The Vista Award recognizes teams that have worked together to develop and maintain safe, quality health care environments; demonstrate effective and efficient communication; and rely on data-based decision-making processes. The VCU Health project received a Vista Award in the renovation category, which means the organization altered existing conditions or added new space to existing structures while keeping the original building envelope essentially intact.

HKS served as the architect on the project, while Barton Malow served as the construction manager. Additionally, ccrd, a WSP | Parsons Brinckerhoff company, designed the mechanical, electrical plumbing, fire protection and low voltage systems, and Dunbar, Milby, Williams, Pittman & Vaughan was the structural engineer. All four companies have local offices in Richmond.

The approximately $36 million renovation of the VCU Health Emergency Department (ED) encompassed more than 67,000 square feet of space on the main hospital’s ground floor. Updates included air-handling units that were added to accommodate the most recent code requirements as well as electrical and telecom rooms that were added in the early portions of the phasing to allow exam rooms to come online as they were completed. A pandemic exhaust system was also added to allow the entire department to go to negative pressure in the event of a mass infection.

The project was completed in four major phases that spanned five years. Two major challenges for the team included renovating the emergency department — which remained in operation 24 hours a day — with minimal disruption while keeping at least 65 exam rooms available at all times.

"The renovation and expansion of the VCU emergency department required the project team to keep the facility fully functional on a 24/7/365 basis," said David Wright, senior vice president for buildings at WSP | Parsons Brinckerhoff, in a statement. "Our complex staging plan enabled the facility renovation and modernization of major building systems to be completed with minimal disruption to ongoing operations."

The team worked with hospital and emergency department leaders on the phased plan, but halfway through the project, hospital leadership requested a change in the phasing priorities that required a more complex phasing plan. Through strong and effective communication, the team was able to meet this request, and the updated plan allowed the renovated imaging department to open almost a year ahead of schedule.

“The completed project is reflective of the input from more than 300 doctors, nurses and staff of the ED, in addition to hundreds of other doctors, nurses and staff that interact with the ED on a daily basis,” said John Duval, VCU Health CEO, in a statement. “It was a truly collaborative effort that reached across the entire health system and whose completion exceeded all expectations.”

A post occupancy evaluation reviewed the functional performance of the space through the triangulation of staff and expert perception, operational data and environmental analysis, according to a statement from HKS. Staff turnover decreased by 36 percent in the adult emergency department. The addition of handrails in exam rooms also led to a decrease in patient falls, with no patient falls that can be directly attributed to the building.
 

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Entering the last stretch of construction on the new patient-care tower for John Dempsey Hospital marks a milestone for Bioscience Connecticut, the state’s $1 billion plan to fund capital projects. The major initiative, which launched in 2010 and stretches into 2018, is intended to make Connecticut a worldwide destination for biomedical research and health care.

The 11-floor, 169-bed patient tower includes key patient areas such as the emergency department, surgery suites and inpatient rehabilitation space. The $318 million building also includes a 28-bed ICU and a public garage with 402 spaces. The tower is scheduled for occupancy in early 2016.

In addition to the new tower, the hospital is spending $163 million on hospital renovations. Those include replacements and upgrades to the HVAC, plumbing and electrical systems. Improvements will also expand the cardiology center, pharmacy and pathology labs. Four vacated hospital floors for clinical support and translational research will also be renovated.

Dallas-based HKS and Boston-based Steffian Bradley Architects are providing design services for the hospital. The designers are incorporating best practices for stability with the aim of achieving a minimum of LEED Silver certification.

Construction planned for the Bioscience Connecticut project also includes the new 300,000-square foot UConn Health Outpatient Pavilion, scheduled to open in January, and the 189,000-square foot Jackson Laboratory for Genomic Medicine, as well as research lab renovations and changes to academic buildings.

The new outpatient building will relocate outpatient services that are currently housed in the Dowling South and Dowling North Medical Office buildings. It will also add 60,000 square feet for new clinician scientist recruits, as well as patient-centered services such as a café, healing garden and retail space.

The Bioscience Connecticut projects to date have created more than 2,600 construction jobs with 81 percent of the contracts awarded to Connecticut companies, an accomplishment that Gov. Malloy had envisioned would reinvent the local economy.

“This is a proud day, not only for the thousands of hard-working men and women who have spent the last 18 months building this facility, but for our entire state,” Malloy said during the topping off ceremony. “Bioscience Connecticut has always been about the future, about what kinds of industries we want our state to be a leader in. The progress being made here is a brick-and-mortar example of what we can do when we pull together and make the tough decisions that will benefit our state over the long term. We are not just making investments, we are seeing results — results that over the long term will mean good-paying jobs with good benefits in an industry that is poised for growth throughout the 21st century.”

