The New Hospital of Cremona

The site straddles the urban expansion of Cremona and the Park of the River Po and Morbasco, reconnecting them. The New Hospital develops as a continuation of the new landscaped Healthcare Park and is arranged in a semi-circular configuration that ensures both elements are physically and visually permeable. The architectural design is based on centralising “cores” that serve as starting points from which new areas of future expansion can develop: at the places where the greenery emerges from the Healthcare Park, covered spaces are created that relate it to the surrounding landscape so that the Park can be colonised over time, enabling the new hospital to become an active place for social encounter and interaction.

To further encourage this development of new relationships with the community, the existing children’s nurseries and educational functions are complemented by a new library and short-stay residences for patients and families.

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The site straddles the urban expansion of Cremona and the Park of the River Po and Morbasco, reconnecting them. The New Hospital develops as a continuation of the new landscaped Healthcare Park and is arranged in a semi-circular configuration that ensures both elements are physically and visually permeable. The architectural design is based on centralising “cores” that serve as starting points from which new areas of future expansion can develop: at the places where the greenery emerges from the Healthcare Park, covered spaces are created that relate it to the surrounding landscape so that the Park can be colonised over time, enabling the new hospital to become an active place for social encounter and interaction.

To further encourage this development of new relationships with the community, the existing children’s nurseries and educational functions are complemented by a new library and short-stay residences for patients and families.

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As a new piece of landscape for the city of Cremona, the Healthcare Park gives the community a new reference point that is animated by spaces for socialising as well as by quieter, more introspective places for care of the person and for general physical and mental well-being, in a setting of naturalness and urban biodiversity. The Healthcare Park contains three characterising elements:

• a climatic forest: a natural system that surrounds the hospital, with green pathways passing through it that interconnect a sequence of therapeutic activities for residents and users of the hospital, alternating with areas of animal and plant biodiversity;
• a vitality ring: this is a pedestrian route with spaces for recreation, sport, and social interaction;
• a rural ring: with an extensive natural system of meadows, and a lake at the centre, is the most important feature of the whole Healthcare Park.

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The hospital building is designed as a single complex containing a multiplicity of functions and relationships. It has seven floors above ground, split into two main blocks connected at the main ground floor entrance (Level 00): the four advanced technology surgery departments (for emergency, cardiovascular, multifunctional, and minor surgery) are contained in a central block. At the level above it, a separate department contains the areas for medium tech/low tech surgery.

An important aspect taken into account at the design stage is the new flexible approach to hospital management: the project has been designed to facilitate the process of re-organising the areas of the hospital when there are changes in healthcare needs (20% of the single rooms can be converted into intensive care areas by introducing a filter, and the remaining 80% are transformable into two-bed rooms should there be an unexpected requirement to provide additional beds). The architecture of the New Hospital of Cremona also establishes a hierarchy of accessibility to the different spaces: from intimate rooms where the privacy and well-being of the patient are predominant to more permeable spaces open to the public, with retail and other services for users of the hospital and for visitors. One of them is the Hospital Street, an area for the public where hospital personnel can also meet and interact. At the level above is a Management Centre, with dedicated spaces for managing the clinical activities that are dispersed across the region.

The design process placed the user at the centre of the hospital system and was based on principles of empathy and creativity, and on understanding the needs of the patient on a par with those of the hospital staff and visitors. The design strategy was guided by assuming that the needs of the patient are fundamentally the centre of the hospital system. Each patient will experience different hospital environments depending on the care pathway they take and on the intensity of treatment they require; the different departments are no longer separate “cells” isolated one from another but are organised instead as different groups of professionals (doctors and nurses) working for the patient. This results in a system where the whole hospital collaborates as a single department in caring for the patient, rather than as a sum of separated departments.

Outpatient services are a strategic part of the New Hospital and act as a bridge between it and the surrounding territory. They consist of:

• Accident and Emergency. Located at the ground floor (Level 00), the A&E Department is a reflection of the ‘hospital in a hospital’ concept and can operate independently without any need for interference with the rest of the hospital; however it is also connected by rapid dedicated routes to the diagnostic services, surgery blocks, the intensive care department, and the inpatient wards. For dealing with health emergencies the A&E Department also has a separate isolation unit where infected patients can be treated, and is connected to the hospitalisation areas by a corridor that can be pre-designated as a dedicated direct route.
• Diagnostic imaging. Located at the ground floor (Level 00) adjacent to Accident and Emergency, this service is connected by dedicated corridors to the Surgery Block and the Intensive Care wards.
• This is at Level 01 away from the other circulation routes, and is connected to the check-in and reception areas.

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The design of the New Hospital takes the opportunity to incorporate nature-based solutions that mitigate the effects of climate change within the building and in the outdoor spaces: it uses natural elements and processes (such as vegetation, water, and the choice of flooring materials) that all work together to mitigate the urban “heat island” effect, reducing the perceived average temperature by approximately 4°C as compared to the present.

As well as using specific materials and construction methods, other passive design strategies such as optimised orientation, wind permeability, and natural daylighting are used to minimise environmental impact and reduce CO2 omissions.

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