Designed Healing

Healthcare Architecture Changing with the Times

Today's healthcare users demand a higher level of healthcare than in the past. Designers and builders are responding with improved landscaping, daylighting and soothing interiors.

by Dale Simpson

Technology, an aging baby boom generation and population shifts have created a spurt in Northwest healthcare construction.

Technology requires design flexibility to accommodate upgrades and often special protection to prevent radiation leakage or equipment damage.

Baby boomers are speeding toward 60 and beyond. They arrive with more education, information and expectations for long healthy lives than any generation in history.

Population shifts from major urban areas to suburban communities are creating demands for medical services in towns where "Doc" once identified the local veterinarian. At the same time, still-growing urban populations are creating pressure on urban medical facilities to keep pace with needs while remaining friendly to local neighborhoods.

The result is profound change. Gone are crowded multi-patient rooms and '50s-era latrine green hallways dotted with stern, unfriendly waiting rooms. In their place are warm colors, art-covered walls, computer game stations, Internet connection and easy visitor access to patients. And that's just the beginning.

As proof, here's a quick tour of the Northwest healthcare landscape, East to West and North to South.

A Healing Design

Spokane's Sacred Heart Medical Center is well along on a $137 million effort. The largest component of the 390,000-sq.-ft. update is an eight-story tower housing women's health services, a new neonatal intensive care unit and expanded surgery center.

The entire project uses design and architecture to promote healing. According to Vince Nordfors, Mahlum Architects' (Seattle) principal, "Every aspect of design from the layout of surgical suites to colors of fabrics in a birthing room is designed to promote a feeling of well-being."

The women's unit features curved walls, soft tones, natural materials and enhanced waiting areas. Labor/delivery suites accommodate mother, infant, family and staff in separate areas. In addition to privacy, each space uses lighting, color, fabric, and other architectural elements to promote comfort.

In the neonatal unit, families gather in three semi-private nurseries that surround the core staff area. Each nursery station has a built-in couch to promote visitor comfort.

The new surgery center doubles the previous space and features 24 new operating rooms, designed to accommodate both technology and patient needs. Unlike traditional surgery centers, this one has windows to the outside.

The upgrade began in early 2003 with the children's hospital expansion. West tower construction is scheduled for completion in August 2004 and the remodel complete in August 2005. The general contractor is Bouten Construction of Spokane.

Harborview Expansion

Seattle's venerable Harborview facility serves four states as a Level One Trauma Center. It plays a crucial role in providing emergency and public health services to Seattle and King County residents, and it is a teaching hospital for the University of Washington.

During the 1990s, a $176 million construction program doubled the size of the then-existing facility, adding 440,000 sq. ft. to the complex. That effort was a sound beginning, but more is needed to maintain service levels and meet increasing demands on the facility.

Designers of Harborview Medical Center's expansion in Seattle are sensitive to the hospital's urban surroundings. ( Image courtesy of NBBJ )

In 2000, after approval of a major bond issue by King County voters, Harborview began a 10 year $292 million expansion program. Needs addressed include major seismic improvements, a new in-patient wing and a multi purpose building.

Lead architect NBBJ of Seattle developed a strategic design plan for a new 10-story 244,800-sq.-ft. in-patient wing, seismic reinforcement of the existing north wing tower and construction of facilities to house specialized services such as King County's medical examiner, research laboratories, an Involuntary Treatment Act courtroom, retail space and underground parking.

"Urban architecture can be challenging, as well as rewarding," said NBBJ's John Pangrazio. "We must be mindful of the need to create the most usable space possible in a restricted urban area. At the same time we must carefully consider the needs of the surrounding community as well as the needs of patients and staff to co-exist in a pleasant, healing environment."

Turner Construction is scheduled to break ground on the in-patient wing and multi-purpose in 2005, and earthquake stabilization in 2007. Projects are scheduled for completion in 2008.

Soothing Interiors Calm Patients

Tacoma's MultiCare Medical Center is nearing completion of a $75 million expansion for new adult and pediatric surgical suites. Four new floors are rising on top of an existing four-story building shared by Tacoma General Hospital and Mary Bridge Children's Hospital. The top floor is being shelled for future use.

Nearing completion, the new 150,000-sq.-ft. facility blends large windows, soothing interiors and artwork to help promote healing as well as privacy and family comfort. At the same time, ample space is provided for doctors and staff.

Surgery rooms feature up to the minute technology and equipment that is ceiling-mounted to provide greater floor space flexibility and utilization.

Portland's Giffin Bolte Jurgens Architects designed the addition to harmonize with the existing structure, also designed by GBF. Skanska (Seattle) is the general contractor.

GBJ Architects also is the principal designer for a $17 million addition to Mary Bridge Children's Hospital and Health Center; also part of the Tacoma Multi-Care complex. The new structure will considerably expand the hospital's out-patient treatment facilities and improve service for local children's clinics.

This three-story project adds 60,000 sq. ft. to an existing 63,000-sq.-ft. structure. Among the child and family-friendly features are larger (100 sq.-ft.) examination rooms that provide ample room for family as well as medical staff.

After passing a bronze rowboat in the entry area, visitors to the new facility can ride a glass-wall elevator that begins in an ocean mural, progresses through a second story landscape and tops off in blue sky at the third level.

The child-friendly concept continues with in-room TV sets that provide entertainment for children and families. These units do double duty as computer terminals for doctors and staff.

Summarizing both projects, GBJ principal Steve O'Shea says: "Our task was to blend up to date technology, while promoting staff efficiency, providing privacy and a healing environment for patients and families."

Landscaping Designed to Soothe

As Washington's first new hospital since 1979, Vancouver's new 200-bed Salmon Creek Hospital is also Legacy Health Systems first venture into the state.

