (such as clinical workflows, application of technology, functioning of the healthcare system in general), our main aim herein was to focus on re-inventing the architectural layout. For benchmarking the performance of our concept with regard to patient experience, we have defined a patient scenario and created simulation models for both the Patient Hub layout and a standard hospital template by Kaiser-Permanente. The simulation results were highly promising, showing clear advantages of the Patient Hub layout throughout all benchmark parameters. We see this as a proof-of-concept of our ideas and as an important validation before implementing the Patient Hub in the real-world.

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Carlos Amato, Leslie McCanne & Chengyuan Yang

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Daniel Ostler, Dirk Wilhelm & Lukas Bernhard

Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland

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Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany

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Amato, C., McCanne, L., Yang, C. et al. The hospital of the future: rethinking architectural design to enable new patient-centered treatment concepts. Int J CARS 17 , 1177–1187 (2022). https://doi.org/10.1007/s11548-021-02540-9

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Received : 06 July 2021

Accepted : 29 November 2021

Published : 15 December 2021

Issue Date : June 2022

DOI : https://doi.org/10.1007/s11548-021-02540-9

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Sustainable Healthcare Architecture - Designing a Healing Environment

Healthcare facility design is a complex endeavor that forces function to follow both form and quality. Healthcare facilities serve a wide range of functions from medical applications (i.e. diagnostic, treatment, emergency rooms, clinics, etc.) to functional programs (i.e. food services, housekeeping, waiting rooms, meeting areas, office space, etc.). Designers of a healthcare facility are required to look at every aspect of human life. These facilities are spaces people live (temporally for treatment) and work in, where they are born and die. With modern medicine’s reliance on technology and demanding building programs, designers of modern hospitals may view healthcare architecture as incompatible with the principles of sustainable design. However, sustainability is not only a moral obligation for the healthcare field, it is beneficial to the patient and fosters a healing environment. Sustainable practices should be adopted for future constructions and renovations of healthcare facilities. These practices will not only save money during the lifespan of most healthcare facilities, they will also make spaces more effective for healing.

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IAI INTERNATIONAL ACADEMIC INSTITUTE

Simay özkan

Increasing environmental problems due to overpopulation, and the negative impacts of these problems on living creatures have brought sustainability forward. Nowadays, when energy consumption is intensified, the exhaustion of fossil fuels which are used as resources has encouraged developing countries to use renewable energy sources. Especially in buildings such as hospitals, energy consumption, and waste management have been given significance. Hospitals are not only those that heal patients with disease, but also those used by staff, attendants and medical students, and are intended to protect their current health. As hospital buildings are associated with hygiene and health, these structures must meet those expectations. Hospitals are institutions that reinforce their energy consumption by having high amounts of energy and continuous waste production. Because of the fact that hospital buildings provide service for 7 days and 24 hours, they consume a large amount of energy and produce both chemical and domestic waste. It is known that this situation harms the environment much more than expected. In addition to energy consumption, there are chemicals that adversely affect human health in unsustainable structures. These chemicals are found in interior materials and furnitures as well as in construction materials. The presence of such harmful chemicals in hospitals contrasts with the aims of such structures which aim to provide health services. Those problems had created the need for "green hospitals" which are taking advantage of renewable energy sources, using environmentally friendly construction materials, planning waste management and providing green environments. Green hospital design includes the use of daylight, proper artificial lighting, vernacular architecture forms and materials, natural and non-toxic materials, good indoor air quality and ergonomics. These structures made with an environmentalist approach contribute to the good management of energy consumption, while reducing the stress on the patients with the elements such as air conditioning and lighting-which has an effect on healing patients. At the same time, depending on the innovative design concept by the green hospital design, hospital staff and visitors feels more comfortable inside the structure. The aim of this study is to describe the green hospital concepts and investigate the effects of green hospital elements into interior space. Acquired information is going to be used in case studies such as; USA/Colorado's first Leed certified hospital called Boulder Community Foothills Hospital and VKV American Hospital which had gained importance with the leadership of green hospital building structure in Turkey. Examples are going to be compared due to green building systems and their reflection to interior space.

Arup Australian Building Codes Board Bovis Lend Lease Brisbane City Council Brookwater Building Commission CSIRO

amreen shajahan

The indoor environment of a mechanically ventilated hospital building controls infection rates as well as influences patients’ healing processes and overall medical outcomes. This review covers the scientific research that has assessed patients’ medical outcomes concerning at least one indoor environmental parameter related to building Heating, Ventilation, and Air Conditioning (HVAC) systems, such as indoor air temperature, relative humidity, and indoor air ventilation parameters. Research related to the naturally ventilated hospital buildings was outside the scope of this review article. After 1998, a total of 899 papers were identified that fit the inclusion criteria of this study. Of these, 176 papers have been included in this review to understand the relationship between the health outcomes of a patient and the indoor environment of a mechanically ventilated hospital building. The purpose of this literature review was to summarize how indoor environmental parameters related to mechanical ventilation systems of a hospital building are impacting patients. This review suggests that there is a need for future interdisciplinary collaborative research to quantify the optimum range for HVAC parameters considering airborne exposures and patients’ positive medical outcomes.

Thesis Research Dissertation

Revisiting the functions and aim of the space is necessary which have been corrupted enough. Buildings of this era might fulfill the requirements but the soul of the design is absent, and only way to put life in any space is when the surrounding thrills the soul of inhabitant, inspire it and heal the bruises and person can connect with the environment, feel peace within and allow it to breath in the tranquility of space. To treat a space like a living organism and design a structure that can breathe into the surrounding, because every structure has an impact on its environment and takes the impact of the environment into itself . It will eventually be obvious in the inhabitant responds to a space and how it gets influenced by it. Hence, living in modern urban stressed life a good architecture can have a therapeutic effect on the souls of individual and spending time in positive amplitude has a remarkable potential to rejuvenate human physical and mental state.

The study assessed the performance of a newly-built sustainable hospital by comparing the thermal comfort of its patients and staff, and the ambient thermal conditions with those of two other hospitals with less sophisticated designs. Additionally, a facility management perspective was used to understand the role hospital administrators had in contributing to sustainable design outcomes and document the unanticipated challenges and unintended consequences of operating the newly-built sustainable hospital. Data were collected through thermal environment equipment, a thermal comfort survey, and interviews with care providers, patients, and facility managers. The hypotheses were that the hospital with the modern and more sophisticated sustainable ventilation design features would have a higher level of thermal comfort and lower heat index in the naturally ventilated wards than hospitals without those features and that thermal comfort would be higher in air-conditioned wards than naturally ventilated wards. The results indicate that sophisticated sustainable hospital designs can improve the ambient thermal environment and occupant thermal comfort but not all those features were necessary. The study also suggests the need for adopting an integrated sustainable design strategy to prevent or mitigate some of the facility operation challenges encountered. Additionally, the study proposes for a shift in thermal comfort standards and green building rating tools to meet the unique thermal comfort needs of hospital users.

Resourceedings

IEREK press

Historically, natural ventilation has been an important factor to achieve thermal comfort and reduce energy consumption in healthcare buildings. Since the recent century, there has been an increasing change and scientific advancement that led to the reliance of mechanical ventilation systems in commercial buildings and especially in hospitals and healthcare settings. However, the fully mechanical system approaches have changed gradually after global warming and the lack of energy sources. In this context, this study investigated systematically, passive ventilation techniques used in medieval near eastern hospitals "Bimaristans" and historical hospitals in Europe. The study traced the roots of natural ventilation in a sample of historical healthcare buildings. It also investigated ventilation techniques used in historical hospitals in Middle East and Europe. This study is looking forward to discover the architectural design parameters' effects of historical hospitals on ventilation, to make a better environment for patients' health by learning from past lessons in traditional architecture , and how could we adapt these techniques in our nowadays healthcare buildings. This step will allow further research on the adaption and integration of passive techniques inherited from the past in our contemporary hospital design.

