FLINT, Mich.—A unique new pediatric healthcare facility in Flint is gaining acclaim for bringing cutting-edge services and settings to those who need them the most.

For many families with children who experience behavioral health issues, accessing treatment and care often requires traveling to multiple care facilities and seeing many different teams of specialists. The Center for Children’s Integrated Services at Genesee Health System (GHS) in Flint was designed to integrate these care services and improve access to behavioral health care for underserved families in Flint.

Designed by national architecture firm HED, the new facility brings all of GHS’s children’s programs into one facility, including the three core children’s behavioral health programs. The health center features an autism playground area intended to be used as a therapeutic tool that allows children with autism to engage with nature through sensory-rich features. The facility is also located along a main bus line, improving transportation accessibility to health services for low to moderate income families.

In the wake of the Flint water crisis The Genesee Health System (GHS) needed a facility to unify its behavioral health services, improve access to behavioral health and primary care services to the underserved low- and moderate-income families of Flint, and create a central facility to develop medical innovation in the evaluation and treatment of lead poisoning.

Working closely with GHS, HED developed a design for a brand-new building that brings all of GHS’s children’s programs under one roof, including the Neurological Center for Excellence (NCE), Child and Family Services (CFS), and the Children’s Autism Center. The Center for Children’s Integrated Services helps reshape the physical and human landscape of Flint, ensuring that the NCE has a permanent physical home, continuing the important work of helping Flint children and their families get the access to behavioral health and primary care services they need.

The design brings together the three core children’s behavioral health programs (the NCE, CFS, and Autism Center) as well as a Community Outreach and a Federally Qualified Health Care (FQHC) center. HED co-located all these programs into one 60,000-square-foot building and utilized careful layouts to improve navigation and efficiency for patients, families, and medical staff while enhancing visibility and accessibility. This facility is vital to supporting the GHS in providing services to Genesee County residents (both children and adults) with serious mental illness, children with serious emotional disturbances and developmental disabilities, and adults and children with substance use disorders.

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LANSING, Mich. – Gresham Smith recently announced that construction is complete on McLaren Greater Lansing, the first facility on McLaren Health Care’s new campus in Lansing. Designed in partnership with national architecture/engineering firm, HED, the nine-story, 517,000-square-foot replacement hospital represents the largest one-time investment in McLaren Health Care history, replacing two existing hospital facilities with one state-of-the-art facility that advances patient care, comfort and convenience.

Designed to meet the needs of residents in Michigan’s capital city, and adjacent to Michigan State University, the new facility includes a Level III Trauma Center/Emergency Department, Orthopedic and Sports Medicine Institute, comprehensive cardiac programs, interventional platform with 20 operating rooms and medical/surgical unit. Intuitive wayfinding, as well as smart planning, help to clearly guide patients, visitors and others to the multitude of services offered.

“From our progressive approach of creating positive user experiences with access to natural light, inspiring environments, and intuitive wayfinding to creating state-of-the-art hybrid operating rooms, this greenfield hospital with set a new standard of highly advanced care in Michigan’s capital city,” said Healthcare Vice President Steve Stokes, AIA, CLGB, NCARB. “The Gresham Smith Team is proud of the collaborative work accomplished with our partners at McLaren Health Care.”

With a focus on human experience and patient safety, the hospital’s 240 private patient rooms feature personal temperature controls, expanded in-room entertainment options and large windows with views of the outdoors. A public cafeteria and community hub offers convenience for family members, staff and visitors, while a training center, simulation labs that support medical education, an expanded lounge and sleep rooms, elevate the staff experience. The design team enhanced operational efficiencies by limiting the travel distance between the emergency department and imaging services. McLaren Greater Lansing was designed and planned to have the ability to change course to respond to future situations that may occur with an adaptable and flexible platform of care.

