COLLEGE/DEPARTMENT: DEPARTMENT OF ARCHITECTURE
SUBJECT: ARCHITECTURAL DESIGN 8-DESIGN OF COMPLEX STRUCTURES
1A
TIME SCHEDULE: 7:30 AM– 2:10 PM MWF
RESEARCH WORK NO.: RESEARCH WORK NO. 1
RESEARCH WORK TITLE: “A TERTIARY GERIATRICS HOSPITAL”
RESEARCH WORK DUE: Sept. 15, 2025
STUDENT: Pajarillo, Giannie Faith
Valencerina, Cleinielle Meyre Chayapan P.
Leones, James Arthur M.
INSTRUCTOR: AR. Joevan F. Rona
I.
INTRODUCTION
As people live longer, healthcare systems around the world face the
challenge and responsibility of caring for an aging population. In the Philippines,
the proportion of older adults continues to rise, with projections showing that by
2040, nearly one in five Filipinos will be over the age of 60 (Philippine Statistics
Authority [PSA], 2020). This demographic shift highlights the growing need for
specialized hospital facilities that not only address the medical conditions
common among older adults, such as chronic illnesses, frailty, and cognitive
decline, but also support their dignity, independence, and quality of life.
Geriatric care is more than medicine; it is about creating environments that
are safe, accessible, and sensitive to the vulnerabilities of the elderly. Hospitals
designed for geriatric patients must balance advanced clinical functions with
humane design, ensuring that wayfinding is simple, circulation is barrier-free,
lighting reduces confusion, and spaces encourage social interaction. Unlike
general hospitals, geriatric facilities must integrate medical, psychological, and
social services in one coherent system of care, reflecting the holistic needs of
older adults.
This research explores how hospital design can respond to these challenges
by examining both local and international case studies of geriatric-focused
facilities. By analyzing programmatic triggers, circulation patterns, site conditions,
and sustainability strategies, the study aims to extract lessons that can guide the
design of responsive healthcare environments for the elderly in the Philippine
context. Ultimately, the goal is to envision hospitals not just as places of
treatment, but as healing spaces where aging is met with compassion, dignity,
and respect.
II.
OBJECTIVES
The objectives of this research are grounded in the belief that hospitals should
not only heal but also honor the dignity of the elderly. By defining the key
medical and operational terms in geriatrics, the study seeks to build a clearer
understanding of the unique challenges older adults face, such as frailty and loss
of independence. It also aims to draw out the differences between geriatric
hospitals and general hospitals, emphasizing that elderly patients require more
than just medical treatment, they need environments designed with patience,
accessibility, and comfort in mind. Beyond technical analysis, this research
illustrates how principles of geriatric care are lived out in daily hospital operations,
from safer circulation routes to supportive social spaces. Ultimately, the study
evaluates how thoughtful design, through space planning, adjacencies, and
human-centered details can protect vulnerable patients, ease the work of
caregivers, and create hospital environments where aging is met with
compassion rather than fear.
1. To define the key medical and operational terms specific to geriatric
hospitals, such as "geriatric syndromes," "multidisciplinary care," and
"functional independence."
2. To explain the fundamental differences between the medical/operational
model of a geriatric hospital and a general hospital.
3. To illustrate how the principles of geriatric care are applied in daily hospital
operations.
4. To analyze the relationship between the specialized medical profile of a
geriatric hospital and its programmatic design.
5. To evaluate the effectiveness of specific design features and their
adjacencies in promoting patient safety, improving care delivery, and
enhancing overall patient outcomes.
III.
CONTENTS OF RESEARCH
LOCAL CASE STUDIES
The National Center for Geriatric Health (NCGH)
In Manila is an annex of the Jose R. Reyes Memorial Medical Center that was
inaugurated in 2010 with the purpose of becoming a premier specialty hospital for
the country's senior citizens (Aquino-Magsaysay, n.d.; Montemayor, 2019;
Montemayor, 2025). Despite the completion of its building structure, the facility has
never fully functioned as the state-of-the-art hospital it was envisioned to be due to
a lack of resources and a legal framework that would allow it to operate
independently (Aquino-Magsaysay, n.d.; Montemayor, 2019).
The facility currently operates as a limited outpatient department (OPD) from
Monday to Friday. Its emergency room and pharmacy are incomplete, and patients
with more than mild conditions must be transferred to the Jose R. Reyes Memorial
Medical Center for care (Montemayor, 2019). Although the hospital is not fully
operational, its architectural and floor plans do exist and have been successfully
obtained by third parties through a formal Freedom of Information (FOI) request to
the Department of Health (de los Santos, 2023; Tabuena, 2023; Bulseco, 2025).
