REMODEL/RENOVATION
| By Zeit, Kristin D | |
| Proquest LLC |
Problem solvers
The 2013
The strong focus on remodeling or renovating spaces over expanding or building new ones remains a priority for many healthcare systems that are still wondering what's what in the unsteady climate of healthcare reform.
And with good reason: Reorganizing or freshening up an existing facility is a less capital-intensive way to address new care models and changing patient expectations.
But every renovation brings with it challenges that no one on the design team sees coming, and in dealing with those challenges, genius is often born.
Now in its fourth year, the 2013 competition focused on two categories: family spaces (which could include anything from waiting areas and consultation rooms * to patient room family zones and respite areas) and nurses' stations. A jury of 28 industry experts assembled by
The text and source lists for the project profiles on the following pages were provided directly by the competition winners and were not vetted by the editors of Healthcare Design.
2013 REMODEL/RENOVATION JUDGING PANEL
Healthcare Market Leader
Cannon Design
Operations and Facilities Planner
Capital Link
Principal
Stantec Architecture
Senior Design Director/Associate
Director of Healthcare Practice
Vice President, Healthcare Market
Sector Leader
Clinical Operations/Design
Specialist
ESa
Interior Designer
Associate
Associate
Lead Interior Designer
President
TAJ Futures
Manager, Facility Planning and Construction
Associate Principal/Senior Vice President
Director. Planning and Business Development
Transition Planner
Balfour
Principal
Peter Lambur Architect
Mary Lee, CID.
Senior Interior Designer/Associate
Stantec Architecture
Partner
MKM Architecture + Design
Vice President
Senior Healthcare Consultant
Health Facility Activation Planner
Vice President/Healthcare Principal
Principal, Programmer/Planner
Principal, Healthcare
Senior Associate/Senior Interior
Project Designer
Perkins+Will
Director of
Principal
designcOnsulTafion
Project Architect/Project Manager
REMODELVRENOVATION - NURSES' STATIONS
It was the design team's primary goal to create a positive, healing, and colorful environment for very sick children while still promoting a calming environment for anxious, stressed-out parents during a very difficult time.
Following comprehensive research for soothing color patterns and shapes, the design evolved into a Northern Lights theme. The concept incorporates color-changing LED lighting over the nurses' stations in the suite. This promoted the tranquil but colorful tone for the space. The lighting system is fully controlled by the staff, enabling them to establish the mood of the space relative to holidays, events, etc. The Northern Lights concept was carried through to the custom signage and artwork in the entire suite.
The PICU department was gutted to create larger rooms incorporating private toilets and family seating areas from old curtain bay areas that had no privacy. The new rooms were also designed to accommodate isolation patients, if required. The old, damaged nurses' station was completely demolished and rebuilt on the same centralized footprint. The juxtaposition of the rooms relative to the centralized nurses' station provides patients, family, and visitors calming visual access to the changing lights above. The modernized nurses' station was further refined to accommodate dedicated docking areas for the equipment away from the path of travel. Overall, the interior architecture encompasses a more efficient workflow for the staff.
The Northern Lights concept was continued at the new family lounge area in the wall colors, furnishings, and artwork. The designers created a space to decompress in a comfortable spa-like atmosphere. This area includes a kitchenette and sleep rooms with individual showers and toilets for those parents staying with their children around the clock.
The design team's objective was met by providing a bright, appropriate design for the PICU department that's been praised by the staff, parents, and patients alike.
Solidifying the project's success, the international medical gas boom equipment vendor commented that the installation was the best one they had been a part of to date. This project is now being used as a model in their catalog and website for future projects.
Architecture, naming & Interior Design: PF&A Design; Mechanical, Electrical & numbing Engineering:
Jury comments:
* The luminous LED ceiling is an amazing element. Great floor patterning from corridor into rooms; the casework has excellent detailing.
