\p'\J/v ^l^ ^*; <í,tp ^\l/iu uf if uy i^U' ií' (P U/ ,/ ^ "^ 1,/ ^ ^ *" (J/ (^ EASTWOOD CHILDREN'S HOSPITAL EL PASO, TEXAS PRESENTED To - PROFESSOR W, LAWER"ENCE GARVIN DIVISION OF ARCHITECTURE TEXAS TEXAS UNIVERSITY PRESENTED BY • JORGE VIRGEN - RJCH IN PARTIAL FULFILLMENT OF THE REQUiREMENTS OF THE BACHELOR OF ARCHITECTURE .DEGREE MAY 5 , 1982 TABLE OF CONTENTS INTRODUCTION - HOSPITAL'S HISTORY.,... ,1 PROJECT STATEMENT - 7 BACKGROUND STUDiES o... ».. l-íf GOALS 18 OBJECTIVES . o • . o • . o • • . « o . o o . 19 ACTIVITY ANALYSIS.o , ifO SITE ANALYSIS ..o ^8 SPACE SUMMARY o. -23 SYSTEMS PERFORMANCE CRITERIA...o...o 139 COST ANALYSIS '• o..........,o 172 DETAIL E D S PAC E LIST.o.•..••.»»•«»•»•••»•*••»»•«....o..•.»..« 1/7 CASE STUDIES., 3^5 CONCLUSiON.- •••« o 0.0 o 00 35'+ BIBLIOGRAPHY 3^3 HISTORY Institutions for the care and shelter of the sick existed in ancient times. Many of them simply provided horaes for horaeless, helpless, or - infirm persons. These were hardly hospitals in the modern definition of that tem. Others provided such medical care and treatment as had been developed in their time and localities. There are records of hospitals in Buddhist India as early as the 3rd century, B.C. In connection with the temples of Aesculapius in ancient Greece and some of the Aegrean - Islands there grew up raedical schools, and in connection with them, - hospitals in which priests of the cult of this. Greek godof medicine ministered to the sick. There are records of hospitals in Rome in the early centuries of the Christian era. The revival of piety in the llth century, pilgrimages to holy places and the Crusades led to the establishraent of many hospitals and to the development of religious orders whose members ministered to the sick. Famous araong these orders is that of the Krdghts Hospitallers of St. John of Jerusalem, sometimes known as the Knights of Malta. The order has been continuously serving the sick in many lands. At Valetta the order built and maintained a large hospital in which members ministered personally to sick patients. After their expulsion from Malta by Mapoleon, the - Knights established their headquarters in Rome and since that time have cared for sick and wounded soldiers of many European wars, maintaining hospitals, ambulance service, hospital trains, and the like. Other religious orders founded during the Middle Ages operated hospitals 1/ and nursed the sick and still continue to do so. In England during the Middle Ages hospitals were founded to serve a variety of social needs. Many of them were for lepers; others housed aged, infirm, and horaeless persons, or provided lodging for pilgrims and wayfarers. Their care of the sick was only incidental to their - other functions. Practically all of them were maintained by monastic orders or other religious foundations. The slow disappearance of - leprosy and the econoraic decline toward the end of the 15th century and the beginning of the l6th led to the closing of many of these institutions. The final blow came when Henry VIII dissolved the religious houses and confiscated their properties. Through the efforts of London citizens, St. Bartholomew's and St. Thomas's were reopened, and in the reign of Edward VI these institutions became, in a sense, municipal hospitals. The beginnings of hospitals in the English colonies in America, which later becanie the United States, followed neither the plan of the organiza- tion of charities by the church nor that of cities to provide institutional care for the indigent sick. This is explainable from the facts that the Catholic Church, the chief dispenser of organized religious charity in Europe, did not flourish in the colonies, and that the early American settlers became farmers in stead of establishing themselves in towns, there being prior to the Revolutionary War very few towns in the - colonies larger than villages. The scattered population had relatively few physicians outside of New York, Philadelphia, Boston, and Charleston In Virginia, the Church of England through its vestries managed local civil affairs, including poor relief, but it did not establish hospitals the population being alraost entirely rural. In Maryland, the Catholics were not iong enough in control of public affairs to develop the system of charities which the Church fostered in Europe. The earliest attempts to establish hospitals were sporadic and - designed to meet local needs of specific nature. The first hospital established in the colonies was in New York City, then known as New Amsterdam. In I658, at the suggestion of a Dutch West India Company surgeon a hospital was erected for the care of sick soldiers, who previously had been billeted in private families, and for the company's negro slaves. The first comprehensive and successful attempt to establish a general hospital was in Philadelphia towards the middle of the 18th century. Thomas Bond, a Philadelphian physician