Design emphasizes easy access, circulation and lush natural surroundings for visitors and patients arriving at the 20-acre campus. The experience begins with a 1,480-space parking lot linked to elevated and enclosed bridges will connect pedestrians to a 470,000-sq.-ft. hospital and two buildings hosting a total of 180,000 sq. ft. of medical offices.

The hospital, which will open to patients in summer 2005, will have 165 beds in the first phase, with future expansion to 220.

Services will include emergency, surgery, a comprehensive cancer center, diagnostics and maternity. In addition, the hospital will have a 15-bed Level III Neonatal Intensive Care Unit (NICU).

Design and operational features focus on sustainability, energy efficiency, and low environmental impact.

Patients, their families and hospital staff will find daylighting in gathering areas and patient rooms. The surrounding campus features green plazas and a green buffer that screens the parking lot. Restorative gardens and green plazas are situated throughout.

"Plantings and water features are designed to be comforting and to put people at ease by providing outdoor green spaces which are accessible through visits to the gardens and views from the surrounding facilities," said Mauricio Villarreal, associate and project landscape architect with Walker Macy Landscape Architects and Planners of Portland.

The general contractor is Skanska, and the architect is Zimmer Gunsel Frasca Partnership of Portland.

Blending Technology with Green Building

Portland's Oregon Health and Science University has linked two substantial upgrades, an expanded patient care unit and a state-of-the-art research facility.

Construction on a new $113.4 million biomedical research building began in spring 2003 and occupancy is scheduled for fall 2005.

The 274,000 sq.-ft., 11 level facility will house more than 400 research and support staff along with an advanced high-field magnetic resonance laboratory. The MRI equipment will be located in the four below-grade levels and surrounded by more than 400 tons of steel plate shielding.

Demonstrating that technology and environment can be friends, the project is being built to meet or exceed Leadership in Energy and Environmental Building (LEED) silver certification standards.

Concurrently, OHSU's 335,000 sq.-ft. patient care facility and 450-space parking structure are in their early stages. Mass excavation of 75,000 cubic yards of soil is complete and two 270-foot tower cranes are assembling the steel skeleton.

Upon occupation in 2006, this 11-story structure will host more than 200 patient beds, state-of-the art surgical suites and intensive care units, as well as more space for ambulatory services and eight new surgical units with room to add four more as need develops.

Again, the emphasis is on patient-friendly enhancements, with robotics incorporated surgery, healing gardens and terraces that provide views of the Portland cityscape and Mt. Hood.

The most unusual feature of the expansion is an aerial tram station connecting the tower's ninth floor to Portland's South Waterfront redevelopment. A two-minute ride to and from the tower connects OHSU visitors directly to public transit and parking.

"In an urban environment where space and traffic are always issues, the aerial tram is an innovative and people-friendly solution for access to OHSU and its facilities," said Bradford Wellstead, founding principal and president of Ethos Development, the owner's representative.

Designed by Angelil/Graham/Pfefinninger/Scholl and Doppelmay-CTEC, the $28.5 million 3,300 linear foot Portland Aerial Tram can move more than 7,000 passengers per day.

Perkins & Will are the exterior building architects, with Peterson-Kolberg associates responsible for interior design. The general contractor is a Hoffman-Andersen joint venture with project management by OHSU Facilities Management and Ethos Development.

Environmental Stewardship

Providence Newberg Medical Center is a rarity in hospital construction: a greenfield project, not an addition to existing structures. It also joins OHSU as one of the few hospitals in the country to be built to LEED silver standards.

"Since environmental stewardship is a core value for Providence, it became a key goal for us during early planning and design sessions," said Mahlum Architect's Mike Smith.

Providence Newberg Medical Center is one of only a few hospitals being built to meet LEED silver standards. ( Image courtesy of Mahlum Architects )

Features such as on-site storm water management, locally manufactured materials, high efficiency mechanical systems and air quality-friendly paint and interior materials are the rule. Mechanical systems will use 100 per cent outside air sources.

Local utility Pacific Gas & Electric is funding and maintaining emergency generators in return for the ability to operate the system during peak demand. The Oregon Energy Trust has awarded Providence Newberg a $199,000 grant for energy efficiency.

The hospital building will have mall-like atmosphere with a two-story glass entry connecting to a galleria with hospital departments arrayed along the building's spine.

Doctors' offices are in a second building, which also houses a conference center and administrative functions. This approach is expected to save $50 to $60 per square foot in construction costs for that portion of the building.

A Guinness World Record-breaking 2,453 people participated in the September 27, 2003 groundbreaking. Skanska Building USA is the general contractor for the $41.7 million project, scheduled to complete in December 2005.

Upgrade Built Around Healing Garden

In Medford, Ore., Rogue Valley Medical Center is underway with a $76-million, 230,000 sq. ft. upgrade built around a three-acre healing garden.

"We're creating a physical image that is technologically advanced and more accessible for a population that reaches from Southern Oregon into Northern California," said Mahlum's Smith.

The garden, designed by Mayer/Reed of Portland, can be viewed from public reception areas and family rooms on the northern end of the new six-story elliptical-shaped patient tower.

A new, two story entrance lobby features an atrium with a 25-by 70-ft. skylight that distributes natural light into registration and reception areas as well as the cafeteria.

Patient rooms are mostly private and feature daybeds for family members. The first floor houses a new emergency department, diagnostic imaging, patient registration and an expanded surgery department.

When building contractor DPR Construction of Redwood City, Calif., completes the project in July 2005, a total of 230,000 sq. ft. will have been added to the facility, about 50,000 sq. ft. remodeled and 25,000 sq. ft. shelled for expansion of the hospital's intensive care unit.