Publicly available photographs of the facility are scarce, and existing images on
public platforms are often mislabeled as the larger Malacañang Complex, where
the hospital is located (Wikimedia Commons, 2023, 2025).
St. Luke's Medical Center in Quezon City
Is a major healthcare institution with a long history, founded in 1903 and
located at its current site since 1961 (St. Luke's Medical Center , Quezon City, n.d.).
As a legacy urban campus with a bed capacity of 633 to 650 beds, the hospital is
undergoing a multi-phase redevelopment to modernize its facilities and enhance its
services (Lucas, 2024; St. Luke's Medical Center, 2024; St. Luke's Medical Center,
Quezon City, n.d.).
The redevelopment is a strategic effort to improve patient flow and service
specialization. The first phase, which is now complete, involved the construction of a
multi-level parking building that also houses new outpatient department (OPD)
clinics, a hemodialysis unit, and outpatient operating rooms (St. Luke's Medical
Center, n.d.-a). This design choice serves to separate the high volume of outpatient
visitors, which averages 2.7 million yearly, from the main hospital, thereby reducing
congestion and streamlining the patient journey (St. Luke's Medical Center, n.d.-a;
St. Luke's, n.d.).
The core of the project is the new 13-story hospital building, which broke
ground in July 2024 and is projected to be completed in 2027 (Lucas, 2024; St. Luke's
Medical Center, 2024). This building will consolidate specialized, high-acuity services
into a single, modern structure. It is designed to house critical facilities such as the
Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), and the Main
Operating Room Complex, as well as departments for nuclear medicine, oncology,
and cardiology (St. Luke's Medical Center, n.d.-a). This architectural specialization
supports the hospital's goals of enhancing clinical efficiency and reinforcing its status
as a leader in medical tourism (Lucas, 2024).
The overall design philosophy also includes an aspiration for a "green campus"
with a "green central park" and "innovation plazas" to foster community connection
and interdisciplinary collaboration among medical staff and researchers (HKS
Architects, n.d.). This approach supports the hospital’s academic mission to
integrate clinical practice with research and education (HKS Architects, n.d.; St.
Luke's Medical Center Foundation, Inc., 2021). The redevelopment is a tangible
expression of St. Luke's' commitment to becoming a premier academic medical
center and a global benchmark for healthcare (Lucas, 2024; St. Luke's Medical
Center, n.d.-b).
INTERNATIONAL CASE STUDIES
Tokyo Metropolitan Geriatric Medical Center
officially known as the Tokyo Metropolitan Geriatric Hospital and Institute of
Gerontology (TMGHIG), is an architecturally and functionally sophisticated institution
designed to serve a rapidly aging population (MyHospitalNow, n.d.-a; Tokyo
Metropolitan Institute for Geriatrics and Gerontology, n.d.). Its design is a thoughtful
integration of robust engineering, strategic patient flow, and a humane, patientcentered atmosphere.
The facility's design and supervision were a collaboration between Sato General
Plan (佐藤総合計画) and Toda Corporation (戸田建設) for its original nine-story
building, which was completed in 2013 (Sato General Plan, n.d.-b; Kindai Kenchiku,
n.d.). A later renovation and expansion led by K.ITO Architects and Engineers added
new buildings and amenities, increasing the hospital's total bed capacity to 451 and
expanding key departments like surgery and rehabilitation (K.ITO Architects and
Engineers, n.d.-a).
Key design strategies of the center include:
Patient and Service Flow:
The hospital is spatially zoned to separate its two main functions: hospital services
and the research institute (Tokyo Metropolitan Geriatric Hospital and Institute of
Gerontology, n.d.). To enhance the patient experience, the design incorporates
calming, non-clinical spaces, such as the Youiku-in and Shibusawa Memorial Corner,
which serves as a relaxation area and a place for health education for patients
waiting for examinations (Tokyo Metropolitan Geriatric Hospital and Institute of
Gerontology, n.d.). Renovations also added a food court, a hospital shop, a rooftop
deck, and an auditorium to improve the overall amenity for users (K.ITO Architects
and Engineers, n.d.-a).
