SAN BEDA CREATE

COLLEGE OF REHABILITATION AND TREATMENT ENTERPRISE

CHAPTER I:

Introduction

1.1 Background and Nature of the Project

San Beda CREATE: College of Rehabilitation And Treatment Enterprise, a Sports
Rehabilitation Complex that is a quality-driven multi-disciplinary rehabilitation
enterprise. Each facility uses a functionally-oriented active treatment method to
achieve its results. The health care professionals work together to deliver the best
possible care. Clinics are staffed with fully qualified and experienced
professionals

including

Registered

Physiotherapists,

Registered

Massage

Therapists, Chiropractors, Certified Athletic Therapists, Certified Kinesiologists,

Registered Occupational Therapists, Registered Dietitian, Psychologist and Sport
Medicine Physicians and Surgeons. A facility holding these prestigious
designations has demonstrated an interest in and commitment to establishing and
maintaining high standards of physiotherapy and sports rehabilitation practice.
San Beda College, a Catholic educational institution, is committed to the Christian
formation of the Bedan Community as its service to the Church, the Philippine
society, and the world. Their medical curriculum develops a strong foundation in
the basic medical sciences leading to effective clinical reasoning and decisionmaking. Medical students engage in a wide variety of learning activities where
they are actively applying evidence-based biomedical knowledge, as well as
honing their skills in providing up-to-date, relevant health care.
San Beda CREATE is a project that explores the possibilities and affects that
design, and its relation to nature, has on healing and the overall health of the
inhabitants of a structure. In times of sickness and injury, time is spent with
professionals in environments that are meant to repair our health in a timely,
painless, sensible manner. These environments can be designed to promote a
healthy mind and body through a strong connection between the built environment
and its natural surroundings.
There are many factors that are involved in our bodys biological recovery time,
and many of these biological responses are induced through our emotions, which
can be controlled in some degree by the spaces that surround us. The spaces we

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inhabit and their exposure to natural elements, such as sunlight and fresh air,
contribute to a patients recovery process. (Sternberg, 2009).
The rehabilitation centre will serve as a transitional zone between the hospital and
the community (school) where patients are taught the requisite skills needed to be
reintegrated into the community. The sports rehabilitation centre will seek to
accomplish two main purposes. They are 1) to help train recovered patients in
skills acquisition for gainful employment and 2) to help provide the opportunity
for patients to gradually acquire socialization skills through their supervised
contact with some members of the community. The idea of trying to include the
public into this proposed design is to help patients learn how to live with people
upon getting back into the community and also to help break down the wall of
prejudice the public has concerning physical and psychological illness.
The state of healthcare buildings has received a lot of attention lately. Hospitals
have turned into institutions producing healthcare services for clients. The
environment is ruled by technology and hygiene requirements. The more beds
there are for patients the better, regardless of the space the patient is left with. The
environment is made into nothing more than it has to be; it stays as an empty
background for operations and interaction between the patient and the nursing
staff. Patients can feel alienated from their lives, families and nature when they are
being hospitalised. They just wait to get better and to get back to their lives. Their
lives do not end while they are in hospital though, and if the surroundings are
actually supporting the healing and are not against it, the homecoming can happen
faster as well.
Our surroundings provide the acting field for our everyday life. Still the huge
effect the environment can have to a person is unfortunately often left unnoticed.
Everybody feels architecture; we experience our environment with all our senses.
Environment meets using our skin, goes inside of us and becomes a part of us
(Sepnmaa 2007:16). Already as children we behave differently in different
environments. Now children spent most of their time in a built environment that
can be considered sick and deceptive and from that they take the values that will
support them later in their life. (Day 1990: 7 8, 11.)

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Although architecture is material, it does not have to be dead but instead filled
with life. Not only can a space be comfortable and easy to use or not disturbing,
but it also can help people to heal and nourish the soul. It can do the opposite as
well. A hospital environment can promote anxiety and stress and it can make you
ill. When we do not pay attention to our surroundings, it can work upon us
without us noticing and do a lot of harm. Architecture can be a dangerous tool and
a powerful healer. (Day 1990: 10.)
Healing is more than nourishing; it is growth towards wholeness though it is
important to understand that it is not curing. The environment does not directly
cure anyone, but the goal is to encourage patients in mental self-healing through
architectural support. In the end healing is a transformation one can do only for
himself.
This success is highly dependent on the school' design and organization of spaces
together with the management within. It is through the application of Modern and
Sustainable strategies combined with the old and proven practices, and the
concept of natural healing; greatly improve the present condition of healthcare
facilities in the country. It is by understanding how the behaviour or perception of
a patient or an individual, we may be able to know the certain facility designs and
come up with a good and effective design which would enable them not only to
heal faster and naturally but encourage them to live a healthier lifestyle.
Since students are prone to deal with illness and injury, the simple idea that nature
has a positive effect on the holistic well-being of individuals is the focus of this
project. This study promotes quality-based healthcare facilities together with an
institution that would focus on sports medicine for a greater number of people,
especially for athletes.

