Starting With Hospitality
Completion Date: August 2008
Owner: PeaceHealth, Springfield, Oregon
Architecture: Anshen + Allen
Hospitality Design: WATG
Contracting: Turner Construction
Lighting Consulting: Kevan Shaw Lighting Design
Civil and Structural Engineering: KPFF
Landscape Architecture: Murase
Mechanical Engineering: Affiliated Engineers
Electrical Engineering: Sparling
Photography: David Wakely; Cesar Rubio Photography
Total Building Area: 1.2 million sq. ft.
Total Construction Cost: $350 million
Cost/Sq. Ft: $291.67
Everyone pretty much agrees that the ingredient that makes modern healthcare design “modern” is hospitality. Starting with attractive exteriors and moving through warm, comfortable public spaces and all-private rooms, architects and interior designers have focused on achieving the feeling of a well-appointed hotel, if not home. And yet, how many hospitality design firms have been involved with these projects? Quite conceivably, PeaceHealth's just-completed Sacred Heart Medical Center at RiverBend in Springfield, Oregon, was unique in signing on with an experienced hospitality designer-a creator of resorts and hotels throughout the world-in developing the design for the new facility. Indeed, the hospitality design firm WATG and its lead designer at the time, Ron Mitchell (who now has his own hospitality design firm, called “think,”) were on board with the project even before the architect, Anshen + Allen of San Francisco, signed on. What prompted this? How did the collaboration work? What are some of the highlights of the finally realized design? All of this and more are addressed by Mitchell, Anshen + Allen's Principal Todd Tierney, and Jill Hoggard Green, Chief Operating Officer, PeaceHealth Oregon Region, in this guided tour through the project.
Green: At PeaceHealth we focus on our patients and families, and we spent a lot of time prior to this project finding out what they wanted. They said they wanted something that reduced stress, a more peaceful environment. In healthcare we often talk about taking an interdisciplinary approach, and we thought, why not go to a hospitality design firm that knows how to create environments like this, and learn from them? There are a lot of things that you can't implement in healthcare, but there's a lot more that has never been considered historically.
Mitchell: PeaceHealth was actively looking for a hospitality design firm to work with in designing its Sacred Heart project, when I was opening up a Seattle office for WATG, the largest hospitality design firm in the world. PeaceHealth retained me for two days a month to work with the board of directors on design issues. What I've done in my work in countries all over the world is try to create environments that lift people's spirits. Achieving that has been a PeaceHealth goal in designing this project. It came to a point, though, where I said I can only take you so far, I'm not a healthcare designer, and PeaceHealth initiated the search that led to Anshen + Allen signing on.
Tierney: This was a very odd pairing of firms and the first couple of months were a little rocky as we got to know and understand each other. But our firm viewed this as an ideal opportunity to broaden our knowledge base, and Derek Parker, director of Anshen + Allen at the time, said we were committed to this and pledged to make it work.
Mitchell: A key factor in the success of this was a Memorandum of Understanding [MOU] crafted by the owner, WATG, Anshen + Allen, and Turner Construction-the contractor-which committed us to project goals and required us to meet monthly to review the program. We checked our egos at the door and along the way became good friends.
Green: The MOU was the creation of Alan Yordy, our CEO, who is quite a visionary. He said we want to bring out the best of the best and, to do this, it helped to codify everyone's understanding of a project. It is a technique he has used and seen work on other projects.
Tierney: We're a very collaborative firm, in that we want to hear what everyone has to say-not that they'll always get what they ask for, but at least we can see where everyone is coming from and seek a middle ground. But the MOU said, in so many words, “this is the value that each of the parties brings, and we have to trust each other.” I'm happy that my team recognized that, in a project like this, when you're working together for years, you're either on board with it or you're off. As it turned out, everyone was on.
Mitchell: The wood and the stone are most definitely northwest regional vernacular. In my field, design always has to be about the place. When you go to Bali, you want to feel that you're in Bali. You don't want sameness from one place to another. So, early on, I said we have to design for Oregon, capturing its colors, materials, and history. You wouldn't do these lobbies in a big city or in Florida. There might be features here I'm not personally fond of, but it's not about me. We chose brick for the exterior because it is timeless and because the University of Oregon campus features masonry exteriors for buildings of all ages. We want to have materials and an image that will work 100 years from now.
Tierney: The board of directors early on said they wanted a deinstitutionalized setting, something that would alleviate patients' and caregivers' fears and anxieties. Some said they wanted a lodge-type setting and included this in their vision statement. In Ron's line of work it's about selling a vision from 30,000 feet-he came in with a perspective on what the lobby should look like, and darned if it doesn't look exactly like that. The board was determined to have that large fireplace, and to have that stone replicated in residential-scale fireplaces in waiting areas for the ICU and ED. The feeling of these spaces needs to translate throughout the facility. And the lobby is fully skylit, so that natural light floods the space and goes deep inside.