* The new space is a total transformation from the existing interior. The color palette speaks to the pediatric patients and uses gold tone without being overpowering. The lighting is vastly improved, and the overall impression is light, bright, and cheerful.
* Good incorporation of lighting to help with way finding and interest.
* This nurses ' station is functionally most interesting since it has well-thought-out access to both workstations and equipment storage spaces.
* Significant improvement in lighting; Northern Lights theme successful positive distraction.
* The success of this design project to me is that it is a pediatric environment that works for all ages. The simplistic design is enhanced by colorful accents and color-changing lighting that works well in telling the pediatric story without being too overbearing.
Reader comments
* I like the open floor plan and colorful lighting. It is very child friendly and less cluttered!
* My child was recently a patient at CHKD PICU and it is a beautiful floor! Very nicely designed.
* The colors are bright and cheerful. When a loved one is admitted to any ICU department, it can be stressful. CHKD's PICU renovation is like seeing "sunshine on a cloudy day. "
* It's nurse friendly and family friendly, too!
* The Northern Lights theme is a great idea!
* A bright and colorful environment is essential for healing; especially when kids are involved. The space is less intimidating and more inviting after the remodel.
* From dreary before to peaceful and bright afterward; the design followed through on the mission.
New Adult Emergency Environment of Care
Why did you decide to renovate? Volume was exceeding the space available for additional treatment spaces, so additional space was added (20,000 square feet) and the existing space renovated (32,000 square feet) to allow the most efficient overall layout possible.
What were your objectives and were they achieved? The objectives were to seamlessly combine the new and renovated spaces to clarify circulation, creating an open clinical core that would allow for better staff observation of patients and improved visual and verbal communication between staff; limit the height of equipment and supply carts in the open clinical core to support the physical layout; and increase patient safety and satisfaction, with the patients directly visible to the open clinical core. Yes, we believe that we did achieve these goals, and that has been corroborated by the users and staff.
How were family, patients, and/or staff involved in the process? They were part of our Environment of Care work groups (concepts, people, systems, layout/operations, physical environment, and implementation). These work groups informed the Interdisciplinary Design Team that developed options to be considered for the new design.
How has the design impacted family, patients, and/or staff? Families and patients have more direct visibility and access to staff. This reduces family and patient stress and creates a more interactive relationship between family, patient, and caregivers. Staff has the ability to visually monitor activity levels throughout the unit to see where additional attention may be required. A low-walled/glazed consult area in the middle of the unit, part of the care center, allows for private consult space without compromising the openness of the unit.
Did you encounter any challenges along the way, and if so, how were they minimized or resolved? The challenges included creating interdisciplinary work groups to assure the coordination required between all of the ancillary support activities to be able to successfully implement our design. This challenge was addressed by including security, materials management, linen, environmental services, pharmacy, laboratory, religious ministries, volunteer services, diagnostic imaging, information technology, registration, administration, physicians, nurses, technicians, financial services, family, and patients in all our work groups, and by appropriately incorporating their feedback to get their buy-in to achieve the shared goals of the project. The various systems they proposed would be reviewed against the previously agreed-to goals and objectives, and if they were met, those systems would be approved. Examples: height of pyxis units; height of linen carts; location of pneumatic tube stations; alcove locations for ultrasound machines; type, quantity, and location of monitors and equipment; patient tracking display monitors; etc. Another challenge was to create an open clinical core with care centers that were welcoming, accessible, built with natural easily maintained materials, and detailed to withstand the level of traffic that this area will experience.
This challenge was met by using solid natural maple as the field material. The maple was accented with stainless steel corners, striping, and bumper guards in locations known to experience the most wear, to enhance the beauty and longevity of the design. Solid surface transaction counters and worktops were also used. Another important detail was that other than accent or task lighting, all of the lighting in the open clinical core is indirect to support the noninstitutional feeling of the unit.
Architectural Basic Services, Programming, Conceptual Design:
Jury comments:
* Good clinical organization at nurses' station with ease of access into and out of open core that combines both workstations and medical supplies and equipment while preserving sight lines to ensure that all rooms are visible from core.