“It is rare you find a collection of firms and individuals all committed and balanced to support the client’s goals and then deliver them,” said HED Healthcare Sector Leader David Jaeger, AIA, LEED AP, EDAC. “HED as architect and engineer of record and in partnership with Gresham Smith and as an entity working in a design-build contract have delivered value to McLaren not typically possible with standard contracting methods.  Many state-of-the-art technical systems were balanced with a budget and schedule that required constant care by all.”

The hospital was completed on-time and under budget, despite workforce and supply challenges caused by the COVID-19 pandemic. Using a factory fabricated ceiling rack system and exterior panels, the construction of the hospital’s enclosure met an aggressive schedule and required fewer contractors to be on site at one time. This also allowed direct connection with the project’s mechanical engineers and the sub-contractors who were brought in early on to discuss the placement of the buildings’ main systems.

“By combining the national expertise of Gresham Smith and HED with the talent of companies in Lansing and throughout Michigan, we assembled a unique team to design and build a healthcare campus that will care for our community for generations to come,” said Daniel Medrano, vice president of Facility Management for McLaren Health Care.

Gresham Smith is also designing and planning the adjacent 60,400 square-foot Medical Services Building on the McLaren Greater Lansing Hospital campus and the cancer center and proton therapy center expansion at McLaren Health Care’s hospital in Flint, Michigan.

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SAGINAW, Mich.—National integrated architecture and engineering firm HED completed the design of a newly opened 93,000-square-foot rehabilitation hospital adjacent to the Covenant Healthcare hospital facility in Saginaw. This new, state-of-the-art rehab hospital features 45 hospital beds, with expansion space to add an additional 15 rooms as demand at the new facility grows.

Spence Brothers was the construction manager for the substantial rehabilitation facility project.

From the onset of the project, the design team focused on providing an Environment of Care centered on the concepts of rejuvenation, restoration, and rehabilitation. To deliver on this goal, the facility incorporates significant amounts of both art and nature, amidst the latest state-of-the-art rehabilitation care technology and tools.

Nothing speaks more clearly to rehabilitation as well as the naturally restorative powers of nature. One of the first experiences that this project offers, as you enter the site from Cooper Street, is the therapeutic North Garden including activities for children and adults. These activities do not stop at the building, they have been pulled forward into the traffic island on the site, to be used as a real-life cross walk experience culminating is a set of stairs to complete your work out.

As you enter the building you know you have arrived at a rehabilitation destination, met by the bold and inspiring colors that accent the natural tones that create the foundation for the building’s interior. Patients are greeted and assisted as needed through check-in and accommodated in an open, welcoming patient/ family support area bathed in natural light, featuring a ceiling hung glass sculpture, with views of the North Garden. Even the corridors leading to all of the outpatient functions that are located on the first floor are incorporated and utilized as therapy spaces to include Zero-G ceiling track, anti-gravity mobility systems. Natural light and visual access to nature is also featured in almost all of the outpatient areas that provide supportive experiences for all of the functions being performed. The building has also been designed to accommodate plans to include an additional South Garden, as funds become available, that will provide additional outdoor spaces for therapy and respite for staff.

The building is clearly zoned to accommodate all of the outpatient functions on the first floor and all of the inpatient functions on the 2 upper floors where similar design features are included, incorporating therapy functions in the corridors and well as dedicated inpatient gyms and related support spaces for each of the Nursing Units.

The second floor has a direct connection to the existing skywalk connected to the existing hospital where 80% of the inpatients will be accessing the new facility. The additional 20% of inpatients will come as referrals from other facilities which will be received at a separate dedicated entrance on the first floor with direct elevator access to the upper floors apart from the outpatient functions.

Art is another therapeutic feature that is incorporated throughout the facility to support the rehabilitative process. Inspirational messages in the functional areas, super-graphics of local nature scenes at the headwall of all the inpatient bedrooms, and photographs of patients and staff working together to reach their mutually developed goals located strategically throughout the facility to reinforce the commitment of the organization to provide the ultimate patient experience.