Sustainability and Resilience:
The building is constructed with a "hybrid seismic isolation structure" to ensure it
remains functional during and after major earthquakes (Tokyo Metropolitan Geriatric
Hospital and Institute of Gerontology, n.d.). The design policy specifies performance
goals for different earthquake magnitudes, from "Level 1" to "Margin Level" events, to
ensure "no damage" or only "minor damage" (Tokyo Metropolitan Geriatric Hospital
and Institute of Gerontology, n.d.). In the event of an infrastructure failure, the
hospital has an independent power generation system that can operate for 72
consecutive hours and a seven-day backup water supply (Tokyo Metropolitan
Geriatric Hospital and Institute of Gerontology, n.d.).
Thematic Design and Aesthetics:
The interior employs a muted color palette to create a sense of "habitation" and
incorporates elements from the nearby Egota-no-Mori Park to bring nature indoors
(K.ITO Architects and Engineers, n.d.-a). Artist Eriko Horiki created washi paper light
installations, including a circular light ceiling designed to create a visual effect of
sunrays, seamlessly blending aesthetic form with practical function (Horiki, n.d.-a;
Horiki, n.d.-b).
It is important to note that a significant portion of the TMGHIG's architectural
details, including comprehensive floor plans and photographs of the interior, are not
publicly available. This is partly due to the hospital's policy that strictly prohibits
photography, video, and audio recording inside the facility (Horiki, n.d.-a).
The Samitivej Srinakarin Hospital's Age-Friendly Hospital
Unit has developed a comprehensive model of care that integrates physical
design, operational strategies, and digital technology to meet the unique needs of
older adults (Samitivej Hospitals, n.d.-b). The hospital's approach is guided by
international standards and has earned the Geriatrics Emergency Department
Accreditation (GEDA) Silver Standard, making it the first hospital in Southeast Asia
and the first outside the United States to receive this recognition (Samitivej Hospitals,
n.d.-b; Samitivej Hospitals, n.d.-d).
The operational model is centered on a "personal health manager" system,
which is based at the Center for Healthy Aging on the fourth floor of the hospital
(Samitivej Hospitals, n.d.-a). This multidisciplinary team, composed of geriatricians,
nurses, pharmacists, and other specialists, is responsible for coordinating a patient's
treatment plan and ensuring a smooth experience across all hospital departments
(Samitivej Hospitals, n.d.-a; Samitivej Hospitals, n.d.-b). This system is designed to
prevent the loss of vital information and streamline the patient's journey, especially
for those with multiple chronic conditions (Samitivej Hospitals, n.d.-a).
Service separation is a key design strategy, with specialized centers and clinics
dedicated to geriatric care. These include the Geriatric Accident & Emergency
Center, Geriatric Spine & Revision Spine Center, and the Samitivej Swallow Solutions
Center for dysphagia (Samitivej Hospitals, n.d.-c; Samitivej Hospitals, n.d.-d). This
micro-specialization allows for tailored care, which has led to positive clinical
outcomes, such as 85% of hip fracture patients beginning to walk within two days of
treatment (Samitivej Hospitals, n.d.-c).
The hospital's physical design prioritizes patient safety and comfort. Patient rooms
feature electronically adjustable beds and a computerized nurse call system with
emergency buttons located at the top of the bed and in two places within the
restroom to prevent falls (Samitivej Hospitals, n.d.-a; Samitivej Hospitals, n.d.-e). New
operating rooms are equipped with anti-bacterial walls and a Laminar Airflow
system to reduce the risk of infection, and Intensive Care Unit (ICU) rooms have
windows to help patients maintain a sense of time and day, thereby reducing the
risk of "ICU psychosis" (Samitivej Hospitals, n.d.-e).
Finally, the hospital demonstrates a strong commitment to both digital innovation
and sustainability. The Samitivej Virtual Hospital extends care beyond the physical
facility with remote services like online consultations, at-home blood collection, and
medication delivery (Samitivej Hospitals, n.d.-g). This digital approach also reinforces
the hospital’s "Go Green" initiatives, with the replacement of paper health reports
and questionnaires with a mobile app, which has saved thousands of sheets of
paper and reduced the hospital’s carbon footprint (Samitivej Hospitals, n.d.-f). Other
sustainability efforts include using label-free, recyclable water bottles and a solar
rooftop that has reduced electricity costs and carbon emissions since 2014 (Samitivej
Hospitals, n.d.-f; Yapita Health, n.d.).
