As the board of Phoenix Children's Hospital searched for a site where they could build their new facility, they discovered an existing hospital that had been closed and in need of great repair. Realizing that renovation would allow them to move more quickly, they decided to purchase the site. The old hospital, though, suffered from a haphazard array of one-story additions of varying construction quality, a hodgepodge of patient units, an absence of simple wayfinding assistance, and a pervasive mold problem. The designers who were charged with renovating this structure-from Karlsberger Companies, based in Columbus, Ohio-faced difficulties they had never contemplated, but in the spring of last year there emerged, in the very same building, a care facility with features to delight all age groups. Recently Joseph A. Kuspan, AIA, vice-president and senior architectural designer, and Linda M. Gabel, IIDA, senior associate and director of interior design, recollected the challenges the project team faced and the inspiration they experienced in bringing a near-dead hospital back to life.

Project Summary

Client: Phoenix Children's Hospital

Architecture: Karlsberger Companies

Photography: Gary Knight + Associates, Inc.

Completed: April 2002

Total Building Area (gross sq. ft.): 38,040 (new); 351, 987 (renovation)

Total Cost (excluding land): $39,300,000

Cost per Square Foot: $101


Kuspan: “There were some ghastly things wrong with this building. Because various wings had been added over the years with no master plan, there was a mix of structural systems, with bearing walls that are not found in modern hospital construction. All of the corridors were ‘plain vanilla,’ with little in the way of wayfinding assistance.”

Gabel: “There was a lot of mold uncovered during the initial construction process, reducing the budget for interior design dramatically.”

Kuspan: “There was so much of this that we would have revised the floor plan completely if we had known about it. As it turned out, we had to rebuild the affected areas and do more painting and VCT [vinyl composition tile] flooring than we had anticipated.”

Gabel: “It was surprising that there was no energy conservation for a building in an area so affected by the sun's heat. We used an exterior solar-shading system, known as ‘eyebrows,’ as well as window detailing and other measures, to bring the building up to modern standards of energy efficiency.”

Kuspan: “Colors were taken from the Phoenix environment: green from the palo verde tree, yellow from the cactus blossom, blue from the desert sky, and turquoise/jade in reference to Native American jewelry; red and purple were the existing logo colors for the hospital. Various color schemes were actually tested by a San Diego company called Sensory Logic, which hooked up electrodes to people at shopping malls to test their reactions to computer-generated models. Perhaps not surprisingly for the Phoenix area, people preferred the cooler palette of blues and greens, as opposed to reds and oranges. However, the use of red in some of the exteriors and entrances does identify the hospital.

“The saguaro cacti are actually flagpoles designating various entrances. Schoolchildren in the area design flags for them, and the flags will be changed periodically.”

Kuspan: “The public spaces were designed to be fun and exciting for kids. In this public entrance area, there is always something slowly changing-the position and color of the lighting, the water feature, or the light through the low, horizontal windows that only kids can peer through. This is not a huge atrium; it's a 45-foot-high ceiling, 25 feet square, but it's pierced with slit windows with different color film over the glass, changing the color of the sunlight as the sun passes overhead; there is also an occasional reflecting effect from the water feature which, frankly, was a happy accident.”

Gabel: “In the dining area we used playful colors for the chairs, again with the horizontal windows scaling the walls down to kid size and breaking up the sunlight. There is a waterfall to the left, and the green wall to the right is along the entrance to a play area.”

Gabel: “Because of the odd nature of the original construction, we found we had a large concrete bearing wall running down the middle of the concourse. This was at a major intersection between the bed tower and ancillary services and saw a great deal of cross-traffic. We wondered, for a while, what to do about this. Our solution was twofold: We decided to perforate the wall at its nonbearing points, to make it resemble mission architecture, and on one side we installed a ‘howling coyote’ sculpture, which can be approached from all sides. This sculpture was actually made by a local artist from old toys pressed together and shaped into the coyote form.”

Kuspan: “Our idea here was to stop people at this major intersection, in an out-of-the-way area, and give people something to look at. Meanwhile, in the dining area we continued the pueblo wall idea as a fence that doesn't look like a fence. Each of the perforations contains color tiles and other items that looking for and touching might amuse kids.”

Kuspan: “The circulation path of the concourse is only eight feet wide, but it feels wider because of all the spaces opening onto it. A lot of thought went into how to design the walls and what to put into them. We have a series of artwork elements (marked by the blue frames) all the way down the hallway, including a fiberoptic diorama of the desert landscape and a kinetic horse race sculpture, and ending with an interactive tic-tac-toe game in the waiting area.”

Gabel: “It's a push-button game, and it's intended to keep both kids and families occupied.”

Gabel: “The NICU [Neonatal Intensive Care Unit] was designed with a serene palette of colors, with amorphous, cloud-like forms on the ceiling and individual stars shining down on the isolettes. A garden is visible through a large window to further help soothe the parents. Acoustic ceiling, floor, and wall materials were used to quiet the unit.”

Gabel: “The entrance to the PICU [Pediatric Intensive Care Unit] features bright colors and patterns from Native American textiles for wayfinding and orientation, as well as views to courtyards outside.”

Kuspan: “The PICU [indicated by the exterior green wall] was newly constructed, with a palo verde tree nearby and a formerly straight sidewalk with some eye-arresting curves built into it. Each PICU room has a view, with this one looking out at the glass connector, providing a sense of openness to nature for a relaxing effect.”

Kuspan: “This water feature alludes to the washes one sees in the Arizona desert. In the background you can see the saguaro cactus flagpoles and the entrance canopy for the emergency department. Beneath the flags is a newly created, vehicle-free pedestrian plaza connecting the ambulatory facility and the hospital. We used just about every color in our palette for this area.” HD

For further information, e-mail lgabel@karlsberger.com or jkuspan@karlsberger.com, or visit http://www.karlsberger.com.

Healthcare Design 2003 May;3(2):46-54