OPEN BUILDING: AN ARCHITECTURAL MANAGEMENT PARADIGM FOR HOSPITAL ARCHITECTURE

This paper discusses a significant and innovative architectural management method, used for the first time in a medical facility under construction in Bern, Switzerland. The 50,000 square meter project – the INO is being managed by the Canton Bern Building Department. The client and the management team recognized when the decision was made to build a major addition that complex buildings such as this only become "whole" over time. They had come to realize, after many conventionally procured buildings, that inevitably the program of functions changes to meet new medical procedures, new regulations, and new market and insurance conditions. Recognizing these dynamics led to a decision to adopt an entirely new process for procuring the facility, and with it a concept of distributed design management. A competition was held to select a design and construction firm for each of three distinct "levels". The primary level is intended to last 100 years and is expected to provide capacity for a changing mix of functions. The secondary level is intended to be useful for 20+ years, and the tertiary level for 5-10 years. The approach discussed in this paper deals in a new way with problems of facilities change, and the concomitant management of distributed design and construction responsibilities. As such, it represents a good example of “open building” theory and practice, an approach to facilities design and construction that is conventional in the office and shopping centre markets and increasingly in multi-family residential construction worldwide. The INO project is the first known project to apply these principles of architectural management in health care architecture. It therefore sets a new standard for adaptable medical facilities, offering an alternative paradigm to meeting critical needs in the field of health care architecture.