JMJ Marist Brothers

NOTRE DAME OF MARBEL UNIVERSITY

College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

Course Subject: Architectural Design 5

Instructor: Ar. Arnie May B. Vilda, UAP
Date Issued: November 4, 2024
Date Submitted: November 11, 2024

Content:

Literature Reviews on Eco-Friendly Hospitals from an Architectural

Perspective and Relevant Literature Review Concerning on Level 2 Hospitals
in the Philippines and its Guidelines

Group 1 – Set A

Antonio, Cassandra
Cenas, Kenny Jay A.
Javing, Karl Michael
Olarte, Kent Laurence
Sanchez, Lloyd Jimuel
Templonuevo, Charlene Mary
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

Review of Related Literature

1. Sustainable Approach of an Eco-friendly Hospital

An important factor of an eco-friendly and sustainable approach is the
necessity of providing buildings with an innovative, beautiful, comfortable, and
sustainable architectural design that accommodates all the possible factors
through sustainable and smart architectural solutions. To design healthy and
sustainable buildings, there is a need to adopt an integrated system that
combines energy, environment, health, and welfare schemes (Dovjak, M. and
Kukec, A., 2019).
An eco-friendly building or ecological building is a building that is eco-
friendly and resource-efficient. This type of building is characterized by its
efficiency in its use of local and renewable materials, in the energy needed to
build it, and in the energy generated while it is in it. Reducing energy use is one
of the focus areas for eco-friendly designers, especially when considering
ventilation and lighting which reduces energy costs and improves ambiance for
building users (Alsawaf E. and Albadry M., 2022).
One of the most crucial aspects of sustainable development that needs
to be considered is sustainable design. Rather than being limited to a building's
appearance or a particular type, sustainable design is an integrated idea with
philosophical dimensions. It introduces sustainable concepts, longevity,
appropriate building materials, and a sense of place while remaining in harmony
with the environment (Ali, A.F., 2019). A sustainable building not only satisfies
human physiological needs but also has a direct correlation with psychological
factors when assessing the building's effectiveness using sustainability
principles, a sustainable building has been referred to as a healthy building.

1.1. Carbon Neutral Hospital

Simon Shaw describes in Guenther (2008, p. 378) a range of strategies
to reduce the carbon footprint in his essay ‘Towards a carbon neutral
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

hospital. The following categories are a blueprint for carbon neutral hospitals
according to Shaw:

1. Minimizing energy demand is the highest priority towards a carbon neutral hospital. Factors that contribute to building energy
efficiency:
• Siting and planning
Solar and wind orientation
Density of site development
• External envelope
Reduce heat losses and gains by high-performance, thermally resistant, and airtight building
Employ envelope to maximize natural daylight and generate heat or even power.
• Internal environment
Analyzing environmental needs could lead to more efficient control of systems
2. Generation of energy (energy sources) - renewable energy
3. Material efficiency - embodied energy and material wise
4. Transport strategy - technological improvements
5. Waste strategy - avoid material consumption and proper waste disposal
6. Carbon offsets - reducing emission or increasing carbon absorption

Table 1.0. Blueprint for Carbon Neutral Hospitals According to Simon Shaw.

While certain healthcare policies, such as waste reduction, have a

long history, efforts to achieve carbon neutrality are only getting started.
Coordination between users, policymakers, and educators at a scale larger
than the hospital is necessary for success. Effective technology and
qualified experts who know how to use renewable resources and energy
efficiency measures economically are essential for success (Guenter, 2008,
p. 386).

1.2 . Green Hospitals

Green buildings are seen as an effective way to implement
environmental, economic, and social sustainability in the construction
industry. The concept of sustainability is essential in responding to green
hospital issues that relate to several aspects, such as the use of natural
resources, the development of alternative energy, the use of an energy-
saving system, as well as efforts to reduce carbon dioxide (CO2) emissions
in both the planning, implementation, and rehabilitation process.
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

Source: Designing a Sustainable Hospital of the Future by Slater B., Guillot R., and Diamond G. (2024).

Guidelines for Indicators of Sustainable Design for Hospital Buildings

Table 1.1. Guidelines for Indicators of Sustainable Design for Hospital Buildings.
Source: Principles for the Sustainable Design of Hospital Buildings by Alsawaf E., Albadry A. (2022)
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

2. Effects of an Eco-Friendly Approach Hospital to the User

As architects, we contribute to improving the health and well-being of the
population with healthier buildings and spaces. However, there needs to be
more connection between architecture and public health.

