Teknolojik gelişmelerin sağlık yapıları tasarımı üzerindeki etkileri
The effects of technological developments on the healthcare buildings design
Yazar: NAZLI CAYMAZ
Danışman: DOÇ. DR. ELMİRA AYŞE GÜR
İstanbul Teknik Üniversitesi / Fen Bilimleri Enstitüsü / Mimarlık Ana Bilim Dalı / Mimari Tasarım Bilim Dalı
Derece: Yüksek Lisans, 2019
Konu: Bilim ve Teknoloji = Science and Technology ; Hastaneler = Hospitals ; Mimarlık = Architecture

Özet:
Son yüzyılda teknolojideki gelişmelere paralel olarak tıp alanında gerçekleşen, hastalıkların teşhisi ve tedavisine yönelik ilerlemeler, tıbbi teknolojideki hızlı değişim ve yenilikler, sağlık yapılarının tanımını ve özelliklerini dolayısıyla da tasarımının yeniden tartışılmasına yol açmıştır. Sağlık hizmetlerinin veriliş biçimlerinde ve bunların uygulandığı kurumlarda yeni arayışlar içine girilmiş, değişen tıbbi prosedürler ile gelişen tıbbi teknoloji mekânsal değişikliklere sebep olmuştur.
Yapılan çalışma ile; sağlık yapılarının teknolojik gelişmelerden nasıl etkilendiğini tespit etmek, bu etkilere bağlı olarak gerçekleşecek mekânsal değişiklikleri tanımlamak ve bunların sağlık yapılarının mimari tasarım sürecine etkilerini incelemek amaçlanmıştır. 
Çalışmanın altlığını oluşturmak adına; yapılan araştırma ve analizlerden yararlanılarak ortaya konulan araştırma soruları; (1) Teknolojik değişim ve yenilikler, sağlık yapılarında mekân organizasyonunu ve mekân büyüklüğünü etkiler mi?, (2) Sağlık yapılarında, teknolojik yenilikler ile mimari tasarımın etkileri güçlendirilebilir mi? olarak belirlenmiştir.
Sağlık yapıları tasarımına teknolojik gelişmelerin katkılarını analiz etmek amacıyla hazırlanan çalışma iki aşamadan oluşmaktadır. İlk aşama literatür taramasıdır. Konu ile ilgili çalışmalar incelenmiş; sağlık yapıları geçmişten günümüze tarihsel süreç içerisinde ele alınmış, sınıflandırılmış, bu sınıf içerisinde hastanelerin tanımı yapılarak, içerdiği bölümler ve bu bölümlerin birbirleriyle ilişkisi hakkında bilgi verilmiştir. Daha sonra konumuzla ilgili olarak teknoloji kavramı ele alınmış, tıbbi teknolojiye bağlı olarak hastanelerin değişimi hakkında bilgi verilmiş ve sağlık yapılarında teknolojiye bağlı olarak gelişen yeni yaklaşımlar incelenmiştir.
Çalışmanın ikinci aşamasında; öncelikle belirli kriterlere göre seçilen 27 akademik makale incelenerek mimari tasarımın sağlık yapıları üzerindeki etkileri kanıtlara dayalı olarak ortaya konulmuş, elde edilen veriler ile belirlenen tasarım kriterleri gruplandırılarak kategorize edilmiştir. Daha sonra, bu kategoriler ile teknolojik gelişmelerin ilişkisi incelenmiş ve bu alanda yapılan uygulamalar, üretilen çözümler analiz edilmiştir. Son olarak, yapılan araştırma çalışmasının bulguları ortaya konulmuş ve belirlenen araştırma sorularına yönelik değerlendirmelere yer verilmiştir.
Sağlık yapıları özelinde teknolojik gelişmelerin, mekânsal değişimler üzerindeki etkilerinin araştırıldığı bu çalışma sonucunda elde edilen bulgular ile; sağlık yapıları tasarımında etkili olan mimari tasarım kriterlerinin teknolojik gelişmelerle yakından ilişkili olduğu ortaya konulmuştur. Elde edilen bir diğer bulgu ise, teknolojik değişim ve yeniliklerin, sağlık yapılarında mekân organizasyonunu ve büyüklüğünü etkilediği olmuştur. Ayrıca sağlık yapılarında, teknolojik yenilikler ile mimari tasarımın; kullanıcı sağlığı, kullanıcı deneyimimi ve operasyonel performans üzerindeki etkilerinin güçlendirilebildiğini kanıtlayan bulgulara ulaşılmıştır. 
Yapılan çalışmayla; sağlık yapıları için tasarım çalışmalarına girdi olabilecek bilgiler ortaya konularak, konu üzerine araştırma yapan mimarlara, tasarımcılara, yönetici ve sağlık hizmetleri sağlayıcılarına yönelik güncel bir altlık oluşturulması ve bu sayede ileri besleme yoluyla gelecekte inşa edilecek projelerin daha nitelikli ve uzun vadeli planlanmasının sağlanması hedeflenmiştir.

