既有大型综合医院的外部公共空间常常为设计师所忽略，理论思考和实践应用都存在一定不足，设计手法相对简陋。像其他既有大型综合医院一样，改造前的广州市第一人民医院外部公共空间存在着环境嘈杂、各种流线混杂交叉、就医体验和使用感受不佳的现实状况。为了寻找更为有利的外部公共空间改造思路和方法，笔者组织团队对广州市第一人民医院外部公共空间改造项目进行了系统研究，利用产学研相结合的模式将理论研究和实践有机结合在一起进行系统分析，研究成果于2021年成功申请到住房和城乡建设部科学技术计划项目——《既有大型综合医院外部公共空间更新改造示范性技术方法》课题。

接着把课题研究成果整理出版了专著《既有大型医院外部公共空间改造方法》，从城市、交通、院区的界面以及医院的管理者、医护人员、病患等多角度、多维度进行分析，以详实的研究内容和合理有效的实施策略，对医疗建筑的社会化、人性化做了较为深入的探讨，是业界研究医院外部公共空间的重要著作之一。现在结合广州市第一人民医院外部公共空间整体提升改造项目的实践，将相关成果做一个简要介绍，希望能抛砖引玉，让更多的专家学者关注医院外部公共空间环境质量，给社会提供更多、更好的研究成果和实践案例。

The external public space of existing large general hospitals is often ignored by designers, and there are certain deficiencies in theoretical thinking and practical application, and the design techniques are relatively simple. Like other existing large general hospitals, the external public space of Guangzhou No. 1 People's Hospital before the renovation has the reality of noisy environment, mixed and intersecting various flow lines, and poor medical experience and use experience. In order to find more favorable ideas and methods for the transformation of external public space, the author organized a team to conduct a systematic study on the transformation project of external public space of Guangzhou First People's Hospital, and made a systematic analysis by organically combining theoretical research and practice with the mode of combining production, university and research. In 2021, the research results were successfully applied to the science and technology plan project of the Ministry of Housing and Urban-Rural Development - "Demonstration Technology Method for the renovation of external public space of existing large general Hospitals". Then, the research results were compiled and published in a monograph titled "Reconstruction Methods of External Public Space of Existing Large Hospitals", which analyzed the interface of the city, transportation, hospital area, hospital managers, medical staff, patients and other aspects and dimensions, and made a more in-depth discussion on the socialization and humanization of medical buildings with detailed research content and reasonable and effective implementation strategies. It is one of the important works on the external public space of hospitals in the industry. Now, combined with the practice of the overall improvement and renovation project of the external public space of Guangzhou First People's Hospital, a brief introduction of relevant achievements will be made, hoping to attract more experts and scholars to pay attention to the environmental quality of the external public space of the hospital, and provide more and better research results and practice cases to the society.

亦园亦林、不止景观 Also garden also forest, more than landscape

广州市第一人民医院源起1899年的广州城西方便所，至今已有125年的历史。医院南部紧邻著名的光孝寺，东西向主干道长约300m，成带状布局（图1）。医院内古榕树枝繁叶茂，树冠达十层楼高，与南部的光孝寺相互联通，在生态环境层面形成一个完整的整体，因此医院的绿树成荫的外部公共空间往外溢出，而不仅仅局限于医院本身，这在建筑密相对较高的广州老城区中显得尤为珍贵。所以在改造的一开始就尝试将广州市第一人民医院的市医大道的外部公共空间作为越秀区绿地生态系统的一个组成单元。从亲生物性的角度，把之前被忽视的明媚阳光、新鲜空气、清脆鸟叫虫鸣，重新引入大众视野，营造出亦园亦林、舒适宜人的康养体验环境和便利高效的就医氛围（图2）。为此，我们基于现状调研和理论研究，制定出一套针对整体空间环境质量提升的优化策略，在功能、交通、人文氛围等方面进行整体性的优化设计。同时，我们将医院放置于更为宽广的城市环境范围内，进行研究系统研究，强化不同元素之间的关联性分析，从而在系统之间形成有机的互动。改造后的广州市第一人民医院外部公共空间，与外部的城市开放空间形成一个有机的整体，在高密度城市环境里，和光孝寺一起形成一个完整的城市公共空间开放绿地系统，给城市居民带来更多的空间使用体验感受，得到了医院领导、医护人员、广大病患、陪同家属、周边居民的一致好评，创作团队一开始的基于社会需要而进行设计的目标得以充分实现（图3）。在这里，外部公共空间的优化改造不仅仅是景观方面的美化，更是基于对人性需求的充分考量而做出的整体空间环境质量的优化提升（图4）。