2.1 User Comfort and Well-Being

In many hospitals in the Philippines, there’s a noticeable absence of
areas dedicated to supporting mental and emotional well-being. Even
though physical health is often prioritized, the emotional and mental health
of patients, staff, and visitors are often overlooked. The cold, clinical
atmosphere found in many healthcare facilities can unintentionally
heighten feelings of anxiety, stress, and even depression (Mae & Joshua,
2021). Without spaces that encourage relaxation and emotional comfort,
the healing journey can take longer and be less effective.

2.1.1 Planetree Theory

It was stated in the study of Isabelle Kras (2011), that other
developments of patients are more or less influenced by the hospital
building and its surroundings. The concept of Planetree stands for
highly valued, people-oriented care in a healing environment with a
healthy organization. Angelica Thieriot started the ‘Planetree’ and was
treated in a hospital where she came out with the firm intention to
change how patients are treated in hospitals. Main topics that need
attention according to Mrs. Thieriot are (Frampton et al, 2009):
 The need for aesthetic surrounding, particularly an environment
which contains elements of nature.
 The importance of good, human contact, continue care and
participation of family.
 The essential interest of empowerment, human dignity and control.
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

2.1.2 Gardening and Landscaping

According to Din,
Russo, and Liversedge
(2023), incorporating healing
gardens into hospital
settings, especially for kids,
aids in mental recovery and
reduces stress while

encouraging play and Figure 2. Outdoor Landscape and Garden of Bendigo

Hospital.
socialization. More such
areas are required in healthcare settings, as evidenced by the wider
advantages, which also include better environmental quality and health
outcomes. Furthermore, It is one of the most aesthetic tools of a green
hospital concept. Plants are considered to infuse positivity and
reduce negativity.

The Indian Green Building Council indicated a set of benefits for green
hospitals, as follows (Alsawaf & Albadry, 2022):

 Can reduce patient recovery time.

 Eliminates Sick Building Syndrome (SBS) for both patients and staff.
 Reduces stress levels of hospital staff, thereby improving the quality
of care.
 Low consumption of energy and water.
 Green buildings can embody the concepts of the industrial
environment that encourage us to emulate nature in using and
reusing resources efficiently.
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

3. Common Issues in Philippine Hospitals for Both General and Level 2

The construction industry designs Level 2 Hospitals in an efficient layout that
improve patient flow, safety, and accessibility. Creating healthier environments through
sustainable materials, natural lighting, and proper ventilation, supporting both patient recovery
and staff well-being while addressing the problems.
3.1. Common Problems
Romualdez, Rosa, and Tobias (2019) provided a comprehensive analysis of the
infrastructure and operational challenges confronting Level 2 hospitals in the Philippines.
These regional and provincial hospitals are frequently located in outdated buildings that
have not seen upgrades in years, resulting in serious issues like overcrowding, poor
sanitation, insufficient ventilation, and unreliable energy and water supplies. The report
emphasizes the pressing need for hospital reforms and infrastructure investment to
improve healthcare quality, patient safety, and operational efficiency within the Philippine
public health system.
The common problems of Level 2 hospitals in the Philippines is the report from the
Philippine Institute for Development Studies (PIDS) (Romualdez et al., 2019):

3.1.1 Aging Infrastructure

According to the Department of Health (2018), Many Level 2 hospitals in the
Philippines are housed in outdated buildings that have not been renovated or upgraded
for many years. These aging structures present significant challenges in terms of
safety, functionality, and quality of care.

3.1.2 Inadequate Space and Overcrowding

In the Philippines, overcrowding is a long-standing issue, affecting both
government and private hospitals (Silva M., Zarsuelo M., et al., 2022). Limited space
and overcrowding are major problems in many Level 2 hospitals. The hospitals often
operate at or beyond their capacity, causing delays in patient care, increased risk of
infections, and overburdened medical staff.
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

3.1.3 Poor Sanitation and Waste Management

Sanitation and waste management are critical in healthcare settings, yet studies
highlight inadequate restroom facilities and poor waste management practices in many
Level 2 hospitals, especially in rural areas. The World Health Organization (WHO)
reported that many Philippine ospitals face sanitation issues, impacting infection
control (World Health Organization, 2020).

3.1.4 Insufficient Ventilation and Airflow

A study by Lee and Peralta (2021) in the Asian Hospital and Healthcare
Management Journal found that ventilation issues are common in Philippine hospitals,
especially in older buildings that lack proper airflow systems. This problem has become
more pronounced due to the need for stringent infection control during the COVID-19
pandemic (Lee & Peralta, 2021).

