© Benjamin Benschneider

When your medical center is generally recognized as the leading cardiology provider in the United States, how do you express that in “bricks and mortar”? That was the question confronting the Cleveland Clinic when it retained NBBJ to plan and design the first major expansion of the Clinic in decades. The result, which opened last fall, is the Sydell and Arnold Miller Family Pavilion, a 10-story structure featuring 278 private patient rooms, 128 exam rooms, 79 procedure rooms, 16 operating rooms, 110 intensive care beds, office space, and amenities for a world-class clientele. International leaders from Western Europe, Russia, the Middle East, and elsewhere routinely journey to the Clinic for state-of-the-art care. The resulting design was successful enough to be awarded a Citation of Merit in this year's HEALTHCARE DESIGN Architectural Showcase review. Adjacent to Miller Pavilion is the new 12-story Glickman Tower which houses the clinic's Urology and Kidney Institute. The Clinic describes the Miller Pavilion as the Clinic's new “front door” and a “gateway to the entire campus.” Recently, NBBJ interior designers Edwin Beltran and Lisa Baker took HEALTHCARE DESIGN editors on a tour of the new building. The “virtual tour” video that resulted from this can be seen at

http://www.healthcaredesignmagazine.com/ClevelandClinic. What follows is an expansion of the “verbal tour” conducted by Beltran and Baker.

© Benjamin Benschneider

© Benjamin Benschneider

© Paul Warchol

© Paul Warchol

Cesar Pelli developed a new, modern aesthetic for the Cleveland Clinic campus, with the Crile Building, the Cole Eye Institute, and the Taussig Cancer Center Institute. NBBJ studied the palette Pelli developed-his distinctive use of granite, glass, and metal-and evolved it for the Miller Pavilion.

In response to these architectural conventions, the new buildings conceptually rotate the horizontal wrapping enclosure by 90 degrees as a way to open the Crile Mall and Arrival Plaza façades. This allows for the perception of the program being contained within two glass volumes and builds upon the relationship of these contained glass volumes to their framing exterior “wrapper.”

A two-story base separates the stone wrapper and the contained glass volume of the Miller Pavilion from the ground plane. Dark polished granite was incorporated into the base to establish a visual relationship to the surrounding context, while the wrapper enclosure incorporates a lighter-toned granite as its primary defining material. Glass and metal panels are used as the primary defining materials framed by the wrapper.

In contrast with the Cole and Taussig Institutes, which bow out into the street, the Miller Pavilion is shaped in the form of a C. The concave geometry helps carve an easily identifiable and welcoming arrival space for patients and visitors. Near-term growth will be accommodated by shell space provided in the building, with longer-term growth planned to its west.
© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

The core of the main public circulation loop is finished with glass cladding that serves as a unifying design detail, allows natural light to flow deep into the facility, and assists in wayfinding. Variations on the degree of opacity and transparency of the glass provide necessary levels of privacy required by the myriad of programs housed within. Laid out in an easy-to-follow race track style, the corridor consists of glass, stainless steel, and terrazzo, with wood features that clearly demarcate important transition and/or destination points. Walnut doors with stainless steel frames and bush hammered slate walls create entryways that contrast the bright white of the walls to provide easily identifiable entry points.

© Paul Warchol

© Paul Warchol

Spacious and comfortable waiting areas for families and visitors offer leatherette seating in groups of two, four, six, or eight. Reception desks finished with bush hammered slate help the information areas stand out. A staff of red-coat greeters is present to answer questions and direct patients to their proper destination.

A Great Hall between Miller Pavilion and Glickman Tower provides an area to exhibit works of art and host special events. The space features several large original sculptures, including an overhead suspended “iceberg” piece by Iñigo Manglano-Ovalle, which brings awareness of global warming issues; fittingly enough, it also happens to resemble a heart. Lining the walls throughout the facility is an outstanding art collection administered by executive director and curator Joanne Cohen [as discussed in “World-Class Art for a World-Class Clinic,” The Art Corner, HEALTHCARE DESIGN, March 2009, p. 50].

© Paul Warchol

© Paul Warchol

© Benjamin Benschneider

© Benjamin Benschneider

All 278 private patient rooms are designed to combine the luxury of a well-appointed hotel with the comforts of home. The facility's modern aesthetic provides a classic and timeless appeal while addressing the large international patient population. Expansive windows bring in an abundance of natural light and allow for panoramic views of the city, Lake Erie, and the large water feature below.

Within each of the clinic's 12 VIP suites is an adjoining, adaptable seating room that can either serve as dedicated space for patient guests or as an additional patient room. In all the rooms, medical equipment is hidden in the headwall millwork, as is an entertainment center at the foot of the bed. The flooring of all rooms consists of warm gray-colored linoleum. The manufacturer went to great lengths to create the specific shade needed. Designers also worked hard to create the proper shade of white for the wall-mounted dispensers, instead of the standard almond color of these items.

Dr. Toby Cosgrove, president and CEO of the Cleveland Clinic, was deeply involved in the development of the interior design, including the fine-tuning and development of the custom-made furniture. Pullout-style sleeper sofas feature custom upholstery to ensure family comfort without sacrificing the needed institutional durability.

Dr. Cosgrove said, “We have wonderful views from this vantage point; why not let patients enjoy this with an observation deck?” The resulting deck is spacious and includes plenty of seating on the deck for fair weather use. Green roofing is planned as well for this area in the near future. Inside is a lounge with lots of natural light and an area set aside for patient, visitor, and staff respite. The lounge is also used for special events, such as artist performances and therapeutic classes such as yoga and meditation.
© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

© Benjamin Benschneider

Conclusions

It's a very complex geometry, but the idea of the building was to create a welcoming form on the very busy Euclid Avenue site that is a terminus for buses using the newly renovated Euclid Avenue corridor and arrivals from the highly trafficked Chester Avenue approach. Dr. Cosgrove wanted the new facility to be not only welcoming, but transparently so. HD
© Paul Warchol

© Paul Warchol

For more information on The Sydell and Arnold Miller Family Pavilion at The Cleveland Clinic, visit http://www.clevelandclinic.org/heart. To view HEALTHCARE DESIGN's virtual tour of the facility, visit http://www.healthcaredesignmagazine.com/ClevelandClinic.

Healthcare Design 2009 July;9(7):65-71