Guangzhou First People's Hospital was founded in 1899 in the west of Guangzhou City, and has a history of 125 years. The south of the hospital is close to the famous Guangxiao Temple, and the east-west main road is about 300m long, forming a ribbon layout (FIG. 1). In the hospital, the ancient banyan tree with a canopy of ten stories high connects with the Guangxiao Temple in the south, forming a complete whole at the ecological environment level. Therefore, the external public space of the hospital with tree-lined trees spills out, not only confined to the hospital itself, which is particularly valuable in the old city of Guangzhou with relatively high architectural density. Therefore, at the beginning of the transformation, we tried to take the external public space of the Medical Avenue of Guangzhou First People's Hospital as a component unit of the green space ecosystem of Yuexiu District. From the perspective of biophilia, the bright sunshine, fresh air, and clear birds and insects singing that had been neglected before were reintroduced to the public's vision, creating a comfortable and pleasant environment for health care experience and convenient and efficient medical atmosphere (FIG. 2). To this end, based on the current situation investigation and theoretical research, we have formulated a set of optimization strategies for the improvement of the overall spatial environment quality, and carried out overall optimization design in aspects of function, transportation, and humanistic atmosphere. At the same time, we placed the hospital in a broader urban environment, conducted systematic research, and strengthened the correlation analysis between different elements, so as to form an organic interaction between the systems. After the transformation, the external public space of Guangzhou First People's Hospital forms an organic whole with the external urban open space. In a high-density urban environment, it forms a complete open green space system of urban public space together with Guangxiao Temple, bringing more space use experience to urban residents. It has been well received by hospital leaders, medical staff, patients, accompanying family members and surrounding residents, and the original goal of the creative team to design based on social needs has been fully realized (Figure 3). Here, the optimization and transformation of external public space is not only landscaping, but also the optimization and improvement of the overall spatial environment quality based on full consideration of human needs (Figure 4).

▼图3    开放、舒适、宜人的外部空间，Open, comfortable and pleasant exterior space

 

▼图4    总平面图，General plan

空间叙事、医养兼顾 Spatial narrative, medical care

作为始建于清光绪25年（1899年）具有悠久发展历史的医院，125年来为民生做出巨大贡献，涌现出一系列可歌可泣感人事迹。这些散落在历史长河中的故事，显示出广州市第一人民医院与广州城市发展紧密关联，深深打动了我。经过多次现场踏勘，在繁杂的现场经过大脑风暴后，笔者决定把这东西向总长约300m的市医大道打造成一个开放式的“院史馆”，将125年的市医重要历史事件在外部公共空间中展示出来，让人们从东门走向西门的过程中，一边观景一边体验，让故事深入人心、安抚病患、疗愈大众。这一想法得到当时广州市第一人民医院领导班子的一致认同，设计团队以此为方向，对空间叙事进行了全面深入地研究。

As a hospital with a long history of development, it has made great contributions to the people's livelihood over the past 125 years and emerged with a series of touching stories. These stories scattered in the long river of history show the close connection between Guangzhou First People's Hospital and the urban development of Guangzhou, which deeply moved me. After many site visits, after the complex scene after the brain storm, the author decided to build this east-west total length of about 300m city medical Avenue into an open "hospital history museum", the 125 years of city medical important historical events in the external public space display, so that people from the east gate to the west gate in the process, while watching the experience, Let the story reach the heart, comfort the patient, heal the public. This idea was unanimously recognized by the leadership of Guangzhou First People's Hospital at that time, and the design team conducted a comprehensive and in-depth study of spatial narrative in this direction.

