Interview with Mª Amor Arroyo Sánchez
Recently at Árgola Arquitectos, we conducted an interview with Mª Amor Arroyo Sánchez, Senior Architect within the company, with the aim of delving deeper into the design of hospital architecture.
Through this meeting, we have a conversation in which the professional shows us how the needs of this type of infrastructure have evolved. She allows us to delve into her projects and the work dynamic she has developed over the years to adapt hospital buildings into functional and efficient infrastructures.
Furthermore, he tells us how he has learned to listen to human needs, developing more humanized areas within the hospitals themselves, so that this building becomes a more pleasant and welcoming place for patients.
Delving deeper into hospital architecture
Árgola Arquitectos (AA): How long have you worked on hospital architecture projects?
Mª Amor Arroyo Sánchez (MA): I finished my degree in 2003 and started working immediately, although it wasn't until 2007 that I began to make contact with healthcare architecture, completing a specialization master's degree during the years 2015-2017. In total, I have been developing hospital projects for 17 years.
(AA): From your perspective, what are the current trends in hospital building design?
(MA): Hospital buildings must be extremely functional; their essence is to serve healthcare activity and users. Therefore, the trend in this type of building is linked to the evolution of current healthcare work, which has recently focused on prevention, process optimization, and reducing stay times in centers, all of which is closely linked to the humanization and universality of treatments.
Furthermore, it must adapt to the dictates established by epidemiology, which means that they must be buildings with a logical flexibility that makes it easy to adapt to seasonal situations, such as epidemics or disease peaks.
Finally, and as part of the changes affecting construction in general, in recent times much of the effort required for this type of project is focused on achieving energy-efficient buildings.
(AA): How has hospital architecture evolved in recent years?
(MA): The hospital is the social institution that has undergone the greatest changes throughout history. Initially, hospitals were created to house vulnerable people who, due to a lack of economic resources, could not access home medical care. Thus, it began as a large container with a very simple functional program that basically consisted of large hospital wards and some additional support spaces.
Throughout the 19th century, as knowledge of the etiology of pathological processes increased, changes began to be implemented, such as the use of single beds and the grouping of patients by type of illness. Furthermore, the importance of ventilation, sunlight, and humidity control was emphasized. In this way, functional programs gradually became more complex, with the addition of specialties and areas for diagnosis, clinical care, recovery, and treatment.
From the 20th century onwards, specific diagnostic and treatment equipment and materials began to be developed, further completing the functional programs.
Currently, science and technology are advancing very rapidly, and architecture must be able to adapt to the changes they impose, as it has done throughout the history of medicine.
(AA): Can you share specific examples of architectural solutions and innovative technologies applied in projects by Árgola Arquitectos?
(MA): The truth is, due to the rapid advancement of the healthcare techniques I mentioned, each project presents us with new challenges in this regard, many of them to be developed even during the construction phase, because the needs of the healthcare building change during the development process.
Most of them are related to High Technology, which includes advanced equipment and systems for the diagnosis, treatment, and management of patients. For example:
We have just delivered the project for a Proton Therapy at the Fuenlabrada Hospital and recently, we have participated in the proposal of 3 more.
Furthermore, in the new Technical and Hospitalization Block of the 12 de Octubre Hospital, we carried out, during the construction phase, the design and implementation of all the advanced technology with which it has been equipped, both in the radiology and interventional radiology areas. Regarding this project, and also during the construction phase, the possibility of installing an open MRI scanner was studied and planned.
We are currently working on the renovation and expansion of the Gregorio Marañón University General Hospital, where we will be implementing Flash radiotherapy, a cutting-edge and innovative piece of equipment for cancer treatment that reduces patients' exposure time to treatment and, therefore, minimizes side effects. Also as part of this project, we are collaborating with the Hospital to improve and expand the Advanced Planning and 3D Manufacturing Unit, a leading multidisciplinary clinical innovation unit in Europe.
In general, in each project we encounter new needs to satisfy and, as I mentioned, these sometimes arise during the construction process, requiring us to study the adaptation of the project and its implementation at that stage.
(AA): What do you consider to be the biggest challenges in hospital design today?
(MA): In addition to the flexibility required for developing projects that involve significant investments and therefore must have a long lifespan, I believe that today we must focus on humanizing the spaces we design, concentrating on the needs and experiences of users, thereby promoting well-being and human interaction. Furthermore, for obvious reasons, energy efficiency is another major challenge, not only in the building itself, given that it is one of the most energy-intensive building types, but also during the construction phase. Finally, we are increasingly facing tighter deadlines for both the design and construction phases.
We address these last two challenges by increasingly incorporating industrialized processes—components manufactured off-site and then assembled on-site. These techniques improve construction efficiency, reduce costs, and enhance the quality of finishes. Whenever possible, we also utilize dry construction systems, which facilitate rapid assembly and allow for future recycling and replacement.
From a sustainability perspective, industrialized construction also offers numerous advantages: reduced waste, reduced use of raw materials, energy, and water, and minimal disruption to surrounding air quality during construction, allowing parts of the building to remain operational with minimal impact. Ultimately, these systems significantly reduce the carbon footprint of buildings compared to traditional construction methods.
(AA): How do you approach space optimization and efficiency in hospital designs?
(MA): From my point of view, experience is fundamental in the development of such highly complex projects to optimize spaces. Studying other projects and direct contact with users and healthcare staff are two of the most powerful tools we have to bring hospital architecture ever closer to its ultimate goal.
