A walk in the woods
Completion Date: March 2009
Owner: Franciscan Health System
Architecture and Interior Design: ZGF Architects LLP
Owner's Representative: Hammes Co.
General Contracting: Sellen Construction
Mechanical Engineering: CDi Engineers
Electrical Engineering: Coffman Engineers
Structural Engineering: PCS Structural Solutions
Civil Engineering: DOWL Engineers
Medical Equipment Planning: ZGF Architects/Catholic Health Initiatives
Photography: © Doug J. Scott
Total Building Area (sq. ft.): 256,000
Total Construction Cost: $95 million
Construction Cost/Sq. Ft.: $270
The South Sound region near Tacoma, Washington, was one of the largest population centers in the state without a central community hospital, and Franciscan Health System decided that more than 3,500 emergencies and 4,000 patients requiring overnight care who had to travel away from the area annually was simply too much. With the establishment of the 80-bed, 256,000-square-foot St. Anthony Hospital in Gig Harbor, the area is now served by a state-of-the-art new facility that is informed by the community's sensibilities and rich history, as well as the beautiful natural landscape, framed and inspired by the surrounding trees and water. HEALTHCARE DESIGN Editor-in-Chief Todd Hutlock spoke with Design Partner Allyn Stellmacher, AIA, LEED AP, and Interior Designer Anita Rossen of ZGF Architects' Seattle office about this multiple award-winning project.
Origins, vision, and siting
FHS recognized that this was a true community hospital it was building, and the goals were rooted around that idea-to build an outstanding hospital that represented the aspirations and nature of the Gig Harbor community. FHS established a list of guiding principles, and we tried to ensure that the building lived up to those principles.
We started the project with an unusual piece of real estate. As you can imagine, between the topography, water, and hills, some of the larger, choice pieces of land had long since vanished from the area. A large part of our goal with the hospital was to respond to the natural attributes of the site. There is a substantial change in grade across the site, close to 100 feet, as well as wetlands, a stream, and a large overhead power line. A large portion of the site was forested, as well. The accomodation of things like parking, future development and growth, and even access to the site were challenges.
Anita Rossen: Gig Harbor has a very rich and deep history in fishing and boat building; they are definitely connected to the water. It isn't exactly rural, but it is on a peninsula and is a densely wooded area. The client wanted the design to blend with these particular surroundings, not necessarily what they might build in Tacoma. We wanted to respond to the trees and the woods, as well as the maritime history of the city. St. Anthony is the patron saint of sailors and fisherman, and the name of the hospital was specifically chosen to reflect this rich maritime tradition. The exterior, landscape, and interiors teams worked closely to achieve this.
Connecting to the environment
Through the design, we developed a story inspired by the Robert Frost poem A Walk in the Woods, mixing conceptual ideas and poetic metaphors. We then applied architectural attributes to emulate the experience of being in a meadow, glade, deep forest, clearing, and so forth. Allyn and the team also designed waiting spaces and secondary patient-care areas like pre- and post-op recovery around views to the garden.
We designed the building to embrace the grade to our advantage as much as possible. The way the building is organized architecturally, when you enter the front door, you immediately are looking out the windows onto the garden, and then the building drops into a slot where you have a large communicating stair, keeping the ceiling line fairly low and keeping your eye straight out onto the garden. When you walk toward the edge of the railing, you get the perception of the depth of the drop down into the active public space-a metaphor for a gathering area.
We had to work hard to make sure we blended all of this with the maritime theme, and to keep the ratio in balance. The team visited the Gig Harbor waterline areas to see the piers, docks, ships, and sea walls, and we pulled in many of these aspects via the lyrical quality of the window fenestration and the paneling design, among other features.
Stellmacher: There are so many natural attributes to the site as far as the color and texture of the materials of the forest and the other parts of the landscape, so we wanted to make a building that in some ways begins to disappear and use natural materials that have an affinity for the weather. The façades of the building really blend with and emulate the Douglas fir trees that surround the site, and we tried to bring the outdoors inside the building as much as possible.
Planning, programming, and layout
Stellmacher: Because of the grade change, the main drop-off for the hospital takes place on the eastern side of the first level, above the public areas of dining and the healing garden, which are on the ground floor. The first floor entry space drops down to the lobby below. There is also a secondary entry on the north side of the first floor, the emergency department entrance, and to the south is a skybridge to the neighboring MOB.
Dropping down to the ground floor on the south end, there are conference spaces and the aforementioned dining, healing garden, and prefunction lobby space. Most of this floor to the north is below grade, and so critical back-of-house pieces are located on this level in a central location for the hospital. The topography helped us create a natural backstage area.
On the second floor, as with the other floors, the lobby faces back to the garden, as an aid to orientation and wayfinding, as well as a connection to the outdoors. This floor features a large interventional suite, catherization labs, acute care, PACU, and a procedure suite. The prep and recovery area features large south-facing windows that infuse a lot of daylight into the space, as we did on many other areas of the building, even the corridor that wraps around surgery.
Upstairs on the third and fourth floors are the patient rooms, with a 16-bed ICU on the third floor and the remainder being medical/surgical beds. Again, connection to the outdoors was important here.
Patient spaces a
nd interior design choices
Rossen: It may look like this simple, clean plan was easy, but it was actually a complicated planning process. The rooms are mirrored, and early on, the decision was made to use an inboard toilet room zoning based on the idea that prioritizing daylighting, views, and patient experience trumped the issue of line-of-sight to the bed. The care delivery area is zoned near the patient room door, and the space created by the placement of the toilet room door allowed for privacy between the caregivers and the patient. Stepping into the room, you get a sense of openness, a hotel-like feel.
The patient spaces use no overhead lighting at all. We used a lot of cove lighting, and the patient units are minimally lit compared to some other facilities. Combined with the palette, use of a Vocera communication system, and views to the outside, this creates a sense of quiet and peace.
Stellmacher: The simplicity of the rooms and lack of forced, overcooked detail creates a quiet, functional space that radiates calm and a respect for the patient. Less can be a lot more, and I think it definitely is in this case.
Rossen: One of things that we really strive to do is to break down the barrier between the edge of the public space and the clinical space; we want them to feel connected and to establish flow. We don't want the patient to have one experience in the main public lobby, and then walk through a set of doors and have a completely different experience. We want there to be a connection, and that the clinical environment should be just as nurturing and life-affirming as the rest of the facility.
Stellmacher: We wanted the building to feel like a restorative destination for the community, not institutional. Healthcare institutions have come to represent communities the same way that buildings like town halls and libraries have in the past; they are important places where activities that affect the lives of everyone in the community in many ways take place. We really wanted St. Anthony to become a more holistic part of the community, and I think we achieved that. HCD
St. Anthony Hospital, Gig Harbor, Washington. For more information on St. Anthony Hospital, please visit www.fhshealth.org. Healthcare Design 2011 April;11(4):46-52