Children At The Heart Of Design For Queen Silvia's Hospital For Children And Young People

The new, 35,000m² hospital, with operating theatres, an intensive care unit and three floors of single-bed patient rooms, provides specialist care for children of all ages from all over Sweden. Patients range from children on short stays after surgery to long-stay patients with serious or life-threatening illnesses, who require 24/7 care. “Our ambition was to create a homely atmosphere for the children and their families, as well as to provide the best possible working environment for our staff,” says Monica Johansson, our client, and the project manager for the hospital. “It was vital that everyone understood what we were aiming for.

WSP attended workshops with the hospital administration, medical teams and technical staff, as well as with the architects and project design and construction team, to identify the requirements of the hospital. 

Communication was key, as project leader for WSP, Marcus Frost, explains; “This was a large and very complex project involving may people. It was vitally important that every member of the project delivery team received accurate information in order to achieve the exacting demands of the project.” 

High-tech but homely

Marcus had a quality assurance role through the various project phases, acting as the client’s representative for the electrical installations. These included the uninterruptable power supply (UPS), lighting and control systems, data and communication, fire alarms, access control, elevator systems and nurse call. “At the same time as creating a highly technical environment, we also had to consider how to create a homely atmosphere for the children,” Marcus continues. “One way of doing this was to hide the installations and medical equipment behind panels in the patients’ rooms so they feel more like a hotel than a hospital ward.” 

From starry skies to precision lighting

Project manager, Ulf Larsson, adds that the lighting was also carefully designed with the child in mind. “For the wellbeing of the children, some of whom are would be staying in the hospital for a long time, we selected circadian lighting schemes, which also reflect the different uses of the hospital. For example, we have interesting, uplifting lighting on the ground floor with its play therapy zone, meeting areas, classrooms, arts and music rooms, while small spotlights create a pleasant atmosphere in patients’ rooms. We are particularly proud of the ceilings in the treatment room and swimming pool featuring a starry night sky. We have also illuminated works of art inside the hospital and outdoors.”

Meanwhile in the operating theatres and treatment rooms, ergonomic lighting contributes to a good working environment for the medical staff. This allows colours to the changed; for example, in the theatres red lights help the surgeons to see anatomical details, while green lights provide greater clarity on video monitors.

From a patient-controlled climate to advanced ventilation technology

WSP’s mechanical engineers were faced with a similar challenge to provide for the comfort of the patients while equipping world-class operating theatres to the highest standards. Project managers, Erwin Spijker and Patrik Holmquist were responsible for the heating-ventilation-and-air-conditioning-hvac, ventilation, sprinklers, medical gases, heat recovery, water and sewerage. 

“Studies show that people heal better in a comfortable atmosphere,” says Irwin. “With patients in single rooms, we were able to give them control of their environment, to change the temperature, raise and lower sunscreens, and so on. Along with the architect we conducted studies to optimise the façade. We are also very proud to have initiated the idea for the indoor garden with its glass roof providing a lovely natural place for patients and staff to relax all year round.”

The operating theatres are world-class and include a large heart surgery unit and hybrid facilities which can combine modern imaging and X-ray technology with surgery to avoid having to move patients between rooms. Purification of the air in these spaces is vital to prevent the spread of infection. “All the air handling units serving the intensive care unit have HEPA filters to filter out airborne particles,” says Patrik. “In addition, we use Taf (Temperature Controlled AirFlow) technology which uses gravity to control the airflow and reduce bacteria carrying particles throughout the room. The ultra-clean air from the ventilation system falls at a speed controlled by the ambient room temperature to ensure optimum purity at the level of the operating table. This is particularly beneficial in these larger-than-usual operating theatres where many staff may be present since it requires less energy than a typical LAF (laminar airflow) ceiling. 

Meeting high energy targets

The hospital’s achievement of Gold in the Swedish energy standard was remarkable, considering the high-energy demands. Locating ventilation units directly above the operating department to ensure maximum energy-efficiency while delivering pure, cool air, was one of WSP’s contributions towards the Gold award. Others included the installation of solar panels across the whole roof area apart from the space occupied by the helipad. This is primarily used for hot water and for heating the swimming pool. “We prioritised energy-efficiency in the design of the lighting control system and selection of luminaires, as well as transformers and UPS systems,” adds Marcus Frost. “The lifts are also designed to recover energy when descending.”

Flexibility now and for the future

The nursing staff had adopted a new way of working to increase their contact with the children, as Monica Johansson explains; “The staff wanted to work in smaller, self-contained units, each with a nurses’ station, team room and documentation located close to the patients, rather than the large, central administration room they had previously occupied.” This required replicating the systems such as IT and telecommunications across all the nurses stations but also demanded a high level of flexibility. “We learned that there may be occasions when nurses’ stations might be combined, for example to have one single station on a floor rather than several,” Ulf Larsson says. “This meant systems such as nurse call had to be capable of operating as individual units or all talking together as a single unit.”

In the infection ward, the hospital wanted rooms where pressurisation could be changed depending on whether the occupants had infections or needed protection from infection. “This is not easy from an engineering point of view,” states Erwin Spijker. “Our solution was to install a sluice between the room and the corridor to change the room pressure from positive to negative.”

In terms of providing future-ready design, Patrik Holmquist predicts; “It’s possible that in the next 50 years, higher levels of, say, heating and cooling may be required. We have installed over-sized ducts to accommodate future changes.”

Robust systems that cannot fail

As an emergency hospital, one of the greatest challenges was to prevent any of the systems from failing. The mechanical solution was to install three air handling units, so if one breaks down or requires maintenance, the others can handle the volume. Similarly, with the power supply, dual systems ensure one can take over if another fails.

Complexities handled by BIM

Due to the complexity of the project and the need to communicate design changes to the whole team as it progressed, high levels of detailed coordination were required from the outset between the many different services in the building. “When we started the project in 2010 we knew there would be changes as it went along,” says Patrik. “For example, the decision to include a sterilisation department was taken relatively late and we had already done a lot of the design. To fit it in, the basement had to be lowered, then all the shafts had to be changed.” In addition, the medical equipment, which can pose significant demands on the building systems, would not be procured till very late in the programme.

In order to manage all the different components of the building, WSP created a BIM model at the start of the project. As it has developed the model has incorporated every part of the hospital in the minutest detail. “This was essential for coordinating the services in the equipment floors and describing to the contractor in what sequence the electrical and mechanical services should be installed,” says Frost, “Or dealing with the many installations in the ceilings, such as sprinklers, medical gasses and all the electricals.”

The BIM model has now been passed over to the client for the continuing management and maintenance of the building.

A most rewarding project

Queen Silvia’s Hospital opened in March 2021 to great acclaim. The last word goes to Monica Johansson. “Thanks to WSP and the whole project team listening to us and being totally committed to the success of the hospital, we have delivered this fantastic project which we see as a model for children’s hospitals in the future. We are the envy of medical staff everywhere for the exceptional working environment we have created. But the greatest reward of all is to have created the very best possible environment for the children.”