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Primary care: radiotherapy and hemodialysis centre in Barcelona, Spain by Baas Arquitectura and Casa Solo Arquitectos
The radiotherapy and hemodialysis centre in Granollers, Spain, designed by Baas and Casa Solo, is an elegant alternative to sterile healthcare architecture
While hospitals naturally require particular sanitary conditions, they must also accommodate people who are among the most vulnerable in society. The newly born, the sick, the injured and the dying are all in need of a comforting environment. This is something that was understood by Lluís Domènech i Montaner, who designed Barcelona’s Hospital de la Santa Creu i Sant Pau in the early 20th century as a series of pavilions set in a tranquil and verdant park on the edge of the Eixample extension.
The 1860 Eixample extension of Barcelona by engineer Ildefons Cerdà was itself a direct response to the dismal living conditions in old Barcelona. At the time, the city was delimited by an urban defensive wall and suffered from severe overcrowding and hygiene issues, with diseases spreading rapidly and an average human life expectancy of only 30 years (today it is 82). Since then, health and hygiene have continued to influence architecture and urbanism; the functionalist movement of the 1920s and ’30s, for instance, insisted that modern buildings must be white, bright and easy to clean. Hospital interiors are typically kept germ‑free with the aid of easy‑to‑clean glazed ceramic tiles and glossy enamel paint, all coloured white. These materials impede acoustic and haptic comfort, but the visual appearance of cleanliness normally takes precedence.
With its noble materials, exquisite ornamentation and innovative underground galleries to connect the different pavilions, the Hospital de la Santa Creu i Sant Pau is both a stunning examplar of Catalan modernism (our local equivalent to the French art nouveau, Austrian Secession and German Jugendstil) and an important precedent to what is referred to today as ‘patient‑friendly’ architecture: one that strives for a more balanced notion of human wellbeing rather than a strictly germ‑free environment. A more recent example of a patient‑friendly building is the radiotherapy and hemodialysis facility in Granollers, 30km north‑east of Barcelona, by Baas Arquitectura and Casa Solo Arquitectos. Here, ‘materials and colours that are less antiseptic than in the typical hospital were used in order to create an environment that is more comfortable and humane’, says Baas founding principal Jordi Badia.
Designed for people who suffer from kidney failure and different kinds of cancer, the clinic contains the very latest in healthcare equipment for blood filtration and radiation therapies, as well as building systems that support such technology – such as an elaborate HVAC system as well as very thick concrete walls and lead doors – yet its architecture is one of dignity and serenity instead of ‘whiteness’.
The new facility adjoins a large, modern hospital complex from the 2010s designed by the architectural firm Pinearq, also based in Barcelona, which is itself an extension to a 19th‑century Catalan modernist hospital and asylum by the architect Josep Maria Miró i Guibernau. The Granollers hospital complex serves a large catchment area stretching from the outskirts of Barcelona to the pre‑Pyrenees; the radiotherapy and hemodialysis centre was built next to it precisely so patients from this vast region requiring long‑term therapy would not have to deal with the added stress of commuting into Barcelona, an ordeal even at the best of times. Hemodialysis patients usually undergo treatment at a centre three times per week, each session taking three to four hours to complete, while radiotherapy sessions are typically five times per week, but shorter in duration.
Catalonia has been building a network of smaller, more locally accessible ambulatory care centres for some time, as part of an effort to improve general health through primary care. This way, pathologies that are more complicated and expensive to care for, requiring centralised XL‑scaled facilities, can be prevented from occurring in the first place. The relatively small size of these facilities – Baas has also designed CAP Cotet in Premiá de Dalt – contribute to making them more patient‑friendly. Bigger is not always better.