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1.2 Statement of the Problem

Despite the great number of healthcare facilities in the Metropolis, the fact
remains that all these facilities cannot cater all the needed specialized facilities for
the increasing number of patients annually, involving orthopedic ailments and
injuries on athletes.
A survey is being conducted every year by the DOH on which it records all the
orthopedic-related injuries. In the past couple of years, there were an average
number of 41,331 cases of injuries within the country and 50% of these cases
were within the Metro.
As of the year 2014, there was an increase of 5% of different injuries within the
Metro, which requires special treatment and demands for specialized healthcare
facilities. These cases tend to increase every year, nevertheless the number of
specialized hospitals or centers are not increasing.
One of which is the Philippine Orthopedic Center. It specializes with different
kinds of complications regarding the bones, joints and the skin. There are only a
small number of orthopedic hospitals or centers scattered within the Metropolitan
making it a horrifying experience for the due to cramped spaces due to poor
planning together with a large number of people gathering on a small space at the
same time. This is one of the major reasons why people tend to be discouraged to
go to the hospital unless they see it fit or seek for urgent medication. Moreover
athletes who experience critical injuries happened to be traumatized even more
because of the terrible service in an orthopedic center.
It is the time wherein we start to welcome the idea of having an Integrated sports
Rehabilitation Complex that would go hand on hand within the Metropolitan area.
The proposed project would set the standards for the Modern specialized
rehabilitation facility and would help the patients, particularly the athletes, to
experience quality recovery through natural healing and achieve fast recovery in
the least possible time. The sports rehabilitation complex would be strategically
located in an area that would be both accessible to and complement with the
garden-like ambiance of the area.

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1.3 Project Goal and Objectives

The goal of this project is to promote quality-based healthcare facilities together
with an institution that would focus on sports rehabilitation as well as medicine
for a greater number of people, especially for the athletes, thereby contributing to
the enrichment of specialized healthcare and rehabilitation of the Filipino people.
The following are its project objectives:
1.

To produce an enhanced sports rehabilitation complex that would have an

educational institution wherein students will learn and acquire knowledge
regarding sports medicine, healthcare and rehabilitation;

2.

To establish an integrated sports rehabilitation complex that is intended to

assist the needs of athletes of the college as well as other patients outside
the institution who needs treatment and rehabilitation through natural
healing and medical intervention at the shortest possible time;

3.

To create an integrated sports rehabilitation complex that would promote

health and wellness programs for athletes and students as well as patients
nearby, who are either in need of rehabilitation or interested to experience
a quality time achieving a healthy lifestyle.

1.4 Significance of the Project

The integrated sports rehabilitation complex would set a new standard for
Philippine specialized healthcare architecture and would serve as a landmark. It
would attend to the medical needs of the patients as well as their physical and
psychological being through designing with nature. It would also aim to serve as
an institution that would promote health and wellness for people who are
interested or conscious with their lifestyle. It would incorporate the Filipino
culture concerning medical care and sports rehabilitation. The project would also
apply sustainable strategies that would be able to compete globally for following
the international standards and that would also help to encourage planners and
architects to create more interesting and sustainable healthcare facilities within the
country using this project as basis for a higher standard for both General and
Specialized healthcare instiitutions.

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1.5 Project Scope and Limitations

This aims to address the current state and condition of San Beda CREATE as a
specialized healthcare, institutional facility and a community space for creating a
basic framework of the proposed project to follow. Listed below are the scoped
and limitations of the proposed project:
1.5.1

Scope

Project Proponent:

The project proponents are the athletes and the students of San Beda
CREATE: College of Rehabilitation and Treatment Enterprise which could
be the first sports rehabilitation complex within the area.

Funding Scheme

The funding scheme of the project is a JVP (Joint Venture Partnership), in

which the project is categorized as a private and medical facility. The
project will be finance with a joint venture capital between private

institutions in the country

Revenues will come from its leasable commercial spaces (i.e. shops and
caf) as well the public fitness areas.

Building Design:

Designing of a new private sports rehabilitation complex in Quezon City.

The sports rehabilitation complex will be a place to improve health
conditions both physically and psychologically, by featuring energy
efficient design as it will apply innovative technologies and architectural

solution for the proposed facility.

The project will be multifunctioning as a specialized healthcare,
rehabilitation and educational institution as well as a community space that
will provide all the necessary facilities within the boundary of its
architectural building type to meet the 21st century design trends.

Space Planning:

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The project will take into account the proper planning implementation of
spaces such as Public and Commercial Space, Training Facilities,
Administrative Division, Technical Department, Educational Institution,
Rehabilitation Area, Service and Utilities and Vehicular access and parking
should be properly planned to enable the project to function properly.

1.5.2 Limitations
The project only focused on architectural planning, designing and

programming of a new sports rehabilitation complex in Quezon City.

The project is concerned in built form although initial environmental
assessment was conducted for the feasibility study of an institutional

facility for the proposed location.

The project is limited to the buildings structural conceptual framework.
The project is mainly focused on design concepts, building technology,
innovations regarding sustainable architecture that are appropriate for a
2001s century sports rehabilitation complex.

1.6

Operational Definition of Terms

Chiropractor - person who practices chiropractic alternative medicine,

specialising in the diagnosis, treatment and prevention of disorders of the
neuromusculoskeletal system and the effects of these disorders on general

health.
Dietitian (or dietician) - is an expert in dietetics; that is, human nutrition and

the regulation of diet.

Emergency Department shall refer to the department of a hospital
responsible for the provision of medical and surgical care to patients arriving

at the hospital in need of immediate care.

Enterprise shall refer to a company that involves a lot of people.
Hospital - is a health care institution providing patient treatment with

specialized staff and equipment.

Innovation shall refer to the new design solutions.
Integrated shall refer to having different parts and acting as a unit.
Joint Venture Partnership shall refer to a kind of partnership between and
private local institution and foreign counterpart.

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Kinesiologists - are highly educated, health care professionals who are experts

in body movement.
Leasable spaces shall refer to commercial areas such as caf and shops.
Massage therapists - treat clients by using touch to manipulate the muscles
and other soft tissues of the body. With their touch, therapists relieve pain,
help heal injuries, improve circulation, relieve stress, increase relaxation, and

aid in the general wellness of clients.

Occupational therapist - works with a client to help them achieve a fulfilled
and satisfied state in life through the use of "purposeful activity or
interventions designed to achieve functional outcomes which promote health,
prevent injury or disability and which develop, improve, sustain or restore the

highest possible level of independence."

Orthopedic surgery shall refer to the branch of surgery concerned with the

conditions involving the musculoskeletal system.

