 Architects

Lemanarc SA
 Location
Zhongshan North Road & Drum Tower Square, Gulou, Nanjing, Jiangsu, China, 210008
 Architect in Charge
Vincent Zhengmao Zhang
 Area
230000.0 sqm
 Project Year
2012
Nanjing Drum Tower Hospital, founded by Canadian Missionary Dr. Macklin, is located in the
downtown center of Nanjing city. It is one of the most renowned hospital in China. The earlier
expansions of the hospital was driven by the of development of modern medical technology as
well as the increasing municipal population. Despite the remarkable scales, most of these early
expansions are hardly more than simple and urgent addition and extension of existing function
to meet the rapidly increasing need for medical service. As a result, the functional layout of
many floors are not well organized and streamlined for the operation of the hospital as a whole.
For instance, the existing outpatient department is on the east side of Zhongshan Rd,
connected with the main buildings of the hospital, which is on the west side, only through a
narrow underground passageway, which makes extra inconvenience to both patients and
staffsIn the year 2004, in answering the rapidly surging demand for medical service by a larger
and wealthier municipal population, Drumtower hospital planned to implement a new expansion
using a 32,000 sqm site between Zhongshan Rd. and Tianjin Rd. The expansion project will
also be followed by a reorganization and overhaul of the existing layout and functions. After
many discussion and consultation with the hospital client, our design team led by Vincent Zhang
helped in making a insightful long-term developing project. According to the project, a total of
2800 beds will be served, of which 1600 is provided by the new expansion. Daily outpatient is
planned to reach 10,000 person. And the overall gross floor area of the hospital is 230,00
m2Scalewise, the project is in fact equal to the GFA of the 420m, 88-floor Jinmao Tower, the
highest building of China back then. But contrary to the general expectation of a high rise
hospital building, we made a seemingly surprising choice: instead of stacking floors one upon
another and resulting in a high floor area ratio, we decided to ‘lay it down’ to create a series of
gardens at the floor area ratio of 5.2. Such preference for low rise building went squarely
against the design trend at that time, which is dominated by the frenzy for skyscrapers. But seen
at present, it is quite sure that we have made a right decision, for the low rise plan not only
reduced the stress on vertical traffic—which is a constant trouble for large general hospitals, but
also creates large areas of urban space with human scales. But the benefits does not come for
free. Indeed, by choosing a more scattered, low rise plan, the architects were facing various
challenges: from organizing the arrangement for the newly built areas, understanding and
analyzing the operation and rules of the hospital, to the planning of ideal operating model for the
new hospital. And more importantly, it requires us to reconsider the possibility of inheriting the
medical culture and explore the new identity of medical service.
The creation of human-scale building through the unification of architecture and landscape

Nanjing Drum Tower Hospital, founded by Canadian Missionary Dr. Macklin, is located in the
downtown center of Nanjing city. It is one of the most renowned hospitals in China.The earlier
expansions of the hospital was driven by the development of modern medical technology as well as
the increasing municipal population. Despite the remarkable scales, most of these early expansions
are hardly more than simple and urgent addition and extension of existing function to meet the rapidly
increasing need for medical service. As a result, the functional layout of many floors are not well
organized and streamlined for the operation of the hospital as a whole. For instance, the existing
outpatient department is on the east side of Zhongshan Rd, connected with the main buildings of the
hospital, which is on the west side, only through a narrow underground passageway, which makes
extra inconvenience to both patients and staffs.

In the year 2004, in answering the rapidly surging demand for medical service by a larger and
wealthier municipal population, Drumtower hospital planned to implement a new expansion using a
32,000 sqmsite between Zhongshan Rd. and Tianjin Rd. The expansion project will also be followed by
a reorganization and overhaul of the existing layout and functions. According to the project, a total of
2800 beds will be served, of which 1600 is provided by the new expansion. Daily outpatient is planned
to reach 10,000 people. And the overall gross floor area of the hospital is 230,00 m2. Scalewise, the
project is in fact equal to the GFA of the 420m, 88-floor Jinmao Tower, the highest building of China
back then. But contrary to the general expectation of a high rise hospital building, we made a
seemingly surprising choice: instead of stacking floors one upon another and resulting in a high floor
area ratio, we decided to ‘lay it down’ to create a series of gardens at the floor area ratioof 5.2. Such
preference for lowrise building went squarely against the design trend at that time, which is
dominated by the frenzy for skyscrapers. But seen at present, it is quite sure that we have made a
right decision, for the low rise plan not only reduced the stress on vertical traffic—which is a constant
trouble for large general hospitals, but also creates large areas of urban space with human scales.
2. The realization of compact efficiency by modulation

