Growth through ingenuity
In 1998, Condell Medical Center in Libertyville, Illinois, was a 70-year-old institution looking to change its image from a “rural hospital” to that of a regional medical center. For this to happen, Condell needed improved circulation for patients, staff, and visitors; greater operational efficiency; state-of-the-art equipment; and a building that would make people feel inspired and welcomed.
Condell Medical Center has been growing rapidly, with its Lake County market share increasing from 14% in 1991 to 29% today, and a 14 to 16% increase in occupancy every year for the past five years. A challenge for the architects was to preserve the hospital's rate of growth while completing an enormous construction project, which included the demolition of the main entrance. After a year of master planning, begun in 1998, it was determined that the best location for the expansion was directly on top of the existing entryway. This meant that the team needed to devise an alternative entry path through an adjacent building that would remain intact during construction. This temporary entrance accommodated a gallery of images of the future building, thus conveying the vision of the new hospital.
Another challenge was the need to construct entirely new department facilities without interrupting services. This was achieved by building additions and then moving entire departments into the new structures. The vacated space then became “swing space” for easily movable departments in the old building. For example, we moved a third-floor surgical suite from the old building directly to the third floor of the new one, and then occupied the old space with offices and a conference room. This space eventually became a laboratory for GI studies—illustrating the flexibility this approach allowed the hospital. Entire walls in the old building have been demolished or rearranged to accommodate changing space requirements.
Accommodating the old to the new created another design opportunity. In 1980, Condell constructed a major addition that matched the floor-to-floor heights of the adjoining bed tower built in 1956 (figure 1). This building used through-wall air conditioning units that did not require overhead ductwork, resulting in very restrictive floor-to-floor heights of 11 to 12 feet. Since the 1980 addition represented most of the existing useable square footage, the hospital decided that building ramps between it and our new building was not an option. The solution: Locate the ducts for the mechanicals in outside buttresses. The result was more duct shafts, with smaller ducts penetrating the building from the outside (figure 2). The ceiling space in the center of the building was then available for other systems. Elevator shafts and linen and trash chutes were also moved to the perimeter to allow maximum flexibility for the floor area.
The newly designed exterior of the building not only presented the solution to a complex problem, but it also became one of the strong aesthetic features of the building (figure 3). Another factor in creating this sculpted exterior was the use of precast concrete. The shafts are self-supporting, allowing more room for ductwork and serving as structural columns for the building. This meant that interior columns could be smaller to allow more usable space, and massive edge beams that often restrict expansion were no longer needed. Precast concrete also allowed the use of applied art; the decorative bands that surround the building are an overlay of an abstracted human figure and a pulse, symbolizing the health of the community (figure 4). The mechanical buttresses were designed as abstracted flower forms, with a leaf-shaped base and stem leading to a flower on top of the buttress (figure 5). In general, as long as the designs are repetitive, one can do almost anything sculpturally with precast concrete. This played into our firm's interest in merging fine art and applied art.
This synthesis is reinforced by the new hospital's interior. Upon entry to the Main Lobby, the visitor/patient is introduced to a three-story, light-filled glass atrium that distinctly curves, suggesting a path to follow (figure 6). The ambience of the Main Lobby is closer to that of a luxury hotel than a traditional hospital. Soaring height, sweeping lines, natural light and materials, and flowing water produce an atmosphere both of grandeur and warmth (figure 7). Within the Lobby, beneath the curved glass curtain-wall, is an intimate seating area. The lower ceiling height, rich textures of fabrics, and deep wood stains of the furniture are a backdrop for conversation or rest. The brushed-bronze elevators, monumental stairway, and information desk are also centrally located in the Main Lobby. All are designed with materials integrated throughout the hospital: maple and anigre woods, brushed bronze, stainless steel, and granite.
Hospital Registration is located to the right of the Main Lobby desk. Registering patients are led to the waiting area by a skylit path that looks out over a garden. All preadmission testing services, such as Phlebotomy, Radiology, EKG, and the anesthesiologist interview, take place in a single area adjacent to Registration. All testing rooms are universal for most efficient use and are served by dedicated elevators. Patients no longer have to travel throughout the hospital and risk getting lost several times to have their preadmission testing done. This centralized admission testing was probably the design feature that took the most time to implement. It involved several departments and required that some department members be convinced that this was a priority because it maximized patient convenience.
Directly off the Main Lobby corridor is the entrance to the Women's Center, which includes the first hospital-based spa in the state of Illinois, the “InnerSpa” (figures 8-10). Soft lighting, soothing colors, and three water features welcome the visitor and/or patient. The full-service spa was designed both to expand the public's view of healthcare and healing and to forge a greater link with the community. Condell's easily ac-cessible InnerSpa is open to the public, as well as to patients and staff.
In addition to traditional spa services, such as massage, manicure, and pedicure (figure 11), the InnerSpa offers cosmetic consultation to women who might suffer disfigurement from a medical condition, chemotherapy, or surgery (figure 12). Patients can now consult hospital experts about prosthetics or be fitted for a wig as part of a truly integrated healthcare program. Surrounding the spa are Women's Imaging, a Daycare Center, and Ob-Gyn physician offices.
Located just past the Women's Center is the Condell Café (figure 13). This combination coffeehouse and gift shop (figure 14) was positioned off the Main Corridor to take advantage of its heavy foot traffic.
The New Life Center (for labor, delivery, and postpartum infant and child care) on the second floor is linked to the Main Lobby by the atrium. The Center contains an activity room with television; children's play area with views overlooking the Main Lobby; and a cozy library complete with fireplace, bookshelves, and Internet connections. The birthing rooms are designed to make a mother feel as if she has checked into a luxury hotel (figure 15). Faux-wood floors, maple and dark cherry TV cabinet, curtains, and a convertible sofa for an overnight guest create a sophisticated, comfortable décor for each LDR/Postpartum Room. Quiet seating areas, located directly across from each birthing room, are provided for families of patients in labor and delivery.
Surgery is located on the third floor, with a waiting area that is connected to the Main Lobby via the three-story atrium. The waiting area (figure 16) has windows on three sides and offers an excellent view of the surrounding landscape. The surgical suite (figure 17) is designed around a sterile core that is directly linked to central sterile processing by an elevator that also serves the sterile core in the New Life Center operating rooms on the second floor. The surgery suite contains two state-of-the-art cardiac operating rooms to house Condell's growing open-heart program.
From concept through completion, our objective for the architecture and interior design was to serve the needs of the patient, the visitor, and the staff at every level. People visiting hospitals are under enormous stress—in some cases fighting for their lives or that of a loved one. What more important place could there be to provide efficient procedures, clear wayfinding, comfortable destinations, and easily accessible, quality care for the patient and visitor? HD
Robert A. Pratt, AIA, is principal of Pratt Design Studio, Ltd., Chicago.
Healthcare Design 2003 November;3(4):44-51