Our “Hospital of the Future” vision is a paradigm shift that will help drive systemic change in
response to pressing health, social and environmental issues. We combine architecture and
engineering, medical planning, sustainable design, evidence-based design, and systems
thinking approaches to respond to the complex challenges of today, innovatively, and
effectively, by building a smart and resilient future for all our tomorrows.
We are working to develop a visionary approach that remodels and redefines healthcare
delivery by peeling away the areas within the clinical setting that need not be in a costly,
physically built space, and developing a reduced footprint solution that becomes a “hospital
without walls”.
In support of an ongoing healthcare innovation that is embracing MedTech and acquiring a
new digital identity we bring the next generation of telemedicine that centralises digital cloud
technologies, Artificial Intelligence (AI), Robotic Process Automation (RPA), and using
technology as an exponent of sustainability, the spaces for our hospital without walls’ clinical
consultations are proposed to primarily be located in the Metaverse, along with virtual learning,
clinical simulation, and development.
No longer limited to the “playground” methodology that was first envisaged, patients will be
able to meet remotely with their clinical teams, clinicians can collaborate, meet, and train with
each other within AI designed spaces developed by our newly formed tangramMETA team.
Our innovation and advanced technology group, created to harness the potential of digital and
virtual technologies as a supporter of environmentally conscious, sustainable designs.
Nor, incorporating the costs of structure, of building fabric, of materials specified for infection
control, or of advanced building and medical services installations. Calming interior designs
and sound waves can be produced to support the therapeutic, healing environment that is
within a virtual location, one which does not impose on any other patient or staff activity within
any costly clinical setting.
Our Green Strategy
Creating the Hospital of the Future that optimises eco-designs and sustainable solutions that
are designed in accordance with the World Health Organisation’s 7 elements of a climate
friendly hospital, which addresses and responds in support of the United Nations Sustainable
Development Goals and targets, we are working to achieve a radical reduction in carbon,
water, and waste footprints, along with capital and operational costs.
In working to ensure a more sustainable future, this is the sector which must be a focus area
as we move forwards. Be it climate, chemicals in the environment, the healthcare industry is
such a large part of the problem. Delivering better solutions here will be key to resolving many
of our global challenges. Thus, our next generation of healthcare facilities must be more
resilient, better designed and built to protect the environment. Hospitals must become better
connected to smarter, digitised, intelligent ecosystems within the city, the community and
home, to respond more responsibly, as we shape a very different future.
Currently hospital buildings as a typology are notoriously high on the continual usage of energy
and water whilst releasing 2.5 times the Greenhouse House Gas (GHG) emissions of most
similar sized commercial buildings, 6% of which is made up of nitrous oxide, a toxic gas 300
times more destructive to the environment than carbon dioxide, along with hazardous waste,
for the safe disposal of which more than half the countries in the world leave unregulated.
These facts condemn the global healthcare sector to being the second worst “environmentally”
performing industry globally.
The shift to constructing sustainable healthcare facilities is largely cantered on reducing the
carbon burden in hospitals whilst ensuring that the occupants are kept safe, and environmental
impact is minimised.
Therefore, it remains essential to involve the incorporation of green designs and concepts into
the process to reduce the impact on the environment, cut down operational costs, and
increase energy efficiency to allow owners and operators to reduce their carbon footprint.
There is no global standard that defines what a ‘green and healthy hospital’ is or should be,
at tangram we are into our 4th decade of delivering healthcare projects in the region that
respond individually to their own specific location and climate. We always advocate the
incorporation of passive sustainable designs in the siting, construction and landscaping of our
projects and incorporate biophilic elements to bring in the calming natural world for its’ healing
and therapeutic properties as we work toward zero – zero carbon, zero waste, zero emissions.
Bringing a new green strategy to the physical building stock, by introducing a range of Modern
Methods of Construction (MMC) delivery options in a factory to frame approach. And, in our
commitment to collaborative project working, we are embracing digital technology from the
outset of each project to allow us to move seamlessly from conception through to delivery,
reducing risk and optimising value and programme along with minimising the impacts that the
building has on the environment.
Modern Methods of Construction (MMC)
Offsite technologies and smart digital construction techniques are now recognised as being
integral to providing critical solutions to many of the complex challenges facing the
construction industry today as we must drive change and reform the way in which we build to
enable the much-needed transformation to a decarbonised future.
Panelised, volumetric modular systems, pod and prefabricated MEP solutions are growing in
popularity, thus, adopting a MMC approach and moving more of the build into a factory setting
can significantly reduce the carbon emissions of a building or structure.
Embodied Carbon
This is the carbon emissions associated with the materials and construction processes
throughout the entire lifecycle of a building or structure.
Manufacturing processes produce much less carbon than traditional onsite construction
processes.