Passive Design - shall refer to design that takes advantage of the climate to

maintain a comfortable temperature in the building.

Philippine Orthopedic Center - It pertains to the specialized healthcare
facility that is concerned with the correction of deformities and injuries of the

bones, joints and associated muscles.

Physicians - a person skilled in the art of healing; specifically: one educated,
clinically experienced, and licensed to practice medicine as usually

distinguished from surgery.

Physiotherapists - experts in movement and function who work in partnership
with their patients, assisting them to overcome movement disorders, which
may have been present from birth, acquired through accident or injury, or are

the result of ageing or life-changing events.

Psychologist - is a professional who evaluates and studies behaviour and

mental processes.
Public Space shall refer to spaces used by the community for social and

public activities.
Recreationshall refer to the activity done for enjoyment and leisure.
Rehabilitationshall refer to a process aimed at enabling persons with
disabilities to reach and maintain their optimal physical, sensory, and social
functional levels, thus providing them with the tools to change their lives towards a
higher level of independence.

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Rehabilitation center shall refer to facility providing therapy for

rehabilitation.
Sports Medicine shall refer to the specialized course offered in the
educational institution that would focus on medical and healthcare for athletes

and outpatients,
Sports shall refer to an activity involving physical exertion and skill that is
governed by a set of rules or customs.
Surgeon shall refer to a specialist in surgery
Sustainable Architecture shall refer to the building design that seeks to
minimize its environmental impact by efficiently and moderately use of

materials, energy and development space.

Training Ground shall refer to the grounds where rehabilitation would take
place.

CHAPTER II:
2.1

Review of Related Literature

Innovative Strategies

Architecture is the science and the art of designing, planning and considering
the different spaces needed where various things were experienced relevant to
its real purpose. Architecture is also stated as a means to take part with the
community and support the quantification of impacts on the environment and
on health. On the other hand Healthcare Architecture solves the problem
regarding the environment by using smaller energy footprint, avoid waste of
materials and lessen the harmful effect to the environment. A holistic
approach, considering the importance and philosophy of Sustainability in a

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manner relevant to healthcare facilities must be applied for a more effective

way of planning and designing a healthcare institution (Miller, 2012).
Sustainable and Innovative Strategies are also applied to achieve a better
experience. Green buildings are one of the best examples wherein innovative
strategies were applied to efficiently use the energy within the building. Green
building is not new to hospital design, in fact there were studies earlier the
Modern Age which tackles various techniques for an efficient Hospital that
would be considered as a self-sustaining building. It is during the Modern Age
wherein principles and goals regarding Green Hospital Design were
formulated for a better prospect. It aims to be the future of human health that
would that would secure a lasting legacy which will continue to challenge and
focus on the movement of Green building into higher heights and of the health
care industry (Guenther, 2013). Like Green Design Principles, Lean-Led
Hospital Design is also practiced by architects globally for a more costeffective way to minimize the waste of construction materials and of the
energy used in the Hospital when it is already in use. Lean Principles explains
how a design care can fulfil its obligation to do no harm and yet enable to
provide in a cost-effective manner. Its goal is not simply to eliminate waste or
increase efficiency but also to ensure that the improvement is always patientcentred in able to create the ideal hospital for the future (Grunden, 2012).
On the other hand sustainable building alone is not enough if things like
nourishing the soul, eco-technology wont be used efficiently and occupantbuilding interaction will not be considered. There must also have a multisensory ambience, spatial sequential experience and embodied resonate in the
human soul for it to be considered a good design. Harmony and balance to the
inner being will only be achieved if critical analysis is also made by shifting
the form and function of modern construction into a

more socially and

environmentally sustainable and people-centred environment (Day, 2014). In

addition, designing a positive role health setting can also play a big part in
reducing healthcare costs; improve patient comfort and independence to
achieve the goal of operating at its peak performance (Leibrock, 2011). A good
design of a healthcare facility or building does not only mean it should look

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good and is sustainable, it must also be in accordance with the behaviour and
setting within the building, operating in its peak performance at any given
time.

2.2

Building Technology

Technologies provide information for buildings that will be relevant by

providing the occupants and building management with their particular needs.
Architecture is becoming more essential as technology integrates with the
city. Functioning Cities needs growing technologies that will result of having
central importance in terms of design, for the urban environment. As people
might think, this shift wont occur but introducing technology in architecture
will be kept developing as it is bound to happen. Cities, with government
agencies and companies involving with projects, will have potential benefits
for the built environment that incorporates technologies (Bratton, 2012).
Technologies help cities to operate more efficiently by better managing
resources. Having sensors in cities will help them in capturing data that
municipalities and companies can collect, analyzes, and model to improve
infrastructure

energy consumption,

public

safety, and

transportation

operations. At a similar but smaller-scale of application, smart building

systems help to oversee the use of resources at an architectural level. The
theoretical savings from these performance-based applications have been
compelling enough that this approach is likely to become a viable model from
a financing perspective. All of which is a good thing.
New architecture, through contemporary and modern, has retained many of its
historical antecedents that also acquired some exciting new components.
One of these is the impact of modern technology. This, itself, has a dual
character: the changing technologies in the sectors that are clients and users of
buildings and the changing technology of the construction process, including
changes of design and execution. The first of these two changes resulted in
new requirements for and in buildings. The second altered the technology of
design and architecture. The function and relations of participants in the

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construction process changed. The new pattern of the client supported by an

expert staff for the buildings that client requires and operates, and general and
specialized designers and contractors exerted strong pressure for the
emergence of new procurement methods. All this is intimately interwoven
with the new technologies in information, telecommunication, and
management (Sebestyen, 2003).

