The purpose of this paper is to describe the process used by our firm in the US to integrate hospital operations and design, to compare that with the normal process in China using design competitions, and to present two alternatives to this process to allow the integration of hospital operations and design in China.

    本文诣在以美国TRO公司为例，探讨美国医院如何将医院的运营管理与建筑设计一体化的方法，并将其与通过设计竞赛的中国式流程进行比较，抛砖引玉的提出了对该种流程的两种思路，从而在中国实现医院的运营管理与建筑设计一体化。

    Typical Process in the United States

    典型的美国医院设计流程 

    Each hospital in the U.S. has its own unique mission and population to serve. There are no “standard” hospitals that do exactly the same thing for the same type of people. Therefore to integrate hospital operations into design, we as architects and planners must spend time to understand each hospital’s mission, goals for the future, characteristics of the population served, and the services to be provided by the hospital to meet that population’s needs. Additionally the hospital industry in the U.S. is competitive so that each hospital has a marketing strategy to attract the patients, doctors, and other medical professionals to their facility, therefore proper planning and design is critical to their success. The following chart explains the part of the process that takes place before the architectural schematic design ever begins. 

    在美国任何一所医院都有其自身的使命和其所需提供医疗服务的人群。没有能准确到对同一类人群都能提供相同医疗服务的标准医院。因此，为使医院运营管理与建筑设计一体化，作为建筑师和规划者，我们必须花时间了解每个医院的使命、将来的目标、服务人群的特征以及为满足此类人群的需求所提供的服务。加之美国的医院行业竞争激烈，使得每个医院都需要制定出一套市场策略用以吸引病人、医生以及其他各种医疗专家为其服务。因此，正确且适宜的规划和设计对医院的成功起着至关重要的作用。以下图表说明了在建筑设计方案开始前的部分步骤。
  

Planning and Programming

规划及任务书

    The first thing that we must do with each hospital is to understand its Mission. Our U.S. hospital system known as the VA has a unique mission to serve veterans of our military after they have completed their military service. This mission is very different from a normal community general hospital or an academic medical center or a specialty hospital that treats only eyes. 

    对于每所医院，我们所要做的第一件事是要了解医院的使命。我们美国的退役军人医院体系有一个独特使命，即在军队老兵完成兵役后为其提供终身的医疗服务。这一使命与一般的社会普通医院或学术医疗中心或治眼病的专科医院是截然不同的。
    Based on that Mission each hospital has a Vision for accomplishing this. This broadly defines where the hospital wants to be in the future. Usually the governing Board or owners of the hospital set the Mission and hire the hospital leaders to provide the Vision.  

    建立在该使命的基础上，每所医院应具备完成该使命的远见。这样可广泛地定义出医院将来的发展方向。通常医院的董事会或医院的所有者会建立一个医院使命并会聘请一位医院领导为其提供卓识的远见。
A Strategic Plan is the collection of strategies for each area of the hospital that it will take to achieve the Mission and Vision. The strategic plan is specific and measurable and contains the data necessary to determine the amount and type of space that will be required by the hospital to accomplish the plan. This data includes among many other things detailed workloads for each clinical department or service separated into inpatient and outpatient procedures, tests, visits, etc. The Strategic Plan is usually established looking forward five years and updated each year to reflect changes in the marketplace, new technologies, and financial position and other critical factors. 

    一个好的策略规划应包含医院的每个部门，而这些策略规划恰恰是帮助我们完成使命和达到预期目标的保证。策略规划是具体的和可测量的。它包含决定医院为实现计划所要求的空间大小和类型的必要数据。这些数据包括从每个临床部门或服务的详细工作量中分出住院及门诊流程、化验及出诊几个部分。策略规划得周期通常为五年。以后每年会根据该医院在市场、新技术、财政地位以及其他关键因素的变化被更新一次。
    These important aspects of each hospital are very important to us so that we can be sure the qualitative aspects of the design reflect the Mission and Vision and that the quantitative aspects including the right amount and type of space is provided  to match the numbers in the strategic plan and that the relationships between departments or services are correct. We must also understand the operational aspects of each department or service to be able to design correctly, and at this point we begin the “pre-design’ phase which usually includes programming and master planning. In the U.S. there are consulting firms that provide this service separate from architectural firms, but many architects including TRO provide this service with in-house staff. Regardless of who does it, this is essential to the total process to be able to integrate hospital operations into design and plan for the future. 