Shao Yen Tan

Kathleen A Connellan

OBJECTIVE: To present a comprehensive review of the research literature on the effects of the architectural designs of mental health facilities on the users. BACKGROUND: Using a team of cross-disciplinary researchers, this review builds upon previous reviews on general and geriatric healthcare design in order to focus on research undertaken for mental health care facility design. METHODS: Sources were gathered in 2010 and 2011. In 2010 a broad search was undertaken across health and architecture; in 2011, using keywords and 13 databases, researchers conducted a systematic search of peer reviewed literature addressing mental health care and architectural design published between 2005 to 2012, as well as a systematic search for academic theses for the period 2000 to 2012. Recurrent themes and subthemes were identified and numerical data that emerged from quantitative studies was tabulated. RESULTS: Key themes that emerged were nursing stations, light, therapeutic milieu, security, privacy, designing for the adolescent, forensic facilities, interior detail, patients’ rooms, art, dementia, model of care, gardens, post-occupancy evaluation, and user engagement in design process. Of the 165 articles (including conference proceedings, books, and theses), 25 contained numerical data from empirical studies and 7 were review articles. CONCLUSIONS: Based on the review results, especially the growing evidence of the benefits of therapeutic design on patient and staff well-being and client length of stay, additional research questions are suggested concerning optimal design considerations, designs to be avoided, and the involvement of major stakeholders in the design process. KEYWORDS: Evidence-based design, hospital, interdisciplinary, literature review, post-occupancy

Manu Palkar

Damien Riggs

To present a comprehensive review of the research literature on the effects of the architectural designs of mental health facilities on the users.BACKGROUND: Using a team of cross-disciplinary researchers, this review builds upon previous reviews on general and geriatric healthcare design in order to focus on research undertaken for mental health care facility design.METHODS: Sources were gathered in 2010 and 2011. In 2010 a broad search was undertaken across health and architecture; in 2011, using keywords and 13 databases, researchers conducted a systematic search of peer reviewed literature addressing mental health care and architectural design published between 2005 to 2012, as well as a systematic search for academic theses for the period 2000 to 2012. Recurrent themes and subthemes were identified and numerical data that emerged from quantitative studies was tabulated.RESULTS: Key themes that emerged were nursing stations, light, therapeutic milieu, security, privacy, designin...

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How the Architecture of Hospitals Affects Health Outcomes

• Cheryl Heller

MASS Design Group is changing the ways health care facilities are built.

A key determinant of everything that matters when it comes to health interventions — the experience, cost, and results — has been hiding in plain sight. It is the buildings and spaces in which patients are treated. The size and layout of a room, whether a bed sits in the middle or against a wall (even which wall), how much space is maintained for patients to walk versus how many beds or operating equipment can be accommodated, have not been considered predictors of health outcomes in the past. That’s changing, as architects and health care organizations come together to incorporate principles of social design into the built health care environment.

A key determinant of everything that matters when it comes to health interventions — the experience, cost, and results — has been hiding in plain sight. It is the buildings and spaces in which patients are treated. The size and layout of a room, whether a bed sits in the middle or against a wall (even which wall), how much space is maintained for patients to walk versus how many beds or operating equipment can be accommodated, have not been considered predictors of health outcomes in the past. That’s changing, as architects and health care organizations come together to incorporate principles of social design into the built health care environment.

• Cheryl Heller is the founding chair of the first MFA program in Design for Social Innovation at the School of Visual Arts in Manhattan and is president of the design lab CommonWise. She is the recipient of the AIGA Medal for her contributions to the field of design and is a Rockefeller Bellagio Fellow. She is the author of The Intergalactic Design Guide: Harnessing the Creative Potential of Social Design .

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Maggie Center – Healthcare Architecture: A Beacon of Design Innovation in Healing Spaces

Maggie Center – Healthcare Architecture – 20 Types of Architecture thesis topics

In the realm of healthcare architecture, the Maggie Center stands as a shining example of design innovation that goes beyond aesthetics, focusing on creating spaces that facilitate healing and well-being. This article delves into the intricacies of Maggie Centers, exploring their architectural typology and their impact on healthcare design.

Understanding the Maggie Center Concept

The genesis of maggie centers.

Maggie Keswick Jencks, a landscape designer, and her husband, architectural theorist Charles Jencks, founded the first Maggie’s Cancer Care Centre in Edinburgh in 1996. The inspiration behind these centers stems from Maggie’s own experience with cancer and the realization that the environment plays a crucial role in the healing process.

Architectural Philosophy

Maggie Centers embody a unique architectural philosophy that emphasizes a non-institutional, homely environment. The spaces are designed to be warm, welcoming, and supportive, fostering a sense of community among patients, families, and caregivers.

Architectural Elements of Maggie Centers

Integrating nature and architecture.

One distinctive feature of Maggie Centers is the seamless integration of nature and architecture. The design often incorporates large windows, skylights, and outdoor spaces, allowing natural light to flood the interiors and creating a connection with the surrounding landscape.

Flexible Spaces for Varied Needs

Maggie Centers are designed with flexibility in mind. Spaces are adaptable to accommodate various activities, from support group sessions to individual contemplation. This flexibility ensures that the center can cater to the diverse needs of its users.

Homely Atmosphere

Unlike traditional clinical settings, Maggie Centers exude a homely atmosphere. The use of comfortable furniture, domestic-scale spaces, and personalized touches contributes to a more relaxed and comforting environment.

The Impact on Healthcare Design

Human-centered approach.

Maggie Centers have pioneered a human-centered approach to healthcare design. By prioritizing the well-being of patients and their families, these centers challenge the conventional notions of sterile and impersonal healthcare environments.

Psychological Well-being

Research indicates a positive correlation between well-designed healthcare spaces and improved psychological well-being. Maggie Centers, with their emphasis on creating uplifting and supportive environments, contribute significantly to the mental and emotional healing of patients.

Integrating Art and Architecture

Art plays a vital role in Maggie Centers, with each center featuring curated artworks that enhance the overall ambiance. This integration of art and architecture fosters a therapeutic environment, stimulating creativity and providing a source of solace.

Architectural Typology: A Thesis Exploration

For architecture students contemplating a thesis on healthcare architecture, delving into the typology of Maggie Centers offers a rich avenue for exploration. Here are key aspects to consider:

Design Principles

Explore the fundamental design principles that define Maggie Centers. Analyze how the architects balance functionality, aesthetics, and human-centric considerations in creating spaces that promote healing.

User Experience

Examine the user experience within Maggie Centers. How do the design choices impact the way patients and their families interact with the space? Consider aspects of accessibility, comfort, and navigation.

Site-specific Design

Maggie Centers are often designed with careful consideration of their specific site and surroundings. Investigate how site-specific design elements contribute to the overall effectiveness of the healing environment.

Sustainable Practices

Analyze the sustainability aspects of Maggie Centers. How do these structures integrate environmentally friendly practices, and what can be learned from their approach to sustainable healthcare architecture?

Calls to Action

Explore maggie centers locally.

Encourage readers to explore Maggie Centers in their localities. These visits can provide firsthand experience and inspiration for those interested in architecture, interior design, or urban design.

Engage in Healthcare Design Conversations

Invite readers to engage in conversations about the role of architecture in healthcare settings. Platforms like forums, social media, and local design events provide opportunities to exchange ideas and insights.

