Circulation Patterns and the Transformation of a Historic Hospital in the Time Perspective of OB

Hospitals are complex buildings that are never finished. They undergo continuous transformations throughout their lifetime. In this scenario the design of the flows and pathways (people and logistics) within the hospital is of great importance in the performance of built environments concerning accessibility to care and efficiency in the delivery of care. The network of flows is in turn linked to needs conditioned by technological developments and health requirements. Given the concept of base building and fit-out systems tested in the INO project, this paper aims to address the notion of ‘open building’ in healthcare buildings studying the relationship between the network of flows and, base building systems. This topic has been developed analysing the empirical case study of Santa Maria Nuova Hospital, which, since the year of its foundation (1288), has never stopped being a hospital. It has undergone several renovation projects over the past six centuries and is now undergoing the final redevelopment process. The paper focuses on certain aspects: What building modifications were necessary to accomplish a change of use in the hospital over time? How circulation patterns evolve throughout the time? Which spatial elements of the original structure allowed for modifications to the architecture and for the circulation to evolve from ring and linear patterns to an integrated network? Through a description of five plans of the hospital we highlight how the spatial elements (cloister and nave) and changes in technical, social, political, and medical practices influenced these patterns. Thanks to this historical analysis the paper contributes to detect the OB matrix not just as physical invariant but also as pattern of occupation of space (intelligibility) supported by cloister and nave presence.