* Imaginative use of wall protection that gives a contemporary look.
* Great luminous ceiling; well detailed; floor patterning is noteworthy.
* The design has a very cohesive, coordinated look. The subdued palette works well with the delineated geometry and lets it shine through without overpowering it.
* Sophisticated design, yet functional.
* Excellent visibility and sight lines, great lighting and color use.
* The light wood and stainless steel give it a clean look and feel. From a safety perspective, the ability to talk with other ancillary departments is enhanced with the open station.
Reader comments
* Beautiful and welcoming appearance for an area that can be frightening to patients.
* Amazing transformation!
* I chose the New Adult Emergency Environment of Care because it still looks like a professional hospital environment but with a refreshing, modern appeal.
* Sleek, clean, and open. Nice blend of maple and stainless. Beautiful and timeless!
* The indirect lighting, wide-open spaces, and the nonindustriallooking hanging ceilings of the New Adult Emergency Environment of Care design create a much less clinical look and appear most transformative from the prior spaces.
Completed in
Of the numerous improvements implemented as a result of the project, the new nurses' stations were designed to add dynamic movement and visual Interest in the upgraded facility. By skewing the angle of the layout, additional space was gained to facilitate patient and staff interaction. These angles are mirrored in the millwork of the station itself, which provides surfaces at multiple heights for accessibility while obstructing unsightly views of computer monitors, cords, and other desktop clutter.
Breaking down a visual barrier, the dated glass partitions used in the pre-renovation facility were removed. Sound control and acoustical privacy are now provided by the floating tile ceilings over the nurses' stations. Because these ceilings, which are reflected in the flooring design, protrude slightly into the adjacent corridors, they also serve as a wayfinding element. By night, the corridor lights can be dimmed, and the glowing ceiling serves as an internal beacon.
Wayfinding is further enhanced by the color choices that correspond to each station-green for the
Architecture & Interior Design: Perkins+Wiil: Mechanical, Electrical & Plumbing Engineering:
Jury comments:
* Great architectural elements to call attention and create interest in space. Huge improvement from what it was, and less clinical in feel.
* Good ADA response. Integration of soffit creates "place. " Clean design with accent colors.
* This has powerful geometry with clean, sweeping lines that define the design. The palette is timeless and neutral with strong, strategically placed accent colors.
* This design stood out because of its symmetry.
* Cool, sleek, functional, inviting.
* Very open, dynamic design, appears highly efficient. Encourages interaction of public and staff. Acoustic treatment and lighting support design intent.
Reader comments
* The effort to enhance communication between staff and patients is commendable.
* What a wonderful result, so efficient yet so stylish!
* I love that the nurses'station has two levels ofaccess...a lower area for handicapped accessibility and taller countertops for patient confidentiality. It is modem but comfortable.
* Clean, modem, inviting, and elegant nurses ' station!
* Cleverly designed nurses'stations!
* Inviting and accessible.
There is no hospital bed; gas and monitoring fixtures are hidden (though these can be revealed if the room must be reverted to standard use). Flexible sleeping provisions include a queen bed for parents, and both a mobile crib and single Murphy bed for patient and sibling. There's a wardrobe, desk, full bath with shower, and TV with gaming system. The color palette is warm, the furnishings soft and noninstitutional.
Architecture & Interior Design: Stanley. Beaman &
Jury comments:
* Lovely and calming while still very colorful and welcoming. Very residential and nonthreatening.
* Love it. Great investment of thought and time into the layout of the patient room for children and family. The color palette, art, and furniture create (better than) homelike feel, generously proportioned for family visits and family stays.
* Simply beautiful. This project's use of warm colors, rarely seen in healthcare settings, and the conceptual design of the room demonstrates carefully crafted interplay of technology, function, environmental control, and comfort.