Consider Maggie Centers in Thesis Research

For architecture students, suggest considering Maggie Centers as a case study or inspiration for thesis research. The unique design principles and holistic approach make them a compelling subject for in-depth exploration.

In the realm of healthcare architecture, Maggie Centers stand as beacons of design innovation, demonstrating the transformative power of architecture in the healing process. As architects, interior designers, and urban planners continue to redefine the boundaries of healthcare design, the Maggie Center concept serves as a source of inspiration and a testament to the profound impact thoughtful design can have on the well-being of individuals and communities.

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• Places - European, Western and Northern Russia

YEKATERINBURG: FACTORIES, URAL SIGHTS, YELTSIN AND THE WHERE NICHOLAS II WAS KILLED

Sverdlovsk oblast.

Sverdlovsk Oblast is the largest region in the Urals; it lies in the foothills of mountains and contains a monument indicating the border between Europe and Asia. The region covers 194,800 square kilometers (75,200 square miles), is home to about 4.3 million people and has a population density of 22 people per square kilometer. About 83 percent of the population live in urban areas. Yekaterinburg is the capital and largest city, with 1.5 million people. For Russians, the Ural Mountains are closely associated with Pavel Bazhov's tales and known for folk crafts such as Kasli iron sculpture, Tagil painting, and copper embossing. Yekaterinburg is the birthplace of Russia’s iron and steel industry, taking advantage of the large iron deposits in the Ural mountains. The popular Silver Ring of the Urals tourist route starts here.

In the summer you can follow in the tracks of Yermak, climb relatively low Ural mountain peaks and look for boulders seemingly with human faces on them. You can head to the Gemstone Belt of the Ural mountains, which used to house emerald, amethyst and topaz mines. In the winter you can go ice fishing, ski and cross-country ski.

Sverdlovsk Oblast and Yekaterinburg are located near the center of Russia, at the crossroads between Europe and Asia and also the southern and northern parts of Russia. Winters are longer and colder than in western section of European Russia. Snowfalls can be heavy. Winter temperatures occasionally drop as low as - 40 degrees C (-40 degrees F) and the first snow usually falls in October. A heavy winter coat, long underwear and good boots are essential. Snow and ice make the sidewalks very slippery, so footwear with a good grip is important. Since the climate is very dry during the winter months, skin moisturizer plus lip balm are recommended. Be alert for mud on street surfaces when snow cover is melting (April-May). Patches of mud create slippery road conditions.

Yekaterinburg

Yekaterinburg (kilometer 1818 on the Trans-Siberian Railway) is the fourth largest city in Russia, with of 1.5 million and growth rate of about 12 percent, high for Russia. Located in the southern Ural mountains, it was founded by Peter the Great and named after his wife Catherine, it was used by the tsars as a summer retreat and is where tsar Nicholas II and his family were executed and President Boris Yeltsin lived most of his life and began his political career. The city is near the border between Europe and Asia.

Yekaterinburg (also spelled Ekaterinburg) is located on the eastern slope of the Ural Mountains in the headwaters of the Iset and Pyshma Rivers. The Iset runs through the city center. Three ponds — Verkh-Isetsky, Gorodskoy and Nizhne-Isetsky — were created on it. Yekaterinburg has traditionally been a city of mining and was once the center of the mining industry of the Urals and Siberia. Yekaterinburg remains a major center of the Russian armaments industry and is sometimes called the "Pittsburgh of Russia.". A few ornate, pastel mansions and wide boulevards are reminders of the tsarist era. The city is large enough that it has its own Metro system but is characterized mostly by blocky Soviet-era apartment buildings. The city has advanced under President Vladimir Putin and is now one of the fastest growing places in Russia, a country otherwise characterized by population declines

Yekaterinburg is technically an Asian city as it lies 32 kilometers east of the continental divide between Europe and Asia. The unofficial capital of the Urals, a key region in the Russian heartland, it is second only to Moscow in terms of industrial production and capital of Sverdlovsk oblast. Among the important industries are ferrous and non-ferrous metallurgy, machine building and metalworking, chemical and petrochemicals, construction materials and medical, light and food industries. On top of being home of numerous heavy industries and mining concerns, Yekaterinburg is also a major center for industrial research and development and power engineering as well as home to numerous institutes of higher education, technical training, and scientific research. In addition, Yekaterinburg is the largest railway junction in Russia: the Trans-Siberian Railway passes through it, the southern, northern, western and eastern routes merge in the city.

Accommodation: There are two good and affordable hotels — the 3-star Emerald and Parus hotels — located close to the city's most popular landmarks and main transport interchanges in the center of Yekaterinburg. Room prices start at RUB 1,800 per night.

History of Yekaterinburg

Yekaterinburg was founded in 1723 by Peter the Great and named after his wife Catherine I. It was used by the tsars as a summer retreat but was mainly developed as metalworking and manufacturing center to take advantage of the large deposits of iron and other minerals in the Ural mountains. It is best known to Americans as the place where the last Tsar and his family were murdered by the Bolsheviks in 1918 and near where American U-2 spy plane, piloted by Gary Powers, was shot down in 1960.

Peter the Great recognized the importance of the iron and copper-rich Urals region for Imperial Russia's industrial and military development. In November 1723, he ordered the construction of a fortress factory and an ironworks in the Iset River Valley, which required a dam for its operation. In its early years Yekaterinburg grew rich from gold and other minerals and later coal. The Yekaterinburg gold rush of 1745 created such a huge amount of wealth that one rich baron of that time hosted a wedding party that lasted a year. By the mid-18th century, metallurgical plants had sprung up across the Urals to cast cannons, swords, guns and other weapons to arm Russia’s expansionist ambitions. The Yekaterinburg mint produced most of Russia's coins. Explorations of the Trans-Baikal and Altai regions began here in the 18th century.

Iron, cast iron and copper were the main products. Even though Iron from the region went into the Eiffel Tower, the main plant in Yekaterinburg itself was shut down in 1808. The city still kept going through a mountain factory control system of the Urals. The first railway in the Urals was built here: in 1878, the Yekaterinburg-Perm railway branch connected the province's capital with the factories of the Middle Urals.

In the Soviet era the city was called Sverdlovsk (named after Yakov Sverdlov, the man who organized Nicholas II's execution). During the first five-year plans the city became industrial — old plants were reconstructed, new ones were built. The center of Yekaterinburg was formed to conform to the historical general plan of 1829 but was the layout was adjusted around plants and factories. In the Stalin era the city was a major gulag transhipment center. In World War II, many defense-related industries were moved here. It and the surrounding area were a center of the Soviet Union's military industrial complex. Soviet tanks, missiles and aircraft engines were made in the Urals. During the Cold War era, Yekaterinburg was a center of weapons-grade uranium enrichment and processing, warhead assembly and dismantlement. In 1979, 64 people died when anthrax leaked from a biological weapons facility. Yekaterinburg was a “Closed City” for 40 years during the Cold Soviet era and was not open to foreigners until 1991

In the early post-Soviet era, much like Pittsburgh in the 1970s, Yekaterinburg had a hard struggle d to cope with dramatic economic changes that have made its heavy industries uncompetitive on the world market. Huge defense plants struggled to survive and the city was notorious as an organized crime center in the 1990s, when its hometown boy Boris Yeltsin was President of Russia. By the 2000s, Yekaterinburg’s retail and service was taking off, the defense industry was reviving and it was attracting tech industries and investments related to the Urals’ natural resources. By the 2010s it was vying to host a world exhibition in 2020 (it lost, Dubai won) and it had McDonald’s, Subway, sushi restaurants, and Gucci, Chanel and Armani. There were Bentley and Ferrari dealerships but they closed down

Transportation in Yekaterinburg

Getting There: By Plane: Yekaterinburg is a three-hour flight from Moscow with prices starting at RUB 8,000, or a 3-hour flight from Saint Petersburg starting from RUB 9,422 (direct round-trip flight tickets for one adult passenger). There are also flights from Frankfurt, Istanbul, China and major cities in the former Soviet Union.