Adepartment matrix is devised according to the division of body parts and treatment methodology,
which facilitates the connection among logistics, equipment and communication.(insert)

Four L shaped medical areas form a continuous enclosure that tightly connects various types of space
both internal and external of the hospital. The perfect vertical correspondence among the underground
pharmacy storage center, the nursery station of the inpatient department and the outpatient
pharmacy greatly reduces delivery distance of medicines. The sampling points on each floor are
standardized, which simplified the logistic connection in the test center. The integrated med-tech and
imaging center is shared between inpatient and outpatient departments, which greatly enhanced the
efficiency of medical equipment. We also designed a branched intersecting system by considering the
space for patients, staffs and treatments. Serving network and served network is woven into a whole
while keeping their independent operation ability. Furthermore, an integrated network with shared
doctor pool and doctor flow is designed to more reasonable and economic use of medical resources
and facilitate the nursing of patients.
A system of unified basic module is applied to the dimensions of most of items, from standardized
document folds, desks and chairs, reception desk, sickbeds, windowsills, doors, doorways and rooms,
to clinic areas, department areas, parking and passages. All the dimensions are integral multiples of
the basic module. And elementary building components made with unified modules are put together to
form modulated spaces of a higher level. The modulation of various functions and needs of the
hospital is a key to our design. Once clearly rearranged and configured, the functional modules are
adapted to the preserved modulated spaces. The universal module is strictly followed throughout the
project, from site planning to the detail design of the furniture. Modulation design process not only
makes possible clear spatial layout and convenient connection, but also provides extra expansion
capacity for the future developments of the hospital. By large-scaleprocurement and parallel
construction, we significantly brought down the building cost. The final building cost of the whole
project is merely RMB 5300 Yuan per square meter, making Drumtower hospital expansion project
one of the most cost-efficient hospital projects in China.
3. The preservation of urban memories from the crossing and overlapping of city axes

One of Macklin’s mottos reads ‘HuaTuo cures human body, wile Holy Spirit saves human soul’. As
distinct from ‘diseases’, which is a pathological concept, the notion of ‘patient’ includes a rich cultural
dimension. Since the establishment of the hospital more than a century ago, Drumtower hospital can
be seen as a miniature of Chinese modern history. More generally, it is also an indication of the
difficult effort to find the self-identity not only by Nanjing, but also China as a westernized ancient
oriental civilization. From the outset of the project, we rediscovered an ancient dating back to Ming
dynasty, which is distinct from the Haussmann style north-south axis from Nationalist era that is
instantiated in Zhongshan Rd. These two axes cross each other at an angle that forms the border of
our site. In order to preserve the ancient axis, the project is arranged following double axes: the med-
tech and inpatient area in the north follow the Drumtower axis, whereas the outpatient in the south is
organized along the Zhongshan Rd. axis. Thus the two axes from different historical periods meet and
cross each other in the site. The resulting stress between the axes gives a special quality to the
landscape space in these areas. In so doing, we not only inherit and preserve the ‘genes’ of urban
memories, but also created a series of useful and interesting spaces.

4. Gardenized architecture with modern technology

In the atrium of the inpatient department, spotlights made of steel and matt glass are integrated into
the roof truss. With natural and artificial illuminating from above, the atrium reminds the visitors of
the purity and sublime one experiences in the interior of a cathedral. While the small balconies
cantilevering from the facades surrounding the atrium in irregular patterns reminds us the choir on
both sides of the cathedral aisle.

Hospitals are places where newborns come to the world and the deceased leave it. It witnesses the
most important rituals of life. It is an island of care and love for the sick and the weak between the
mundane and heaven. In our project, the metaphor of island is emphasized by the partial isolation of
the main buildings from the surrounding.

In etymology, the term ‘hospital’ as the same root as ‘hotel’, both of them come from Latin hospis,
literally meaning ‘guests’. It means that in Western tradition, hospital is essentially related to the
merciful action of gathering and treating of patients. On the contrary, in traditional Chinese, the
concept of hospital, i.e. ‘医院’ (yiyuan), is a combination of two characters, one means ‘healing’, and
the other means’ garden’. In contrast to the ‘gardens’ in Western culture, which constantly represents
a “internalized nature” and has become a symbol of highest good, in Chinese traditional understanding
of garden emphasizes the symbiosis relation between patients and residence. Out of this
consideration, we designed three levels of gardens that can be shared throughout the hospital.