Feature
Site
Bicol Region
General
Tokyo
National
Hospital &
Samitivej Srinakarin —
Metropolitan
Center for
Geriatric
Age-Friendly Unit
Geriatric Medical
Geriatric
Medical
(Bangkok, TH)
Center / Institute
Health (Manila,
Center
(Samitivej)
(Tokyo, JP)
PH) (NCGH)
(Cabusao,
(TMIG/TMGH)
PH)
(BRGHGMC)
Urban central Regional
Located within a large Purpose-built
Manila site
campus
private tertiary hospital institutional
within the Jose serving the
in urban Bangkok; unit campus
R. Reyes
Bicol region; is integrated into a
combining
complex;
more
multi-specialty
hospital, research
constrained
land/room for campus that supports institute and
Feature
Bicol Region
General
Tokyo
National
Hospital &
Samitivej Srinakarin —
Metropolitan
Center for
Geriatric
Age-Friendly Unit
Geriatric Medical
Geriatric
Medical
(Bangkok, TH)
Center / Institute
Health (Manila,
Center
(Samitivej)
(Tokyo, JP)
PH) (NCGH)
(Cabusao,
(TMIG/TMGH)
PH)
(BRGHGMC)
land and
phased
ancillary services.
education
historic fabric growth and (Samitivej).
facilities —
(limited room integrated
planned for
for large
regional
geriatric research
expansions).
services.
and clinical care.
(NCGH).
(BRGHGMC).
(TMIG/TMGH).
Compact/lega
Highly structured
cy hospital
Newer
circulation with
layout;
regional
Age-friendly design
distinct public,
circulation
planning
strategies
clinical and
constrained by allows clearer
implemented: wider
service flows;
older
separation of
corridors, universal
pedestrian and
buildings—
patient/publi
Circulation
access, clearer
internal
operational
c and service
wayfinding and ED
circulation
workaround
circulation,
triage protocols for
planned to
required for
though
older patients.
minimise
separate
implementati
(Samitivej).
disorientation for
staff/service
on varies.
older patients.
routes.
(BRGHGMC).
(TMIG/TMGH).
(NCGH).
Limited
dedicated
Has OR/ICU
Advanced
geriatric
capacity as Full tertiary-level
geriatric
OR/ICU
part of the
OR/ICU facilities in
perioperative
capacity;
general
hospital; geriatric care and critical-care
complex cases hospital;
protocols (e.g.,
capability with
often referred geriatric
geriatric-friendly
multidisciplinary
OR / ICU
within DOH
patients
anesthesia and
support;
network —
managed
perioperative
specialized
geriatric
within these pathways) applied
protocols for
approach is
units as
within mainstream
frail/older adults
consultative for demand
OR/ICU services.
in ICU/OR
inpatient
grows.
(Samitivej).
contexts.
wards.
(BRGHGMC).
(TMIG/TMGH).
(NCGH).
Basic on-site
Expanded
State-of-the-art
Comprehensive ondiagnostics
diagnostic
diagnostic
site diagnostics (CT,
Diagnostic (labs, X-ray,
services
services closely
MRI, advanced labs)
s
ultrasound);
integrated on
integrated with
with pathways that
advanced
campus
research
prioritise rapid, lowimaging and
(imaging and
programs (early
Bicol Region
General
Tokyo
National
Hospital &
Samitivej Srinakarin —
Metropolitan
Center for
Geriatric
Age-Friendly Unit
Geriatric Medical
Feature
Geriatric
Medical
(Bangkok, TH)
Center / Institute
Health (Manila,
Center
(Samitivej)
(Tokyo, JP)
PH) (NCGH)
(Cabusao,
(TMIG/TMGH)
PH)
(BRGHGMC)
specialised
labs) to serve stress access for older detection of
diagnostics
regional case patients. (Samitivej).
dementia, frailty
sometimes
mix.
assessment tools).
require referral. (BRGHGMC).
(TMIG/TMGH).
(NCGH).
Small/limited
Dedicated,
Larger
service yard
sophisticated
service/utility
and
Service functions
service-yard
areas allow
constrained
benefit from hospital- planning with
more efficient
Service
logistics due to
scale logistics; not
clear clean/dirty
supply,
yard /
inner-city site;
geriatric-exclusive but separation and
waste, and
logistics
requires careful
operationally efficient capacity to
patient
scheduling of
within the larger
support research
transport
deliveries and
campus. (Samitivej).
and clinical
logistics.
waste flows.
expansion.
(BRGHGMC).
(NCGH).
(TMIG/TMGH).
