Can hospitals cure urban blight?

They are major employment engines.  They see heavy traffic volumes of people flowing in and out at all times of the day.  They are major destination points within a community.  But how often is the hospital campus perceived as part of the urban fabric?  The urban hospital faces several challenges.  Some are located in blighted areas and need to create a strong campus perimeter to promote safety for staff and patients, even as they voraciously gobble up the surrounding neighborhood.  Others are faced with residential neighbors who view growth of the campus as infringement on their property rights and insist in walls, fences and landscaping to create a buffer zone.  In either case, this leaves the campus cut off from the rest of the neighborhood, feeling less than an accessible wellness resource. What could be achieved if instead the campus was permeable? What if the campus master plan was in fact a community plan?

As we move into a post-reform healthcare world, a greater focus on treating the whole person has come to the forefront, including comprehensive management of disease and prevention.  In addition, the level of satisfaction that a patient has with the care they receive is going to drive reimbursement. This leads to a much more multidimensional purpose for the hospital campus:

Retail therapy
We don't often view a hospital campus as our destination for gift shopping, or a lunch with friends. But we could.  In addition to capturing the huge audience of staff, patients and visitors, retail and dining venues can also be a resource for others in the neighborhood,  or even destinations on their own.  This serves to draw people in to the campus where the wellness opportunities can be prominently marketed as well as to erase negative associations that a community might have with a hospital. Hospitals become the perfect place for community wellness activities like farmers markets, fitness centers and therapeutic landscapes. Bike and walking paths and trails can add to the experience and be a resource for staff as well.

A development blueprint
If healthcare organizations could work more closely with cities as they develop their master plans, they would be able to leverage and even influence things like locations of transit stops, streetscape design, and zoning guidelines.  Imagine being able to locate affordable multifamily housing including senior living facilities within walking distance. Partnering with the community to create land swaps can allow campus expansion that is a win for both the campus and the community.  Sustainable design initiatives can also lead to sustainable communities.  LEED credits such as development  density, alternative transportation, places of respite, permeable pavings, and percentages of landscape can also aid in helping the hospital to respond to its urban context while also opening it up as an accessible resource of wellness in the community.

Creating a unifying vision for the hospital campus within the community can also help the master plan to better reflect the hospital’s organizational goals and mission. The master plan can be linked to other development efforts within a neighborhood to become part of a community master plan that incorporates initiatives and interests of public transportation planners, city planners and even community stakeholders such as non-profits, business owners and residents.

Evaluating solutions from the point of view of the larger context allows you to integrate cultural perspectives of your healthcare customer. Tying into the neighborhood culture humanizes the hospital, allowing patients to have a more personal and contextual experience.  Growth is an inevitable part of a hospital’s existence.  Acquisition of surrounding land is key to survival, but at what cost to the urban fabric?  The hospital cannot simply act as a vacuum cleaner for blighted properties, what it does next with those properties is key to the success of the neighborhood. 


  1. yes indeed theres volume campus colloectives in hospitals and other high traffic density locations too, indeed calls FOR MASTERFUL PLANNING AND ORGANISATION, to reach customers in their confort zone, in what is a 'foreign' situation

  2. This is a perspective from an architect ,practicing in South India who is involved in Health Care Architecture.
    There are entire city districts and towns that are centered around large hospital and indeed is the very reason for its existance. And yet in most instances there are no context specific vision or development regulations ---one general ,useless,outdated set of rediculous so called by-laws are the only basis for urban development-- Angela's vision seems almost utopic in the third world scenario-- still lets strive for such sensibilities--- seems like something from Pattern Langage

  3. Thanks for the great comments! You both speak to the idea of hospital as "fortress," an imposing institution that one only visits when sick, therefore, there are no positive associations about going there. Even in the US, we have this challenge. At a time when we need to collectively focus on wellness, it is imperative that hospitals integrate themselves into the communities they serve.

  4. In the past indeed, hospitals were built as fortresses,and in many instances they have caused blight by gobbling up residential neighborhoods. But I believe this is changing. For hospitals that have been built or expanded within cities, many have incorporated atria with commercial spaces that act as an extension of their environment. They are more open, welcoming, convivial. In some instances, however, hospitals that could no longer expand or replace themselves within central cores have moved to the periphery

  5. A good example is the Henry Ford West Bloomfield Hospital in West Bloomfield, Michigan. Completed in 2009, this facility has a 270,000 sf clinic facility joining a 192 bed hospital, designed to grow to 300 beds. In the center of the facility is a series of three interconnected interior atriums that provide public access to a day spa, retail shops, a coffee shop, a tea pavilion, a health-food cafe (Henry's)and casual seating and tables amid over 100,000 indoor live trees and plants. The atriums are open to the public and are routinely used by groups of local residents for lunches, card games, and even knitting circles! The last time I was there, I saw several tables being used for a bridge card players and another group playing dominos at several tables. There was an indoor farmers market with vendors selling organic produce, and when I got to the elevator lobby there was a group of women seated in a circle, talking and knitting! The atriums have also hosted free music performances. The Detroit Symphony has played concerts there, and the large atrium has been used for weddings and professional meetings and presentations.

    Patient rooms are 100% private, and the facility scores in the top 99th percentile nationally in patient satisfaction.

  6. What a wonderful example, and a great resource for the community. Cleveland Clinic has also done a lot to reach out to the main campus area. They have a farmers market, public performing art shows and gallery tours of their art collections.


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