By Train: Yekaterinburg is a major stop on the Trans-Siberian Railway. Daily train service is available to Moscow and many other Russian cities.Yekaterinburg is a 32-hour train ride from Moscow (tickets RUB 8,380 and above) or a 36-hour train ride from Saint Petersburg (RUB 10,300 and above). The ticket prices are round trip for a berth in a sleeper compartment for one adult passenger). By Car: a car trip from Moscow to Yekateringburg is 1,787 kilometers long and takes about 18 hours. The road from Saint Petersburg is 2,294 kilometers and takes about 28 hours.

Regional Transport: The region's public transport includes buses and suburban electric trains. Regional trains provide transport to larger cities in the Ural region. Buses depart from Yekaterinburg’s two bus stations: the Southern Bus Station and the Northern Bus Station.

Regional Transport: According the to Association for Safe International Road Travel (ASIRT): “Public transportation is well developed. Overcrowding is common. Fares are low. Service is efficient. Buses are the main form of public transport. Tram network is extensive. Fares are reasonable; service is regular. Trams are heavily used by residents, overcrowding is common. Purchase ticket after boarding. Metro runs from city center to Uralmash, an industrial area south of the city. Metro ends near the main railway station. Fares are inexpensive.

“Traffic is congested in city center. Getting around by car can be difficult. Route taxis (minivans) provide the fastest transport. They generally run on specific routes, but do not have specific stops. Drivers stop where passengers request. Route taxis can be hailed. Travel by bus or trolleybuses may be slow in rush hour. Trams are less affected by traffic jams. Trolley buses (electric buses) cannot run when temperatures drop below freezing.”

Entertainment, Sports and Recreation in Yekaterinburg

The performing arts in Yekaterinburg are first rate. The city has an excellent symphony orchestra, opera and ballet theater, and many other performing arts venues. Tickets are inexpensive. The Yekaterinburg Opera and Ballet Theater is lavishly designed and richly decorated building in the city center of Yekaterinburg. The theater was established in 1912 and building was designed by architect Vladimir Semyonov and inspired by the Vienna Opera House and the Theater of Opera and Ballet in Odessa.

Vaynera Street is a pedestrian only shopping street in city center with restaurants, cafes and some bars. But otherwise Yekaterinburg's nightlife options are limited. There are a handful of expensive Western-style restaurants and bars, none of them that great. Nightclubs serve the city's nouveau riche clientele. Its casinos have closed down. Some of them had links with organized crime. New dance clubs have sprung up that are popular with Yekaterinburg's more affluent youth.

Yekaterinburg's most popular spectator sports are hockey, basketball, and soccer. There are stadiums and arenas that host all three that have fairly cheap tickets. There is an indoor water park and lots of parks and green spaces. The Urals have many lakes, forests and mountains are great for hiking, boating, berry and mushroom hunting, swimming and fishing. Winter sports include cross-country skiing and ice skating. Winter lasts about six months and there’s usually plenty of snow. The nearby Ural Mountains however are not very high and the downhill skiing opportunities are limited..

Sights in Yekaterinburg

Sights in Yekaterinburg include the Museum of City Architecture and Ural Industry, with an old water tower and mineral collection with emeralds. malachite, tourmaline, jasper and other precious stone; Geological Alley, a small park with labeled samples of minerals found in the Urals region; the Ural Geology Museum, which houses an extensive collection of stones, gold and gems from the Urals; a monument marking the border between Europe and Asia; a memorial for gulag victims; and a graveyard with outlandish memorials for slain mafia members.

The Military History Museum houses the remains of the U-2 spy plane shot down in 1960 and locally made tanks and rocket launchers. The fine arts museum contains paintings by some of Russia's 19th-century masters. Also worth a look are the History an Local Studies Museum; the Political History and Youth Museum; and the University and Arboretum. Old wooden houses can be seen around Zatoutstovsya ulitsa and ulitsa Belinskogo. Around the city are wooded parks, lakes and quarries used to harvest a variety of minerals. Weiner Street is the main street of Yekaterinburg. Along it are lovely sculptures and 19th century architecture. Take a walk around the unique Literary Quarter

Plotinka is a local meeting spot, where you will often find street musicians performing. Plotinka can be described as the center of the city's center. This is where Yekaterinburg holds its biggest events: festivals, seasonal fairs, regional holiday celebrations, carnivals and musical fountain shows. There are many museums and open-air exhibitions on Plotinka. Plotinka is named after an actual dam of the city pond located nearby (“plotinka” means “a small dam” in Russian).In November 1723, Peter the Great ordered the construction of an ironworks in the Iset River Valley, which required a dam for its operation. “Iset” can be translated from Finnish as “abundant with fish”. This name was given to the river by the Mansi — the Finno-Ugric people dwelling on the eastern slope of the Northern Urals.

Vysotsky and Iset are skyscrapers that are 188.3 meters and 209 meters high, respectively. Fifty-story-high Iset has been described by locals as the world’s northernmost skyscraper. Before the construction of Iset, Vysotsky was the tallest building of Yekaterinburg and Russia (excluding Moscow). A popular vote has decided to name the skyscraper after the famous Soviet songwriter, singer and actor Vladimir Vysotsky. and the building was opened on November 25, 2011. There is a lookout at the top of the building, and the Vysotsky museum on its second floor. The annual “Vysotsky climb” (1137 steps) is held there, with a prize of RUB 100,000. While Vysotsky serves as an office building, Iset, owned by the Ural Mining and Metallurgical Company, houses 225 premium residential apartments ranging from 80 to 490 square meters in size.

Boris Yeltsin Presidential Center

The Boris Yeltsin Presidential Center (in the city center: ul. Yeltsina, 3) is a non-governmental organization named after the first president of the Russian Federation. The Museum of the First President of Russia as well as his archives are located in the Center. There is also a library, educational and children's centers, and exposition halls. Yeltsin lived most of his life and began his political career in Yekaterinburg. He was born in Butka about 200 kilometers east of Yekaterinburg.

The core of the Center is the Museum. Modern multimedia technologies help animate the documents, photos from the archives, and artifacts. The Yeltsin Museum holds collections of: propaganda posters, leaflets, and photos of the first years of the Soviet regime; portraits and portrait sculptures of members of Politburo of the Central Committee of the Communist Party of various years; U.S.S.R. government bonds and other items of the Soviet era; a copy of “One Day in the Life of Ivan Denisovich” by Alexander Solzhenitsyn, published in the “Novy Mir” magazine (#11, 1962); perestroika-era editions of books by Alexander Solzhenitsyn, Vasily Grossman, and other authors; theater, concert, and cinema posters, programs, and tickets — in short, all of the artifacts of the perestroika era.

The Yeltsin Center opened in 2012. Inside you will also find an art gallery, a bookstore, a gift shop, a food court, concert stages and a theater. There are regular screenings of unique films that you will not find anywhere else. Also operating inside the center, is a scientific exploritorium for children. The center was designed by Boris Bernaskoni. Almost from the its very opening, the Yeltsin Center has been accused by members of different political entities of various ideological crimes. The museum is open Tuesday to Sunday, from 10:00am to 9:00pm.

