Saddleback Memorial Medical Center (SMMC), located in Orange County, one of the highest growth areas in California, is a 1970s-vintage general acute care hospital with some unique demographic adjacencies that significantly influenced the design of the 55,000-square-foot Meiklejohn Critical Care Pavilion addition. The hospital's immediate neighbor is the large senior community of Leisure World. Although SMMC also serves the young families that comprise the largest segment of the population in the surrounding new communities, the Leisure World geriatric population has always been a major force in shaping hospital services.

Project category: New construction (completed July 2002)

Chief administrator: Stephan B. Giedt, CEO, (949) 837-4500

Firms: Taylor & Associates Architects, (949) 574-1325; Questar Engineering, Inc., (949) 723-9440

Design team: Linda Taylor, AIA, ACHA, President; Randy Regier, AIA, Principal-in-Charge; Damon Barda, AIA, Associate; Terry Devine, AIA, Interior Designer (Taylor & Associates Architects); Jim Salomon (Questar Engineering, Inc.)

Photography: Assassi Productions

Total building area (GSF): 55,000

Construction cost/sq. ft.: $313

Total cost (excluding land): $26,000,000 (total project cost)

The new Critical Care Pavilion was designed to provide intensive care and emergency services for the entire community, but with a special consideration for the needs of the elderly. The first-floor Emergency Care Unit (ECU) is more than double the size of the old ECU, primarily to include a 10-bed, 23-hour-stay unit to accommodate the high volume of cardiac observation patients. The unit is designed such that the various levels of acuity are separated but in close proximity, to allow flexible overflow and overlapping visual supervision from local nurses’ stations and the central command hub. A dedicated elevator provides direct access to the rooftop helipad and the ICU on the floor above.

The Intensive Care floor is comprised of two 11-bed units, including four isolation rooms and a shared service core accessible from both units. Because site constraints dictated a square building footprint, three of the patient rooms in each unit could not be located on an exterior wall. The design incorporates a large band of clerestory windows above the nurses’ stations that effectively flood the interior core area of each unit with controllable natural light. The resulting effect is a tight triangular unit that minimizes nursing distances yet achieves the desired light and open feeling that promotes health and well-being for patients, staff, and visitors.