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The color aesthetic for most of the 1 million-square-foot hospital, including inside the 384 patient rooms, is soothing and earthy with paintings of native North Dakota flowers. One of Sanford Health’s highest priorities was to ensure each room is bathed in natural sunlight, and the X-shape of the building will allow each room to have an unobstructed view of the sprawling 100-acre campus in southwest Fargo.

“Natural light can be such a powerful tool in the healing process and in promoting positive well-being of patients, staff and guests. We optimized the size and placement of the windows in the lobby’s design to allow for maximum light,” said Paul Richard, the medical center’s president, in a statement.

With a nearly $500 million price tag, Sanford Health has spared no expense in adding distinctive gothic features that characterize all of its properties. The health system paired up with Dallas-based architects HKS and construction company Mortenson in Minneapolis to design and build the expansive Fargo facility. The hospital’s lobby area covers 4,000 square feet and rises to a dramatic 44 feet at its highest point. Reception houses a grand piano next to a main lobby, gift shop, chapel and dining areas. Public seating is on the first floor, and surgery waiting areas on the second and third floors feature views of the lobby below.

While the hospital’s entrance is grand in scale and style, the 345-square-foot patient rooms have been designed to feel cozy and comfortable. Labor, delivery, recovery and surgery rooms will include a family area, complete with sleeper sofa for overnight stays. Patients won’t have to hear rolling laundry carts go by, as a linen pass-through system similar to modern-day laundry shoots will be included to minimize patient disruption.
“Designing a new medical center from the ground up is an extraordinary opportunity to do things right for our patients,” said Kelby Krabbenhoft, Sanford Health president and CEO, in a statement at the time of the project’s 2011 announcement. “This project and other system developments around the world are a credit to the vision of past and current boards, and the administrations of our legacy organizations and all of our staff involved today. They deliver on the promise we made to expand health care, research and education as well as employment and economic benefits.”
The giant campus is being built to allow for future expansion, and patient rooms have been designed to be flexible and adapt to changing services over time if necessary. Each patient room, with the exception of the labor, delivery and recovery rooms, is the same size to allow for smooth transitions.
Sanford Health plans to staff more than 7,000 employees at its Fargo medical facility. The health provider has poured more than $600 million into improving its facilities throughout northern Minnesota and the Dakotas.

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“The celebration today is a testament to the excellent job of the project team in delivering a top-notch facility ahead of schedule,” said Stephen Powell, consultant for project manager CBRE Healthcare at the ceremony. “For a project in northeast Ohio to be able to say we made it through this past winter two weeks ahead of schedule, and still beat cost targets, is a testament to the process and team we have in place.”

“It is so great to see the building take shape on our campus after all the months we spent planning it,” said Grace Wakulchik, chief operating officer at Akron Children’s Hospital. “Everything about the building is so well thought out and it is all about providing the best care to our patients and their families.”

One of the largest pediatric hospitals in the country, the Akron Children’s Hospital manages more than 700,000 patient visits annually. Upon completion, the $200 million, seven-story addition will house the hospital’s new emergency department, as well as an outpatient surgery center. A 100-bed neonatal intensive care unit and new labor units will also be added to provide additional care for those with high-risk pregnancies. Crews will connect the new addition to the existing facility February 2015, and the structure will welcome its first patients later that spring.

HSK Architects and Hasenstab Architects worked jointly to design the new facility, which is being constructed by the Boldt Company and Welty Building Company. The project team also includes civil engineer Environmental Design Group, MEP engineers CCRD and BWK, and structural engineer Thorson Baker. Mitchell and Dynamix Engineering will provide medical equipment and technology respectively.

To deliver the facility in an efficient manner, the design and construction team used an integrated project delivery method that involved the entire team from onset of the project. This method also allowed the building’s future users to provide input during the design process. Hospital staff and patient families were even invited to weigh in on potential furnishings for the new facility to select the most comfortable and functional options.

Two hundred past and current patients were also integrated into the addition’s design through the hospital’s Graffiti Project. This project honored patients, who were nominated by the hospital community, by spray-painting their names on the facility’s concrete slabs. As construction progresses, the names will be covered by the building’s exterior but will remain with the structure.