Regarding energy efficiency, from the first steps of the proposals we take into account active measures on the design of the facilities aimed at achieving the lowest possible consumption, and passive measures on the constructive and architectural design aimed at reducing energy demand.
(AA): What are the key aspects to consider when creating a patient-centered hospital environment?
(MA): Creating a patient-centered hospital environment involves reviewing how the building relates to its users in order to design hospitals that combine the need for humanizing architecture towards users with a commitment to comprehensive sustainable construction, seeking with all this, the health and well-being of the people who will inhabit it.
That is why we approach healthcare building projects not only from a technical and functional perspective, but also by considering human aspects, with a commitment to improving the healthcare experience for users: patients, families, and staff. It is essential that we create spaces where people feel comfortable and that their basic needs are met.
(AA): How can architectural design contribute to the well-being and recovery of patients?
(MA): It is documented that, by considering certain design factors, it is possible to positively influence patient recovery; the basic pillars to address are:
• Spatial quality, referring to adequate lighting and sufficient ventilation.
• Universal accessibility, to provide maximum autonomy to people with special needs.
• Environmental and material clarity, to create welcoming and comfortable spaces that promote the user's healing and the comfort of their family members.
• Functional clarity, since a clear arrangement of spaces and a hierarchy of circulation in the building eliminate the feeling of labyrinthine and alien spaces.
• Biophilic design, introducing natural elements and ecological and VOC-free materials. Soft colors, vegetation, etc., to promote active and healthy development in contact with nature.
(AA): Highlight one or two projects you have worked on at Árgola Arquitectos that you consider outstanding examples of hospital architecture.
(MA): Since 2019, the year I started working at Árgola Arquitectos, I have had the opportunity to work on important national healthcare projects.
At the Isabel Zendal Emergency Hospital, we carried out in parallel the execution project and the construction of the entire logistics area, now the SERMAS Logistics Center, and its urbanization in integration with the Institute of Legal Medicine and Forensic Sciences.
In the new technical and hospitalization block of the 12 de Octubre University Hospital I have had the opportunity to be part of the development team of the execution project and later of the construction management team, which has given me the opportunity to closely follow the materialization of the building.
I am currently working on the implementation project for the renovation and expansion of the Gregorio Marañón University General Hospital.
Furthermore, during these years I have also participated in the development of various proposals for this type of architecture: the expansion and renovation of La Paz Hospital, the proposal for the construction of the Third Hospital of Malaga, etc… In this sense, competitions and proposals give us the opportunity to investigate and propose innovations that we then implement in the projects.
(AA): Describe the unique and challenging aspects of these projects.
(MA): Their functional complexity and size are undoubtedly two of the most challenging aspects. Furthermore, these are leading public hospitals in healthcare and research, equipped with the most advanced technology available in the sector. I would say they are at the forefront of the hospital sector in this country, and that is what makes them such challenging projects.
To all this, we must now add the challenge of managing increasingly tight deadlines. The first phase of construction on the Technical Block and Hospitalization Ward of HU12O, a 140,000 m2 building, has been successfully completed in 28 months, which has been a challenge for everyone involved: the owners, the construction company, and us as the project management team.
(AA): How do you anticipate that emerging technologies will impact hospital design in the future?
(MA): Emerging technologies are significantly changing the design of hospitals of the future. For example, telemedicine is enabling more flexible, patient-centered spaces, and AI is being developed to optimize resource management and improve patient care. Furthermore, virtual and augmented reality are transforming how medical environments are designed and experienced, enhancing staff training and patient comfort. In short, emerging technologies are bringing us closer to more adaptable, efficient, and patient-centered hospitals, creating increasingly proactive healthcare environments.
(AA): Given the constant evolution of healthcare, how do you design hospital facilities to be adaptable and flexible to future changes?
(MA): We achieve adaptability to future changes through the design of modular spaces and flexible construction systems that allow for easy modifications. Furthermore, we strive to incorporate reserve spaces so that units can grow over time, especially those areas working with evolving technologies. A clear and organized functional and circulation layout from the outset also helps to organize future expansions in an integrated and orderly manner. This is not just about space; it also involves considering all aspects of the facilities, creating designs and layouts that can be adapted over time to the changing needs of healthcare.
(AA): From your perspective, how do you envision the future of hospital architecture?
(MA): It's difficult to make a prediction given the speed of technological and medical advances. But I certainly believe that the future of healthcare architecture will continue to be increasingly patient-centered while also prioritizing energy efficiency: nearly zero-energy hospitals are already a reality; now we must believe that it's possible to achieve healthcare buildings that produce energy, which can be used by their immediate surroundings, and that help to enhance the context in which they are located.
(AA): You are part of the Árgola Arquitectos team, could you describe your experience at the company? What things would you highlight?
(MA): As part of Árgola Arquitectos, what I would highlight most is the team's human qualities and their excellence in approaching projects. The opportunity to develop large-scale healthcare buildings alongside colleagues who have created projects that are among the leading healthcare facilities in this country over the last few decades is a truly enriching experience. Furthermore, working daily with multidisciplinary teams across all areas of this field and leveraging the resulting synergies makes working at Árgola Arquitectos a fantastic professional experience.
Following this interview, we at Árgola Arquitectos want to not only showcase another side of hospital building construction, but also highlight the often-overlooked aspects of these projects. These are buildings where the human element must be a key consideration in the design process, since, ultimately, they are structures that we will all be able to use.