3.1.5 Lack of Accessibility Features

Spatial accessibility plays an important role in ensuring equitable access to
healthcare (Leyso N. & Umezak M., 2024). Accessibility features such as ramps,
elevators, and wheelchair-accessible restrooms are often absent in older Level 2
hospitals, presenting challenges for elderly and disabled patients. Bautista (2019)
found that accessibility is a common concern in Philippine hospitals, particularly in rural
facilities where retrofitting is complex and costly.

3.1.6 Energy and Water Supply Interruptions

Inconsistent power and water supplies disrupt hospital operations, affecting
lighting, air conditioning, and medical equipment functionality. A report by the
Department of Health emphasizes the need for reliable energy and water systems to
support uninterrupted healthcare delivery in regional hospitals (Department of Health,
2018).
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

References:
Dovjak, M., Kukec, A. (2019). Creating Healthy and Sustainable Buildings: An
Assessment of Health Risk Factors, Springer Nature. http://dx.doi.org/10.1007/978- 3-
030-19412-3
Alsawaf E., Albadry A. (2022). Principles for the Sustainable Design of Hospital
Buildings
Ali, A.F. (2019). The role of building technology in obtaining sustainable place.
Sulaimani Journal for Engineering Sciences, 6(4).
Alsawaf E., Albadry A. (2022). Principles for the Sustainable Design of Hospital
Buildings cited from Setyowati, E., Harani, A.R., Falah, Y.N. (2013). Green building design
concepts of healthcare facilities on the orthopedic hospital in the tropics. Procedia-Social and
Behavioral Sciences, 101: 189-199.
Mae, N., & Joshua, M. (2021). Philippine Mental Health Act: Just an Act? A Call to
Look Into the Bi-directionality of Mental Health and Economy. Frontiers in Psychology, 12.
https://doi.org/10.3389/fpsyg.2021.706483
Kras, I. M. C. (2011). Sustainable hospital buildings [Master’s thesis, Technical
University of Delft]. Faculty of Architecture, Urbanism and Building Sciences, Department of
Real Estate and Housing, Corporate Real Estate Management laboratory.
College Bouw Ziekenhuisvoorzieningen (CBZ). (2007). Gebouwdifferentiatie van een
ziekenhuis. Utrecht, Netherlands: CBZ.
Din, S. K.-J., Russo, A., & Liversedge, J. (2023). Designing Healing Environments: A
Literature Review on the Benefits of Healing Gardens for Children in Healthcare Facilities and
the Urgent Need for Policy Implementation. Land, 12(5), 971–971.
https://doi.org/10.3390/land12050971
Alsawaf, E. S., & Albadry, A. M. (2022). Principles for the Sustainable Design of
Hospital Buildings. International Journal of Sustainable Development and Planning, 17(6),
1797–1808. https://doi.org/10.18280/ijsdp.170614
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

Romualdez, A. G., Jr., Rosa, J., & Tobias, P. (2019). Public Hospital Reform and
Quality of Healthcare Services: The Case of Philippine Regional Hospitals. Philippine Institute
for Development Studies.
World Health Organization. (2020). Situation Analysis of Public Health Facilities in
Southeast Asia: The Philippine Context. WHO.
Department of Health. (2018). Philippine Health Facilities Development Plan 2017–
2022. DOH.
Silva MEC, Zarsuelo M-AM, Naria-Maritana MJN, Zordilla ZD, Lam HY, Mendoza MAF,
et al. Policy Analysis on Determining Hospital Bed Capacity in Light of Universal Health Care.
Lee, D., & Peralta, M. (2021). Healthcare Infrastructure in Southeast Asia: A Focus on
Ventilation and Infection Control. Asian Hospital and Healthcare Management Journal, 15(2),
50–57.
Leyso N. & Umezak M., (2024)S patial inequality in the accessibility of healthcare
services in the Philippines.
Bautista, M. (2019). Healthcare Accessibility and Equity in the Philippines: Challenges
in Provincial and Rural Hospitals. Philippine Journal of Public Health, 12(3), 102–110.
Department of Health. (2018). National Strategy for Healthcare Facility Resilience in
the Philippines. DOH.
 JMJ Marist Brothers
NOTRE DAME OF MARBEL UNIVERSITY
College of Engineering, Architecture, and Computing
Alunan Avenue, City of Koronadal 9506
South Cotabato, Philippines

PLANNING AND DESIGN GUIDELINES FOR HOSPITALS AND OTHER HEALTH

FACILITIES IN THE PHILIPPINES
SOURCE: DEPARTMENT OF HEALTH PHILIPPINES