As we continue to grow in our understanding of the role that the built environment plays in the healing process, architects and caregivers need to work together to support the health and well-being of patients and of the providers who care for them. As we understand more and more about the subtle dimensions of wellness and healing, architecture and interior design are responding with environments that are more sensitive, not only to the physical well-being of patients, but also to their emotional and psychological well-being.

Stress and anxiety can prolong the healing process and sometimes can contribute to further illness and disease—thus, the healthcare setting should not contribute to the patient's stress or anxiety; instead, it should reduce the stress and anxiety often associated with a visit to the clinic or a stay in the hospital.

We worked with Boone County Hospital to expand services, improve patient accommodations, and maximize operational efficiencies while supporting the well-being of patients, families, and caregivers. New cardiac rehabilitation, respiratory therapy, surgery, outpatient and inpatient recovery, dining/cafeteria, emergency services, specialty clinics, radiology, laboratory, ICU, and birthing departments were added to the hospital.

Patient rooms were renovated to make them accessible, and they were all upgraded, from double occupancy rooms with a toilet and sink to private rooms with a full bath. The remodeling was coordinated and phased to maintain services and minimize disruptions. To facilitate traffic flow and create efficient access for patients and families, site circulation was revised, and a rooftop helipad with interior access was added.

The entry vestibule/reception area has a low ceiling, supporting a sense of arrival and containment—promoting feelings of safety and reducing the sense of being overwhelmed and disoriented that is common in healthcare facilities. While in this more intimate space, the patient or visitor has an opportunity to visit the gift shop and ask for assistance at the reception desk. Beyond the reception desk, the path opens into the spacious, daylight-filled atrium, which offers clear views of major destinations within the facility and overlooks a healing garden. The atrium connects the new facility with the existing facility and serves as a gathering and orientation space.

The design supports caregivers, offering a more efficient environment in which to work. All patient rooms can be monitored from a single station. Caregivers have instant access to needed supplies and equipment in patient rooms, yet patients and families are not overwhelmed by a room that is full of medical equipment.

Project category: New construction & Remodel/Renovation (completed August 2000)

Chief administrator: Joseph Smith, CEO, (515) 432-3140

Firm: Horty Elving, (612) 332-4422

Design team: Leo Monster, COO; Chris Colantti, AIA, Project Architect; Linda Engel, CID, Project Interior Designer

Photography: Dale Photographics

Total building area (GSF): 49,235 (new); 17,881 (renovation)

Construction cost/sq. ft.: $121 (renovation and addition)

Total cost (excluding land): $8,150,787