空间叙事轴由东门开始，步移景异地逐步往西门发展，结合具体空间节点，用起承转合的手法，布置了以下叙事内容:1899城西方便所、1901城西方便医院、古城墙典故、1921广州市立医院、1935广东仁爱医院（前身）、1948广州方便医院、1954广州市第一人民医院、1982广州医学院教学医院、1993三级甲等医院、2003抗击非典立功勋、2014广州市第一人民医院南沙医院……。相对应的空间节点分别为:地景台阶——立院雏形、绿化药园——立院根基、城墙回音广场——立院史记、方便石与念祖亭——立院理念、饮水思源泉——铭记历史展望未来、教学相长亭——多层次交流互动平台、方便园——自然形态绿色园林、功勋钟亭——钟声悠扬博古通今、休闲密林——生态环境绿色低碳……（图5）

The spatial narrative axis starts from the east gate, and gradually develops to the west gate by moving the scenery to different places. The following narrative contents are arranged :1899 West City Convenience Office, 1901 West City Convenience Hospital, Ancient City Wall Stories, 1921 Guangzhou Municipal Hospital, 1935 Guangdong Ren 'ai Hospital (predecessor), 1948 Guangzhou Convenience Hospital, 1954 Guangzhou First People's Hospital, 1982 Guangzhou Medical College Teaching Hospital, 1993 Third Class A Hospital, 2003 fighting against Africa Meritorious achievements, 2014 Guangzhou First People's Hospital Nansha Hospital...... . The corresponding spatial nodes are: landscape steps - the prototype of the Academy, green medicine garden - the foundation of the Academy, the echoing square of the city wall - the history of the Academy, the convenience stone and the Pavilion of reading Zu - the concept of the Academy, the source of drinking water - remembering the history and looking forward to the future, the Pavilion of teaching and learning - a multi-level exchange and interaction platform, the convenient garden - a natural form of green garden, the merit bell pavilion - the bell is melodic and ancient Tongjin, leisure dense forest - ecological environment green and low carbon...... (Figure 5)

在空间叙事的格局下，广州市第一人民医院的外部公共空间作为城市公共空间开放系统中的积极分子，以更为开放多元的方式融入到广州市的生态绿色环境系统中，为广州的绿色生态可持续发展提供了有力的保障和支持，同时也为院内的使用者提供了高品质的户外空间（图6、图7）。

Under the spatial narrative pattern, the external public space of Guangzhou First People's Hospital, as an activist in the open system of urban public space, integrates into the ecological green environment system of Guangzhou in a more open and diversified way, providing a strong guarantee and support for the green ecological sustainable development of Guangzhou. It also provides a high-quality outdoor space for the users of the courtyard (FIG. 6, FIG. 7).

广州老城区旧医院的外部公共空间由于建立较长的渐进式更新建设发展，加上日益增多的机动车进入医院，导致大部分旧医院的外部公共空间总体上空间质量较差。改造前的广州市第一民医院外部公共空间人车混杂，几乎成了一个大型的户外停车场，就医体验的安全性、便利性非常差。因此改造设计将功能、交通、景观作为一个整体进行优化整合，提出步行优先的策略，把机动车引入地下车库，地面除紧急车辆和救护车外，不设其他停车位。既考虑医院各功能单元之间的物流、人流和信息流的便捷通畅，又充把先前被机动车占用的外部空间，重新还给医院的病患和医护及后勤人员，营造出步行优先的人性化外部公共空间开放系统，安全、高效、便利，从根本上改善外部公共空间的使用感受。

The external public space of the old hospital in the old city of Guangzhou is of poor spatial quality due to the establishment of a long period of gradual renovation construction and development, coupled with the increasing number of motor vehicles entering the hospital. Before the transformation, the external public space of Guangzhou First People's Hospital was mixed with people and vehicles, almost becoming a large outdoor parking lot, and the safety and convenience of medical experience was very poor. Therefore, the transformation design optimizes the integration of function, traffic and landscape as a whole, puts forward the strategy of giving priority to walking, introduces motor vehicles into the underground garage, and does not provide other parking Spaces except for emergency vehicles and ambulances on the ground. It not only considers the convenience and smooth flow of logistics, people and information between the functional units of the hospital, but also fills the external space previously occupied by motor vehicles and returns it to the patients and medical and logistics staff of the hospital, creating a humanized external public space open system with pedestrian priority, which is safe, efficient and convenient, and fundamentally improves the use of external public space.