* This is it! This is my #1 choice because of what it does to redefine the patient and family experience in an inpatient setting.
Reader comments
* I love the idea of Nadia 's Room. I currently work at a children 's hospital and think it is extremely important to have rooms such as this to allow parents and patients a more comfortable living space...warmer and not so sterile.
* This truly is a "familycentered" environment. I love the idea of the double bed... getting away from the typical hospital bed. It allows the parent to spend the night with their child in comfort. I love it!
* The renovation of Children 's Healthcare of
*This space looks so inviting for the unfortunate families who have to spend extended amounts of time in the hospital with their beloved children. What an incredible difference when compared to a typical hospital room!
*Transforming a typical clinical space into a welcoming and homelike environment is certainly a challenge.
*Beautiful color schemes!!! This is definitely a warm and welcoming renovation.
Saint Luke's
The Saint Luke's
Garage entrance
Since the garage entrance is the first impression encountered, one of the main goals of this remodel project was to create a front door that reflects the hospital's high-quality standard of care and emphasis on patients and their families by providing an aesthetically beautiful facility-a facility that offers a feeling of destination and a sense of arrival.
Atrium lobby
Once you enter through the garage, you are spilled onto a welcoming and open pathway into the atrium lobby. The original space was a vast three-story atrium with a small, hard-to-find information desk and walls that seemed to make the surroundings intimidating. The intent for this space was to soften and create clear, defined circulation systems to orient patients, staff, and visitors. The remodeled space provides a warm, bright, and welcoming space as volunteers assist families with their wayfinding needs. Color and finishes were carefully selected to de-emphasize the institutional feel and provide a more expansive and hospitable space not unlike a hotel lobby.
The atrium was infilled with a monumental staircase that interconnects multiple floors and provides a series of new family spaces. The staircase serves as the main circulation between other areas of patient care as well as enhanced access to the cafeteria, patient floors, and surgery. This arrangement further simplified wayfinding and provides for a less confusing and more comforting and supportive atmosphere.
Waiting areas
Individuals waiting for results of loved ones undergoing neurosurgery or receiving stroke care, now have additional family-oriented spaces with added daylight brought in from the atrium and courtyard glass. Relaxing hues and use of wood and other natural surfaces impart feelings of warmth by creating a connection to the environment.
The completed renovation provided a major upgrade to an existing 30-year-old structure and allowed for the expansion of services and programs to provide an even higher level of comfort and quality patient care.
Jury comments:
* Great entrance, particularly with the limitations of precast parking garage panels. Expansive vistas and improved natural wayfinding.
* This project provides an excellent redevelopment of a dreary, uninspired space to create a new positive first impression for visitors with critical improvements to facility circulation.
* The new waiting areas on the structurally infilled floors replace the outdated and bland atrium while retaining its dynamic truss and skylight. Warm wood contrasts nicely with the cool and neutral tones of pewter metal, glass, and dark/light fabrics.
* Takes a tough problem and offers a great solution-makes lemonade out of a lemon.
* This project actually addresses the issue of hospital first point of contact head on.
* The sheer transformation of this project is what gives it notice, most notably the attempt to give the experience a much more humane sense of scale and to make that space more usable.
Reader comments
* Really like the modern open space concept.
* What a bright and cheerful improvement!
* Love the design of the building and the brightness and cheeriness of the waiting area.
* I chose Saint Luke's as it was the most drastic and impressive transformation. The striking new entrance coupled with the renovation from the old, oh-sofamiliar, claustrophobic waiting room were the final decisionmaking factors.
* Lighter atmosphere but still roomy!
* From the parking garage through the lobby and to the waiting area, they brought it current and gave an inviting space for the patients, family, and staff to appreciate.
Architecture:
MS Center at Swedish: Patient and Family Waiting Area
"The clinic has a very relaxing effect when you walk in, as you are greeted by a wall of plants. "-MS Center patient
The
The design team conducted extensive research on how MS patients interact with the built environment. Every major step of the clinical visit was studied. Friction points were identified and resolved. A patient focus group was created to influence and review design. The team learned first and foremost that the new space had to meet the various physical and emotional needs of people with MS.