Mary Free Bed, based in Grand Rapids, Mich., is reportedly the largest non-profit rehabilitation system in the country.

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CHICAGO—Loyola Medicine, a Chicago metro area medical group, has just opened a new, 30,000-square-foot regional clinical laboratory facility to serve Loyola University Medical Center, its academic medical center, and two community hospitals, Gottlieb Memorial Hospital and MacNeal Hospital.

Designed to consolidate several smaller lab spaces across the three-facility system, and to significantly improve workflows and inventory control, the new laboratory is housed on the system’s Maywood campus of Loyola University Medical Center. The laboratory was planned and designed by HED, an integrated design firm with a long history of work in the healthcare sector, and built by Leopardo Construction.

“As a part of this project, we really focused on reimagining the lab team’s processes. We wanted to help Loyola optimize workflows and improve efficiencies, so the design exercises we went through focused on these kinds of major flow improvements,” said Aaron Shepard, a principal and project leader with HED.

Newly located on the fourth and fifth floors of the campus’ existing Emergency Medical Services building, the new lab features great daylight access in the open concept lab space.  Administrative functions are also located adjacent to the open lab, providing efficiency in specimen processing. The lab also features several major, new automated equipment systems, and was designed with these upgrades in mind.

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FLINT, Mich.—The Genesee Health System and the Greater Flint Mental Health Facilities Inc. have just  broken ground on a new GHS Center for Children’s Integrated Services building in Flint. The new state-of-the art mental and physical health treatment center will bring comprehensive care for Flint and Genesee County children to a single location, designed by the healthcare system to serve the growing needs of families in both the wake of the pandemic and Flint water crisis.

The 60,000-square-foot building, designed by national integrated architecture and engineering firm HED and being built by DW Lurvey Construction, will bring all GHS children’s program areas under one roof, including the Neurodevelopmental Center for Excellence (established by the court rulings following the water crisis), Children’s Autism Center, a Federally Qualified Health Center, Child and Family Services, and Community Outreach programing.

During April 25, 2014–October 15, 2015, approximately 99,000 residents of the City of Flint were exposed to lead when the drinking water source was switched from the Detroit Water Authority to the Flint Water System (FWS). This new facility will specifically foster medical innovation in the evaluation and treatment of lead poisoning, informing best practices that will shape healthcare across the nation and world.

The Center will improve access to behavioral health and primary care services for low- to moderate-income residents of the Flint area and will act as a cornerstone of future neighborhood redevelopment. The building design includes a café, outdoor plaza, secure playground, and other comfortable waiting spaces intended to make the facility feel inviting for regular, repeat visitors while supporting clinical programs with an activities-based approach.

The building includes a series of “autism pods” as well as an autism playground area as a part of a highly developed treatment facility for children on the autism spectrum, one of the leading outcomes seen from the water crisis.

“Carefully selected surface materials for touch and playground objects designed to enhance motor skills offer a valuable set of interactions with the building and site for children suffering from neurodevelopmental problems,” said Jessi Mesalic, NCIDQ, an associate with HED.

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OAK BLUFFS, Mass.—Nearly 7,000 square feet of underutilized space at the Martha’s Vineyard Hospital have been renovated and repurposed during the coronavirus pandemic, the medical center recently announced.

The redesigned space will provide extra space for the hospital’s primary care center, which services the small island community’s year-round residents as well as its traditional influx of summertime visitors. Due to the island’s increased visibility and desirability as a tourist destination, the hospital also needed to be expanded—while simultaneously protecting the community’s limited space and wish to maintain its traditional ways of life.

In keeping with the desire of the community to ensure that the hospital maintains its look as part of the island’s infrastructure, the design motif for the expanded wing employed a nature theme. Accordingly, the colors, sounds and lighting in the reconfigured lobby evoke the sand, water and stone that are so much a part of the island’s topography and surroundings. As patients and their families await consultations in the hospital’s lobby, they will be bathed in natural “light fills.”