    我们对每所医院的这些重要的方面都非常重视。我们不仅要做出一个能更好地反映出医院使命和远见的设计，而且在数量上也要确保空间的数量及类型与策略规划中的数量相匹配。我们还必须充分了解医院各科室和各项服务的运行情况从而能够做出准确的设计。在此之后，我们就步入设计前阶段，通常设计前阶段包括任务书与总体规划。在美国，有专门提供该项服务的咨询公司，这些咨询公司不同于建筑公司。但是仍有很多建筑公司包括TRO公司的内部工作人员会提供该项服务。不管谁提供该项服务，任务书的制作与总体规划设计对于医院未来的运营管理与建筑设计和规划一体化的整体进程是非常必要的。
    Programming is in its simplest terms the written requirements to be met by the design. It is difficult if not impossible to judge different designs unless they are based on the same set of requirements. The programming phase is where the hospital staff and the architects develop a common understanding and agree on the requirements or objectives that will be met by the design. The program is comprehensive and includes each department or service within the hospital and is based on operational practices for each. The following are some examples. 

    任务书用最简洁的语言来表达即是设计必须满足的要求。任务书是衡量不同设计作品好坏的统一标准。设计任务书阶段是医院的员工及建筑师之间对设计要求及设计目标所达成共识和协议的阶段。设计任务书包含了医院中的每个科室或每项服务按其具体的操作惯例对设计提出的要求。以下是一些范例。
    In programming an outpatient clinic it is important to start with the annual or daily patient visits to each individual clinic and to consider the length of time each day that the specific clinic will be in operation. It is also important to know the staffing for each clinic. From this we can calculate the number of exam rooms and doctors offices needed. 

    若规划一个门诊部，最重要的就要以每个单独的门诊部每年或每天的出诊量进行估算，并要考虑每个门诊部门每天出诊时间的长度。同时，了解每个门诊部的职工安置情况也是非常重要的。通过以上分析，我们可以计算出医院检查室及医生办公室的所需数量。
    Assume that the general surgery clinic will average 72,000 patient visits in one year and that the clinic will operate 5 days each week for 48 weeks allowing times for holidays. 

    假设普通的临床门诊平均每年出诊72，000次，门诊在允许休假的情况下运营48周，每周营业5天。 

    72,000 visits each year/240 days each year = 300 visits each day. 

    每年门诊量为 72，000人次/每年240天=每天门诊次数为300次。 

    Assume that each patient will be in a private exam room for 20 minutes for each visit and that the doctor will go from one exam room to another and not stay only in one room. The doctor will have a separate office. Allow for a utilization rate of 75% since every exam room will not be occupied 100% of the time because of scheduling, cleaning, etc. and assume that the clinic will operate 8 hours each day. 

    假设每位病人每次在单独检查室的看病时间为20分钟，并且医生并不只是停留在某一个检查室里工作而是从一个检查室再到另一个检查室。医生将会有分开的办公室。考虑到由于每间检查室因为有时序安排和清扫时间的情况下使用率为75%而不是100%。假设门诊部每天工作8小时。 

    300 visits each day x 20 minutes/visit = 6,000 exam room minutes or 100 exam room hours. Divide this by 8 hours and 75% utilization and

100/8=12.5/75%=16.6 or 17 exam rooms are required for this clinic. 

    每天300次x20分钟/每次=6，000分钟的检查时间或100个小时的检查时间。除去8小时和75%的利用率以及100/8=12.5/75%=16.6或17个检查室（该门诊部所需数量）。
    The following is a sample space program for a typical outpatient clinic that shows each room, the number of rooms, and the size of each room expressed in net square meters. 

    以下是一个标准的门诊部门空间规划样例。该样例已显示出每个房间：房间的数量、用净平方米表示的房间大小。 

通过看以下的楼层平面图从而了解设计任务书中的细则是非常重要的。 

    Net square meters is the clear inside area within a room specified in the program. Therefore a typical exam room is 12 net square meters, so the plan should show a room with inside dimensions of 3 meters x 4 meters. 