2.3

Laws and Codes of Healthcare Facilities

Hospitals and other health facilities should be a source of strength during

emergencies and disasters. They should be ready to save lives and to continue
providing essential health services such as laboratories, medicines, treatment
and rehabilitation. They should also be the symbol of hope during these
critical times and contribute to the communitys sense of security and wellbeing. However, there are circumstances where hospitals and health facilities
are made vulnerable, especially during an emergency or disaster. The hospitals
or health facilities may be damaged or destroyed; or their capacities stretched
to the limit by the surge in number of patients seeking health services and
support.
Thats why Laws and Codes were formulated and mandated. Laws, Codes and
Standards are the basis for the minimum requirement in a building in order to
avoid unwanted accidents to happen. These laws were mandated to make sure
that the people using the building are safe.
These are policies of the State to safeguard life, health, property, and public
welfare, consistent with the principles of environmental management and
control; and to this end, make it the purpose of this Code to provide for all
buildings and structured, a framework of minimum standards and
requirements by guiding, regulating, and controlling their location, siting,
design, quality of materials, construction, use, occupancy, and maintenance,
including their environment, utilities, fixtures, equipment, and mechanical
electrical, and other systems and installations (National Building Code).
Alongside with the National building Code of the Philippines, Codes such as

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the Philippine Mechanical Code (Republic Act 8495) and Fire Code should
also be consider in case of emergency in order the ensure the safety of all the
people and buy enough time for them to vacate the building without any
injuries.
Republic Act 8495, also known as the Mechanical Engineering Act of 1998 or
Mechanical Code, is the law regulating the practice of mechanical engineering
in the Philippines. Its purpose is to set minimum standards for the design,
construction and quality of materials pertaining to the mechanical works,
processes, and equipment of all building, structures, mechanical plants, to
safeguard life or limb, property and public welfare. (Philippine Mechanical
Code)
The Fire Code of the Philippines (PD 1185) sets the uniform standards and
regulations for the prevention and suppression of fires; for incorporating fire
safety design and constructions; and for the provision of protective and safety
devices in buildings, facilities, and structures in order to effect a meaningful
reduction in death and injury to persons, and loss and damage to property by
fire. (Fire Code of the Philippines IPD 1185)
Not only do laws pertain to the condition and spaces within the building but it
also pertains to the accessibility of people to enter the building. An Act to
enhance the mobility of disabled persons by requiring certain buildings,
institutions, establishments and public utilities to install and incorporate in
such buildings, establishments, institutions or public utility, such as
architectural facilities or structural features that shall reasonably enhance the
mobility of disabled persons, such as sidewalks, ramps, railings and the like.
(Republic Act 344 - Accessibility Law)
There are also laws concerning about Waste Management in order to ensure
the proper disposal of waste especially in Medical facilities where there are a
lot of chemicals used and contamination is strictly monitored.
Republic Act 9003 sets the guidelines and targets for solid waste avoidance
and volume reduction through source reduction and waste minimization
measures, including composting, recycling, re-use, recovery, green charcoal

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process, and others, before collection, treatment and disposal in appropriate

and environmentally sound solid waste management facilities in accordance
with ecologically sustainable development principles. It is equipped with the
proper machinery to carry on the task stated by the law, through the National
Solid Waste Management Commission. (Ecological Solid Waste Management)
2.4

Healthcare

As early as Ancient Greek time, healthcare is already being practiced inside

temples where soldiers from wars are being treated. Greeks even used to build
temples for their Gods and Goddess, to bless them and help to heal their
people. After thousands of years, healthcare developed from the use of herbs
into chemicals for treatment and vaccines for prevention.
Dr.Topol suggested that If we keep practicing medicine as we know it today,
healthcare will become an unbearable burden. We are in a real race between
healthcare innovation and the resistance to change of the medical
system.(Topol, 2013)He then offers, through numerous examples, an exciting
vision for the future, when technology can be used to dramatically improve the
quality of care and reduce cost at the same time. However, there was still a
problem regarding the lack of expertise of surgeons and doctors due to limited
informations. For decades, doctors had no idea what they wanted, and
software developers have given it to them. Deaths were recorded not only
because of illness but also because of errors in distinguishing the particular
disease. (Trotter, 2011) As time passed by and people learned more a lot
medicine and tries to improve more advance technologies, it is possible that
someday, healthcare would not be as complex as what it is right now.
(Williams, 2011)
Development in healthcare aims to discourage the use of wasteful spending of
money with medicines, and encourage the application of modern technology
together with architectural designs that would enlighten the mood within the
hospital using the principle of Healing through Space(Goodman, 2015). It
aims to make healthcare affordable and yet it still gives quality services for the
people.

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In the modern age, Japan, is the country that specializes modern healthcare
due to their advance knowledge of healthcare together with their advance
medical technologies which tends to improve and almost treat illness that were
once incurable It is through Joint venture that an integrated orthopaedic
hospital could be available in partnership with the Japanese investors. (Topol,
2013)
2.5

Management Of Healthcare Facility

Management in a healthcare facility is one of the key factors whether to tell

that a hospital is operating its functions properly (Buchbinder, 2011). It is
through proper management that would enable to achieve an organized and
systematic method on dealing with the patients, visitors, and other personnel
in the hospital. Healthcare management also offers tremendous opportunities
across the spectrum of healthcare delivery and payment organizations
(Friedman, 2012). There are 14 different healthcare and related settings.
These include long-term care, physician practices, commercial insurance,
consulting firms, pharmaceuticals, medical devices, information technology,
and biotechnology which require management in every department.
Excellence in the healthcare industry means simultaneously satisfying patients
and associates, garnering strong earnings, and providing high-quality care and
a good Management (Griffith, 2011). Several American healthcare
organizations (HCOs) have achieved excellence using a similar management
approach: create a welcoming environment, continuously improve work
processes, and encourage a supportive culture. Employees and care-giving
teams enjoy working in these HCOs because they have the tools and
motivation to delight customers while providing excellent care.
In Reaching Excellence in Healthcare Management, it demonstrates that
achieving excellence is an effort based on evidence, not guesswork. A few key
elements in achieving excellence include strong commitments from the board,
a united effort from the management team, and the forced departure of people
who do not accept the need to change. While achieving excellence takes time
and practice, the payoff starts is great (Griffith, 2011).