Mostly retrofit
opportunities
— priority is
Newer
Integrates clinical
functional
regional
excellence with
upgrades
construction Incorporates ageresearch and
(accessibility, allows
friendly design
community
safer
integration of principles,
health;
Sustainabili bathrooms,
greener
accreditation/recogni environmental
ty / Age- ramps). Some building
tion for senior care
and operational
friendly
recent
strategies
and protocols to
strategies support
features
program
and ageimprove safety and
long-term
reports and
friendly
comfort for older
sustainability and
policy interest finishes where patients. (Samitivej; IHI specialized
in
budget
recognition).
geriatric
strengthening permits.
programming.
geriatric
(BRGHGMC).
(TMIG/TMGH).
services.
(NCGH).
Highly
Greater
constrained by physical
dense urban
capacity for
Expansion
site — future
expansion;
potential
growth likely
government
via resupport for
purposing,
phased
Expansion possible
Designed to
within the broad
accommodate
hospital campus (unit- research and
level scale increases, clinical
new age-friendly
expansion;
programs) without full ongoing rolling
campus
upgrades and
Feature
Bicol Region
General
Tokyo
National
Hospital &
Samitivej Srinakarin —
Metropolitan
Center for
Geriatric
Age-Friendly Unit
Geriatric Medical
Geriatric
Medical
(Bangkok, TH)
Center / Institute
Health (Manila,
Center
(Samitivej)
(Tokyo, JP)
PH) (NCGH)
(Cabusao,
(TMIG/TMGH)
PH)
(BRGHGMC)
vertical infill or development redevelopment.
integration with
policy-led
of geriatric
(Samitivej).
academic/resear
redevelopmen services.
ch activities.
t. (NCGH).
(BRGHGMC).
(TMIG/TMGH).
Space Requirements for a Geriatric Hospital according to the Department of
Health of the Philippines
IV.
JUSTIFICATION
Our proposal to build a specialized hospital in Clark, Pampanga, is grounded
in a critical analysis of the region's demographic trends and existing healthcare
infrastructure. Central Luzon is the third most populous region in the Philippines,
with a population exceeding 12 million, and is projected to continue growing.
Despite this large population, there's a significant geographical and service
access gap for advanced medical care. Patients in this region, particularly those
from provinces further north, must currently travel to Metro Manila for specialized
treatments. This journey is not only costly but also time-consuming, with travel
often taking several hours, which can be life-threatening in emergency situations
like a heart attack or an acute renal crisis. We’ve identified cardiovascular and
renal diseases the primary focus because they represent the most significant and
rapidly increasing disease burdens in the Philippines. According to recent
demographic data, Pampanga has a notable and expanding senior citizen
population, who are disproportionately affected by chronic conditions. A 2024
study examining the health of senior citizens in the province found that a large
percentage suffered from comorbidities, with hypertension, diabetes, and
cardiovascular diseases being particularly prevalent. The rising rates of these
diseases, coupled with a lack of dedicated, advanced facilities in the immediate
area, creates a compelling case for a specialty hospital that can serve as a
regional hub for advanced care. By focusing on these two specialties, our design
directly addresses the most urgent health needs of the community while also
carving out a distinct market position. It allows us to create a highly efficient,
purpose-built facility where every design decision, from the placement of a cath
lab to the lighting in a dialysis unit, is optimized to support the specific needs of
these patients.
V.
CONCLUSION
The study of hospital and medical school integration highlights how architecture can
bridge the dual responsibilities of healing and education. By examining case studies
such as Baguio General Hospital and Medical Center, St. Luke’s Medical Center–
Global City, and Johns Hopkins Hospital, it becomes clear that the success of these
complexes lies in how well they manage circulation, zoning, and shared facilities
while maintaining patient safety and academic quality. Hospitals are not just
treatment spaces, they are living classrooms where the future of healthcare is
shaped. This dual role demands designs that are both efficient and adaptable,
balancing the intense needs of patient care with the structured requirements of
medical training.
For Baguio City, the challenge is greater due to its mountainous terrain, unique
climate, and strict zoning regulations. Yet these same conditions also present
opportunities for innovative, climate-responsive, and sustainable design. Passive
cooling, natural ventilation, tiered building forms, and ecological strategies such as
rainwater harvesting and green roofs are not only possible but necessary to ensure
that hospital-school complexes remain resilient. More than buildings, they must
become environments of compassion, resilience, and learning.
In the end, hospital and medical education spaces can coexist successfully when
design is rooted in human needs and ecological responsibility. Safety, efficiency,
and sustainability must guide every decision, from circulation layouts to infrastructure
systems. As Baguio continues to grow as both a medical and academic hub, the
creation of such integrated complexes will define how the city heals its people and
prepares its future healers. This research underscores that architecture has the power
to sustain life not only in the present but also in generations to come.
VI.
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