Where Nicholas II was Executed

On July, 17, 1918, during this reign of terror of the Russian Civil War, former-tsar Nicholas II, his wife, five children (the 13-year-old Alexis, 22-year-old Olga, 19-year-old Maria and 17-year-old Anastasia)the family physician, the cook, maid, and valet were shot to death by a Red Army firing squad in the cellar of the house they were staying at in Yekaterinburg.

Ipatiev House (near Church on the Blood, Ulitsa Libknekhta) was a merchant's house where Nicholas II and his family were executed. The house was demolished in 1977, on the orders of an up and coming communist politician named Boris Yeltsin. Yeltsin later said that the destruction of the house was an "act of barbarism" and he had no choice because he had been ordered to do it by the Politburo,

The site is marked with s cross with the photos of the family members and cross bearing their names. A small wooden church was built at the site. It contains paintings of the family. For a while there were seven traditional wooden churches. Mass is given ay noon everyday in an open-air museum. The Church on the Blood — constructed to honor Nicholas II and his family — was built on the part of the site in 1991 and is now a major place of pilgrimage.

Nicholas and his family where killed during the Russian civil war. It is thought the Bolsheviks figured that Nicholas and his family gave the Whites figureheads to rally around and they were better of dead. Even though the death orders were signed Yakov Sverdlov, the assassination was personally ordered by Lenin, who wanted to get them out of sight and out of mind. Trotsky suggested a trial. Lenin nixed the idea, deciding something had to be done about the Romanovs before White troops approached Yekaterinburg. Trotsky later wrote: "The decision was not only expedient but necessary. The severity of he punishment showed everyone that we would continue to fight on mercilessly, stopping at nothing."

Ian Frazier wrote in The New Yorker: “Having read a lot about the end of Tsar Nicholas II and his family and servants, I wanted to see the place in Yekaterinburg where that event occurred. The gloomy quality of this quest depressed Sergei’s spirits, but he drove all over Yekaterinburg searching for the site nonetheless. Whenever he stopped and asked a pedestrian how to get to the house where Nicholas II was murdered, the reaction was a wince. Several people simply walked away. But eventually, after a lot of asking, Sergei found the location. It was on a low ridge near the edge of town, above railroad tracks and the Iset River. The house, known as the Ipatiev House, was no longer standing, and the basement where the actual killings happened had been filled in. I found the blankness of the place sinister and dizzying. It reminded me of an erasure done so determinedly that it had worn a hole through the page. [Source: Ian Frazier, The New Yorker, August 3, 2009, Frazier is author of “Travels in Siberia” (2010)]

“The street next to the site is called Karl Liebknecht Street. A building near where the house used to be had a large green advertisement that said, in English, “LG—Digitally Yours.” On an adjoining lot, a small chapel kept the memory of the Tsar and his family; beneath a pedestal holding an Orthodox cross, peonies and pansies grew. The inscription on the pedestal read, “We go down on our knees, Russia, at the foot of the tsarist cross.”

Books: The Romanovs: The Final Chapter by Robert K. Massie (Random House, 1995); The Fall of the Romanovs by Mark D. Steinberg and Vladimir Khrustalëv (Yale, 1995);

See Separate Article END OF NICHOLAS II factsanddetails.com

Execution of Nicholas II

According to Robert Massie K. Massie, author of Nicholas and Alexandra, Nicholas II and his family were awakened from their bedrooms around midnight and taken to the basement. They were told they were to going to take some photographs of them and were told to stand behind a row of chairs.

Suddenly, a group of 11 Russians and Latvians, each with a revolver, burst into the room with orders to kill a specific person. Yakob Yurovsky, a member of the Soviet executive committee, reportedly shouted "your relatives are continuing to attack the Soviet Union.” After firing, bullets bouncing off gemstones hidden in the corsets of Alexandra and her daughters ricocheted around the room like "a shower of hail," the soldiers said. Those that were still breathing were killed with point black shots to the head.

The three sisters and the maid survived the first round thanks to their gems. They were pressed up against a wall and killed with a second round of bullets. The maid was the only one that survived. She was pursued by the executioners who stabbed her more than 30 times with their bayonets. The still writhing body of Alexis was made still by a kick to the head and two bullets in the ear delivered by Yurovsky himself.

Yurovsky wrote: "When the party entered I told the Romanovs that in view of the fact their relatives continued their offensive against Soviet Russia, the Executive Committee of the Urals Soviet had decided to shoot them. Nicholas turned his back to the detachment and faced his family. Then, as if collecting himself, he turned around, asking, 'What? What?'"

"[I] ordered the detachment to prepare. Its members had been previously instructed whom to shoot and to am directly at the heart to avoid much blood and to end more quickly. Nicholas said no more. he turned again to his family. The others shouted some incoherent exclamations. All this lasted a few seconds. Then commenced the shooting, which went on for two or three minutes. [I] killed Nicholas on the spot."

Nicholas II’s Initial Burial Site in Yekaterinburg

Ganina Yama Monastery (near the village of Koptyaki, 15 kilometers northwest of Yekaterinburg) stands near the three-meter-deep pit where some the remains of Nicholas II and his family were initially buried. The second burial site — where most of the remains were — is in a field known as Porosyonkov (56.9113628°N 60.4954326°E), seven kilometers from Ganina Yama.

On visiting Ganina Yama Monastery, one person posted in Trip Advisor: “We visited this set of churches in a pretty park with Konstantin from Ekaterinburg Guide Centre. He really brought it to life with his extensive knowledge of the history of the events surrounding their terrible end. The story is so moving so unless you speak Russian, it is best to come here with a guide or else you will have no idea of what is what.”

In 1991, the acid-burned remains of Nicholas II and his family were exhumed from a shallow roadside mass grave in a swampy area 12 miles northwest of Yekaterinburg. The remains had been found in 1979 by geologist and amateur archeologist Alexander Avdonin, who kept the location secret out of fear that they would be destroyed by Soviet authorities. The location was disclosed to a magazine by one his fellow discovers.

The original plan was to throw the Romanovs down a mine shaft and disposes of their remains with acid. They were thrown in a mine with some grenades but the mine didn't collapse. They were then carried by horse cart. The vats of acid fell off and broke. When the carriage carrying the bodies broke down it was decided the bury the bodies then and there. The remaining acid was poured on the bones, but most of it was soaked up the ground and the bones largely survived.

After this their pulses were then checked, their faces were crushed to make them unrecognizable and the bodies were wrapped in bed sheets loaded onto a truck. The "whole procedure," Yurovsky said took 20 minutes. One soldiers later bragged than he could "die in peace because he had squeezed the Empress's -------."

The bodies were taken to a forest and stripped, burned with acid and gasoline, and thrown into abandoned mine shafts and buried under railroad ties near a country road near the village of Koptyaki. "The bodies were put in the hole," Yurovsky wrote, "and the faces and all the bodies, generally doused with sulfuric acid, both so they couldn't be recognized and prevent a stink from them rotting...We scattered it with branches and lime, put boards on top and drove over it several times—no traces of the hole remained.

Shortly afterwards, the government in Moscow announced that Nicholas II had been shot because of "a counterrevolutionary conspiracy." There was no immediate word on the other members of the family which gave rise to rumors that other members of the family had escaped. Yekaterinburg was renamed Sverdlov in honor of the man who signed the death orders.