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2.6

Designs against the Elements

Buildings are our third skin. To survive we need shelter from the elements
using three skins. The first is provided by our own skin, the second by a layer
of clothes and third is the building. In some climates it is only with all three
skins that we can provide sufficient shelter to survive, in others, the first skin
is enough. The more the extreme the climate, the more we have to rely on the
building to protect us from the elements. Just as we take off and put on clothes
as the weather and the climate changes so we can shed skin. (Roaf, Fuentes,
Thomas, 2010)
Riverine flooding is the term of reference to describe inland flooding that
result from precipitation overwhelming the base flow capacity of the
watershed streams and rivers. Shallow flooding is defined as flooding with an
average depth of 1 to 3 feet (30 to 90 cm) in areas where a clearly defined
channel does not exist. One of the reasons these floods occur is due
ponding. Ponding happens in flat areas in which water collects or ponds in
depressions. (Watson & Adams, 2011)
The point of departure for most tropical architecture is climate. At the simplest
level, modern tropical architecture has been simply an adaptation of modern
trends in design and construction to climate, taking into consideration some
changes in the lifestyle that the tropical climate affords. Often, there has been
an exploration of open and semi-open spaces, verandas and balconies, and
open plans. (Bay &Ong, 2011)
The Philippines tropical climate proves to be a major design hurdle for any
structure that is built here in our country. Some use these and turn them into
their advantage and create brilliant design solutions while some simply build
their building to adapt in this environment.

2.7

Sustainable Design

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Environmental and human health impacts of materials are a hidden cost of our
building environment. Impacts during manufacture, transport, installation, use,
and disposal of construction materials can be significant, yet often invisible.
Construction materials and products can be manufactured hundreds, even
thousands of miles from a project site, affecting eco-systems at extraction and
manufacturing locations, but unseen from project location. Likewise,
extraction of raw materials for these products can occur far from the point of
manufacture, affecting that local environment. Transportation throughout all
phases consumes fuel and contributes pollutants to the atmosphere. Disposal
of manufacturing waste and used construction materials will affect still
another environment. (Calkins, 2010)
Calkins cited that to address the goal of sustainable development, the
construction material production and construction industries must shift their
use of resources and fuels from nonrenewable to renewable, from waste
production to reuse and recycling, from emphasis on first costs to life-cycle
costs such as water, emissions, and pollution are factored into the price of
materials (Kibert, 2011)
Just because green roofs and solar panels are installed into the building its
automatically called sustainable, that is the biggest misconception of people
today. Sustainable building considers everything from construction to building
operation and from the materials that are used to waste that the buildings
produce. We cannot simply call a building green by the flashy technology it
use, proper design and architectural solutions must still be applied to be able to
call a building fully green and sustainable.
Calkins also stated in the book some suggestions into lessening the impact of
the material production. One is the use of nearby and local materials, good
quality materials are not always flown in from a different country. One must
simply look nearby; asses the materials quality and integrate it into the design.
It is also stated in the book the performance factor of materials, is one type of

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cement better than the other? and such. These guidelines will help any
designer into making a structure that truly considers the environment.
During the past decade there has been significant progress in mainstreaming
ecological principles into architectural practice. A variety of voluntary
sustainable design guidelines and standards such as the US Green Building
Councils Leadership in Environmental Design, the UKs Code of Sustainable
Homes, and the International Organization for Standards. (Guzowski, 2010)

2.8

Sports Medicine

Sports medicine is also known as sport and exercise medicine in which it

focuses on aiding people or specifically the athletes to improve their athletic
performance, recovery from sports injuries and prevent future injuries. It also
focuses on definitive and comprehensive reviews that is therefore interpreted
and evaluated to provide the rationale for the application of research findings.
(Starkey, 2012) It is known to be as a fast growing healthcare field due to
health workers who specialize sports medicine in order to help many normal
people as well as great athletes. It bridges the gap between science and
practice in the promotion of health and exercise, and in the scientific
assessment, understanding and study of sports performance.

Step-by-step instructions for sports medicine patients are provided and

instructed to health workers that serve as a guide in order to avoid wasting
time and also to avoid miscommunication among patients and healthworkers.
Usually there are 300 rehabilitation exercises for patients which would ensure
the fast recovery of chronic bones instability. (Safran, 2012)Aside from the
regular practices and exercises, special routines are also implemented in order
to achieve desirable results in a short amount of time such as the use of
aquatics in orthopedic and sports medicine rehabilitation and Physical
Conditioning. The use of aquatic methodologies is applied in both
rehabilitation and physical conditioning appropriate for the general population

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up to the elite athletes. (Wilk, 2014)The use of aquatics in orthopedic and

sports medicine rehabilitation and physical conditioning represents a new era
in the development and use of aquatic therapy and is perfect for health
workers, sports medicine professionals, athletics trainers, personal trainers and
conditioning coaches.
Cultural attitudes, beliefs, and expectations are also important considerations
that should be recognized in order to be able to modify professionals
behaviour accordingly to reflect their sensitivity to their patients needs,
therefore resulting in a comfortable and positive healthcare experience for
everyone. (Cartwright. 2011)

2.9

Sports Science

Sports science refers to the discipline that studies how the healthy human body
works when conditioning or doing exercise, as well as how sports. It
incorporates areas such as psychology (sport psychology), anatomy,
physiology