Arrival at the hospital has also been set up for ease of access, such that the rear parking lot allows direct ingress via a walk-in entryway. This is meant to foster a greater feeling of accessibility for new arrivals and be more welcoming than a more typical healthcare entryway.

The repurposed wing at the Martha’s Vineyard Hospital features 16 entirely new examination rooms as well as office areas for care providers. The main feature of the renovated space is the

MVH Primary Care Internal Medicine Suite, which expands the amount of healthcare space and capabilities for treatment that are available at the hospital.

Furthermore, the new layout allows for doctors and nurses to be working in contiguous offices rather than being spread apart within the hospital setting.

Martha’s Vineyard Hospital president and CEO Denise Schepici and Hospital Facilities Director John Murray worked on the redesign in conjunction with officials from the Boston offices of the architecture and engineering firm HED.

Less than 20,000 people live on the island year-round, but the population can grow far larger during the peak of summer tourism.

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PASADENA, Calif.—Architecture and engineering firm HED, which has offices in Los Angeles, has merged with healthcare design firm Puchlik Design Associates (PDA), which is located in the city of Pasadena, just north of central Los Angeles. The two companies announced the merger at the start of the new year.

Leadership staff from PDA will join HED’s Los Angeles team this year as the two firms work jointly on creating an expanded office space.

In a statement, Peter Devereaux, HED’s CEO, said that because his firm has partnered with PDA on multiple projects in the past, he recognized a similarity in the cultures of the two firms that would well together under a joint operation.

“HED has a large presence in Southern California, and we have been serving clients in the healthcare sector in other parts of the country for decades,” Devereaux said in his statement. “Bringing in PDA was a natural step towards [providing] greater nationwide service.”

Added Gerry Puchlik, principle of PDA: “Like PDA, HED advocates that the role of the designer is to directly and positively impact end users, and they seek to produce designs that create this positive impact for clients and communities through deliberate decision making that contributes to care delivery, health and well-being of the people who inhabit these spaces.

“I can’t imagine a better fit for the future of our talented team.”

HED’s merger with PDA is part of the firm’s designs to increase its presence in the California healthcare market. The firm already has nearly 500 employees working at four offices in California (Los Angeles, San Diego, Sacramento and San Francisco) as well as other locations in Boston, Detroit, Dallas and Chicago.

HED has rapidly expanded from only four offices just a few years ago. The merger will give the firm its ninth office location, which will be sited in Pasadena, the city that famously hosts the annual New Year’s Day Rose Parade.

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OAKLAND, Calif.—Architecture firm HED and general contractor Herrero Builders of San Francisco have jointly announced the completion of the South Wing Renovation of the Alta Bates Summit Medical Center hospital campus in the San Francisco Bay city of Oakland. The expansion was necessary due to an ever-increasing population throughout the East Bay and a greater need for MRIs and guest services on the existing campus itself.

The announcement said that HED worked alongside client Sutter Health on a master plan for facilities management that required seismic upgrades in the earthquake-prone Bay Area and repairs that had been long delayed on crucial maintenance items.

The project entailed 37,000 square feet of renovation to the facility’s ground floor, which was the second in a series of upgrades engaged in as part of the master plan developed by HED for Sutter Health. Unveiled in 2018, the facilities master plan “organized and sequenced” over 70 individual tasks necessary across the medical campus over the next decade.

“As we looked at the varied needs across the campuses, we knew one thing clearly—we never wanted to undergo a renovation project in the same space twice,” Shurid Rahman, project manager with Sutter Health, said in a statement. Rahman added that the healthcare firm’s plan was to “make these renovation disruptions as minimal as possible” while the healthcare facility remained open for business.

The ground-level renovations came with a price tag of $30 million for upgrades to the South Wing of the Alta Bates Campus building. This included an expanded suite specifically for MRIs to address what has been described as a “growing stroke problem” in the East Bay. The new MRI suite replaces a trailer that warehoused the facility’s machine prior to this expansion.