For seven years the remains of Nicholas II, Alexandra, three of their daughters and four servants were stored in polyethylene bags on shelves in the old criminal morgue in Yekaterunburg. On July 17, 1998, Nicholas II and his family and servants who were murdered with him were buried Peter and Paul Fortress in St. Petersburg along with the other Romanov tsars, who have been buried there starting with Peter the Great. Nicholas II had a side chapel built for himself at the fortress in 1913 but was buried in a new crypt.

Near Yekaterinburg

Factory-Museum of Iron and Steel Metallurgy (in Niznhy Tagil 80 kilometers north of Yekaterinburg) a museum with old mining equipment made at the site of huge abandoned iron and steel factory. Officially known as the Factory-Museum of the History of the Development of Iron and Steel Metallurgy, it covers an area of 30 hectares and contains a factory founded by the Demidov family in 1725 that specialized mainly in the production of high-quality cast iron and steel. Later, the foundry was renamed after Valerian Kuybyshev, a prominent figure of the Communist Party.

The first Russian factory museum, the unusual museum demonstrates all stages of metallurgy and metal working. There is even a blast furnace and an open-hearth furnace. The display of factory equipment includes bridge crane from 1892) and rolling stock equipment from the 19th-20th centuries. In Niznhy Tagil contains some huge blocks of malachite and

Nizhnyaya Sinyachikha (180 kilometers east-northeast of Yekaterinburg) has an open air architecture museum with log buildings, a stone church and other pre-revolutionary architecture. The village is the creation of Ivan Samoilov, a local activist who loved his village so much he dedicated 40 years of his life to recreating it as the open-air museum of wooden architecture.

The stone Savior Church, a good example of Siberian baroque architecture. The interior and exterior of the church are exhibition spaces of design. The houses are very colorful. In tsarist times, rich villagers hired serfs to paint the walls of their wooden izbas (houses) bright colors. Old neglected buildings from the 17th to 19th centuries have been brought to Nizhnyaya Sinyachikha from all over the Urals. You will see the interior design of the houses and hear stories about traditions and customs of the Ural farmers.

Verkhoturye (330 kilometers road from Yekaterinburg) is the home a 400-year-old monastery that served as 16th century capital of the Urals. Verkhoturye is a small town on the Tura River knows as the Jerusalem of the Urals for its many holy places, churches and monasteries. The town's main landmark is its Kremlin — the smallest in Russia. Pilgrims visit the St. Nicholas Monastery to see the remains of St. Simeon of Verkhoturye, the patron saint of fishermen.

Ural Mountains

Ural Mountains are the traditional dividing line between Europe and Asia and have been a crossroads of Russian history. Stretching from Kazakhstan to the fringes of the Arctic Kara Sea, the Urals lie almost exactly along the 60 degree meridian of longitude and extend for about 2,000 kilometers (1,300 miles) from north to south and varies in width from about 50 kilometers (30 miles) in the north and 160 kilometers (100 miles) the south. At kilometers 1777 on the Trans-Siberian Railway there is white obelisk with "Europe" carved in Russian on one side and "Asia" carved on the other.

The eastern side of the Urals contains a lot of granite and igneous rock. The western side is primarily sandstone and limestones. A number of precious stones can be found in the southern part of the Urals, including emeralds. malachite, tourmaline, jasper and aquamarines. The highest peaks are in the north. Mount Narodnaya is the highest of all but is only 1884 meters (6,184 feet) high. The northern Urals are covered in thick forests and home to relatively few people.

Like the Appalachian Mountains in the eastern United States, the Urals are very old mountains — with rocks and sediments that are hundreds of millions years old — that were one much taller than they are now and have been steadily eroded down over millions of years by weather and other natural processes to their current size. According to Encyclopedia Britannica: “The rock composition helps shape the topography: the high ranges and low, broad-topped ridges consist of quartzites, schists, and gabbro, all weather-resistant. Buttes are frequent, and there are north–south troughs of limestone, nearly all containing river valleys. Karst topography is highly developed on the western slopes of the Urals, with many caves, basins, and underground streams. The eastern slopes, on the other hand, have fewer karst formations; instead, rocky outliers rise above the flattened surfaces. Broad foothills, reduced to peneplain, adjoin the Central and Southern Urals on the east.

“The Urals date from the structural upheavals of the Hercynian orogeny (about 250 million years ago). About 280 million years ago there arose a high mountainous region, which was eroded to a peneplain. Alpine folding resulted in new mountains, the most marked upheaval being that of the Nether-Polar Urals...The western slope of the Urals is composed of middle Paleozoic sedimentary rocks (sandstones and limestones) that are about 350 million years old. In many places it descends in terraces to the Cis-Ural depression (west of the Urals), to which much of the eroded matter was carried during the late Paleozoic (about 300 million years ago). Found there are widespread karst (a starkly eroded limestone region) and gypsum, with large caverns and subterranean streams. On the eastern slope, volcanic layers alternate with sedimentary strata, all dating from middle Paleozoic times.”

Southern Urals

The southern Urals are characterized by grassy slopes and fertile valleys. The middle Urals are a rolling platform that barely rises above 300 meters (1,000 feet). This region is rich in minerals and has been heavily industrialized. This is where you can find Yekaterinburg (formally Sverdlovsk), the largest city in the Urals.

Most of the Southern Urals are is covered with forests, with 50 percent of that pine-woods, 44 percent birch woods, and the rest are deciduous aspen and alder forests. In the north, typical taiga forests are the norm. There are patches of herbal-poaceous steppes, northem sphagnous marshes and bushy steppes, light birch forests and shady riparian forests, tall-grass mountainous meadows, lowland ling marshes and stony placers with lichen stains. In some places there are no large areas of homogeneous forests, rather they are forests with numerous glades and meadows of different size.

In the Ilmensky Mountains Reserve in the Southern Urals, scientists counted 927 vascular plants (50 relicts, 23 endemic species), about 140 moss species, 483 algae species and 566 mushroom species. Among the species included into the Red Book of Russia are feather grass, downy-leaved feather grass, Zalessky feather grass, moccasin flower, ladies'-slipper, neottianthe cucullata, Baltic orchis, fen orchis, helmeted orchis, dark-winged orchis, Gelma sandwart, Krasheninnikov sandwart, Clare astragalus.

The fauna of the vertebrate animals in the Reserve includes 19 fish, 5 amphibian and 5 reptile. Among the 48 mammal species are elks, roe deer, boars, foxes, wolves, lynxes, badgers, common weasels, least weasels, forest ferrets, Siberian striped weasel, common marten, American mink. Squirrels, beavers, muskrats, hares, dibblers, moles, hedgehogs, voles are quite common, as well as chiropterans: pond bat, water bat, Brandt's bat, whiskered bat, northern bat, long-eared bat, parti-coloured bat, Nathusius' pipistrelle. The 174 bird bird species include white-tailed eagles, honey hawks, boreal owls, gnome owls, hawk owls, tawny owls, common scoters, cuckoos, wookcocks, common grouses, wood grouses, hazel grouses, common partridges, shrikes, goldenmountain thrushes, black- throated loons and others.

Activities and Places in the Ural Mountains

The Urals possess beautiful natural scenery that can be accessed from Yekaterinburg with a rent-a-car, hired taxi and tour. Travel agencies arrange rafting, kayaking and hiking trips. Hikes are available in the taiga forest and the Urals. Trips often include walks through the taiga to small lakes and hikes into the mountains and excursions to collect mushrooms and berries and climb in underground caves. Mellow rafting is offered in a relatively calm six kilometer section of the River Serga. In the winter visitor can enjoy cross-mountains skiing, downhill skiing, ice fishing, dog sledding, snow-shoeing and winter hiking through the forest to a cave covered with ice crystals.