由于历史发展的原因，市医大道下有清代古代城墙的遗址，经过多次填埋，导致南面高而北面低，倾斜角度最大达到15度，不仅使用不便利，在观感上也让人体验不舒服，改造设计，将东西想倒入填平此道路的横断面基本水平同时结合主要交通道路与北部建筑主要出入口场地之间的高差。设计成树池和座椅有机结合的空间点，巧妙连接高差，形成各自独立的空间领域，达到了空间体验多元化的效果（图8、图9）。

Due to the reasons of historical development, there are ruins of ancient city walls in Qing Dynasty under Shiyi Avenue. After many landfills, the south is high and the north is low, with a maximum tilt Angle of 15 degrees. It is not only inconvenient to use, but also uncomfortable to experience in terms of perception. The basic level of the cross section of the road is filled and the height difference between the main traffic road and the main entrance and exit site of the building to the north is combined. It is designed as a space point organically combined with the tree pool and the seat, and cleverly connects the height difference to form their own independent space fields, achieving the effect of diversified space experience (FIG. 8 and 9).

树池与座椅的一体化设计，让使用者有机会以全新的角度去感受上百年古树带来的特殊场所体验。在高大挺拔的古树下，清风拂面、光线柔和、鸟鸣清脆、心情舒畅，仿佛在原始树林里纵情吸氧（图10）。这种在闹事中返璞归真的意境，对病患及医护人员而言都是极为珍贵的资源。这种环境氛围对于疗愈身心、提高康复效率也有着非常重要的积极作用，充分显示出设计者从细微处着手，展现大爱仁心情怀的姿态。
The integrated design of the tree pool and the seat gives users the opportunity to experience the special place experience brought by the century-old tree from a new perspective. Under the tall and straight old trees, the breeze touches the face, the light is soft, the birds sing crisp, and the mood is comfortable, as if they were enjoying oxygen in the primitive forest (FIG. 10). This sense of simplicity in the midst of chaos is an extremely valuable resource for patients and medical staff alike. This kind of environment also plays a very important positive role in healing the body and mind and improving the efficiency of rehabilitation, which fully shows that the designer starts from the details and shows the attitude of great love and benevolence.

文化入心、低碳设计 Cultural heart, low carbon design

作为一个有着125年历史的旧医院而言，如何用时代性的语言传承和发扬“善守之堂、岭南名院”的优良历史传统，便是设计核心之一。笔者在《现代医院建筑创作的“三Y”理念与实践》中，梳理出一套针对提高医疗类建筑空间环境质量的“三Y”设计理念，即“环境医人（病患）”、“环境怡人（医务工作者）、“环境育人（成长中的医生及医学院校学生）”。广州市第一人民医院外部公共空间整体改造项目就贯彻了“三Y”理念，将文化作为灵魂注入到每一个场所细节中，让使用者通过“五感”（形、声、闻、味、触），感受到贴心的关怀。例如，将“方便石”与 “念祖亭”整合进设计中，化有形为无形，以润物细无声的姿态疗愈每一个人。另外一个重要理念就是低碳设计的全面尝试，设计充分整合利用现有的素材，“树、亭，石、水”均作为现有元素，充当外部公共空间的营造的主体，而新介入的树池座椅、教学相长亭地面等则使用木材建造，最大程度使用高性价比的固碳材料。通过整合已有资源及使用高固碳材料，实现了设计的低碳化，营造出亲人、便民、舒适、高效的“家”一样健康、安全、温情的广州市第一人民医院外部公共空间。

