Nature &  Nurture


Designing Sustainable Healthcare Facilities 

Since 1991, A3 Architects has built an impressive portfolio of sustainable, specialist healthcare facilities throughout the continent. Therefore, it should come as no surprise that SCAPE decided to lean into their well-found architectural knowledge of creating harmoniously suitable end-user hospitals to glean some more insight. Read along as Milos Petkovic, A3 Architects’ Senior Professional Architectural Technologist, shares the inside-scoop behind their ‘careful consideration’ when designing these spaces.  

Key Considerations for Designing Sustainably 

When it comes to coordinated services, hospitals are some of the most complex building projects out there. Going green takes it another notch further, adding an additional layer of complexity that affects almost everyone involved. Perhaps the biggest challenge can be aligning the client’s expectations with the architect’s design philosophy and Green Building Council South Africa’s (GBCSA) sustainable requirements. However, transcending the tagline of simply placing green design principles on paper for the sake of ticking something off your list, greenfield facilities need to prove that sustainable design is both possible and feasible – leading to real change. The pursuit of an improved building environment has to progress the quality of the patient, staff, and visitor’s experiences. In design terms, this progression of sustainable synergy is both logical and natural, evolving from the architect’s conceptual design into the final build.  

The Nature of a Green Star Hospital  

The Green Star rating concept is relatively new to hospitals in South Africa. As such, the first and only Green Star-rated facility in the country is Cintocare Head and Neck Private Hospital in Pretoria. The project, which was completed in 2021 and received a 5-star GBCSA rating, required the development of a custom evaluation tool and served as a learning curve for the entire design team. The Green Star-rating system is a tool that objectively measures the design of green buildings. Since the rating is based on both the ‘Design’ and ‘As built’ criteria, the designer’s success lies in constructing a building exactly as the plans were intended and presented. A3 Architects’ design philosophy perfectly merged with GBCSA’s credit requirements, with many parallels between its green principles and design process. Due to the high energy and water consumption required for the daily operations of a hospital, developers are radically rethinking the healthcare industry’s impact on the environment. What makes the Cintocare hospital so unique is its ability to reduce its operational footprint to create a place that comes alongside nature to nurture.  


Healthcare-Specific Systems and Materials 

Hospitals need to be designed with appropriate HVAC (heating, ventilation, and air conditioning) systems to manage indoor air quality and infection control. This system is integrated and coordinated with all other services within the facility to allow maintenance and optimal functioning. Cintocare has an installed Building Management System (BMS) that links all of the systems and services throughout the building together to be monitored and controlled from a centralised system. 

End-User Fundamentals   

When specifically designing healthcare facilities, A3 Architects’ design philosophy is centred around the well-being and experience of the patients, staff, and visitors. Fundamental end-user elements to consider include thermal comfort, natural light, green spaces, and establishing a visual connection to the natural environment in and around the facility. Aurecon and A3 Architects worked closely together to apply the new requirements of GBCSA’s PEB v1 (Custom) Healthcare tool to Cintocare’s design. Green Dot materials were also used throughout the building process. 

The Future of Sustainable Facilities 

A3 Architects is in the process of constructing the Johannesburg Surgical Hospital (JSH) in Fairlands, Johannesburg. This specialist facility will cater to its own unique context and site, while drawing on the architects’ design philosophy and utilising the latest materials and systems. 

Healthcare facilities carry enormous potential to be more than just ‘buildings that house services to treat patients.’ Part of the design process behind green hospitals is also considering the people inside. Everyone from the cleaning staff to the nurses rely on functional well-being to cater to the needs of those who walk through the doors of the facility. Similar to what we see in nature: the environment influences the outcome. Within the context of a hospital, the health and well-being of the staff will greatly benefit the patients. An abundance of natural light, visual links to nature, and access to open landscaped gardens for staff, patients and visitors are some of the elements that can make a substantial difference. Therefore, architects should strive to design buildings that can assist in the healing process, fostering an environment where the patient’s experience inside the facility is beneficial to their recovery. 

Kevin Hinde, CEO and Principal Architect, and Milos Petkovic, Senior Professional Architectural Technologist 

A3 Architects


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