(exercise

physiology),

biomechanics

and

biochemistry

(kinesiology). Performance consultants together with Sports scientists are

growing in demand and employment, due to the increasing focus within
sporting world on achieving the best possible results. Through years of study
of sport and science, researchers have developed a greater knowledge and
understanding on how the human body reacts to exercise, sports, training and
many other stimuli. (Knowles, 2014)
There should be an outstanding linkage between human anatomy and exercise
physiology in order to call that an exercise is executed properly. These days,
functional training for sports, new understanding of functional anatomy are
created in order to help the general population to execute the different
exercises without risking ones life and avoiding unwanted results due to poor
execution of other intense work outs. (Gillam, 2014)

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Exercise and Sports science major are both multi and interdisciplinary.
Multidisciplinary in the manner that it is the integration of physiology,
anatomy, physics, psychology and learning theory in order to explain
responses and adaptation to exercise and training then applies that knowledge
to enhance the physical potential for sports, health and rehabilitation.
Interdisciplinary, since it draws from business administration and biology to
provide a foundation in these disciplines to support exercise science
applications as well as to enhance the preparation for the career. (Brancazio,
2012)

2.10

Sports Rehabilitation

Sports Rehabilitation focuses on understanding, treating and preventing

exercise and sports related injuries. Its a dynamic and varied career which
equips health workers and health professionals alike with the contemporary
skills, knowledge and abilities to support athletes and players of all the
abilities through the delivery of safe and effective care. (Comfort, 2010)
The use of aquatics in Sports Rehabilitation represents a new generation of
rehabilitation that is informative enough to cure an injury in short period of
time. Theories and applications of Aquatic Therapy emphasize physiological
benefits. Guidelines and indications for Aquatic Therapy which covers pool
selection, facility design and engineering considerations, which stresses the
need for collaboration between designers and end-users when planning aquatic
facilities. (Wilk, 2014)
Another kind of rehabilitation or therapy is the so-called Biomedical
Acupuncture. There are techniques that enhance athletic performance,
accelerate recovery after intensive workouts, and speed trauma rehabilitation
after surgeries or injuries. These is a technique that is very useful not only for
athletes, but for all patients. Acupuncture is not a new technique, in fact it is
being used through ages, as a medical procedure which requires great skill and

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knowledge to master. It uses pressure points in order to control either the flow
of blood or the energy. This technique is believed to be as the ultimate
technique in medical care since it can cure a lot of disease and psychological
problems in some instances. (Ma, 2011)
2.11

Health And Wellness

Health promotion and wellness is designed to provide healthcare providers

with both the theoretical knowledge and practical skills they need to provide
high-quality clinical preventive services. (Wilk, 2014) It is a behavioural
social science that comes from psychological, physical biological environment
and medical sciences to promote health and prevent disease, disability and
premature death through education-driven voluntary behaviour change
activities. (Scaffa, 2010)
The public healthcare approach focuses on preventing illness and disability, as
well as promoting health and wellness. Primary healthcare, a branch of public
health, specifically focuses on preventive health and health promotion
measures. Health promoting occupational therapy is about enabling people to
take control of, and improve their health and well-being through their
everyday work (occupation), since good health or ill health is a consequence
of what people do or dont do every day. (Hawk, 2013)

2.12

Healing Architecture

Throughout our lives we are forced to deal with illness and injury. The simple
idea that nature has a positive effect on the holistic well-being of individuals is
the focus of this project. This thesis explores the possibilities that the spaces in
which we inhabit have on the healing and recovery process.
Nature has long been proven to have certain healing effects on individuals.
Access to natural elements such as light, airflow, and views of nature can all
have an effect on how we heal. Our body is constantly reacting to the spaces in

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which we inhabit. These spaces can have a direct effect on an individuals

physiology and mental comfort. Stress levels and the mood of a patient may
have the greatest effect on the healing process.
Physical rehabilitation is a process. There are many methods and systems
being used to rehabilitate our body. In order for the body to heal, the mind and
soul need to be in a good place. How can a rehabilitation center be design to
induce hope and optimism? A healthy, stress-free mind is not only less likely
to become physically ill, but may also allow the body to return to full health
faster.
Part of having a satisfying life is being able to do things that you enjoy.
Typically people that live more active, healthy lifestyles can say that they are
happier than those that dont. Recently our culture has shifted towards a more
stressful life in which people are substituting time typically spent being active,
with heavier workloads and stationary leisure activities (Eichelberger, 2010).
People are exercising less and less and also eating more convenient processed
foods, which may lead to physical or mental problems as they age. A Physical
rehab center aims to bring people recently recovering from surgery or injury
back to full health so that they can enjoy the things that make them happy.
There are many environmental variables that can be associated to healing. This
thesis will explore elements such as views, natural light, airflow, and natural
sounds. Communal green spaces and healing gardens will also be looked at to
create a direct connection to nature. These variables will be used to establish
not only a more natural and peaceful sense of place, which is inductive to
healing, but also create an experience. Experiences are what we look back on
and relate to. Familiar scents and views bring back memories which can instill
a sense of calmness and peace, creating a healthy mind and body. Our present
experiences are a product of our past experiences and we can relate the old
with the new. We draw from our past to help us understand our current
situations.

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According to Christopher Day, To be healing, a place must be harmonious.

