B-House

B-House
I wake up and… then what?
 

What if a patient designs the healthcare center?

Some claims pop up so often in promotional texts that no one believes them anymore. One of them: the patient comes first. Would it? B-House is a proposal for a healthcare building based entirely on the patient.

The project was started by Boukje Bügel-Gabreëls (1969 – 2020), a fellow classmate who became seriously ill. During her illness and rehabilitation process she encountered the limitations of the current healthcare architecture. This triggered her to create the ‘Manifesto of Healthcare’ and to think about how we could improve healthcare buildings. B-House is a reaction to the manifesto.

Boukje wrote down her experiences in diaries and shared them with her loved ones. In words and images she initiated spatial proposals. Hope is central in all her stories. The resulting values and resources support this and also address a strong connection with nature and people.

B-House replaces the current Reade rehabilitation center in Amsterdam, which will move to the site of the OLVG West hospital in the edge of the city. The current building turns away from both the city and the park behind it. B-House does the opposite: it adapts to the immediate environment through urban life in the ground floor and through a garden as an extension of the Vondelpark. In this way, B-House is an inherent part of the city and B-House gives back space to the surrounding residents and visitors. Patients (or rather: residents) of B-House are an inseparable and autonomous part of society.

Focusing on the patient: designing in the I-perspective
The project has been approached completely from the point of view of the resident. During the design process, the question was constantly asked “I wake up.. and then what?” “What do I do next, what does my day look like?”

In this way the building has grown from the bed. Step by step, spaces were added and the scale of the design grew: from bed, to home, to common areas, building, health clinic, spa, garden, park and city. Residents can determine for themselves to what extent they want to be part of the community.

This way of designing has led to a main set-up of three buildings: First a residential building (bed house) on the Overtoom, where each house has a view of the quiet park side, as well as involvement with the busier communal city side. Secondly there is a health clinic, where the route is continuous. Patients do not walk back into the waiting room, but after the treatment room they walk back to the exit via a kind of cloister with a flower garden. Thirdly there is a spa, which is part of the Vondelpark as a sunken garden in built form.

B-House concerns a current issue: can architecture influence healthcare?
An interesting background is that the human view of healthcare always has many parallels with the world views of the time. Where in the Middle Ages the sick were mainly isolated by epidemics, in the Renaissance people wanted to heal people. Subsequent technological developments made hospitals increasingly necessary and economic developments increasingly efficient. The exponential economic growth and political developments of the last decades have led to a privatization of healthcare. At the same time, the current pressure on healthcare, an aging population and increasing population demand a revision of the healthcare vision.

During the process, interviews and workshops were held with relatives of Boukje, healthcare providers, healthcare developers, scientists, the current owner of the building and others. It was striking that everyone wants the same thing: everyone knows someone who has been in hospital and above all wants to be there for that person and take care of them. They all want to be part of the ‘broad care team’. There was also a general call for the building to be very specific, but flexible at the same time, appropriate for the present time. Every patient is unique and has their own needs.

This fits in with the development of healthcare, where large healthcare locations are increasingly shifting to the outskirts of the city and more specialist, informal or regular healthcare locations are designed integrated into the city, with patient-oriented scaling down. The integration of the building promotes healthy urban life, in which prevention is key. The soft design language, the idiom, in a rigid basic grid of CLT wood structure and the connection between nature and people promote well-being.

B-House is mainly intended as an instigator to think about better healthcare buildings, in addition to showing a number of concrete design solutions. Due to the privatization of healthcare, many healthcare buildings have been designed as efficient machines, where the insurer determines the quality of vulnerable life. In B-House this is radically reversed: here the resident, their relatives and therefore the quality of life (and death) are key on all scale levels.

In B-House everyone is more human and less patient.