    净平方米数是规划中所指定的房间以内净得的使用面积。因此，一间标准检查室有12净平方米的面积。所以平面图中应以3米乘以4米的内部尺寸来显示一个房间的净面积。

    Department gross square meters is the total floor area of the department including the inside corridors, wall thicknesses, structure used only by that department. This does not include corridors, stairs, elevators, mechanical or electrical equipment rooms serving the building. When all of the net areas of the department are added together, and factor is applied to the total to convert the net area to department gross area, and the factor will be different for different departments. For example in the outpatient clinic example a factor of 1.4 is applied to the total net to compute the total department gross area. The factor for surgery which requires separate corridors for clean and soiled is 1.75, while the factor for pharmacy or lab which has large rooms and few internal corridors may be only 1.25. 

    科室总体平方米数是指科室总体的楼层面积，包括内部走廊、墙壁的厚度以及仅用于该科室的结构部分。但此面积不包括服务于该座建筑物的走廊、楼梯、电梯、机械或电气设备房的面积。当该科室的总净面积相加在一起，科室的总面积就可用一定的系数乘以净面积转变为科室总面积。对于不同的科室，其系数是不同的。例如在门诊部这个系数是1.4。外科的系数为1.7，因为外科要求设有洁污分离走廊，而需要设有大房间而非室内通道的药方或实验室的系数则仅为1.25。

    Building gross square meters is the total area of the building including exterior walls, main corridors, lobbies, elevators, stairs, structure, mechanical and electrical equipment rooms in addition to all of the department gross areas. Usually the building gross area is a factor of 1.25 to 1.35 times the total department gross area or 1.65 to 1.75 times the total net areas. These are very important factors to know, because the architect and client can work together closely before any design work is done to establish the total size of the building and then work the design to meet the total gross area budget. If the gross area is too large for the budget, the architect and client can work together before the design begins to reduce the program to match the budget.  

    建筑总平方米数是指建筑物总面积，包括外墙、主走廊、大厅、电梯、楼梯、结构、机械和电器房间，以及所有科室的面积。通常，建筑的总面积是从1.25 至1.35中的系数乘以所有科室的总面积或从1.65至1.75中的系数乘以总的净面积。有很多重要的系数我们务必要了解清楚，因为在任何一项设计工作开始之前建筑师和业主都要一起工作确定建筑的总体尺寸，随之使设计能够符合总体建筑面积，和整个项目的预算。如果建筑总面积大大超出了预算，则建筑师与客户需在设计之前减少规划以满足建筑面积的预算。 

    Once the program is approved and design begins, the architect and the client should work very closely together to continue integrating operations into design. The following example for a typical outpatient clinic shows why this is important. 

    一旦任务书被认可且设计开始启动，建筑师和业主应紧密合作，共同致力于将医院的运营管理与设计一体化。下面以一个标准的门诊部为例来说明为什么这一点很重要。 

    This floor plan is based on several operational things. If the clinic plans to use a different operational model, the floor plan would need to be very different. The following are some examples: 

    这张楼层平面图是基于几种运作流程来设计的。若门诊部平面图使用一个不同的运作模式，则该楼层平面图就会截然不同。以下是一些例子： 

·          Patient privacy and staff efficiency are very important so the patient and family waiting is in separate room separated from the patient treatment area so conversations between the staff and patient cannot be heard by others and staff cannot be stopped or interrupted by people sitting outside the exam rooms.
    病人的私密性和医护人员的高效率是非常重要的。病人及病人家属等候的区域都在分开的房间，且与病患治疗区域相分离，使得医护人员和病人间的谈话不会被其他人听到。同时，医护人员也不会因坐在检查室外的人而受到干扰或停止工作。 

·          The reception room is separate from the waiting room with windows so the staff can see the patients, but the patients and families cannot hear conversations about other patients. Patient records and computer screens cannot be seen by anyone but the staff. It is also possible to do patient registration and cashier functions at each clinic if each patient has an appointment rather than have the long lines and multiple windows in the main lobby for these functions.
    接待室和等候室用有窗户墙隔开，这样医护人员可通过窗户看到病人，但病人及其家属听不到有关其他病人的谈话。病人的档案及计算机屏幕除医护人员外，其他人无法看到。如果病人提前预约，在每个诊所都可提供看病挂号及结帐的服务，从而使病人免于在大厅排很长的队伍并来往于众多窗口才能得到这些服务。 

·          The patient comes into the treatment area only when an exam room is available on goes straight to that room except for getting weighed and measured.
    病人只有在有空闲的诊疗室时才能进入治疗区。他们通常在被测量完体重和身高后被直接带入诊疗室。 