This means bringing change as an organic development so that new buildings
seem not imposed aliens but inevitably belong where they are, responsive to
their surroundings. Healing also involves invisible responsibilities like
minimizing off-site pollution. But places and buildings must be more than
that: they must be nourishing to the human being. (Day, 2012)
Healing gardens have long been used in history to aid in the healing journey.
Restorative gardens have been used by sick and healthy alike all the way back
to the Middle Ages. According to the book, Restorative Gardens: the healing
landscape, For the sick of body or troubled in spirit, the garden relaxes and
soothes and thereby encourages the body and the mind to restore themselves.
(Kaufman & Warner, 2010)
A healing garden refers to an enclosed space, a maintained environment that is
thoughtfully designed to treat the patient on a spiritual level, just as a
prescription drug is engineered to heal on a biological level. This brings up the
point, why cant other spaces be healing spaces? Why cant we have healing
corridors, and healing entry ways? How can we take traits from these healing
gardens and create spaces architecturally that are designed to have similar
effects on a patients holistic well-being?
Natural light, air quality, and pleasant views can all be described as indirect
connections we experience with nature when inside a building. Having access
to sounds and smells and also being exposed to the rhythms of time,
distinguishing day and night, can give us that contact with the outside
environment. (Esther, 2009) Watching the seasons change and experiencing
these transitions can create excitement and joy to the observer. These indirect
connections with nature can primarily be accomplished through the use of
windows. Operable windows allow sounds and scents to travel indoors.
Windows also provide natural light to enter the building.
Natural light may be the most studied environmental attribute that affects our
experiences in a building. Fluorescent bulbs may conserve energy, but at what

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cost? At 120 flashes per second they have been proven to cause hyperactivity,
headaches, and eye strain. (Day, 2004) Diffused natural light can create a more
soothing environment that better fosters healing. Noises, either from a nearby
lake or trees rustling in the wind can also bring forth pleasant memories to a
patient. Even urban noises such as traffic can drown out noisy medical
equipment and the constant footsteps of nurses and practitioners, allowing the
patient to momentarily forget their current situation and simply relax
2.13

Architecture and the City

Winny Maas argued in his book "MetacityDatatown" that another perspective

in solving the problems of urban decay is through data and statistics. He
believed that instead of looking at the physical problems, why don't we solve
it from the statistical point of view? On the topic of cities, He said, "...Initially,
one can describe its vastness and explore its contents perhaps only by
numbers or data. By selecting or connecting data according to hypothetical
prescriptions, a world of numbers turns into diagrams. These diagrams work
as emblems for operations, agendas, and tasks.(Maas, 2010)
With this perspective, problems and scenarios of the city are offered in a
nonsubjective and non-biased perspective. This procedure might be able to pin
point problems that are not entirely visible but highly connected and of vital
importance.
In the book "S, M, L, XL", Rem Koolhaas explores the theories lacking in
architectural thought. He examines the phenomenon of the everyday life and
then assesses its cohesion with architecture. He argued that a theory of bigness
in architecture is what we need. Sheer size, or Bigness as Koolhaas refers to it,
generates its own logic. (Kookhaas, 2011)
Bigness destroys the very fabric of architectural thought. Architecture was
once graced by form and function but now, architecture is nothing but an open
block where its the interior architecture that matters the most. He further

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argues that bigness dissolves the essence of architecture and diverts it into this
strictly utilitarian model of living.
2.14

Architecture and Nature

The influences that architecture, and its relationship to nature, has on the
human bodys ability to heal and remain healthy. The site of a building is an
important factor as to how we relate to and experience a building. Our
surrounding environments play a key role in our moods and behavior.
Therefore it is important to take into consideration the relationships that our
built environments have with the natural environment, and how these
relationships can be used to instill a sense of happiness that is conducive to
healing.(Clemente, 2014)
Many healthcare facilities are designed in a way that fosters quantity rather
than quality. Long corridors, repetitive patient rooms, and cramped waiting
rooms create an environment that feels gloomy, or dead. When visiting a
facility designed to heal, an individual should walk inside and feel a sense of
life. By harnessing nature and allowing the outside to flow indoors, spaces can
be created that are enjoyable and stress free. A patient should be able to
explore the facility, which creates a sense of community, and the design should
suggest this. Large open spaces that connect different aspects of the program,
and also exposed stairways and circulation paths allow connections to be made
by all inhabitants of the structure, and can also promote an active lifestyle.
Design can influence the process of obtaining wellness. Rather than moving
between waiting rooms and patient rooms, which can create stress and anxiety,
a more holistic approach can be implemented towards the journey to healing.
(Steer. 2015)
Our physical environment can be broken down into three dimensions:
architectural features, interior spaces, and ambient features. (Dijkstra, 2006)
These categories create the stimuli that we are exposed to, and have a direct
impact on our relationship with space. Architectural features consist of the
permanent structures and their layout. Interior spaces include the less

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permanent fixtures within a building, like furniture and artwork. Ambient

features include lighting, odors, sounds, and climate. (Day, 2012)
2.15

Case Study

2.15.1 Rehabilitation Center Groot Klimmendaal

Location: Arnhem, Netherlands
Architect: Koen Van Velsen
Size: 14,000 sqm
Constructed: January 2010

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The Rehabilitation Centre Groot Klimmendaal is located in a dense wooden

area in the eastern part of the Netherlands. The project itself aims to blend in
with its surroundings to create a sense of peace and relaxation. The project is
the first step towards a greater master plan which aims to evolve the site into a
public park filled with one and two story buildings. Nature is a strong aspect
to the master plan and the design attempts to bring the natural environment
inside to the patients that occupy the rehabilitation center. (Mazzoleni, 2013)
The building has a small footprint to the overall site, but the design still allows
for 14,000 square meters of usable space. The program is set up so that the
offices are on the ground level, clinical and recreational areas are located
above, and on the roof there is a Ronald McDonald house. The program
allows for much more than the typical rehabilitation center. Patients and their
families have full access to sports facilities, fitness areas, a swimming pool,
restaurant, and even a theatre. The clientele is not restricted to patients and
their families; community organizations often use the spaces such as schools,
theatre groups, and a variety of community clubs and committees. Due to the
broad range of usages and inhabitants, the project is located in a central
location in the community.

