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MCDM AG.COM | M A RCH /A PR IL 2017 | Medical Construction & Design 35 comprehensive treatments for patients. The open-plan design promotes com- munication among staff and patients, positioning the Central Institute of Mental Health as a model facility and trendsetter in healthcare, as well as psychotherapeutic and psychiatric research. TREND #2: Consolidation In recent years, the number of hospitals in Germany has been declining by fi ve to 10 percent despite the steady increase in the demand for healthcare. According to a joint study by BDO and the German Hospital Institute of the Health Care Industry, three out of four hospitals are not suffi ciently investing money and resources back into their facilities. Inadequate fi nancing for hospitals is the main reason 30-50 percent of hospitals suff ered fi nancial losses for more than 10 years. This lack of investment leads to an aging and outdated infrastructure. The high investment jam and fi nancing defi cit present huge challenges for the hospitals. The result is that these outdated facilities are being shut down and consolidated into one new facility that meets the demand of a larger population. Common design challenges when consolidating multiple facilities is cost and effi ciency. For instance, three rural hospitals were merged into one new build- ing at the SBK Villingen-Schwenningen in southwest Germany. To break down the overwhelming size of the new facility, the design team implemented Evidence-Based Design strategies and Lean processes to provide effi cient workfl ow and easy navi- gation for patients and their families. A patient tower is located in the east and in the west, providing an overview of the entire building. Attractively designed courtyards with landscape accents divide the basic body while simultaneously ex- posing natural light into the building. The design team welcomed natural light with a skylight in the main foyer and expansive windows in patient rooms. The design of the building is inspired by the surround- ing landscape; rather than building up, the building fi ts horizontally among the rolling hills. Left: The Central Institute for Mental Health is designed as an open and light house with a view of the surrounding area, plenty of daylight, a place to relax for the patients and meeting areas. Right: The textile fl ooring at Klinikum Essen Mitte provides a hotel-like atmosphere. With its varying dark-striped pattern structure, it gives the corridors a comfortable atmosphere, lowers the sound level and creates a pleasant, quiet basic mood. Below: A stylish ambiance is found in the amenity areas at Klinikum Essen Mitte. $4,920 Healthcare spending per capita in Germany — international.commonwealthfund.org 32,872 Total number of offi ce-based psychiatrists, neurologists and psychotherapists working in the ambulatory care sector — international.commonwealthfund.org