·          Doctors and nurses go to each exam room rather than staying in one place and have each patient come to them.
    医生和护士去不同的检查室为病人治疗而不只是停留在同一个房间，而让病人去找他们。 

·          A central charting and conference area is provided for nurses and doctors and students (if it is a teaching facility) can meet to discuss cases, view images, discuss test results, etc. without being heard by other patients or families.
    护士、医生及学生（如果该院是个教学单位）可使用为他们提供的单独的中央会诊室来进行病例讨论、观看影像、讨论化验结果等。这些均不会被其他病人或病人家属听到。 

    This is not necessarily the right design for any hospital, but it is based on one specific operational model. This is only one example of many that it takes to design a good hospital to integrate operations into design for each department or service. 
    这只是一个基于具体的运作模式进行的设计，对其他医院未必是最合适的。这也是将医院的各科室或服务实现医院运营管理与设计一体化而设计出一所好医院的成功样例之一。
    Changes are happening rapidly in healthcare, so it is also very important to keep the design flexible to respond to future change. This requires the architect to be educated and informed about future trends in healthcare so that the design can work for more than one client at one point in time and not just design to the operations on one place today. That is a subject for another presentation.
    医疗产业目前正发生着翻天覆地的变化，因此使我们的设计能灵活运用于将来的发展变化中显得尤为重要。这就要求我们的建筑师要受到良好的教育并可洞悉医疗产业将来的发展趋势从而使我们的设计在某一方向上可同时适用多个业主的设计需求，而不是将设计停留在今天的某一个地方的运行方式上。这是另一篇陈述的题目。

    Current State in China 

    中国目前的状况 

    Now let’s look at how the design process for hospitals is done in China today. Since most of the hospitals are public, the rules require that the architect be selected by a design competition. The firms can be invited to participate based on their interest and qualifications, but the hospital has very limited input to the competing firms prior to the competition. This means that only one or very few firms that may have any relationship with the hospital and know anything about its future goals or current operations and no firms have knowledge of operational improvements the hospital wants to make in the new building.
    现在让我们一起来看看当今中国的医院设计流程是怎样运作的。由于大多数医院都是公立医院，国家条例要求通过设计竞赛来选择建筑师。基于其兴趣和资质，有些公司会被邀请参加此次竞赛。在竞赛前，医院很难对这些公司提出自己的想法和要求。这就意味着仅有一家公司或几乎没有公司与该医院有任何的关系并且知道任何与该医院将来目标或当前的运作有关的信息。也不会知道医院在新建大楼中想要对医院运行的改进。
    Usually the panel of judges for the competition includes more non-hospital people than hospital people, and this means that the winning scheme may not necessarily be the best hospital that it can be. There are many other factors to consider in the design of any building such as the outside appearance of the building, the relationship of the building to its surrounding neighbors, the impact of the building on traffic and the environment and designs can generally be evaluated well by a panel with respect to these factors. However, this process can be a barrier to integrating hospital operations into design.
    通常竞赛中的评审团中非医院人士多于医院界人士，这就意味着获胜的方案未必能设计出最好的医院。在建筑物的设计中，还有很多其他方面的因素也被列入考虑的范围，如建筑物的外观、该建筑物与周围建筑物的关系、建筑物对交通以及环境的影响。设计方案往往会由于这些因素而得到很好的评估。然而，这一设计流程势必阻碍了将医院的运营管理与设计一体化的整体进程。 

