Khoo Teck Puat Hospital (KTPH):

A Case Study Of Designing Green

Health Facilities

Donald Wai
Director (Hospital Planning and Infrastructure)
Khoo Teck Puat Hospital, Singapore
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 Khoo Teck Puat Hospital (KTPH)

• Opened: 2010
• No. Of Beds: 591
• Gross Floor Area (GFA): ~110,000 m2
• Acute Hospital With Operating Theatres, ICUs,
Emergency, Wards and Specialist Outpatient Clinics To
Serve the Northern Region of Singapore
• Under National Healthcare Group (NHG), Public
Healthcare Cluster of Singapore
Components of Yishun Health Campus (YHC),
National Healthcare Group (NHG), Singapore

Khoo Teck Puat

Hospital (2010)

Admiralty Medical Yishun

Centre (2017) Community
Hospital (2015)

Polyclinics, GPs Day Rehab, Day Nursing Home

Care, Home & Others
Care,
Community
Homes

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MAP OF SINGAPORE

Khoo Teck Puat

Hospital
Khoo Teck Puat Hospital

Alexandra
Hospital

Alexandra Hospital 4
Alexandra Hospital
 “Hassle-Free Hospital”
“I posed the challenge to the AH rebuilding team: build a
hospital… designed with patients unambiguously at the
centre of the focus, with technology fully exploited for the
benefit and convenience of patients…. It will be a hospital
which is well linked… and to which the patients can be
transferred seamlessly… It will be a hassle-free hospital.”

- Mr Khaw Boon Wan

Singapore’s former
Minister for Health
Parliamentary Debate
17 March 2004

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Challenges To Architects
• Award winning reference site
• “WOW” for patients, visitors and staff
• Could be criticized by small-minded people
• Reasonable cost

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Design Preferences

• Welcoming
• Seamlessly connected to the
neighbourhood
• Architectural solutions before
engineering solutions
• Modernising traditional designs
that work
• Greenery preferred over hard
surfaces
• Ease and low cost of
maintenance

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Benchmarks

Raffles Hotel

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 Design Objectives
1) Energy Efficiency
2) Green And Biophilic Design
3) Patient Centric
4) Ease of Wayfinding
5) Technology As An Enabler
Energy Efficiency
• Use of passive solutions
rather than engineering
measures
• To be 30% more energy
efficient than existing
public hospitals
• Tropical building, with good
natural ventilation
• Use of overhangs and high
ceilings
• Use of renewable energy
sources
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 Building Design And Orientation
• Designed as a V-shaped configuration of 3 blocks,
the ‘V’ opens to the north, letting in air breezes that
skim over an existing storm-water pond, adjacent to
the hospital site
• The envelope of the buildings allows for permeability
and shade. This allows patients good access to
natural light, cooling breezes and views, without
exposure to excessive solar glare
• The subsidized ward tower is orientated to capture
the prevailing North and South East winds. This helps
to achieve optimal wind speeds to cool the wards.
Spatial Layout Of Khoo Teck Puat
Hospital
Subsidized Ward Tower

Medical Centre

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 Architectural “Wing Walls”
• Aluminum fins or “Wing walls” along the building’s walls
were designed to channel the prevailing winds into the
building by increasing the wind pressure build up on the
façade
• Wind tunnel tests conducted at the National University of
Singapore (NUS) found that these fins would enhance
the air flow by 20-30%
 Engineering Measures
• Solar Photovoltaic Voltage (PV) system
• Solar Hot Water systems
• Use of Yishun Pond water for irrigation measures
 Green And Biophilic+ Design
• Lush, green functional spaces at every level
• Trees and shrubs act as sun shades
• Facilities conservation of tropical flora and fauna species
• Rooftop farming: Edible gardens in the sky

+ Biophilia: A instinctive tendency for humans to seek connections with nature and other forms of life
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 Biophilic Design
• KTPH is designed to be ‘forest-like’, water
features with aquatic species, and plants that
attract birds and butterflies were introduced.
• Greenery extends from the central courtyard to
upper levels of the buildings and down into the
open-to-sky basement 1, with skylights bringing
natural lighting to the basement 2 carpark
 Sight, Scent And Sensation
• Balconies with scented and colourful plants give a
thereupatic experience to the patients
• The open, naturally ventilation design brings about
thermal comfort for patients and creates a
salutogenic sensation for them to recuperate well1

