The new Center for Care and Discovery (CCD) on the University of Chicago Medicine’s campus is a massive building. Designed by Rafael Viñoly Architects (New York) with Cannon Design (Chicago), the facility’s 1.2 million square feet are spread out across a relatively low 10-story profile on a 102,000-square-foot floor plate. Its exterior horizontal banding of windows promises lots of natural light and pleasing views for patients and staff, which the building delivers—but the design also yielded another result.

The Chicago Tribune described the CCD as an “intimidating, land-locked cruise ship.” Project director Chan-li Lin of Rafael Viñoly Architects doesn’t mind the description, though. “That’s kind of what it looks like,” he says, referencing the cruise ships he often sees coming down the Hudson River from his view out of his New York office window. “One of Rafael’s favorite buildings in Chicago is The Merchandise Mart,” he continues. “It’s big, blunt, with an enormous floor plate that makes it very flexible. The CCD is very much like that.”

In fact, it was the client’s demand for future flexibility to accommodate changing technology and new care delivery models that influenced both the large floor plate and the CCD’s keen focus on modular design and vertical integration.

Best laid plans
Initially, the goal of the project was to expand an existing facility that would serve as a replacement for the 30-year-old Bernard A. Mitchell Hospital. During preliminary design discussions, Rafael Viñoly came up with the idea to construct one building that would bridge across Maryland Avenue instead of two separate towers, as the client originally envisioned. This connection advances the hospital’s goal of maximum efficiency, because it allows varying functions to be contiguous and reduces the need for staff to travel between floors.

Addressing the client’s desire for flexibility, the CCD was designed to accommodate continually changing medical technology and practices. The planning module, developed in collaboration with Cannon Design, features an 18-foot floor-to-floor height that allows for extensive engineering system infrastructure to be housed above the ceiling without impact to the spaces on the floor. The large 31.5-by-31.5-foot square structural grid allows for great flexibility in planning for essential components, such as patient beds and equipment in operating and procedure rooms. With the grid and these components in place, a patient unit can be reconfigured into a procedure room and vice versa.

“On our site visits, we saw some hospitals that had ORs on two floors, which worked just fine,” says Elizabeth Lockwood, project manager, for University of Chicago Medicine. “But we liked the idea of having just one big floor. The units can flex over time in size.” Also, one floor cuts down on travel time for staff.

“The client always saw this as a 100-year building,” says Elizabeth Rack, principal, Cannon Design. ” They wanted something that would adapt to the changing nature of healthcare.”

Cannon introduced its universal grid theory several years ago, a concept of planning and designing healthcare buildings within a precise, three-dimensional grid in order to achieve a measurable advantage in initial capital cost, speed to market, operating economy, and future adaptability. In this case, the grid’s floor-to-floor heights were increased in the basement and ground levels to align floors with existing buildings; and reduced on the upper nursing floors with the understanding that this room typology would not change within the short or long term.

“The development of the universal grid was a response to optimizing all major hospital programmatic platforms within a singular structural grid,” Rack says. “The importance of the universal grid is heightened by a building of this size and complexity where different programs are stacked vertically.”

Modern warmth
According to Lin, once the client approved building over Maryland Avenue, it was an easy decision to put a sky lobby on the seventh floor. This open, expansive space with breathtaking views of the university, Washington Park, Lake Michigan, and the downtown Chicago skyline houses central reception, family waiting areas, a chapel, a business center, cafeteria, conference center, and other public spaces.

Aside from the view, color is also used to decorate the sky lobby in the form of back-painted yellow, maroon, and green glass walls. Joe Cliggott, project manager for Rafael Viñoly Architects, says, “the design isn’t cool or stark. It’s a warm, modernist approach.”

And while the scale, materials, and furnishings of the ground floor lobbies and sky lobby may be more reminiscent of an office building than a hospital, for families waiting several hours, the grandness and uniqueness of the sky lobby and its views allows them to find their own space and define their waiting experience. Multiple areas provide varying degrees of privacy and seating options—including closed-off square “pods” for VIPs or large groups. “You feel like you’re in Chicago,” says Michael McMann, director, New Hospital Pavilion Operations Planning for University of Chicago Medicine, adding that a cancer patient who was transferred to the facility from Mitchell Hospital told him that she used to feel so alone when she’d get to her room, but not anymore. “It was exactly what the design intended,” he says. “Patients still have this connection to the world around them, and they don’t feel isolated and alone.”

