City of waiting : a primary healthcare center for Laguna Beach, California

Abstract

A design inquiry was undertaken into the alienating spatial qualities of healthcare facilities. The spatial tissue of the modern hospital and clinic was found to correspond tightly with Michel Foucault's definition of an institutional "disciplinary environment." As market-driven healthcare systems compete for patients, institutional power structures are being reversed. Patients have acquired the power of consumers. A new healthcare center must be an inherently open, non-disciplinary environment. On average, half of the time spent within a healthcare building is spent waiting. Yet the activity of waiting is thinly defined and unsatisfactorily inscribed by isolated waiting rooms. This thesis proposes that the realm of waiting be delimited, reconceptualized, and reconfigured in relation to building circulation and medical care spaces in order to catalyze a loosening of the traditionally closed clinical environment and its integration into the physical fabric and social life of the city. Strategies and tactics are described to reconsider the waiting experience and other overconstrained components of healthcare architecture. These tactics are deployed and tested in the design of a primary healthcare center in a small beach-side city.