1 Wai,
Donald (2013), A Salutogenic Study Of Occupants In A Singapore Hospital For Comfort
Modeling
 Rooftop Farming
• KTPH’s unique rooftop farm forms part of its skyrise
greenery design2
• The rooftop farm at the Specialist Outpatient Clinic
(SOC) Tower has more than 100 species of fruit trees, 50
species of vegetables and 50 species of herbs
• Run by volunteers from the nearby community, the farm
is also a source of organic produce for the hospital’s
kitchen
• Acts an educational hub for visitors and students to learn
how food is grown naturally in urban Singapore
2 Wai,
Donald (2011) Council of Tall Building and Urban Habitat (CTBUH) Conference
“Beyond Skyrise Gardens: The potential of urban roof-top farming In Singapore”

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 Rooftop Farming
Other benefits:
• Engages the community to become active volunteers
• Reduces Urban Heat Island Effect
• Cuts down utility consumption for air conditioned clinics
below the farms

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 Rooftop Farming
• Utilizes unused roof space
• Produce is sold to the community to raise
“green” funds to rejuvenate the farmland
 Increase In Overall Green Area
• KTPH had achieved a green plot ratio of 3.92, or
a total surface area of horizontal and vertical
greenery that was almost four times the size of
the land that the hospital is built on
• In addition, 18% of the hospital’s floor area
account for blue-green spaces and 40% of all
such spaces are publicly accessible
 A Healing Environment
• Studies3 have suggested that the environment plays
an important role in helping patients to recover faster
• The views of the pond and basement garden serve as
healing elements for patients

3Nirmal Kishnani and Giovanni Cossu- Ramboll (2016): Enhancing Blue-Green and Social
Performance in Dense Urban Environments- Biophilic Design – Singapore’s Khoo Teck Puat
Hospital
 Integration Of Pond With Hospital
• The site for the hospital was chosen for its proximity
to the Yishun Pond
• The massing is designed to open up to ‘embrace’ the
pond, ‘drawing in’ greenery and water to make the
hospital and pond an integrated entity
 Redevelopment of Yishun Pond
• The surroundings of Yishun Pond has been redesigned
as a park in 2009-2011 which would serve the
recreational and social needs of residents and patients
• The concrete edges of the pond were remodelled and
aquatic plants were introduced to improve the water
quality. Habitats for flora and fauna were created
 Health Promotion
• Walking trails and lush greenery were added, linking Yishun
Pond to the hospital and nearby residential estates
• With the incorporation of the pond, the total blue-green space
available to KTPH patients and visitors increased by 400%

Before

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After After
Green Collaboration
To
Yishun Central 1

inlet
KHOO TECK
PUAT
HOSPITAL inlet
Wetland
Lakeside
&
Promenade Native
Marsh Area
Woodlands

YISHUN
POND Pump House
Treatment

Flower Garden
Inlet Lookout tower/ Trail
deck

Outlet

Landscape
&
To Foot path
Yishun Park

Yishun Pond Features

Yishun Pond (Before And After)

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 Post Occupancy Evaluation And Built
Experience: Lessons Learned
• In 2016, a post-occupancy evaluation (POE)3 was
conducted at KTPH on a sample group of 200 users
comprising of patients, staff and visitors and at an
older hospital which was designed based on an
earlier approach to healthcare design
• The POE focused on the effects of water and
greenery on user perceptions and feelings of well-
being

3Nirmal Kishnani and Giovanni Cossu- Ramboll (2016): Enhancing Blue-Green and Social
Performance in Dense Urban Environments- Biophilic Design – Singapore’s Khoo Teck Puat
Hospital
Post Occupancy Evaluation And Built
Experience: Lessons Learned (1)

• The POE revealed that KTPH’s use of biophilic

design (BD) elements such as greenery and
water attributed to it performing better than its
counterpart when comparing perceived beauty,
self-reported well-being, and user awareness of
and proximity to nature
• Over 80% of respondents said yes when asked if
hospitals ought to invest in blue-green elements
Post Occupancy Evaluation And Built
Experience: Lessons Learned (2)

• KTPH is ranked first in Singapore in the annual

Ministry of Health (MOH)’s public satisfaction survey.
Results of the 2016 study suggest that this
preference, at least in part, is linked to the quality of
its space and biophilic attributes
• Climatic studies conducted revealed that KTPH is
significantly cooler in the afternoon. This is most
likely due to shading and evaporative cooling from
water features
 The Benefits Of Biophilic Design
The Khoo Teck Puat Hospital was the winner of the first-
ever Stephen Kellert* Biophic Design Award in 2017. The
hospital’s design has seamlessly integrated with nature to:
• Help patients forget their pain and improve their rate of
recovery by immersing them in a natural healing
environment
• Create an invigorating park-like ambiance for caregivers
and the general public
• Enhance views and provide access to nature for a
conducive working environment for staff

*Stephen Kellert: Social ecologist and pioneer in

linking biophilic principles to the built environment
Design Thinking

• Human-centred approach
• Deep dive
• Visual thinking
• Rapid prototyping
• Fail early, fail often

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Salamat