There can be much less transportation needed to be used reducing the constant flow of trucks
and lorries in and out of site with materials or products and components to be put together
from different points of origin. Once factory prefabrication is complete it can be delivered to
site quickly in a programmed and efficient single series of agreed deliveries, saving upto 40%
of transportation needs, reducing time, cost, and pollution.
Waste also can be drastically reduced, the standardised size and fixings of components and
repetitive processes creates much more accuracy in production and gives less room for errors,
enabling better control of material quantities needed to be available. By allowing for a more
strategic workflow which can be more precisely monitored, honed, and managed, material
wastage can be minimised. This will reduce waste generation which combined with improving
recycling, reuse, and circularity of most typically perceived “waste products” which can then
be diverted from landfill.
Operational Net-Zero Carbon
This is when the net amount of carbon emissions associated with the building’s operational
energy, on an annual basis, is equal to or less than zero. Operational energy consists of the
annual amount of energy required for heating, cooling, lighting, and power.
This part of the net-zero element is influenced in the design stages of construction. MMC and
offsite construction can offer a controlled manufacturing process that is able to deliver to a
higher quality and to more of a certainty of achieving the required performance levels for low
U values, good insulation, and minimal air leakage etc. This manufacturing process also
produces greater levels of air tightness and an overall improved building performance. All
instrumental in ensuring buildings meet operational net-zero requirements.
Advancing to net-zero carbon can prove to be key for the delivery of any future hospital and
any buildings of growing complexities, hospitals are the very microcosms of our cities, we must
not shirk from our responsibilities as designers and must prepare these costly, physical assets
for adaptability, disassembly, and reuse.
The Healing Environment
Critical to all our work in the healthcare sector, is creating a healing environment that has
nurturing and therapeutic effects is key. Research shows that well designed healthcare
environments can reduce patients stress and anxiety, accelerate recovery, reduce lengths of
inpatient stays and medication use, along with promoting an improved sense of well-being,
improving patient outcomes. Additionally, staff and visitor experiences are improved,
satisfaction and productivity rates increase and positivity’s in staff recruitment and retention
are achieved.
We ensure that natural light, calming interior design, improved internal air quality and comfort
levels that include noise reduction are all combined with the psychology of colour, textures
and the inclusion of the building at one with nature, both internally and externally. Making
hospitals healthier places to stay, visit and work in.
Virtual Hospital and Cyber Clinics
To provide a patient-centric remote care model that reduces patient visits to hospitals and by
delivering healthcare to where patients live, and work will break down the walls and remove
the need for many outpatient consultations and functions to be held within costly, centralised
facilities that can concentrate on the care of our more needy patients as we expand on the
now familiar telemedicine platforms which have grown in usage over the last few years.
Utilising affordable remote diagnostics and monitoring via sensors, apps, and equipment
connecting patient and clinical team through web-based or smartphone apps, advances in
technology can make it easier for more people to access healthcare, in convenient locations
when and how they need to. Telehealth is especially helpful to monitor and improve ongoing
health issues, such as medication changes or chronic health conditions. enabling quick and
easy data flow between clinicians and patients, utilising existing continuous home clinical
monitoring techniques to relay data, home sample collection methods for ease of delivery for
lab analysis and courier deliveries for prescriptions. Reducing the need for patient and
medication management to take place in costly clinical settings.
For remote communities and patients unable to access or use web-based equipment, physical
cyber clinics will be created, where trained staff can aid those who need it to use equipment
provided to access this service with privacy. Such facilities will take the cost pressures off as
they are removed from the costly clinical staffing and servicing of more acute level spaces.
Consultations with clinicians who also may be sitting outside of costly acute settings, and will
be relayed electronically, and held within virtual spaces, designed using AI and based in the
Metaverse. Where the cost of creating calming, relaxing and therapeutic healing environments
are free of the more expensive physical constraints, of structure, building fabric, infection
control management, servicing, and cleaning.
We utilise blockchain technologies to structure, code and store all sensitive health data with
inherent security that simplifies health information exchanges.
Virtual learning and development
Virtual training will become more prevalent in the future, though, never fully replacing handson, in-person medical training and simulation. The opportunities to carry out much of this
remotely and collaboratively in spaces created in the Metaverse will bring wider and more
diverse participation. It will alleviate time and cost constraints, whilst being more accessible to
all.
Our Hospital of the Future typology is based on patient-centric care which reduces the cost of
healthcare delivery, whilst improving its efficiency, access, and quality. It may look very
different from the hospital of today as it responds to the speed, capacity and quality of growth
needed across the sector, and physically offers only services that cannot be digitised. We
must all take steps to reduce the carbon burden on the environment, reducing and
transforming how we build is critical to not only our own health, but to the health of our planet.
2024
