Elizabeth Seton Pediatric Center’s New Facility Emphasizes Home
The new Elizabeth Seton Pediatric Center campus in Yonkers, N.Y., co-locates the services and programs for the treatment and long-term care of medically fragile children while providing outreach programs to the community. Designed by Perkins Eastman and achieving LEED Silver certification, the 165,000-square-foot, 138-bed pediatric facility has an overarching goal of providing a homelike and stimulating experience for its residents.
According to Elizabeth Seton CEO Pat Tursi, the need for a new building was twofold: “The building we were in, located in Chelsea in lower Manhattan, was being sold. In addition to that, however, the space we were in wasn’t meeting the needs of the children, each of whom has multiple chronic illnesses. It was built for a much lower acuity level than we were actually serving, and it was more of a custodial model than what we wanted or needed from a clinical, social, and developmental standpoint.”
The facility wasn’t pressed for bed space; in fact, the new building adds only one more bed. But the previous space was just 90,000 square feet, woefully inadequate for the patients’ specialized needs.
With real estate costs in New York City proving to be prohibitive, the search for a new home eventually led north to Yonkers. “The choice was resource driven,” says Tursi.
“If we had all the money in the world, we would have built in the city, but you just can’t find affordable real estate on the level we needed at this point, even in the outer boroughs, because we tried.” The chosen site was a 1950s golf course, a brownfield site that required significant cleanup but wound up being ideal.
“We wanted the children to have the full experience and joys of childhood,” says Tursi. “We have loving and dedicated staff and great kids, but we were lacking the physical environment to enhance that and bring it to a different level. We were able to create a space that would hold all of the creative and innovative ideas for the kids to thrive and grow and ultimately to reach their developmental milestones.”
That vision was achieved through a plan that embraced culture change within the facility. “We spent a lot of time investigating best practices and evidence-based design ideas, as well as speaking to kids and parents,” says Perkins Eastman’s David L. Hutchinson, AIA. “We really got to know this population. This is a residence for most of these kids, and we wanted to make sure we reflected that in the design.”
The center of each of the three residential floors is mainly offices and therapeutic rooms. Two V-shaped wings come off of that clustered core; each wing is considered a “neighborhood,” housing 48 residents each. “Each neighborhood was named after a prominent New York City park, including Ellis Island Park, where all new admissions go for evaluation,” says Rob Messina, director of facilities at Elizabeth Seton.
Emphasis was placed on the design of the bedrooms, family rooms, play rooms, and destination spaces on the individual floors. These spaces and the way they’re incorporated are, according to Tursi, the key to delivering that homelike feeling.
“In the family rooms and play rooms, there are all sorts of different activities happening with all sorts of different people, just like in your own house,” says Tursi. “You might have someone doing homework, another person having a snack, and someone else watching TV. These spaces really reflect that, and they’re the core of each neighborhood.”
These spaces also allowed therapy to be brought to the children, rather than disrupting their day by having them leave their school classrooms—where more than 75% of the children spend their days from 9:30 to 3—to travel to sometimes distant therapy areas.
Utilizing a universal design concept, the bedrooms have either multiple bed or private suite layouts and accommodate all acuity levels to promote flexibility in resident placement. “The idea behind the geometry of the floor was that we wanted as few children as possible, but large enough to make for an efficient child/staff ratio,” says Nancy Bullock, Project Director at Elizabeth Seton. “The building block is a four-bedded room, unlike what you would find in an acute-care hospital, where private rooms are the norm. We wanted and needed visual and auditory access to four children at once, not just for nursing staff, but for other specialized caregivers, as well.”
The four-bedded room design resembles a four-leaf clover, with each leaf feeling like a single room, with a drop ceiling, privacy curtain, and individualized ceiling designs.
“Everything was built along that four-bedded design because we knew that we didn’t want kids left alone,” says Tursi. “With our staffing ratios and the acuity of the patients, I can have one RN and four children in a room and they would never be by themselves. Acute care is short term; a child will be there for a relatively short period of time, and most times, the parents will be there with them for the entire length of stay. But most of our kids are here long term, and the family simply cannot be here 24/7.”
There are no centralized nursing stations at Elizabeth Seton; nurses do their work in the family rooms and other common areas, as well as in the patient room, adding to the community feel of the building and supporting the important connections between the children and staff. “We never had traditional nurses’ stations in the old facility,” explains Tursi, “but there was always a gathering space, so to speak. The change here is that now that gathering space incorporates children at the same time.”
Charting is still an issue, but a planned transition to electronic medical records will help, as there are already a number of touchdown stations in place around each neighborhood, both inside and just outside of each resident room, and tucked into various other nooks and crannies around the space. There is also a “team office” in each neighborhood intended for private meetings when necessary.
Every design aspect is meant to support a better life and clinical outcome for the residents. From ceiling decoration to coordinated flooring textures, all design decisions were driven by the child’s capability to positively engage with his or her surroundings through sensory perception.
For example, as children are transported, their heads are typically reclined, making ceilings the primary visual event. As a result, fanciful ceilings and lighting patterns became important design features.
“It became very clear that we needed to approach these kids from a sensory perspective in order to have this environment actually heal and help them,” saysHutchinson. “Understanding that the children’s vision is often compromised, as well as their ability to communicate, we needed to communicate through color, lighting, and textures.”
Additionally, the design team developed a color scheme that mirrored psycho-physiological visual development. As yellow is the first identifiable color by an infant, the babies’ floor emphasized yellow. And as violet is the last identifiable color by a child, the older children’s floor emphasized violet. Upon entering the main elliptical-shaped lobby, these colors progress through the spectrum, from front doors to elevators and up to the floors.
While a post-occupancy evaluation survey is currently under way, the staff has already observed a distinct change in the children, reporting that they’re more attentive, they sleep and eat better, and self-destructive behavior is almost no
nexistent. And of course, there are lots of smiles.
“The word that seems to come up when we talk to the parents and families about the new space—and I know this will make the architects cringe—is that this is Disneyworld to them, and I think that fits,” says Tursi. “Not in that it physically resembles an amusement park, but there is magic captured in this building.”
Completion date: February 2012
Owner: Elizabeth Seton Pediatric Center
Architecture: Perkins Eastman
Interior design: Perkins Eastman
Contracting: (see ‘Construction’ below)
Engineering: Jaros Baum & Bolles (MEP & Lighting); Langan Engineering and Environmental Services(Geotech); Goldstein Associates Consulting Engineers (Structural)
Construction: Construction Manager, Andron Construction
Medical Equipment: Shen Milsom & Wilke
Photography: Chris Cooper (Interior Photography); Sarah Mechling (Exterior Photography)
Total building area:165,000 sq. ft.
Total construction cost:$75,000,000
Cost/sq. ft.:$454.54/sq. ft.