Lake Shartash (10 kilometers from Yekaterinburg) is where the first Ural gold was found, setting in motion the Yekaterinburg gold rush of 1745, which created so much wealth one rich baron of that time hosted a wedding party that lasted a year. The area around Shartash Lake is a favorite picnic and barbecue spot of the locals. Getting There: by bus route No. 50, 054 or 54, with a transfer to suburban commuter bus route No. 112, 120 or 121 (the whole trip takes about an hour), or by car (10 kilometers drive from the city center, 40 minutes).

Revun Rapids (90 kilometers road from Yekaterinburg near Beklenishcheva village) is a popular white water rafting places On the nearby cliffs you can see the remains of a mysterious petroglyph from the Paleolithic period. Along the steep banks, you may notice the dark entrance of Smolinskaya Cave. There are legends of a sorceress who lived in there. The rocks at the riverside are suited for competitive rock climbers and beginners. Climbing hooks and rings are hammered into rocks. The most fun rafting is generally in May and June.

Olenii Ruchii National Park (100 kilometers west of Yekaterinburg) is the most popular nature park in Sverdlovsk Oblast and popular weekend getaway for Yekaterinburg residents. Visitors are attracted by the beautiful forests, the crystal clear Serga River and picturesque rocks caves. There are some easy hiking routes: the six-kilometer Lesser Ring and the 15-kilometer Greater Ring. Another route extends for 18 km and passes by the Mitkinsky Mine, which operated in the 18th-19th centuries. It's a kind of an open-air museum — you can still view mining an enrichment equipment here. There is also a genuine beaver dam nearby.

Among the other attractions at Olenii Ruchii are Druzhba (Friendship) Cave, with passages that extend for about 500 meters; Dyrovaty Kamen (Holed Stone), created over time by water of Serga River eroding rock; and Utoplennik (Drowned Man), where you can see “The Angel of Sole Hope”., created by the Swedish artist Lehna Edwall, who has placed seven angels figures in different parts of the world to “embrace the planet, protecting it from fear, despair, and disasters.”

Image Sources: Wikimedia Commons

Text Sources: Federal Agency for Tourism of the Russian Federation (official Russia tourism website russiatourism.ru ), Russian government websites, UNESCO, Wikipedia, Lonely Planet guides, New York Times, Washington Post, Los Angeles Times, National Geographic, The New Yorker, Bloomberg, Reuters, Associated Press, AFP, Yomiuri Shimbun and various books and other publications.

Updated in September 2020

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Sverdlovsk Oblast, Russia

The capital city of Sverdlovsk oblast: Ekaterinburg .

Sverdlovsk Oblast - Overview

Sverdlovsk Oblast is a federal subject of Russia, the largest region of the Urals, located on the border between Europe and Asia in the Urals Federal District. Yekaterinburg is the capital city of the region.

The population of Sverdlovsk Oblast is about 4,264,300 (2022), the area - 194,307 sq. km.

Sverdlovsk oblast flag

Sverdlovsk oblast coat of arms.

Sverdlovsk oblast map, Russia

Sverdlovsk oblast latest news and posts from our blog:.

26 May, 2020 / Unique Color Photos of Yekaterinburg in 1909 .

2 December, 2018 / Yekaterinburg - the view from above .

21 November, 2018 / Abandoned Railway Tunnel in Didino .

12 October, 2017 / Northern Urals: Manpupuner Plateau and Dyatlov Pass .

20 April, 2015 / Multicolored aurora borealis in the Northern Urals .

More posts..

History of Sverdlovsk Oblast

The first people settled here in the Stone Age. At the end of the 16th century, the Russian kingdom gained control of the region. In the 17th century, the most significant stage of the initial development of this area happened, when Russian settlers began a massive advance to the east. In 1598, the first settlers founded the town of Verkhoturye on the territory of the present Sverdlovsk region.

Verkhoturye became the first capital of the Urals because of its strategic location on the Babinov road - an important crossroads of trade routes. Sverdlovsk oblast acted as a transshipment base between the central part of the country and the actively developed regions of Siberia and Central Asia.

The presence of strategic reserves of iron and copper ore, as well as large forest areas, predetermined the specialization of the region (ferrous and non-ferrous metallurgy, wood processing, mining, etc.). Exploration of minerals in the Sverdlovsk region began at the end of the 17th century.

In the 18th century, the Demidov dynasty founded several plants in the region that turned into large production and economic complexes. The local industry was characterized by a high level of technological development. The blast furnaces of the Ekaterinburg, Nevyansk, Tagil iron-making plants were superior in performance to the best European models of that time, and their products were the leading item of Russian exports.

More historical facts…

The launch of the Trans-Siberian Railway became a landmark event in the life of the Middle Urals, allowing large-scale export of plant products. Between 1920 and 1930, the Urals was able to once again take its place as the leading industrial region of Russia by strengthening its mining industry, creating new production facilities, developing energy and mass urban construction.

In the years of the first five-year plans, along with the reconstruction of old enterprises, several new large industrial facilities were opened: Uralmashzavod, Uralelektrotyazhmash, tool and ball bearing plants in Sverdlovsk, Uralvagonzavod and Nizhny Tagil metallurgical plant in Nizhny Tagil, pipe plants in Pervouralsk and Kamensk-Uralsky, copper smelters in Krasnouralsk and Sredneuralsk, the Ural aluminum smelter in Kamensk-Uralsky and others.

On October 3, 1938, the territory of Sverdlovsk Oblast was finally formed. During the Second World War, from July 1941 to December 1942, more than 2 million people came to the Urals region, of which more than 700 thousand stayed in Sverdlovsk Oblast.

In the postwar period, Sverdlovsk Oblast continued to develop as a major industrial center of the Urals. The industry of the region was a supplier of the most important types of machinery, products of ferrous and non-ferrous metallurgy, chemical, electric power, light, and food industries. Mechanical engineering and metalworking retained their leading place in the structure of the local industry.

Being one of the most important industrial and defense centers of the Soviet Union, the Sverdlovsk region remained closed to foreigners until 1991.

Beautiful nature of Sverdlovsk Oblast

Forest stream in Sverdlovsk Oblast

Author: Vlasov Pavel

Sverdlovsk Oblast nature

Author: Oleg Seliverstov

Sverdlovsk Oblast is rich in forests

Sverdlovsk Oblast - Features

Sverdlovsk Oblast received its name from its administrative center - the city of Sverdlovsk (Yekaterinburg). The name appeared on January 17, 1934, together with the formation of the region. After renaming Sverdlovsk back to Yekaterinburg, the region was not renamed and retained its Soviet name.

The territory of Sverdlovsk Oblast stretches from west to east for 560 kilometers, from north to south - for 660 kilometers. The climate is continental. The average temperature in January is about minus 16-20 degrees Celsius, in July - plus 19-30 degrees Celsius.

The Sverdlovsk region, being one of the oldest mining regions of Russia, is rich in a variety of natural resources. Today, the local mineral and raw materials base provides a significant part of the production of Russian vanadium, bauxite, chrysotile-asbestos, iron ore, refractory clay. The region is the main raw source for Russian aluminum industry.

There are significant reserves of nickel ores, precious metals, mineral and fresh groundwater, practically unlimited reserves of building materials. There are deposits of stone and brown coals, chromites, manganese and certain prospects for discovering oil and gas fields. Forests cover about 80% of the territory.

Sverdlovsk Oblast is an important transport hub of Russia. The Trans-Siberian Railway passes through its territory. Koltsovo is a large international airport located in Yekaterinburg. The largest cities and towns of Sverdlovsk Oblast are Yekaterinburg (1,493,600), Nizhny Tagil (340,700), Kamensk-Uralsky (162,500), Pervouralsk (117,700), Serov (93,900), Novouralsk (79,000), and Verkhnyaya Pyshma (76,400).