Furthermore, the campus’s food program was updated to be better able to serve a larger contingent of patients and visitors, as well as give staff and visitors and patients an “elevated dining experience.” The old kitchen and cafeteria date from the 1980s and thus were in need of a modern update.

A doctor’s lounge was also added for the hard-working healthcare professionals at the site to have a break area.

“The interior renovation of this building incorporated a complete reconfiguration of uses to adapt to the changing needs of the Sutter Health organization,” Brett Paloutzian, principal of HED, said in a statement. “Through our integrated partnership with Herrero Builders and Sutter Health, we were able to deliver this complex renovation project utilizing LEAN construction principles and met Sutter Health’s goals for the project’s schedule and budget.”

The construction and design firms’ LEAN Integrated Delivery Process was utilized to fashion the doctors’ lounge, cafeteria and MRI suite inside the campus’s most-visited buildings.

In addition to its San Francisco offices, architecture firm HED has other California locations in Los Angeles, Sacramento and San Diego. Herrera Builders opened in San Francisco in 1955, and its portfolio includes seismic upgrades, tenant improvements and brand-new construction.

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As our world continues to take action against the real threats of the climate crisis, it’s clear that we in the healthcare industry must throw out our staid assumptions and safety nets to identify areas where we can reduce our own impact as well. Wrapped in industry regulations and limitations for decades, we may have become some of the guiltiest of those in the building industry of saying “not this project” in spite of the measured significance of our industry’s environmental impact. Estimates vary, but it has been reported that the U.S. healthcare industry contributes 8 – 10 percent of the nation’s greenhouse gas emissions.

The following represent a few of the most common healthcare industry assumptions that should be re-evaluated to help us improve our environmental impact right now:

