Contemplating Purpose

Minutes past a January midnight in 2007, my wife and I found ourselves in an ambulance heading for a prominent Dallas area hospital, projecting possible outcomes with hope and dread for the emergency delivery of our then 30-week-old son. 

Upon arrival at the emergency department, we were transferred to a dimly lit, confining observation room via a hypnotic maze of coldly bright, insipid corridors. For the following hours in wait—spent in a viewless, character-devoid space without any direct sight of another human being or the outside world—we had much time to reflect and to escalate our anxieties, to feel helplessly alone and tormented.

It was an ironically insightful set of experiences that highlighted the prevalent underdevelopment of the emotional and aesthetic dimensions of the patient experience in the design of healthcare facilities. The event inspired a transformation of an ongoing project that—after several drafts—had then achieved its most pragmatic functional goals.

The very next draft saw a project infused with a purpose beyond the design of a place to administer care; it became a place that does.

Doctors' vision
In December 2006, three young physicians set out to establish a new model of care delivery, combining the programs of urgent and emergency care centers under one roof.

The building program included urgent care rooms, special treatment rooms, radiology suites, and critical care suites. Having the specialized expertise and experience in emergency medicine, they envisioned a patient experience-centered environment to support the delivery of high-quality healthcare at record time.

The physicians and 5G Studio developed the joint positions in favor of maximizing efficiency through clear spatial organization and designing architectural conditions that reassure and nurture basic human needs, creating what today is Legacy ER in Frisco, Texas.

Clear spatial organization
The building design articulated operational efficiencies without sacrificing the architectural experience of the patients, the physicians, and the staff. The staff core is centrally positioned to allow unobstructed surveillance and access while allowing staff presence to be sensed by the patients; its layout is rigorously fitted under an elemental ceiling spine that bisects through the interior.

The patient/physician circulation loops around the staff core. It is entered through a triage—a translucent transitive cubic space that links it to the waiting area. Yet another outer loop organizes the treatment rooms, which are configured in a same-handed orientation.

Clarity and efficiency form the framework from which the experiential and spatial opportunities emerge.

Optimal access to natural light and view
Understanding the positive behavioral effects of natural light and exposure to the outdoors, the programmatic components were configured to allow direct visual and daylight access to the exterior from all occupied spaces. When horizontal exterior views are undesirable, tall landscaping elements are placed some distance away from the exterior windows, to create perceptible exterior gardens that screen the views beyond.

Along paths without horizontal exterior views, clear-glazed skylights allow for sight of the sky. In rooms requiring privacy from the exterior, glass panes are acid-etched up to 6 feet and left clear above that to provide a necessary level of privacy without using any secondary system, such as blinds or curtains. It also maintains a direct sightline to the sky. Employing these simple strategies, patients can remain assuredly connected to the world beyond the healthcare setting.

Accessibility and interaction
The doctors fell in love with the proposed design for its openness, clarity, and sensitivity to their passionate goals of elevating the level of patient care. Patients are often reserved from discussing their health concerns openly with their care providers. To penetrate the psychological barriers, the different levels of treatment zones were organized without doors and walls while providing strong spatial and visual cues to distinguish one zone from another.