Multiple sclerosis is a degenerative disease that attacks the central nervous system, often resulting in impaired vision and mobility. In response to this, the design includes a special wayfinding program to guide patients easily and safety throughout the clinic. A hallmark of this program is the living "green wall" that serves as a unique visual reference, greeting patients as they step from the elevator, guiding them to the patient and family waiting area or one of the two mirroring clinics on either wing of the Center.
Signage offers bright color contrasts, and art is big in scale and easy to see. In addition, materials and finishes were selected for ease of movement, with transitions between materials carefully contrasted and placed to reduce the potential of trips and falls. Handrails offer needed support and opportunity for respite. Sliding doors and automatic door operators improve accessibility.
MS patients are typically scheduled for extended visits with many different care team members. A primary goal of the new Center was to consolidate previously disparate services to provide a convenient one-stop shop. A typical visit to the MS Center can last several hours. The Patient and Family Waiting Area was designed as a centralized, comfortable place for patients and their families to rest between appointments.
Features include abundant natural light, floor-to-ceiling windows, and access to an outdoor terrace. The space was designed so that patients and their families could open or close operable curtain systems placed throughout the space for more or less privacy, breaking the area down into smaller "family" units when desired. An educational wellness center is located adjacent to the waiting area. Displays feature educational material, research, and news related to MS. Products made especially for MS patients are featured.
Turning to nature's power to heal, a main tenet of evidence-based design, the new waiting area brings the outdoors in as much as possible. A white, chiseled-marble wall envelops the lobby, complementing the adjacent green wall. The use of floor-length windows, transparent doors, and open patient areas helps infuse natural light into every area within the Center.
Jury Comments
* The living wall is a striking feature of this design. Providing access to nature indoors, in a highly stressful environment, supports attention restoration theory.
* Beautiful transition of space. The wayfinding is clear. The materials use is beautiful! The quality of light is such a huge improvement. Lovely!
* One of my top picks in the first round, this project benefits from a research-oriented approach producing an outside-the-box design solution. Unconventional elements, green wall and soft curtain dividers, contribute to a calming yet invigorating environment with a healthy and hopeful vibe.
* Having a colleague and friend with multiple sclerosis, I appreciate the overall layout of this unit and how it attempts to decrease travel distances for the patients. And there 's a wonderful feeling of normalcy and openness and relief that is embedded in the design.
* The entire design is a phenomenal reflection of a deep understanding of the unique needs of patients with multiple sclerosis. It is apparent the design team did their research, listened to the voice of the patient and caregivers, and integrated evidence-based design principles. The landmark "living green wall" initiates a memorable first and lasting impression for meaningful human-centered multisensory experiences that are supportive to the physical and emotional needs of MS patients.
* The overall design is inviting, purposeful, and reflects meaningful investments centered specifically on the well-being of patients with MS.
Reader comments
* This is purely and simply a patient-care driven design solution. The design team including designer, contractor, doctors, hospital, donors, and most importantly patients and their families, worked together towards one goal-a relaxing and comfortable environment promoting the effectiveness of MS care.
* So bright and welcoming! Does that give the feeling of a medical facility? Very relaxed looking.
* The green wall is awesome! Also opening up the wait area to natural light and views. Great job!
* The use of natural colors, natural light, and finishes that are bright create a very inviting space. The space appears to be peaceful and calming which will contribute to healing and recovery. The large windows allow so much light which is much needed for spaces in the Northwest. An amazing transformation!
* I love how they brought the outside in, also loved the use of curtains to promote a less institutional feel.
* I love the living wall 🙂
* Feels clean and calming and modem.
Architecture & Interior Design and Landscape Design:
Editor-in-Chief
Healthcare Design
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