who had studied medioine in England and was familiar with English hospitals, and Benjamin Franklin were its chief - promoters, Franklin obtained a grant of 62,000 from the Provincial Legi_s lature on the condition that a like sum be raised by public subscription in Philadelphia. This was done and the managers of the hospital rented a house and in it opened (l75l) the Pennsylvania Hospital, the oldest - hospital in the United States. Five years later they completed their new plant on Spruce Street on which site the Pennsylvania Hospital has been in continuous operation ever since. Most early hospitals were established as charities for the poor and the homeless and for the isolation of persons suffering from certain - communicable diseases. Unfortunately, because of lack of knowledge of the causes of diseases, of the sources of infection and many of the simple principles of sanitation and ventilation, they were unable to protect adequately the health and lives of their patients. Early hospital surgery was fought with heavy mortality as was hospital obstetrics. Hospital fever spread by overcrowding and faulty ventilation, carried off many more - patients. With the discoveries of Louis Pasteur and Joseph Lister there came about great changes in surgical technique, with increasing safety to surgical patients in hospitals. The discovery of methods of anesthesis still further prometed surgical practice and developed and increased - demand for hospitals, As modern medicine developed, increasing knowledge of the causes of diseases, improved methods of diagnosis and treatment, and the techniques essential there to hospitals became organizations of facilities by means of which the knowledge and skill of physicians, raade more effective by the service of trained nurses and technical personnel, were brought to bear on the problems of diagnosis and the care and - treatment of the sick, Hospitals became institutions for the practice of modem scientific medicine for the acutely ill rather than for the cus- todial care of the homeless chronic sick, This led to a great increase in the number and variety of hospitals, for as specialization in medicine developed there came a demand for special hospitals; in more recent years however, the development of iarge general hospitals with many special departments has tended to lessen the need for special hospitals. The Bureau of the Census reports that there were in 1939 in the United States 6,991 hospitals and sanatoriums with a total bed capacity of 1,186,262 and 63,627 bassinets, In 1939 these institutions adraitted 9,627,000 in-patients and gave them a total of 355,145,000 days of care exclusive of care of the newbom,3 5 As recently as 1942-43 hundreds of plans for hospitals and some for matemity hospitals were submitted to the War Production Board with - requests for priorities showed little or no understanding by the architect or hospital administrator of the functional aspects of hospital planning and operation. During the war years Dr, Vane Hoge, Marshall Shaffer, - August Hoenack, George Ivanick and Neil McDonald in the U.S. Public Health Service set up a long range plan of cooperation between their group and private architects, hospital consultants, administrators and department heads. The oiåginal work of the group of crusaders was centered on improving the design of hosoitals to be built under World War II's Lanham Act. Suggestions made by the Public Health ServLce in 1942-43 soon proved their worth in the steady improvement in plans submitted to the Hospital Division of W.P.B. during the last part of 1943 and on through the life of W.P.B.'s priority system. During the past seven years, the Bureau of Medical Services of the - U.S. Public Health Service under the direction of Dr. Jack Mazur, and its Division of Hospital Facilities and Medical and Hospital Resources \inder the respective directions of Drs. John W. Gronin and John R. Mcgibony and Marshall Shaffer have carried on a continuing research program on the - function and the design of a modem hospital. PROJECT STATEMENT INTRODUCTION BACKGROUND STUDIES GOALS a OBJECTIVES "All children shoxiLd be tirelessy, noisy, playful, grubby - handed except at raeal tiraes soiling and tearing such clothes as they need to wear, bringing not only the joy of child hood into the house but the dust and mud as víell; in short everything that makes the - qiiiet and order of sickness and nursing impossible" George Bemard Shaw The main objective of the proposed children's hospital is to create an environmental space sioitable for the children's psychological well being during medical treatment, The aura of the building raust coincide with that of the children, fulfilling their particular needs. The child's needs are special; his own personal scale is different from that of the adult, Soraetimes even children's diseases are different and require special treatment with special facilities.