As an old hospital with a history of 125 years, how to use the language of The Times to inherit and carry forward the fine historical tradition of "good care Hall, Lingnan famous hospital" is one of the core of the design. In the "Three Y" Concept and Practice of Modern Hospital Architecture Creation, the author combs out a set of "three Y" design concepts aimed at improving the spatial environment quality of medical buildings, namely "environment for medical people (patients)", "environment for pleasant people (medical workers)," environment for educating people (growing doctors and medical college students) ". The overall renovation project of the external public space of Guangzhou First People's Hospital implements the concept of "three Y", infuses culture as the soul into every detail of the site, and allows users to feel intimate care through the "five senses" (shape, sound, smell, taste, touch). For example, the "convenience stone" and "Nian Zu pavilion" are integrated into the design, turning the tangible into the intangible, and healing everyone with a silent posture. Another important concept is the comprehensive attempt of low-carbon design, the design fully integrates the existing materials, "tree, pavilion, stone, water" as the existing elements, acting as the main body of the construction of external public space, while the newly inserted tree pool seats, teaching pavilion floor, etc., are built with wood, and the maximum use of cost-effective carbon fixation materials. Through the integration of existing resources and the use of high carbon fixation materials, the low carbon design is realized, and the external public space of Guangzhou First People's Hospital is as healthy, safe and warm as a family, convenient, comfortable and efficient "home".

 ▼ 广场俯瞰，Square overlook

▼ 教学相长亭环境氛围，Teaching phase Changting environment atmosphere

 ▼ 人文与绿色相映，Culture and green complement each other

 ▼ 公园化的医院外部空间，Parkized hospital exterior space

 ▼ 原有景观资源的整合运用，The integration of the original landscape resources

项目名称：广州市第一人民医院整体外部公共空间提升改造
项目类型：医疗建筑
设 计 方 ：华南理工大学建筑设计研究院有限公司
公司网站：https://www.scutad.com.cn
联系邮箱：805433157@qq.com
设计年份：2018年09月
完成年份：2019年05月
主创：陈文东——华南理工大学建筑设计研究院有限公司 二院副院长，建筑学博士（师从何镜堂院士，2008年博士毕业），高级工程师，硕导，主攻城市大型公共建筑、医疗建筑、校园规划及其建筑设计等，2023年出版专著《建筑六式》，中国建筑工业出版社，2024天河体育中心花市牌楼主创
设计团队：郭卫宏（项目负责）、陈文东（专业负责及主创）、邱伟立、赵丹、冯雪莹、陈卓宇、张邦图、李耿吉、文瑶、周华忠等
项目地址：广东省广州市
用地面积：14019平方米
摄影版权：诺金浮图摄影工作室徐勉
业 主 方 ：广州市第一人民医院

Project name: The overall external public space improvement of Guangzhou First People's Hospital
Project type: Medical building
Designer: South China University of Technology Architectural Design and Research Institute Co., LTD
The company's web site: https://www.scutad.com.cn/
Contact email: 805433157@qq.com
Design Year: September 2018
Year completed: May 2019
Creator: Chen Wendong -- Deputy Dean of the Second School of Architectural Design and Research Institute of South China University of Technology Co., LTD., Doctor of Architecture (under the supervision of Academician He Jingtang, PhD in 2008), senior engineer, master's supervisor, mainly focuses on urban large-scale public buildings, medical buildings, campus planning and architectural design, etc., published in 2023 monograph "Six Types of Architecture", China Architecture Industry Press, 2024 Creator of Flower Market Archway of Tianhe Sports Center
Design team: Guo Weihong (project manager), Chen Wendong (professional manager and creator), Qiu Weili, Zhao Dan, Feng Xueying, Chen Zhuoyu, Zhang Bangtu, Li Gengji, Wen Yao, Zhou Huazhong, etc
Project address: Guangzhou, Guangdong Province
Land area: 14,019 square meters
Copyright: Xu Mian, Nuo Jin Floating Picture Photography Studio
Owner: Guangzhou First People's Hospital