Rehabilitation Center for Post-Stroke Patients (90 Beds) in Sergiyev Posad

Idea projektu

Stroke is an acute disruption of blood supply to the brain. It can occur at any age, but its frequency and prevalence increase with age. Based on my family's experience, I have identified two major shortcomings in existing rehabilitation centers:

1）The lack of psychological support significantly slows recovery. Beyond a sense of control and privacy for patients, daily exercises to stimulate cognition, socialization, and physical activity also play a crucial role in brain healing.

2）Low engagement levels among post-stroke patients negatively impact both patient and family confidence in the rehabilitation process. A rehabilitation center should optimize recovery by developing new skills that help patients not only return home but also regain the ability to earn a living.

Based on the above, a new approach to rehabilitation center design is proposed. The site for this center was chosen strategically—located in the heart of Sergiyev Posad, adjacent to the Trinity Lavra of St. Sergius, surrounded by forests. Along the southern boundary flows the Bondyuga River, while the northern side borders Suvorova Street, separating the center from residential areas. These conditions are particularly favorable for post-stroke patients, as they offer not only scenic views of the city but also proximity to religious landmarks (such as the "crosses" of the Lavra), providing spiritual support for middle-aged and elderly patients.

Popis projektu

In accordance with my graduation thesis topic, the selected site accommodates the following departments:
1. Admission Department
2. Treatment Department
3. Administrative and Utility Block
4. Food Service Unit
5. Inpatient Department:
5.1. "Mercy" Unit
5.2. Long-term Residence Unit (30 days to 6 months)
5.3. Short-term Rehabilitation Unit (5 to 30 days)
5.4. Day Rehabilitation Unit
6. Social Rehabilitation Department
7. Retail Block
8. Medical-Labor Rehabilitation Department
9. Restorative Treatment Department
10. Ritual Services Department
11. Animal-Assisted Therapy Zone

The Admission Department, Food Service Unit, and Social Rehabilitation Department face the northern side towards Suvorova Street. The Treatment Department is oriented towards the southwest. Its facade features a zigzag design with self-supporting panels and stained glass windows spanning from the first to fifth floors. The south-facing stained glass offers a splendid view of the Trinity Lavra of St. Sergius.

To accommodate patients with varying post-stroke conditions, the rehabilitation center includes specialized inpatient units:
- The "Mercy" Unit serves elderly patients with limited mobility who require full-time care, featuring intensive care rooms with 24/7 medical supervision.
- Other units include: Long-term Residence (30 days to 6 months), Short-term Rehabilitation (5 to 30 days), and Day Rehabilitation.
- The inpatient building facade incorporates sliding sun-shading panels.

The inpatient department provides direct access to:
- Treatment Department
- Food Service Unit
- Social Rehabilitation Department
- Medical-Labor Rehabilitation Department
- Restorative Treatment Department

The center prioritizes two rehabilitation methods:
1. Art Therapy: The Medical-Labor Rehabilitation Department houses workshops (choir studio, embroidery, handicrafts, and art therapy rooms) where patients engage in creative activities. The auditorium and reading room host theater therapy (performances, storytelling sessions, literary gatherings).
2. Animal-Assisted Therapy: Conducted in the central winter garden surrounded by galleries. Animals, veterinarians, and therapists access this space via the ground-level basement. An adjacent dog-walking area is provided. The Ritual Services Department (with a separate entrance) is also located in the basement.

A Retail Block adjacent to the Medical-Labor Rehabilitation Department displays and sells patient-made crafts. Some works will also be sold in souvenir shops near the Trinity Lavra entrance.

Technické informace

The structural system of the buildings is combined: primarily frame-based with load-bearing walls for stairwells and elevator shafts. The columns are constructed from monolithic reinforced concrete finished with cement-sand plaster over metal lath. Interior columns measure 250x250 mm, while those supporting the atrium are 500x500 mm. Column spacing varies (3.6 m, 5.1 m, etc.) according to room functions. The inpatient department employs 200x500 mm pilasters at 3.6 m intervals.

Floor heights measure 4.2 m for the ground floor (excluding inpatient areas) and 3.3 m for upper floors. Load-bearing walls consist of 200 mm thick monolithic reinforced concrete. Floor slabs utilize both monolithic and precast beamless reinforced concrete construction (200 mm thick).

The primary load-bearing structure comprises reinforced concrete columns interconnected by beamless floor slabs and roof decks. Metal trusses (1 m high parallel chords) support glass panels in the winter garden and lobby areas.

Exterior walls combine self-supporting 200 mm aerated concrete blocks with 250x250 mm reinforced concrete columns. Stairwells feature 200 mm monolithic reinforced concrete walls. Roof access is via stairwell extensions, which also house ventilation shafts and smoke control equipment (including roof-mounted air supply fans for elevator shafts).

Stairwells follow Type L1 design with natural lighting through glazed exterior openings. The retail block features an open staircase illuminated by a rooftop skylight, while the lobby contains an open staircase opposite the main entrance. Additional open staircases serve the auditorium for evacuation. All stair treads (150 mm risers, 300 mm runs) and landings are monolithic reinforced concrete.

The treatment and inpatient departments contain two hospital elevators (2500 kg capacity) and four passenger elevators (630 kg). Interior partitions use 150 mm aerated blocks, with waterproofed cement-plastered partitions in bathrooms for ceramic tile installation up to suspended ceiling height.

Flooring specifications:
- Ceramic tile with waterproofing in bathrooms, kitchen, and laundry areas
- Porcelain tile in entryways, evacuation routes, and technical rooms
- Synthetic gym flooring in the sports hall

Exterior doors include insulated aluminum single/double-leaf designs with double-glazed panels. Technical room entrances use insulated metal doors, while interior doors feature decorative plastic-clad designs.

Dokumentace

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