Patient priority
The focus on the patient is experienced on multiple levels throughout the CCD. With a typical size of 342 square feet (including bathrooms), all 240 private patient rooms can comfortably accommodate multiple family members. “We want the family to be around our patients,” McMann says. “We want them to feel at home.” Larger 528-square-foot patient room suites feature a separate family area with its own TV and storage space. Patient rooms also have expansive cantilevered windows with mirrored glass corners that, according to Cliggott, “create drama and make the space feel that much larger.”

Window views, again, are the chief “decorative elements” in the patient rooms, and the space is warmed by maple woodwork and colored wall panels. There is little variation in flooring on the patient units and wayfinding is pretty much limited to signage—“more directional than decorative,” Lin says. An art program is in the works, but the size of the building may prove to be a challenge with its long corridors and vast wall space.

Privacy was also a design priority in the patient rooms, as was expanding the visual connectivity between patients and nurses by placing decentralized nurses’ stations between rooms. Despite the large floor plate, waiting areas close to patient rooms and nurses’ stations are easily accessed from the main elevators. Patient units, which are organized around a racetrack design, are accessed off a long central corridor that runs almost the entire width of the building.

“The nice aspect of the racetrack layout is that the units can flex in size over time,” Lockwood says. “We still have these four main front doors but can operate as a 24- or 48-bed unit.”

In addition, the CCD has a ma
ssive green roof and hopes to achieve a LEED Silver designation. An onsite underground storm water detention basin holds 250,000 gallons of water. Among other sustainable features are LED fixtures in operating rooms, high-performance exterior cladding, high recycled content in materials, and low-flush toilets.

Raising the bar
Open only since February, the CCD has raised the bar for an institution known as both a world class research institute and a neighborhood healthcare provider, replacing the 30-year-old Mitchell Hospital that could no longer accommodate changing technology and new care delivery models. According to Cliggot, the building design is also “raising the bar in the ways staff are able to work efficiently behind the scenes to provide a superior level of care.” The large floor plates provide opportunities for horizontal adjacencies, rather than relying on more inefficient vertical circulation. The large, comfortable waiting spaces, access to natural daylight and views, big patient rooms, and decentralized nurses’ stations are features that were missing in the old  facility (which is still being used for some services). Although there are no plans to measure outcomes directly related to design features, Cliggot says that “the real proof of the built environment’s impact will be over the lifespan of the facility, as it continues to adapt for new technologies and treatments.”

Breaking it down
The 102,000–square-foot floor plates created by bridging over Maryland Avenue allow the identical floors of University of Chicago’s Center for Care and Discovery to be configured for a wide range of programs, such as procedure suites and inpatient nursing units. They also allow, for example, accommodation of all 28 new surgical operating rooms of multiple types and a shared prep/recovery area organized horizontally on a single level for maximum connectivity and operational efficiency.

On each nursing floor, 80 inpatient bedrooms are contiguously arranged and can be flexibly subdivided into changing ratios between acute care versus intensive care beds, and changing numbers of beds per nursing units.

Public spaces in the center are created within an intelligent stacking of its programs in each section. Maryland Avenue lobbies and the sky lobby are sandwiched between clinical floors. Patients and visitors first travel from lobbies on both sides of drop-off to the sky lobby—centralized reception, check-in, waiting, and public amenities are located on this level.

Elevator access up to nursing floors on levels 8-10 and down to procedure floors on levels 5 and 6 are made from the sky lobby, minimizing travel times between the waiting areas to the destinations. Separation of flows between floors are maintained by dedicated elevators for the public, patients, physicians, staff, and materials. Spaces on Levels 2-4 are reserved for future expansion.

Green in the center
Here’s an inside look at the sustainable design features included at the Center for Care and Discovery:

• Extensive green roofs
• LED fixtures in operating rooms
• Lighting controls/occupancy sensors throughout
• Energy recapture on elevators
• High-performance exterior cladding
• High recycled content in materials
• Low VOC in all paints and sealers
• Low-flush toilets
• Local and regional materials
• Connectivity to multiple forms of public transit
• Heat recovery on chillers
• Recycling during both construction and operations.

Sara O. Marberry, EDAC, is a contributing editor for Healthcare Design. She is a writer, blogger, speaker, and strategic marketing and business consultant in Evanston, Ill., and the former executive vice president of The Center for Health Design. She can be reached at sara@saramarberry.com.

For a source list relating to this project, see University Of Chicago's Center for Care and Discovery: Project Breakdown.