Green: Hospitals are a part of their community, and may well be for 100 years or more. We wanted a building that was timeless, that would be as relevant to the area 100 years from now as it is today. I said to Ron, “I want Frank Lloyd Wright meets the Northwest.” One interesting result of this is that people who are not patients or families come here from town to sit and visit and have lunch-the lobby is really a front porch. It's a much different feeling from your typical quaternary regional referral center, which is what we are.
Patient care areas
Mitchell: We used colors and lighting to create a subdued, serene feeling. There was a lot of dialogue with Anshen + Allen on many details-for example, the bathroom mirror. In a hotel you don't find a stainless steel-framed mirror, you have a mirror that is decoratively framed. Anshen + Allen said, this is a healthcare environment, it has to be cleaned, but I asked whether there was artwork in the hallways and, if so, what about that? It turned out that cleaning was not an issue, it's an architectural mindset in healthcare design but it didn't apply in this case. But, to Anshen + Allen's credit, they kept the focus on infection control and on the materials needed for this. And, as it turned out, the compromises weren't that significant-we didn't use natural woods in the patient areas but faux woods are very strong now. We were able to bring framed mirrors and amenity shelves into the bathrooms. Patient rooms have faux wood floors, as much window space as possible, and a day bed for families. We had to work through the privacy issue. In hotels, the guest has privacy vis-à-vis the staff but in hospitals staff wants clear visibility of patients, and you have to work through that conflict. Anshen + Allen always kept an open mind-here's what we're trying to accomplish, what materials are available for this?
Tierney: We did a mock-up of the patient room in a warehouse and worked through all the operational issues in detail. You absolutely can't have carpet in patient rooms, and they wanted wood flooring, but we knew that we had to go with seamless sheet goods. In designing the bathroom, Ron fought for that decorative frame mirror and we realized it wouldn't be an infection control issue. But we still had to work out the right location for the bedpan, sharps, gloves, and the like. A major help with this was the work of Lola Fritz, an experienced ER nurse who was the hospital's main point of contact on this. Staff operations and maintenance were major issues and her guidance was invaluable.
Green: In most hospitals about 10% of bathrooms are ADA-accessible but here it's 100%, thanks in large measure to our hospitality approach. We've installed showers in every one and tried for the most effective use of space. We even used sliding barn doors for the bathroom, which require considerably less space than swinging doors, although it took a while for the regulators to understand and accept this. But that's one of the advantages of the hospitality approach, which can open up new thinking about regulations.
Mitchell: With this site we wanted to take advantage of the views and positioned the hospital cupped against a stand of very mature Douglas firs and broad-leaf maples and angled to look up the river. We wanted to cut down as few trees as possible and ended up removing 22 mostly diseased, unstable trees that were too close to the building. Our intention was to use this for the timber in the porte cochere, but after the time it would've taken to dry the wood and get it certified, it ended up being cheaper just to purchase the wood locally. We used laminated timber, and Anshen + Allen worked very creatively with the local fire marshal to get this done. The result is a public gathering place that feels very much at-home for local residents. Meanwhile, we used the wood from the cut down trees for the ceiling in the atrium and parts of the chapel, among other things.
Tierney: This was Ron's concept and he stuck to his guns on this, and it's very successful for the mass of the building and its welcome distraction for patients and families. But we did have to deal with this creatively to meet code. The porte cochere is technically not part of the building-it is connected by roof overhangs and extension of the vestibule. This allowed us to take some liberties with the design.
Mitchell: This was a once-in-a-lifetime experience and I don't think I'll see its like again. It's a very different client perspective-you're working with a small group of decision makers, or even one very rich man, in designing hospitality; healthcare is much more institutional and consensus-driven in its decision making. I would like to do another healthcare project, if asked, but I wouldn't feel comfortable reaching out for this. Besides, I might have just had my best-ever experience with this and been spoiled for anything else!
Tierney: It's interesting, we're always looking for qualified people for our design staff, but sometimes it's a matter of finding the right people, who bring a fresh perspective to things. Working with Ron opened up new areas of creativity for us. I remember Derek [Parker] noting that the sconces Ron wanted to place by the patient room doorway wouldn't work because they'd tend to snag passing IVs. Ron said, let's figure out how to make it work, and came up with low-lying, rounded sconces that wouldn't get caught. They looked custom, but they weren't-we didn't have the budget for that. They're straight off the shelf. There are a lot of tricks like that you can do, you just have to find the right shelf. Working with Ron pushed us all in new directions. It was a great project, and a lot of fun.
Green: We wanted this to be a great environment for our patients and families, and everyone signed on with fervor, including Turner Construction, which was an extraordinary partner in this. It wasn't “just another building.” I remember chatting with a family waiting outside for the father to be discharged and the little three-year-old said, “This is my daddy's hospital.” I said it certainly was, but we all had this pride of ownership.
For more information visit http://www.peacehealth.org.