    Alternative Processes 

    可供选择的流程
    There are two possible alternatives to the current process in China that can make a difference in the way designs can integrate hospital operations.
    1. One alternative is for the hospital to select a firm to work with them to develop all of the “pre-design” information including a detailed space and functional program and provide this information to each of the architectural firms invited to participate in the competition. This system is used in several European countries in conjunction with a design competition, and typically the firm doing the “pre-design” work is not allowed to participate in the design competition since it would have an unfair advantage. Each of the designs is scored on how well it meets the program in addition to the other usual factors. A scheme that ignores or fails to meet the program in a major way is usually disqualified.
    第一个可行性方案是该医院聘请一家公司与其共同制定出所有“设计前期”的信息，包括一份详细的建筑功能与空间的任务书，并将此任务书提供给所有被邀请参赛的建筑公司。这一方案已经用于许多欧洲国家。为避免不公平的因素，完成设计前期工作的公司不得参与该设计竞赛。每个设计成果除一般的因素外均以设计符合设计任务书的好坏程度来评判分数。若某项方案忽视或在主体上未能符合设计任务书，通常会落选。
    2. A second alternative is for the hospital to select an architect without a design competition based on their experience and qualifications similar to the way most hospitals in the US select architects. This is known as a “Qualifications Based Selection” or QBS process. The following is based on the QBS process used by the Department of Veterans Affairs which is one of the largest hospital systems in the US and is a Federal Government department that provides healthcare to eligible veterans of military service after they are no longer in the military.
    第二个可行性方案是医院根据专业资质和工作经验选出一个建筑公司，而不采用设计竞赛模式，这种方法在美国被普遍采用。这种方式叫“资质竟标法”，或叫“QBS”流程。以下我们将让大家看一个专为符合要求的美国退役军人服务的，归美国政府管理的最大的医院系统采用“QBS”流程来选择建筑师的实例。
    The first thing the hospital should do is to determine the scope of services to be provided by the architect for the project. This may or may not include the “pre-design services” discussed above. The purpose of a QBS process is to select an architect that the hospital feels will be most likely to provide the best results. It is important to understand that the “pre-design” work discussed above is a critical part of integrating hospital operations into design whether this is dome by the selected architect or by a consultant or the hospital itself. Without proper programming and planning, the process is incomplete.
    首先医院必须确定需要建筑公司为项目所提供的服务内容。这些内容不一定要包含之前所提到的设计前期的服务。使用QBS的主要目的是选出一个医院认为能为他们提供一个最佳方案的建筑师。在这里设计前期的工作是至关重要的。不管是由被选上的建筑公司，或咨询顾问公司，或医院自己提供的。没有合适的任务书和规划，QBS的流程就不完整。
    The first step is to identify several firms that are capable of doing the project and ask each to submit a letter of interest that they will or will not respond to a “Request for Qualifications” or RFQ. The VA, because it is a government entity, must advertise publicly and let anyone respond who believes they are qualified. Private hospitals generally limit the number of firms invited to ten or fewer. Once the Qualifications are received, a committee of the hospital usually including management and key physicians review the “quals” and score the responses using a scoring system similar to the one below used by the VA.
    第一步是要选出几家有能力的建筑公司，并要求每家公司提供一封表示他们是否会对“资格预审”简称RFQ作出回答的信。因为退役军人医院属政府部门，他们必须公开刊登广告邀请所有认为自己符合资格的公司参加“资格预审”。私人医院则可限制参加“资格预审”公司的数量，一般不多于十家。在收到所有公司的材料后，由行政管理人员和医生组成的医院评审团会审阅所有“资格预审”的材料并用与以下退役军人医院打分表格相似的系统对每个公司进行打分。 

     SHORT-LIST CRITERIA UTILIZING THE SF330 FORM

资格初步审查标准的运用

Department of Veterans Affairs – Architect/Engineer Evaluation Board

    1.      Specialized experience and technical competence of the firm (including a joint venture or association) with the type of services required

公司的是否具备提供所要求服务的专业经验及技术能力（包括合资的或联合体的）

     Assignable point rang   …………………………………………………..(0 to 40)

    2.      Specific experience and qualifications of personnel proposed for assignment to the project and record of working together as a team

参加此项目的人员的经验及资格

     Assignable point range ……………………………………………….(0 to 40)

    3.      Professional capacity of the firm in the designated geographic area of the project to perform work (including any specialized services) within the time limitations. Unusually large existing workload that may limit A/E's capacity to perform project work expeditiously

    公司在一定时间及项目所在地理位置范围内提供服务的生产能力（包括特定的服务）。通常公司现有的巨大的工作量可能限制建筑公司按时完成此项目。

     Assignable point range ………………………………………………….(0 to 20)
    4.      Past record of performance on contracts with the Department of Veterans Affairs. This factor may be used to adjust scoring for any unusual circumstances that may be considered to deter adequate performance by an A/E. (Firms with no previous VA experience receive a +5 rating)

    过去是否有为退役军人部工作的经验。这项指标在特定的情况下可能用来调整分数，以帮助决定该建筑公司完成此任务的能力。（没有为退役军人部服务过的公司将被加5分）

     Assignable point range …………………………………………………(-20 to 20)

    5.      Geographic location and facilities of the working office(s) which would provide the professional services and familiarity with the area in which the project is located

    公司的地理位置取决于该公对项目所在区域的熟悉与否。 

    Assignable point range …………………………………………………(0 to 20)