"As Akron Children’s grows to meet the current and future needs of children and their families, it was important to us to keep our patients at the heart of it all," said Gretchen Jones, director of principal giving for the Akron Children’s Hospital Foundation. "Our patients’ names will forever be a part of our new building and they will continue to inspire us as we serve them and other families."

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The firm, which is serving as contractor, has worked closely with project subcontractors and architect of record HKS to collaborate on the $297 million project. Both Brasfield & Gorrie and HKS hold local offices in Orlando, Fla.

“Collaboration is an element of IPD in which the contractor and the subcontractors work together with the designers through the design phase so the end result is a product that is achievable, is buildable and all the while we’re providing real-time estimates and budget updates to ensure the owner that we’re staying consistent with our financial responsibilities,” said Jerry Whitfield, senior project manager with Brasfield & Gorrie, in a statement.

The project consists of the 10-story, 300,000-sqaure-foot North Tower, the five-story, 100,000-square-foot south expansion and 100,000 square feet of renovation. The project team recently celebrated the topping out of the North Tower.

According to Brasfield & Gorrie, the IPD delivery method improves construction efficiency, risk management, and the predictability of cost and schedule. The construction project has implemented detailed phasing due to the sites urban setting and close proximity to the existing hospital, which continues to operate daily.

“This approach invited everyone to the table early on to map out the construction strategy, thereby increasing transparency and enabling us to provide Orlando Health with realistic cost projections at the start of the project,” said Ren Tilden, operations manager at Brasfield & Gorrie, in a statement.

Currently, all project subcontractors on the project are working in a warehouse near the jobsite in order to work alongside the project team to increase collaboration and maintain strong communication.

“The best outcome of this process is that it is enabling us to deliver a building that satisfies the expectations of our client while deepening trust and support between contractors and subcontractors,” Tilden said.

This is the third IPD health care project for Brasfield & Gorrie. The firm has also implemented IPD in past projects including the Texoma Medical Center in Denison, Texas, and the Spring Valley Hospital in Las Vegas.

Construction on the Orlando Regional Medical Center is expected to complete in late 2014.

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The MIBG treatment targets cancer cells directly and avoids collateral damage to other parts of the body that can occur during traditional therapy. Because of the high volume of radiation transmitted during the procedure, the patient is isolated from his or her family and friends during treatment, which can add anxiety and stress to the situation.

Brassfield & Gorrie based their design for the therapy room around this situation and gathered feedback from Erin and Stephen Chance, who had a son that was a patient at Children’s Healthcare of Atlanta. Previously, he had to travel to Children’s Healthcare of Philadelphia for these treatments because that was the nearest MIBG facility. The Chances worked with the construction team to develop a new design to make the experience more bearable. Televisions are included in each room, as well as three-way video and microphones, so the patient can see their family, talk to them and even play video games with them through the monitors.

Healthcare Construction + Operations News spoke with Tom D’Aleo, project manager at Brasfield & Gorrie, about the patient feedback and the experience designing for this new kind of patient experience.

Q: What kind of questions do you have to ask to get patient feedback that can then be incorporated into a design?

D’Aleo: Throughout the project the number one question was in regards to what can be done to make these two rooms — the parent and patient room — as comfortable as possible because both the patient and parent will be in the rooms for several days.

Q: What other aspects of design did you have to consider in terms of considering the patient experience for this project?

D’Aleo: HKS was the architect on this project and they were great to have on the team because this project was one that evolved throughout the construction process. One item that was taken into account during the planning stages of this project was how to create two adjoining rooms similar to a hotel room due to the fact that there was not enough space to have an anti-room. We used the existing patient room adjacent to the MIBG room as an “ante-room” and the parents’ room because during this treatment process the parent will be the person interacting most with the patient. During the treatment the patient emits radiation and others can only have limited exposure. We installed a lead-lined door between the parent room and MIBG room similar to what you see in adjoining hotel rooms.

Q: What was the biggest challenge on the project and how did you overcome those challenges?

D’Aleo: Space limitations were probably the biggest challenge because we had to work within the footprint of two existing patient rooms and convert one to an MIBG room and the other into an “ante-room” or parent room.

Q: Do you have any other pieces of advice for a professional designing a facility based on the patient experience?

D’Aleo: During the treatment, there are lead shields that need to be rolled into the room and placed in front of the doors, because the walls were lined with ¼-inch lead and the doors were only 1/16-inch lead. While this room is not being used for treatment, the heavy lead shields need to be stored somewhere, so having a storage closet nearby to store these shields and radioactive waste is something that needs to be considered. This is sometimes very hard to do while renovating due to space limitations.