Sverdlovsk Oblast is known for its traditional International exhibition of armament in Nizhny Tagil, annual Russian Economic Forum in Yekaterinburg. Yekaterinburg is the 4th largest scientific center in Russia after Moscow, Saint-Petersburg and Novosibirsk.

It is one of the most important industrial regions of Russia. The structure of the local industrial complex is dominated by ferrous and non-ferrous metallurgy, enrichment of uranium and iron ore, engineering.

The largest enterprises of ferrous and nonferrous metallurgy are the Nizhnetagilsky Metallurgical Combine, the Kachkanar GOK Vanadiy, VSMPO-Avisma, the Pervouralsky Novotrubny Plant, the Bogoslovsky and the Ural Aluminum Smelters, the Kamensk-Uralsk Metallurgical Plant, the Sinarsky Pipe Plant, the Seversk Pipe Plant, as well as enterprises of the Ural Mining and Metallurgical Company (Uralelectromed, Sredneuralsky Copper Smelting Plant, Metallurgical Plant named after A.K. Serov, etc.).

The most important enterprises of the machine-building complex are Uralvagonzavod, Ural Heavy Machinery Plant, Uralelectrotyazhmash, Uralkhimmash, Ural Turbine Plant, Ural Civil Aviation Plant. Uralkhimplast, which produces synthetic resins, is the largest chemical plant in Russia.

Attractions of Sverdlovsk Oblast

Coniferous forests and numerous rivers make the nature of the Sverdlovsk region attractive for tourists. There is a number of reserves and nature parks: Visimsky State Nature Reserve, Denezhkin Kamen National Nature Reserve, Pripyshminsky Bory National Park, Oleny Ruchi Nature Park, Chusovaya River Nature Park, Bazhovskiye Places Nature Park, Rezhevskoy Nature and Mineralogical Reserve.

Some of the most interesting sights located outside of Yekaterinburg:

• Nevyansk Tower - a leaning tower in the center of the town of Nevyansk, built by the order of Akinfiy Demidov, the founder of the mining industry in the Urals, in the first half of the 18th century;
• Cathedral of the Savior’s Transfiguration in Nevyansk;
• Battle glory of the Urals - an open-air museum of military equipment in Verkhnyaya Pyshma;
• Automotive equipment museum in Verkhnyaya Pyshma - one of the largest collections of Russian cars, special equipment, motorcycles, bicycles;
• Obelisk symbolizing the border between Europe and Asia in Pervouralsk;
• Verkhoturye - a historical town with a kremlin and a lot of churches called the spiritual center of the Urals. The Cross Exaltation Cathedral of the St. Nicholas Monastery is the third largest cathedral in Russia after the Cathedral of Christ the Savior in Moscow and St. Isaac’s Cathedral in St. Petersburg;
• Mount Kachkanar located near the border between Europe and Asia. At the top of the mountain there is the Buddhist Monastery of Shad Tchup Ling;
• Monastery in the name of the Holy Royal Passion-Bearers on Ganina Yama standing on the site of the extermination and the first burial of the remains of the family of the last Russian Emperor Nicholas II and his servants;
• Museum Complex Severskaya Domna in Polevskoy, 52 kilometers from Ekaterinburg - an industrial and architectural monument (1860);
• Open-air museum in Nizhnyaya Sinyachikha - Ural wooden architecture and the richest collection of the Ural house painting;
• Severskaya Pisanitsa - a monument with rock paintings and images of the Neolithic Age located near the village of Severka.

Sverdlovsk oblast of Russia photos

Pictures of the sverdlovsk region.

Sverdlovsk Oblast scenery

Author: Anatoliy Kislov

Bridge in Sverdlovsk Oblast

Author: Igor Romanov

Road in the Sverdlovsk region

Sverdlovsk Oblast views

Field of dandelions in Sverdlovsk Oblast

Winter in Sverdlovsk Oblast

Author: Isupov Sergei

Churches in Sverdlovsk Oblast

Abandoned church in the Sverdlovsk region

Author: Timofey Zakharov

Wooden church in Sverdlovsk Oblast

Orthodox church in Sverdlovsk Oblast

Author: Kutenyov Vladimir

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zaha hadid architects to build soundwave-inspired philharmonic concert hall in russia

# PUBLIC ARCHITECTURE PROJECTS

zaha hadid architects has been selected by the jury of an international design competition to build the new sverdlovsk philharmonic concert hall in yekaterinburg, russia. echoing the physical aspects of sound waves, the design is based on the properties of musical sound resonance creating wave vibrations in a continuous smooth surface.

zaha hadid architects’ design re-interprets these physical acoustic properties to define spaces for the auditoria, which includes a 1,600-seat concert hall and a 400-seat chamber music hall. these spaces are nestled within the surface deformations of the suspended canopy, appearing to float above the new civic plaza that is both the lobby of the philharmonic concert hall and an enclosed urban square.

the lobby serves not only as an introduction to the world of symphony music, but also as a welcoming public plaza for all members of its local community. large glazed facades blur the boundary between interior and exterior; inviting visitors to experience the spaces within.

‘russia has been a formative influence on zaha hadid architects’ creative work‘, says christos passas, project director at zaha hadid architects. ‘from very early in her career, zaha was attracted to the russian avant-garde who conceived civic spaces as urban condensers that catalyze a public realm of activity to enrich creativity and community; allowing space itself to enhance our understanding and well-being. these principles are embedded within the design of the new sverdlovsk philharmonic concert hall.’

zaha hadid architects was selected from 47 international teams who submitted proposals. the design competition was organized by the ministry of construction and infrastructure development of the sverdlovsk region, with the assistance of the charitable foundation for support of the ural philharmonic orchestra.

the existing sverdlovsk philharmonic building dates back to 1936 and is very well attended throughout the year. the orchestra’s new home seeks to provide an inspirational venue to meet the increasing popularity of the orchestra’s program of concerts — and also create a new public plaza for the city.

project info:

architect: zaha hadid architects (ZHA)

ZHA principal: patrik schumacher

ZHA design director: christos passas

ZHA project architect: alessio costantino

ZHA design lead: ben kikkawa, melhem sfeir, zsuzsanna barat, afsoon es haghi

ZHA design team: duo chen, christina christodoulidou, anna uborevich-borovskaya, ekaterina smirnova, aleksandar bursac, alicia hidalgo lopez, maria-eleni bali, eckart schwerdtfeger, maria avrami, valeria perco, sattor jabbor

ZHA senior interior designer: sonia renehan

ZHA cultural researcher: vera kichanova

ZHA administrator: nastasija hahonina

ZHA project consultant: liudmila harrison-jones

ZHA graphic design: silviya barzakova

ZHA videography: henry virgin

local architect: SPEECH (moscow); sergey tchoban, marina kuznetskaya, daria demidova

structural engineering: AKT II (london); daniel bosia

MEP engineering: atelier 10 (london); meredith davey, ivan jovanovich, piers watts-jones, younha rhee

façade engineering: OPTIMISE (london); scott cahill, adam willetts, tim macfarlane (glass light and special structure)

landscape design: ARTEZA (moscow); irina chebanenko

theatre consultant: theatre projects (london); david staples, dave agnes

acoustic engineering design: marshall-day (melbourne, hong kong); peter fearnside, peter exton, thomas scelo

lighting design: OVI (new york); enrique peininger, jean sundin and markus fuerderer

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