1. Plan for Change in Place – Given the evolving nature of the healthcare industry, buildings must be designed and planned for with change in mind. Creating a space that can serve multiple generations, with room for new equipment no matter its size, with flexibility in floor plans and floor to ceiling heights should be of the utmost priority. Our industry shouldn’t just be looking at flexibility at the site scale either, but also within the building floors and interior space planning itself. By proactively conducting a thorough “Backfill Master Plan” to imagine the future possibilities for existing buildings, we can prevent short-sighted decision-making in unit by unit renovations.
2. Just Follow the Damn Energy Code – Shielding hospitals from State and Federal energy regulations for decades, the industry has only delayed the uphill battle toward resolving the climate crisis – thus putting our own facilities even further at risk. Whether required or not hospital systems should mandate that their own facilities will meet code expectations, no matter the up-front investment required in research and development. While we fully recognize that hospitals require some unique exceptions because of technical specificity, those in facilities roles in this industry should not carte blanch ignore code direction.
3. Don’t Rule Out Wood – With the advancements in more sustainable wood harvesting and construction (i.e. structural design solutions like cross-laminated timber), builders are significantly reducing the carbon emissions of buildings in other building sectors. The healthcare industry should similarly not rule out the use of these new systems and lean on our conservative past.
4. Optimize Equipment Efficiency – If equipment is the biggest energy hog, we have to begin collectively evaluating its highest and best use, systemically – and that may not be through tying it to a particular facility, provider, or even healthcare system as has historically been the case. These equipment resources should be considered community assets and allocated in such a way as to limit their replication and limit their down time, thus limiting their production as well. One simple way to reduce their electricity usage is to increase the natural right in the building through windows. Although, if they are building in an area with a lot of sunlight, they may also need Commercial Window Tinting to make sure the light isn’t too bright.
5. Look Beyond the Building’s Walls – Transit to and from healthcare facilities must become a community-wide planning consideration. Through strategically siting hospitals or clinics within transit-oriented developments, partnering with local jurisdictions to develop bussing partnerships, and more, we can greatly reduce the impact of healthcare-related transit through smart facility planning. By building more garages and offering hotel-like valet services the industry has furthered bad behavior and required more land area for our facilities at the same time.
6. Plan for the Home Health Revolution – Hospitals are notoriously expensive. So providers, policy makers, and insurance systems are looking toward care that brings healthcare services to the patient instead of them to the hospital. This popular “hospital-at-home” concept is gaining traction in some regions and with some populations already. Whether resulting in patient rooms that flex for more diverse functions, reducing bed counts, or limiting hospital co-services, we should be utilizing data to prepare for this impending revolution.
7. Localize the Temperature – One of the greatest environmental impacts of healthcare spaces is that of energy consumption for temperature control. With very specific temperatures needed for the benefit of patients with unique conditions, most healthcare spaces are kept much cooler than necessary. Healthcare needs to consider this differently. In the office design industry, for instance, a heated work chair was recently developed to solve localized temperature control challenges. This same concept could easily be applied in healthcare through specifically cooling orthopedic tables when applying their unique adhesives, or to beds where the patient is in need of a body temperature reduction.
8. Prioritize Physical Investments in Accordance with Risk – While costs can often be analyzed on a dollar by dollar basis, healthcare facilities should be evaluating their facility planning choices on a more sophisticated level than this. Material and construction costs alone are not what make a decision clear. Some spaces are simply more critical and more cost-weighted because of their function themselves. For instance, locating a pharmacy in a basement could put it at risk of flooding. While not a physically challenging space to build, pharmacies to hold a high amount of costs within them due to the drug compounds. It is also a critical resource to the operation of the hospital. So clearly, the construction cost is not the only thing to consider when prioritizing facility renovations. By thinking this through hospitals are more likely to eliminate emergency renovations and save a lot in materials as well.
9. Design Your Health First – The design of a healthcare facility impacts the health of the surrounding community. It is widely noted that 30 percent of Social Determinants of Health are directly related to either the air and water associated with a medical campus or the impacts of transportation to and from the campus – think a sea of asphalt and the resulting negative environmental impacts. To strengthen a positive impact, consider undertaking a pre-design “health checkup” that honors the standards set by the American Institute of Architects for healthy communities: Environmental Quality, Natural Systems, Physical Activity, Safety, Sensory Environments, and Social Connectedness.
10. Hire Certified Specialists – Healthcare design is not “just architecture.” These highly complex, operationally driven buildings require specialized facility planners, designers, and managers. When seeking to improve environmental efficiency a LEED Certified designer is expected, and when seeking to improve the quality of your healthcare campus, look for a board-certified healthcare architect, licensed through the American College of Healthcare Architects (ACHA). The intersection of these two specialists will help optimize any facility with each of the items mentioned.

As an industry seeking to improve health outcomes for the people it serves, it is time that we become the most aggressive in the effort to reduce our environmental footprint. From technology solutions, to urban planning solutions, to operational and regulatory solutions, building designers are key to a large amount of these conversations, and our commitment to environmental efficiency is thus paramount. This work requires long-term, collaborative partnerships across design disciplines, with institutions and individual campuses, and with product and equipment designers as well.

Timothy Hurvitz, AIA, LEED AP BD+C, ACHA Candidate and Sharon Woodworth, FAIA, LEED AP BD+C, EDAC, ACHA are Associate Principals and Healthcare Studio Leaders with HED, based in the firm’s San Francisco studio. Tim has specialized in the design of healthcare projects for nearly 15 years. Woodworth, a trained nurse and educator, is also an accomplished Architect with more than 20 years of experience that builds on her earlier career as a nurse and her ongoing work as a design educator. Their firm, HED, seeks creative solutions that have a positive impact for its clients, the community, and the world. Since its founding in 1908, HED has earned a reputation for excellence in all facets of the designed and built environment, including architecture, consulting, engineering, and planning services. The firm of 420 people serves clients in a broad range of market from eight U.S. offices.

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