INTRODUCTION

Background on Green Architecture, Sustainable Architecture and their application in Design for
Disaster Mitigation* (Macro to micro, history, Classification, type, differences in approach, etc)  
Background on Tertiary Hospitals* (Macro to micro, history, Classification, type) 
Relationship between 

Green Architecture, Sustainable Architecture and their application in Hospital Design for Disaster

Mitigation* (relevance, significance/impact of the study to architectural application)

*Include sources/ in-text citation

The sustainable development concept was introduced for the first time by Brundtland Commission
(WCED, 1987); since then, this term has evolved in accordance with social and economic changes. The
emergence of this concept is based on the necessity to correlate human development with the obligation
to manage resources as effectively as feasible. It was a crucial moment when the scientific world realized
the limited nature of all resources.

The buildings of the future will be focused on people and on the planet, respectively, on the concerns
regarding the next generations. Thus, the materials from which they are/will be built must be
environmentally friendly. The way that they are heated and cooled, to ensure their use/operation, must
also be environmentally friendly. Buildings have the role of making people’s lives easier, as they evolve in
sync with the technological developments and then become intelligent buildings, capable of providing
people with the healthy environment and comfort that are needed for carrying out daily activities.

Additionally, sustainable architecture designs help in realizing constructions with the goal of limiting their
environmental impact. This goal is attained by achieving energy efficiency and improved livability for
inhabitants, and by having a positive impact on health, well-being, and comfort, and the way to achieve all
of this is through the incorporation of suitable technologies within the building.
Designing sustainable architecture entails taking several essential elements in account, as follows:

 building orientation on the land surface and natural light dependence;

 natural ventilation;
 shading vs. sunlight provided by all the pre-existing elements in the site;
 the use of biomass;
 domotics/home automation/Ambient Assisted Living.

Hospital design refers to the physical environment that includes the indoor environment (e.g. noise, air
quality and lighting), the interior design (e.g. furniture, fixtures and materials) and the configuration (e.g.
relative locations and adjacencies of spaces) of a hospital. According to the model of system accidents
proposed by Reason [1], hospital design may impact patient safety, directly or indirectly, as a latent
failure and a barrier.
https://www.healthdesign.org/sites/default/files/news/Joseph_2007_architectureofsafety_000.pdf
Lundin’s article “A Consciously Applied Design-Driven Dialogue Can Improve Healing
Architecture” reflects on the conception of knowledge in practice and the skills that architects
need to make users’ implicit tacit knowledge explicit. Lundin (2020) states that the focus on
evidence can obscure other important aspects of creating a healing environment. Instead of
using evidence as a base for design, it should be regarded as an increased amount of
information that enriches the design. Lundin argues for a design-driven dialogue in the early
phases of the design process to activate the tacit knowledge that is inhabited in the user’s
practices of healthcare delivery and how patients and professionals use and occupy the
healthcare buildings. To unveil this tacit knowledge, users should participate in the creation of
design artifacts during the design process.
https://journals.sagepub.com/doi/10.1177/1937586720971396?icid=int.sj-abstract.similar-
articles.2

The hospital design for medical and non-medical spaces can help improve a patient's recovery
situation and well-being, as well as relieve staff stress [24]. Architectural structures, including interior
and exterior design, should consider visitors' needs and create a positive experience [25]. It
describes the physical ethos of the ward as a latent message of expectations for improving patient
satisfaction, creating a positive self-image, and its influence on the staff's mood and behavior 
https://www.researchgate.net/publication/5871782_The_architecture_of_safety_Hospital_design

Tertiary hospitals offer the highest level of specialised care that a patient can expect from the medical
system. This type of facility hosts medical consultants from a wide range of specialities and has state-of-
the-art tools and equipment to carry out and support complex diagnostics, treatments, and procedures.
Often, the patients brought to such a facility require long-term care and complicated treatments or
procedures such as major surgeries, transplants, treatment for severe burns or injuries, or specialist
cancer management.

Healthcare buildings play a significant role in delivering healthcare services and

outcomes (e.g. quality, suitability, cleanliness, patient experience, value for
money and risk mitigation).
The term tertiary care came into hospital parlance a few decades ago, but only in 2013 was it integrated
into the US National Library of Medicine’s Medical Subject Headings thesaurus, when it was defined as
“care of a highly technical and specialized nature, provided in a medical center, usually one affiliated
with a university, for patients with unusually severe, complex, or uncommon health problems.

Hospitals, and health facilities in general, are exposed systems that can suffer severe damage as a result
of intense natural phenomena. Given the seriousness of the risk, new health facilities must be built to
standards that can help them to withstand the natural hazards that surround them. It is also necessary
to assess the vulnerability of existing buildings with a view to identifying their weaknesses, and to plan,
design, and carry out the physical interventions or retrofitting needed.