Wedged into the north-western corner of the Granollers hospital complex, the ambulatory care clinic for radiotherapy and hemodialysis makes the most of its irregularly shaped site. To the south, where it meets the more institutional architecture of concrete and high‑pressure laminate panels of the existing hospital, the building retreats to create a small entrance plaza, a welcome addition to the narrow street. Since the site is sloped, there is another entrance on the top floor, accessible from a garden within the hospital grounds. The clinic’s vertical stratification helps structure the programme: spaces for radiotherapy are concentrated on the ground floor, while the second floor is dedicated entirely to hemodialysis. The intermediary level is a mechanical floor that conveniently services the floors both above and below. Overall, there is roughly 1m2 of mechanical floor area for every 2m2 of clinic. Two lightwells, one of which is enclosed while the other extends, above the ground floor, to the front facade, puncture the building mass to supply the deep and partly sunken interior with natural light.
Clad entirely in a solid clay brick that looks handmade but is industrially produced, the building’s exterior walls are rounded at all corners, creating a facade that playfully curves in and out. Brick pilasters, protruding out every 800mm, accentuate the building’s curves while providing shade (lessening heat gain) and improving interior privacy. In front of the lightwell opening onto the facade, the pilasters briefly transform into pillars, while at mid‑height they are interrupted by extensive brick latticework to naturally ventilate the intermediary mechanical level. With its tripartite composition of horizontal bands, which vary in width according to interior ceiling heights, the building’s facade is a veritable catalogue of the many architectural uses of the humble brick – clearly a reference to both the original Catalan modernism of the Hospital of Granollers and the town’s important ceramics industry.
The interior of the radiotherapy and hemodialysis centre is where patient friendliness is most palpable. Upon entry, patients are greeted by brick walls, wooden doors and raw concrete ceilings textured by rough‑sawn board formwork: a far cry from the typical hospital interiors of stainless‑steel surfaces, panic doors and acoustic ceiling tiles with fluorescent lighting. Borrowing some cubic metres from the mechanical floor above, the foyer and waiting room on the ground floor are serene double‑height spaces fitted with pendant lights designed by Alvar Aalto. Rarely does a public healthcare waiting room look this dignified.
The elegance of these interiors is made possible by a clever design decision: separating the patients’ circulation from that of staff. It is only when a waiting patient’s turn is called and they enter the treatment zone, through changing rooms, that they encounter highly antiseptic architecture. The entire ‘front of house’ avoids any semblance of a hospital, including the stressful buzz of medical staff hastily at work, which greatly reduces stress and improves patient wellbeing.
In the treatment areas, cleanliness and functionality rule, yet walls and ceilings around the radiation therapy machines feature backlit images of the scenic landscapes of nearby Montseny to distract anxious patients. To help contain radiation, these treatment rooms feature concrete walls that are more than 2m thick in places, along with hefty sliding doors containing lead. The hemodialysis floor, by contrast, contains a water purification plant that is purposely exposed behind a glass wall in the entranceway, the only technology visible outside a treatment area. Its sight reassures hemodialysis patients that the water meets very high purity requirements.
Although it is completely hidden, the intermediary mechanical floor likewise contains highly advanced systems. Heating and cooling requirements are met by two independent ground‑source heat pump systems (24 wells 130m deep) as well as two independent air‑source heat pump systems, lest one system should fail or require assistance. Electrical service is backed up by an emergency diesel generator as well as large batteries and photovoltaic panels on the flat roof.
Interestingly, no louvres or grilles are visible anywhere in the foyers and waiting rooms: air circulation, both supply and return, is through simple holes bored through brick, timber and interior windowsills. This reveals the degree to which mechanical systems and technology are banished from view in these spaces.
The radiotherapy and hemodialysis centre belies the cutting‑edge technology it contains, going to significant lengths to do so. A peek through the centre’s brick latticework reveals, in places, opaque wall construction behind. The facade treatment is not applied exclusively for purposes of ventilation or shading, but also for that of architectural composition and ornament – clear evidence the building seeks to distinguish itself from functionalist or high‑tech architectures of cleanliness and techno‑progress.
2025-04-09
Reuben J Brown
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