Maria Chiara Torricelli

Hospital health care offer. A monitoring multidisciplinar approach

The experience we are going to show here represents the synergic work of researchers coming from different cultural extractions: bioengineers, architects and physicians. The Monitoring System (called MonLAB) wanted by Careggi Hospital (Florence, Italy) together with University of Florence is supervising the process of deep rethinking of the hospital itself, started in 1999 and scheduled to end in 2010. To do this, we developed many procedures and ICT tools to achieve these main goals: time and cost monitoring, critical moments prevision and alerts generation, real-time control of hospital evolving estate in terms of beds, ambulatories, deposits, clinicians rooms, technologies and more.

Circulation Patterns and the Transformation of a Historic Hospital in the Time Perspective of OB

Hospitalstr aretr complextr buildingstr thattr aretr nevertr finished.tr Theytr undergotr continuoustr transformations throughouttr theirtr lifetime.tr Intr thistr scenariotr thetr designtr oftr thetr flowstr andtr pathwaystr (peopletr andtr logistics)tr within thetr hospitaltr istr oftr greattr importancetr intr thetr performancetr oftr builttr environmentstr concerningtr accessibilitytr totr care andtr efficiencytr intr thetr deliverytr oftr care.tr Thetr networktr oftr flowstr istr intr turntr linkedtr totr needstr conditionedtr by technologicaltr developmentstr andtr healthtr requirements. Giventr thetr concepttr oftr basetr buildingtr andtr fit-xad‐outtr systemstr testedtr intr thetr INOtr project,tr thistr papertr aimstr totr addresstr the notiontr oftr ‘opentr building’tr intr healthcaretr buildingstr studyingtr thetr relationshiptr betweentr thetr networktr oftr flowstr and, basetr buildingtr systems. Thistr topictr hastr beentr developedtr analysingtr thetr empiricaltr casetr studytr oftr Santatr Mariatr Nuovatr Hospital,tr which,tr since thetr yeartr oftr itstr foundationtr (1288),tr hastr nevertr stoppedtr beingtr atr hospital.tr Ittr hastr undergonetr severaltr renovation projectstr overtr thetr pasttr sixtr centuriestr andtr istr nowtr undergoingtr thetr finaltr redevelopmenttr process. Thetr papertr focusestr ontr certaintr aspects:tr Whattr buildingtr modificationstr weretr necessarytr totr accomplishtr atr changetr of usetr intr thetr hospitaltr overtr time?tr Howtr circulationtr patternstr evolvetr throughouttr thetr time?tr Whichtr spatialtr elementstr of thetr originaltr structuretr allowedtr fortr modificationstr totr thetr architecturetr andtr fortr thetr circulationtr totr evolvetr fromtr ring andtr lineartr patternstr totr antr integratedtr network? Throughtr atr descriptiontr oftr fivetr planstr oftr thetr hospitaltr wetr highlighttr howtr thetr spatialtr elementstr (cloistertr andtr nave) andtr changestr intr technical,tr social,tr political,tr andtr medicaltr practicestr influencedtr thesetr patterns. Thankstr totr thistr historicaltr analysistr thetr papertr contributestr totr detecttr thetr OBtr matrixtr nottr justtr astr physicaltr invariant buttr alsotr astr patterntr oftr occupationtr oftr spacetr (intelligibility)tr supportedtr bytr cloistertr andtr navetr presence. KEYWORDS:tr hospitals,tr circulationtr pattern,tr support,tr transformation,tr intelligibility 1tr Circulationtr patternstr overtr time Santatr Mariatr Nuovatr hospitaltr istr onetr oftr thetr mosttr importanttr hospitalstr intr Florence.tr Ittr wastr builttr intr thetr historic centretr oftr Florencetr andtr cantr betr proudtr oftr atr longtr developmenttr history,tr startingtr fromtr itstr foundationtr (1288)tr uptr until today.tr Below,tr wetr willtr recounttr thetr historytr oftr thetr Santatr Mariatr Nuovatr buildingtr throughtr atr descriptiontr oftr the principaltr transformationstr thetr hospitaltr underwenttr overtr timetr intr antr attempttr totr interprettr thetr majortr causes underlyingtr thistr processtr oftr change:tr hospitaltr set-xad‐up,tr thetr evolutiontr oftr medicaltr procedures,tr politicaltr causestr or naturaltr events.tr Thistr descriptiontr willtr betr summarizedtr intr fivetr planstr wheretr sometr diagramstr showtr thetr circulation patternstr andtr representtr theirtr evolutiontr overtr time. 1.1tr 1288-xad‐1500tr Thetr foundation Santatr Mariatr Nuovatr hospitaltr wastr foundedtr intr 1288tr bytr onetr oftr thetr mosttr importanttr merchantstr intr Florence,tr Folco Portinari.tr Ittr wastr built,tr intr responsetr totr thetr populationtr growth,tr totr taketr caretr oftr thetr poortr andtr thetr sicktr andtr totr give themtr spiritualtr support.tr Ittr wastr constructedtr attr thetr limittr oftr thetr lasttr walltr surroundingtr thetr city.tr Intr thistr waytr patients couldtr benefittr fromtr thetr healthytr environmenttr andtr thetr inhabitantstr oftr Florencetr weretr nottr botheredtr bytr thetr bad smellstr comingtr fromtr thetr hospitaltr (Lucarellatr 1986).tr Thetr hospitaltr wastr situatedtr ontr thetr northtr sidetr oftr atr squaretr intr an areatr closetr totr thetr Churchtr oftr Sant’Egidiotr andtr atr smalltr conventtr nexttr totr it.tr Thetr originaltr structuretr oftr thetr hospitaltr was