The Carolinas Medical Center campus looked pretty rigid before the Levine Children’s Hospital project came along; leadership looked to Columbus, Ohio-based firm Karlsberger to help lead them to a new place. Bookended by two existing towers, the new 234-bed, 240,000-square-foot facility is a colorful, lively, yet sophisticated building that helps to establish a new brand for the hospital while maintaining ties to the existing structures. HEALTHCARE DESIGN Managing Editor Todd Hutlock spoke with Karlsberger Vice-President and Project Architect Mark Hollern, AIA, and Vice-President and Director of Interior Design Susan Long about the project.

Mark Hollern: Charlotte is a very dynamic, growing town, and we wanted to draw on that. The vision buzzwords were “progressive,” “sophisticated,” “evolving,” “dynamic,” “high-tech,” and “vibrant.” We evolved these ideas further into the prismatic theme, which is carried through all aspects of the building.

On the exterior, the “fins” are made of a dichroic laminated glass that changes color as one moves around the building. The fins alternate between red and green dichroic films to vary color from as many angles of viewing as possible. The skylight on top of the building also has this dichroic film, and the sign in front of the building contains dichroic glass, as well. Dichroic glass is also featured in the chapel, the donor recognition pieces, and the second- and third-floor balconies. The main commissioned sculpture in the lobby is made from prisms. It distributes a subtle refraction of light without overpowering.

The terrazzo floors have mirrored chips in them, so the light bouncing off of them reflects back in a subtle way.

Susan Long: In the lobby, there are also some twinkle lights off the elevator on the vertical wall that have a nice little sparkle. A similar light is used on the soffits throughout the space.

As you move around the building and as the day goes on, the natural light that enters the building shifts and moves and the colors will diffract and change with that movement. It is important for a pediatric space to be dynamic, for patients and for staff, and the shifting colors add a little sense of discovery to the building that keeps it fresh. The transparency of the building is also important, as all the natural light entering the building really helps maintain a connection to the outdoors for patients and for staff. The lighter value of the paint colors helps to pull the light in, as well.

We knew the fins would throw light, but we didn’t know how much light they would throw, so it was a pleasant surprise to see how much color would enter the patient rooms. The fins also throw light on the outdoor terrace.

Hollern: Carolinas Medical Center wanted to focus on the children’s hospital as a Center of Excellence. They didn’t want it to outshine the rest of the hospital, but it needed to be different and show progression. To the left of the children’s hospital is the Dickson Tower, the main entrance of the building. Some of the precast elements of the Dickson Tower were brought into the new building, and as your eye moves around the building, you can see it evolve and change, then move into the other existing tower, as if they are bookends. We often referred to the Dickson Tower as “The Grandfather” and to the new building as “The Grandchild.” We did want to maintain unity, however; for example, the same bluish-green tinted glass is used throughout.

Hollern: The blue canopy is the main entrance to the children’s hospital, next to the main entrance of Dickson Tower. On entering the building, the atrium space leads visitors around to elevators; there is a wall graphic around the elevators with large scale glass marbles that differentiate the children’s elevators from the adult elevators.

The second floor has administrative functions, the family resource center, and the chapel. The third floor is outpatient diagnostics. Some of the lighter functions, such as MRI or ultrasound are located in the children’s hospital, but heavier functions are in the adult portions of the hospital.

The fourth floor is a rehab unit, and the fifth floor is outpatient surgery. Sixth floor is critical care; seventh floor is NICU. Floors eight through 11 are the med/surg and progressive floors. These floors typically contain 20 beds with four observation beds to allow for future growth.

Long: We made sure that we didn’t use any age-specific designs or complicated themes. We wanted to make the space pleasant for all patients regardless of age, but also for the staff and families. The design is very simple with soft colors and gentle application. Many children’s facilities are designed with lots of colors, but that can become overbearing.

The artwork used throughout the building was selected from a child’s perspective. is age-specific geared toward the children. It brings in a variety of textures and themes. There was a collaborative approach to selecting the artwork between the hospital staff, Karlsberger, and a local art consultant.

Hollern: Our designers sat in on all the art committee meetings to ensure that the architecture and design elements weren’t being overpowered by the artwork. The floors were all divided into subthemes with appropriate artwork placed there.

Foundation Vice-President Michael Rose sold off one of the floors to the Carolina Panthers football team. We needed to ensure that their powerful image didn’t overpower the surroundings; luckily, that floor’s theme was “energy,” and our designer incorporated their needs, as well as the needs of the hospital successfully.

Long: Charlotte Parents magazine ran a contest with local children that resulted in more than 600 pieces of artwork. This allowed the hospital to place art in lots of areas that weren’t originally intended, such as staff corridors and lobbies. This really helped to bring the entire space together.

Hollern: The hospital made a conscious decision not to make patient rooms excessively large. That space was instead devoted to common areas; Levine has a strong Child Life program in place. If you look at a floor plan, you’ll see waiting rooms and patient rooms, but also large play space for the children.

The patient rooms are where the child can get away from the world into a “safe zone.” The rooms are divided into all the necessary spaces: a nursing zone, a parental area, and the patient care space in the middle. The rooms are comfortable, but aren’t oversized. There was still a 30% increase over the previous children’s spaces.

Long: We’re finding that even though the rooms aren’t as large as those in other hospitals we’ve designed, there are so many amenities that the families are staying in the rooms rather than feeling like they need to escape to other areas of the hospital.

It was important to provide adequate sitting and sleeping space for families and visitors, but we didn’t want the sleep sofa to be cumbersome to operate. To maximize that space, we worked with a furniture manufacturer in North Carolina to create a custom bench and sleep sofa. The sleep sofa doesn’t have any mechanical parts to convert the sofa to a larger sleep area.

Hollern: The colored LED lights in the windows, the patient room ceilings and the corridors, the colored fins, as well as the lights behind the fins and in the lobby really added to the goal of having the building be dynamic. One of the rituals for the children staying in the facility is “putting the building to bed” at night, and the lighting controls of the building help with this. This helps children feel more at home, where there is a similar ritual of bedtime being at a certain time every night.

Hollern: The first week after the hospital opened, I saw a child and his mother at the elevators, leaving a med/surg unit. The child was crying, and when we asked what was the matter, the mother responded, “He was just discharged and doesn’t want to leave!”

Long: Karlsberger did the architecture inside and out, the interior design, the signage and wayfinding, the furniture selection, and was involved in the artwork. Because we had a comprehensive team with the same vision and the same goals, it led to the success of the building. HD