Layer 1: The six large gardens formed by the building volumes can be shared with hospital and the
public. To the north, the courtyard enclosed by both the new and the existing parts of the hospital
provides for staff, patients and the public with tranquil places for rest and recreation. A roof garden
resulted from overlapping of north and south volumes is facing Tianjin Rd to the west of the site, it
serves as an sheltered entrance space. In due correspondence, we also create a double floor space in
the east entrance on Zhongshan Rd. Emergency area is located in a gardenized corridor linking Tianjin
Rd and Zhongshan Rd, which is accessible from all the directions. The atrium surrounded by
outpatient department is itself a huge greenery area. While the outpatient lobby beneath is naturally
illuminated by a dozen bamboo-planted light wells, which brings sunlight—together with beautiful
shadows of bamboos—to the lower area. Last but not least, the open plaza in the south is presented
to the public, especially college students of the nearby Nanjing University.

Layer 2: The second layer of gardens is composed by scores of smaller light wells scattered evenly
throughout the hospital. From med-tech, inpatient and emergency, tp outpatient and conference
areas, these light wells not only brings in skylight and therefore save the energy, but also help
creating gardenized spaces.

Layer 3: The third and the most intimate layer of gardens are those on the facades: the project
provides each room with an small vertical garden right in front of windows.

Thanks to the ubiquitous presence of garden, external interfaces of traditional Chinese architecture
become multi-layer and multi-functional green spaces. At least six layers are instantiated in the
interface, they are: light, wind, landscape, plants, usage and filter. Inspired by such layers of
gardens, we intend to ‘translate’ these separated layers into the facades of the new buildings. Instead
of papers, we use translucent glass on the bay window, which provides soft and bright natural
illumination to the insides. In the place of traditional bamboo curtains, we use perforated aluminum
panel as sunshade. Furthermore, green plants are woven in front of every window on the facade,
which reminds us window frames in traditional Chinese architecture.

Light

The bay windows are made of matt glass panel, through which the smooth and soft light provides the
indoor space with better lamination than normal windows and therefore help reduce illumination
energy consumption. In the mean time, the translucent panel also guarantees privacy for the ward.

Wind

Between the recessed and bay windows in each facade unit, we integrated on each side a side an
opening window, which allows for natural ventilation parallel to the façade. During the summer, the
lateral air flow dissipates the heat near the windows, and prevent the overheating of the room inside.

View

The glass panels on the recessed windows forms different frames optimized for viewing. Together with
the asymmetric shapes formed by surrounding bay window, it provides unique relationship with the
exterior landscape.

Plant

Taking advantage of the longitudinal areas between recessed windows and bay windows, we designed
a planting box, so that plants like ivy could grow in this space, which are watered by drip irrigation
technology.

Usage

The internal space of the windowsill has the same height as tables. In clinics, windowsills become
natural extension of clinic desks and serves as extra areas for storage of books and documents. In the
wards, however, they provide spaces for flowers, which also contribute to the gardenization of indoor
environment.

Shading

The outmostlayer of the façade is made by a hangingsystem of perforated aluminum panel with
similar translucency with that of matt glass. Itcovers the entire façade creating an efficientshading
system. Nanjing is one of the hottest cities of China in summer, local building usually consume a lot of
energy for air conditioner. Benefited from the external shading, the new hospital, which is mainly
arrange on the east-west axis, save a significantly amount of energy in this respect.

Although the new expansion of Drumtower Hospital exceeded 10,000 daily visitors during its first
month after completion.we can hardly feel the noisy and crowdedness that are daily routine in many
other hospitals. The sunshine and gardens are everywhere in sight. Instead of using skylight as a
symbolized expression of grandiose and sublime, we try to let it seep smoothly into every corner,
illuminating what is going on there everyday. Of course we are not able to cure all the diseases, but it
is within our ability to treat all the people in the hospital kindly and mercifully. In the year 2012, the
new expansion of Drumtower Hospital was voted by Nanjing citizens as the first of ten most
remarkable landmark architectures—an honorable fact that speaks quite a lot for itself.Drumtower
hospital’s design has won the award of WAN for the year of 2013, in the section of Healthcare
Architecture. it is the only hospital design which got this award in the region of China.

It seems to the architect that in the era of ‘de-architecturization’, the building behavior will finally
evolve and become the instrument of making gardenized architectural contexts. In other words,
architecture will once again become the bearer of garden. The Drumtown expansion project therefore
can be seen as a pleasant step in this direction.