Photo Credit: © Nick Merrick, Hall+Merrick Photographers

Hamad Medical City Medical Education and Simulation Center

Qatar is preparing to host the FIFA World Cup in 2022, and addressing their healthcare infrastructure in preparation of related growth. The welcome attention has brought a flood of western interest and investment capital to the country—a surge that has enabled rapid growth in infrastructure, education, and healthcare. In response to the challenge to create a world-class healthcare system, the Hamad Medical Corporation, the largest health system in Qatar, envisioned a center for medical training to improve primary care, enhance skills, and train both residents and surgeons.
In partnership with Weill Cornell’s Medical School, Doha, the new Medical Education and Simulation Center provides a centralized location to provide orientation training to new nurses, and physicians, focusing on team-based communication and standardized protocols. In concept, this facility aims to present state of the art training for a culturally diverse community of care providers.
The center repurposes an existing partially-constructed abandoned concrete building into an expanded medical training facility. To support the new program, the building was expanded, adding an additional column bay of area to the original floor plate, as well an additional floor for surgical training, increasing the building area by two-thirds. The design creates an overarching steel truss spanning the abandoned concrete structure reducing its impact on the concrete frame. An extra floor is hung from the truss. A carefully developed rooftop sunscreen and exterior skin complete the building.
A centrally located slice through the building creates a “Virtual Atrium” – providing a location to project real-time video of simulation sessions, as well as views into the learning spaces on each level.
Skills labs and classrooms provide orientation space for recently hired nurses. Simulation exam rooms for standardized patient interface provide training and evaluation spaces for the medical residents. Simulation labs for Labor and Delivery, Critical Care, and Operation Room scenarios help staff and students master protocols without risks to patients. The surgical training floor provides twelve stations for HMC surgeons to sharpen their skills and master new surgical methods.
The building provides supporting spaces including flexible classrooms, collaborative lounges, café and event space, and a 500-seat auditorium for use by the health system and the larger community. Virtual lounges situated on each floor allow staff and students to observe training remotely through the AV system, or to review recorded scenario sessions on demand.
The building was designed to the Qatar standards for sustainable design (QSAS), which closely resemble the USGBC guidelines for LEED certification. With an appetite for modern design, but a need to reference historical forms, the design team developed a balanced approach overlapping the glass enclosures with a gradient stone screen that is based on the program behind, and creating a rhythm that combines contextual identification with a sustainable contemporary architectural aesthetic.
In keeping with an attitude of health and well-being, the material finishes were selected for their material health attributes to reduce the toxic load to the building occupants. Plumbing fittings meet Qatar’s strict water conservation goals, and lighting design focused on energy conservation.

Design Challenge

Qatar’s Supreme Council of Health has developed an ambitious strategy for transforming the care provided to its citizens and guests. An emphasis on “primary care with a first point of contact,” approach to patients and “standardized care pathways,” has led to development of standard protocols and guidelines for disease management are part of the effort. As part of this strategy, the HMC Medical Education and Simulation Center will focus on training new hires, medical residents, and established staff to provide standardized care, enrich communication and inter-disciplinary team skills, and master new techniques related to medical and surgical advances. Two educational drivers focused the design solution. The client wanted to highlight the educational activities of the center by placing “learning on display”. This was achieved by utilizing a European modular wall system organized with full glazing panels situated parallel to circulation, providing views into the learning spaces, and a spine of “infrastructure” modular panels to accommodate plumbing, electrical, and medical gas requirements. 85% of the interior partitions are comprised of this system. Of equal priority, was creating a collaborative learning environment. To address this need, the team focused the program around a central slice through the building, cutting away a portion of the existing concrete slab to provide a 3-story virtual media “souk” in which real-time simulation events could be broadcast to a larger learning audience. Situated adjacent to the “souk”, flexible study lounges offer areas for learners to gather for social interaction and collaboration. An interstitial floor separates the existing structure from the suspended truss-table structure that supports the final floor of the building and supports the surgical training program. This floorplate accommodates the 12 surgical bays and adjacent support spaces required for surgical training. Full glazing on the building’s Northern face provides natural daylight to the surgical suite. The building skin is designed to address the harsh conditions of the climate while taking advantage of the building orientation. The Northern face provides full glazing deeply recessed within a rhythm of columns and vertical shading screens. The remainder of the building consists of a pattern of stone and punched openings, selectively placed to enhance building performance while responding to the building program within. The abandoned structure included a partially constructed auditorium “bowl”. Capitalizing on the existing footprint, the team simplified the form of the auditorium while emphasizing the building gesture, located at the entrance to the health campus by wrapping it in a skeletal steel structure and glass panel. This new skin floats free of the existing concrete form allowing the skin to be illuminated from within, and serving as a beacon at the campus entrance at night.

Physical Context

This small nation of 1.7 million people is ranked among the wealthiest countries in the world with a 2017 GDP of 57,905 EU per capita (compared to 35,009 EU GDP per capita in the UK.) However, the population’s cultural approach to healthcare does not focus on preventative and primary care contact. As a result, patients present at the hospitals with more complex and more serious health conditions. The need to change the care model is dramatically illustrated by the number of visits to the emergency department. Hamad Medical Corporation in Doha, Qatar, is regarded as the busiest emergency department in the world, with a staggering 1,500 patient visits per day across the health system. The strategy for transforming care, published as part of Qatar’s Vision 2030 places an emphasis on a “first point of contact care” approach to patients and “standardized care pathways.” This has led to the development of improved standardized care modules within the hospital setting, a primary care clinic prototype for implementation across the country, and the development of the Medical Education and Simulation Center for improved patient safety and outcomes. The Medical Education and Simulation Center is situated a climate with relentless sun, and hot harsh temperatures and desert conditions. Standard building code within Qatar requires adherence to QSAS, a sustainability code similar to the USGBC LEED certification program. To address building performance considerations, the façade was designed to provide shading to the harsh sun, including a floating roof plane screening the entire building, deep set windows with sun screening on the Northern façade, and reflective light-colored stone with deep set punched openings on the East, West, and South facades. Water and energy conservation are paramount in the tiny nation, so highly efficient mechanical and electrical systems were utilized with chilled beam cooling system, LED lighting fixtures, high efficiency plumbing fixtures, and gray water recycling for the limited landscape. The utilization of a modular demountable wall system for 85% of the interior walls limited material waste and provided plug and play prefabricated columns for plumbing, gases, electrical and cabling. A focus on daylighting, and material health in interior finishes embodies the building program’s focus on health and well-being.