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The process for this project included a strong collaboration between architects
and clientele. The idea that a positive, physically stimulating environment is
beneficial to the revalidation of its patients was a core concept in the design. A
strong sense of community and environment help to create spaces that are both
positive and rejuvenating. A long wooden staircase is a key component to the
interior space and was designed to promote physical activity as inhabitants
move from floor to floor. Both direct and indirect routes are used in the
circulation of the building. This helps create both familiarity and also
promotes mental stimulation as patients explore the different spaces.
The compact design allows for minimal energy consumption. Sustainable
materials were chosen for walls, ceilings, and facades which would require
little maintenance. The design also addresses sustainability on the social and
economic level as the design allows for a vast variety of potential future uses
of the building. Voids throughout the center allows for natural light to creep
deep into the spaces. The long
narrow design also allows for beautiful natural views to the forest in many
areas of the building. (Verderber, 2010)
The premise for this design is that connections to nature and the natural
environments are beneficial to the mood, and in return, the well-being of the
patients. Healthy design invites its users to maintain a healthy, physically
active lifestyle. The Groot Klimmendaal building does a superb job in
addressing the design problem and creating a connection to nature.

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2.15.2 BeitHalochem Rehabilitation Center

Location: Beer Sheva, Israel
Architect: Kimmel-Eshkolot Architects
Size: 6,000 sqm
Constructed: February 2011

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Located on the outskirts of Beer Sheva, Israel, BeitHalochem Rehabilitation

Center harnesses inspiration from the desert landscape and the surrounding
desolate environment which creates a structure that resembles rocklike
formations. The thick structure creates quiet, relaxing personal spaces, while
the corridors between these spaces serve as both circulation and community
areas. Courtyard spaces are created resulting from long spanning bridges
which run between the various masses of the structure. The rehab center serves
to restore full health to wounded veterans and create a home for their families.
There is a strong sense of experience as one navigates between the thick
concrete walls and public spaces throughout the building. (Verderber, 2010)
A strong sense of positive and negative through the use of voids allow light to
reflect off the surfaces of the center and help diffuse an intense sunlight,
creating a tranquil environment. The concrete materiality of the building
allows for stored energy to be captured during the day and later released
during the cooler nights. (Nickl-Weller, 2013)
The environment and design create strong outdoor public spaces allowing the
veterans and their families to enjoy the outdoors, giving them a peaceful
environment to relax. Due to the physical condition of many wounded
veterans accessibility was a major design aspect for the center. With varying

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elevations throughout the interior and outdoor spaces, ramps are in place as
well as wider circulation paths to allow comfortable living conditions for the
patients.
Community and family are two terms the architects kept in mind while
designing this rehabilitation center. Not only does the program allow for
families to remain with injured veterans, it allows for members within the
community to experience and use the spaces within the center. Community
rooms are used by different organizations and clubs within the community
which brings all types of community members into the structure. A place of
healing should not be restricted to patients and practitioners. Diversity creates
a sense of comfort and normal to the patients. They do not feel isolated from
the community with the presence of both familiar and new faces alike.
(Mazzoleni, 2013)
Architecturally, the design for BeitHalochem Rehabilitation Centre is both
creative and functional. The negatives and voids are used in a way that allows
circulation and natural elements such as sunlight to be drawn into the building.
Strong views to the landscape can be obtained from nearly every space within
the building. It is truly a place of healing, and the design allows it to be.

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CHAPTER III: Research Methodology

3.1

Overview

The chapter will render the technicalities of the gathered facts and philosophical
theories that will greatly validate this search. It will present the different
methodologies and research strategies approach to give the most effective way to
grasp and comprehend specific topics and their relation in the research. It will define
the scope and limitation of the design research, participants, with the informative data
among the existing to search information systems. All of these will help on
formulating the final output as basis for the research conclusion.
3.2

Research Design
3.2.1

Historical Research

The researcher will take into consideration the significance of the background
and the history of the topics that is related in the statement of the problem. The
knowledge on the development of healthcare in the country as well as its
impact on the society states significant importance in the research.
The historical method of research will be conducted on the following topics.

History and development of healthcare education and practice in the

Philippines

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History and development of specialized healthcare and rehabilitation

center in the Philippines

Hospital design and development

3.2.2

Descriptive Research

This method will gather interesting information regarding the current trends in
healthcare, hospital facilities and rehabilitation. The awareness of the current
conditions in relation with the project is critical with coming up of effective
solutions to the problem. The method to be used will both be Qualitative and
Quantitative to efficiently identify the data needed for such topics. To provide
current conditions and facts, government information will be highly utilized.
Data will comprise subjective information, facts, narrative outputs, trends,
sustainable strategies, healing through space, images, case studies of other
orthopedic hospitals, statistics, analysis and will be non-bias in all forms of
moral and ethical discipline.
The approach of the research can easily discuss key points for each topic is
important in distinguishing and identifying major problems and complications
in every aspect of the research. This research will allow comparative analysis
of current comparable developments and designs that can aid to further
improved the solutions for the problem.
3.3

Research Instruments
3.3.1

Written Literature

The use of reliable books will make the data more valid and more erodible
than electronic sources such as websites in the internet. The use of books will
mostly provide the background information, general principles and codes that
will guide the study towards a great design. Solutions to encountered problems
would also help the researcher to learn from it and to avoid further
complications. This will include books in UST library, electronic readings,
journals, news articles, magazines, National Building Code, Fire Code and
Accessibility Code.
The topics of the book sources would include studies on

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Healthcare
Hospital design and Architecture
Natural healing through spaces
Standards and guidelines for Hospital and Rehabilitation design
Building Codes

3.2.2

Electronic Sources

For topics that is not available on books electronic sources such as EBSCO
will be used. The researcher will be selective in choosing electronic sources.
The following will be the most frequently visited websites:

www.doh.gov.ph
EBSCO website
City government websites

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