    6.      Demonstrate success in prescribing the use of recovered materials and achieving waste reduction and energy efficiency in facility design

    证明废料回收及节能的成功经验。 

    Assignable point range …………………………………………………(0 to 20)

    7.      Inclusion of small business consultant(s) (1 point), and/or minority-owned consultant(s) (1 point), and/or women-owned consultant(s) (1 points), and/or veteran owned consultant(s) (1 point), and/or disadvantage veteran owned consultant(s) (1 point), and/or HUBZone consultant(s) (1 point)

    有小顾问公司共同参加（加1分），有少数民族的顾问公司参加（加1分），有妇女的顾问公司（加1分），有退役军人的顾问公司（加1分），有残废的退役军人的顾问公司（加1分），或HUBZone 的退役军人的顾问公司（加1分）

     Assignable point range …………………………………………………(0 to 6)  

 Revised: July 13, 2004

    For additional assistance, call Bob Smoot at (202) 565-6400

Based on the scoring sheet and sometimes including talking to references of other hospitals, a short list of usually 3 to 5 firms is made and each firm is invited to make a presentation to the committee. It is very important for this interview that the firm bring the actual people that will do the work to meet the committee. Each of the short list firms is considered qualified to do the project, and the interview is to determine which team the hospital feels they can work with the best. Firms are generally not asked to present any specific design to the committee at this time, but it is good to see projects that are similar to this one that the firm has designed and to learn how the firm approached each project. The following is another scoring sheet used by the VA for the interview.
    根据打分的结果，有时还参考其他医院的经验，有3到5家公司会通过初步预审。他们每家会被邀请向评审委员会作一次汇报。这是非常重要的面谈，因为公司会让具体负责项目的人员与评审委员会见面。每家通过初审的公司都具备了完成项目的能力。通过面谈，医院会选出他们认为最好的一家公司。在此阶段，公司一般都不会被要求对该项目做出具体的设计方案。但公司最好向评审委员会展示他们以前做过的与此项目类似的设计成果，并了解该公司是怎样对项目进行具体操作的。以下是另一张退役军人医院使用过的评分表。 

    
    Final negotiations including fees are usually held with only the chosen firm, and the VA rules prohibit discussing fees until the firm is chosen. Private hospitals sometimes ask for a fee proposal from each short-listed firm so that price can be compared.
    最后的收费谈判是在医院和被选上的公司之间进行的。规则规定在没有选出中奖公司时，美国退役军人医院是不允许谈论收费的。私人医院有时会要求每家通过初审的公司准备一个收费建议书作为评判的标准之一。
 

    Summary

    总结
    Integrating hospital operations into design requires close collaboration with the hospital and the architect working together before design of the building begins. While the process using design competitions can produce attractive buildings that meet many needs, this process makes it very difficult for the architect to develop and understanding of the hospital operations before design begins.
    将医院的运营管理与建筑设计一体化要求医院与建筑师在项目的初始阶段就建立紧密的合作关系。虽然建筑设计竞赛能产生符合许多要求的，具有漂亮外形的建筑，但这种流程使建筑师很难在设计开始时真正理解医院的运作流程。
    Design competitions require several months of work by the hospital and more than one architect that could better be applied to the project if the architect is selected based on experience and qualifications and given the time to work more closely with the hospital to develop a better understanding of the current operations and future goals for the project. This also can apply the funds used to pay competition fees to the pre-design work to get better results.
    如果医院在进行设计竞赛前，能化几个月的时间邀请几个具备一定资质的建筑公司对医院现有的及未来的运作流程有一个很好的理解，并能将一部分竞赛费用于设计的前阶段就能取得很好的结果。
    The pre-design work can be done by another firm or by the hospital but having an architect that is experienced and capable of doing this phase can result in a shorter time and less cost. A single firm can provide multiple design options for the hospital, architect, and governing authorities to chose from and still have the benefit provided by design competitions. TRO has provided these services for many years to both its U.S. and China clients both in the private and public sectors. 

    虽然设计的前阶段可以有咨询顾问公司或医院自己来完成，但由一位有经验和能力的建筑师来担任此工作能节省时间和费用。通过恰当的方法，选择独家建筑设计公司向医院提供所有的服务，也能取得设计竞赛达到的效果。TRO 在过去许多年为许多中国和美国的客户提供了这种服务。