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The fourth annual competition included 350 hospital nominations and brought a record of nearly 170,000 votes, more than double for 2011.

HKS had many projects on the list including the Miami Children’s Hospital coming in fourth place, Health Central Hospital in Ocoee, Fla., at seventh place, the University Hospital Ahuja Medical Center in Beachwood, Ohio, in 12th place and the Phoenix Children’s Hospital placed 20th on the list.

Jeff Stouffer, principal, academic and pediatric practice leader and principle-in-charge for the Phoenix Children’s Hospital, feels that the Phoenix Children’s Hospital was designed not as a hospital, but as retreat for healing.

“The goal of the project was to create a healing oasis for the children and families in Phoenix,” said Stouffer.

The addition of the building includes a large tower with four floors of clinics and seven floors of inpatient beds. The existing hospital had used bold colors, so HKS carried that concept to the Phoenix Children’s Hospital and brought all of the colors from the desert to the hospital, whether it was from plants or animals, or the surrounding environment.

“We were designing this for children of all ages, since most children’s hospitals treat patients up to 18 and 21; and so our goal was not to be childish, but to be child-like and to respond to people of all ages,” said Stouffer.

A statement piece within the hospital is housed within the atrium, and is a LED “waterfall” on a large concrete wall. Originally a real waterfall was to go there, but due to the possibility of diseases transferred through water, HKS created a waterfall of lights.

“We decided to create the feeling of a waterfall with LED lights, so we have LED lights behind acrylic panels, and they’re full spectrum so they can be adjusted to any color. It just became what I call the ‘Theatre of Lights,’” Stouffer said.

The Arizona-based Phoenix Children’s Hospital is one of the 10 largest children’s hospitals in the county and provides specialty and sub-specialty outpatient, inpatient, emergency and trauma care. The hospital offers 40 sub-specialty fields of pediatric medicine and has focused development on medical programs to build Centers of Excellence is neurosciences, cardiac services, neonatology, hematology/oncology, orthopaedics and level 1 trauma.

Each floor has a sculpture of a different animal to help with wayfinding. Rooms are all private rooms and have space for two family members to spend the night, along with space for laptops, Wi-Fi access, storage space and private bathrooms.

Construction was completed in 30 months, opening in 2011, with the clinics opening in January and inpatient rooms in the summer. The 800,000-square-foot project was delivered $48 million under budget due to economic factors as well as the HKS team reducing the overall cost and delivering the project under budget. In addition, the hospital was completed four months ahead of schedule with a total construction cost of $275 million.

HKS Delivers More Winning Designs
Among the list of winners was the Health Central Hospital in Ocoee, Fla. The hospital began in 1952 as the West Orange Memorial Hospital in Winter Garden, Fla., and served the community’s maternity, surgical and general health care needs. In 1993, West Orange Memorial closed and re-emerged as Health Central Hospital in the new location of Ocoee, and now provides 440,000 square feet of space including a cardiac care unit, an inpatient and outpatient rehabilitation center, surgery center, pediatric care unit and more.

University Hospital Ahuja Medical Center (UHAMC) was also awarded recognition on the “Top 20” list for its design. Shannon Kraus, senior vice president at HKS Architects and lead designer for UHAMC believes that the hospital is certainly deserving of being on the prestigious list.

“We didn’t aim to be the most beautiful facility, we aimed on creating a relaxing environment that helps disarm stress when you drive on to the site; something that connects you with nature and that promotes healing. And I think it’s in that, that it became a beautiful facility,” said Kraus.

The UHAMC came to the greater Cleveland, Ohio area to provide specialized medical and surgical services to the community. UHAMC was built in response to an aging population lacking convenient access to services such as inpatient, outpatient, and emergency services in the area.

Located near wetlands, building the facility proved to be an asset to HKS, not a challenge.

“We took a site that had a fair amount of wetlands on it and worked to not only protect the wetlands but we really embraced them as part of the natural feature of the project. And so we worked to balance function with form in a way that we can connect the public throughout the hospital with nature, to bring the outside in,” said Kraus.

Overall, the project was one of great success in terms of design and construction, and the idea of patient healing was also achieved, according to Kraus.

“When you can balance function — integrating hospitality with health care — that’s when you can really create places that help with healing, that help reduce stress and help improve outcomes,” said Kraus.

The 375,000-square-foot hospital features a fertility center and specialized services in urology, orthopaedics, digital radiology, infectious disease and more. Construction lasted approximately three years and resulted in a 375,000-square-foot hospital with a 60,000-square-foot office building.

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