Abstract:
Advances in the field of medicine, in parallel with the developments in technology in the last century; developments in diagnosis and treatment methods of diseases, rapid changes and innovations in medical technology, have led to a re-discussion about the definition of the healthcare buildings and their design. New searches have begun in the delivery of healthcare services and in the facilities where they are applied, also changing medical procedures and developing medical technology have caused spatial changes in the healthcare facilities.
The aim of this study; is to determine how the healthcare buildings are affected by technological developments, to define the spatial changes that will occur due to these technological effects and to examine these changes' effects on the healthcare buildings' architectural design process.
In order to form the base of the study; two main research questions were defined by using the information obtained from the research and analysis as follows; (1), Does technological change and innovation affect space organization and space size in the healthcare buildings? and (2), Can the effects of architectural design be strengthened by the technological innovations in the healthcare buildings? Sub research questions are; (1), What innovations in the technological field can contribute to the architectural design of the healthcare buildings? and (2) Do technological change and innovation affect the number of people providing healthcare services?
The study, which was prepared in order to analyze the contribution of technological developments to the design of the healthcare buildings, consists of two stages. The first stage is the literature review. Studies on this subject were reviewed; the healthcare buildings have been examined and classified in the historical process from the past to the present, the definition of hospital has been made and information about the departments they contain and their relationship with each other has been given. The detailed information obtained about hospital departments and their functions were analyzed to determine their relevance to technology. In the light of the information obtained in hospitals; it has been determined that the technological equipment they contain have an important place in the functioning of the diagnosis, treatment units and operating theaters and therefore they are closely related to the developing technology. In addition, technological advances, in patient care units, polyclinics and other services, have usually been used for the supportive purpose. 
Then, the concept of technology has been discussed in relation to our subject, information has been given about the change of hospitals depending on medical technology and new approaches that have developed depending on technology in the healthcare buildings have been examined. These approaches, which were determined by taking architectural effects into consideration, were grouped as innovations in organizational, information technology, clinical and user support systems. According to the data obtained, it has been determined that the innovations in the organizational and clinical fields directly affect the spatial changes, while the innovations in the field of user support systems and information technology indirectly cause spatial changes. Then, in the light of these approaches, which are predicted to lead the future of healthcare buildings, concept projects that have been designed with different and innovative perspectives have been examined and the reflections of technology usage on architectural design have been analyzed.
In the second stage research study was conducted. The scope of the two-stage study, conducted to test the defined research questions, was limited to literature research and analysis of case studies considering the difficulty of collecting information in the healthcare facilities regarding ethic reasons. Firstly, the effects of architectural design of the healthcare buildings were established based on evidence by examining 27 academic articles and design criteria determined by the data obtained were grouped and categorized. Then, the relations between these categories and technological developments were examined and the projects produced in this context were analyzed. While examining the effects of hardware innovations related to technological developments in architectural design with the example of the patient room, the contribution of technological developments to the architectural design process in the software dimension with the example of simulation program is discussed in the context of the healthcare buildings. Finally, the results of the research study have been gathered and evaluations have been made for the identified research questions.
The research, aimed to determine the effects of technological developments on the healthcare building design, started by analyzing the effects of architectural design of the healthcare buildings based on evidence. According to the data obtained from this analysis, it has revealed that the determined architectural design criteria in the healthcare buildings have direct effects on user health, user experience and operational performance.
In order to analyze the relationship between these design criteria and technology, the applications developed by putting technology in the forefront during the architectural design process were examined and the effects of these innovative solutions produced by the technology, on the user health, user experience and operational performance, were discussed.
With the data obtained as a result of this study, where the effects of technological developments on spatial changes in the healthcare buildings have been examined; it is shown that architectural design criteria which has effects on the healthcare building design are closely related with technological developments. Sometimes these technological developments feed the architectural design but sometimes design lose its effectiveness due to changes and innovations and has to transform.
Another data obtained is that technological changes and innovations affect the space organization and the size of the space in the healthcare buildings. With the help of simulation programs, which is one of the software products of technological developments, space sizes and inter-spatial relations for the planned capacity can be tested and feedback can be provided to improve architectural design. Thus, along with the architectural design, operational processes can be improved, employee productivity and user satisfaction can be increased.
Finally, it has been shown that the effects of architectural design can be strengthened with technological innovations in the healthcare buildings. When the effects of technological developments on architectural design are examined, it has been identified that the architectural design elements, strengthened by technological innovations in the field of organization, informatics and user support systems, has contributed to user experience, operational efficiency and improved health data.
In addition, with this study it is emphasized that the importance of at long-term thinking about future changes and flexible planning which enables grow and change in order to meet the problems and needs of the future, especially considering the rapidly developing technology, at the beginning of the programming and designing stages of the healthcare buildings. Thus, fewer changes will be made when it is necessary, the cost of changes will be less, as well as technical, functional and behavioral aspects of use will be minimized.
The study has been prepared for; emphasizing that the design of the healthcare buildings should be handled with a different and careful approach than other building types, considering that the every decision to be taken will have direct effects on human life, as well as the diversity and features of the functions it possesses, and contributing to the literature studies in this field to provide an up-to-date base for the architects, designers, healthcare facility managers and healthcare providers. The fact that the study contains a systematic analysis of how technology affects the design of the healthcare buildings, both provides an originality factor for the study and creates the necessity to be supported and improved with the future studies.