The 250,000-square-foot bed tower addition may look like a perfect fit on the five-acre Centra Lynchburg General Hospital campus in Lynchburg, Virginia, but placement of the $47-million addition took a lot of time, talent, and collaboration between designers at HKS Architects, Dallas, Texas, and contractors at Barton Malow, Southfield, Michigan, to seamlessly mesh the old and the new.
The addition itself boasts 108 private rooms with separate floors for cancer patients, surgery patients, and a new unit for treating neurological, orthopedic, spine, and total joint replacement patients. A new, expansive dining area, with state-of-the-art food preparation areas to support the added patient volume, replaces the hospital's 40-year-old kitchen. The new tower also includes a renovated pharmacy, laboratory, and X-ray areas, as well as one floor of shell space for future expansion. Community health events, continuing education, and on-site physician meetings are held in a new conference center.
However, merging the addition with the existing facility proved to be a complicated endeavor from the start. Still, management at Lynchburg General Hospital was set to expand and improve patient care through a major expansion that emphasized cutting-edge care while focusing on the healing environment of the facility. Centra Health decided to create a team very early on, which was not only key to a successful preconstruction phase, according to Matt Wood, project director for Barton Malow, but also, it helped keep the project on schedule and on budget through its final completion. “This all led to a longer-than-usual, but successful preconstruction phase that established a very solid budget, schedule, and plan for executing the work in the construction phase,” Wood says. “The positive and team-oriented tone established in preconstruction continued into the construction phase.”
However, before plans could be drawn and finalized, a big question still had to be answered. Where should the new addition be located on the landlocked campus?
The big question answered
Lynchburg General Hospital, originally built in the 1950s, had already undergone a number of expansions including a major effort in the 1990s, vertically expanding the hospital with two additional floors.
“The bed tower addition was designed to accommodate additional vertical growth,” says Chuck Means, principal designer with HKS. “However, we had to rethink the design when the local building codes changed-calling for an upgrade in seismic design standards. Under the new codes, we could not expand the building vertically.”
Lynchburg's management regrouped to consider their options, according to Bill Varner, vice-president of strategic planning and marketing with the hospital. “Like many hospitals, we didn't have a perfect solution,” he says. “All of the options had imperfections. We had to choose the one that made the most sense in terms of cost and work flow implications.
“This project was essential for us to meet the growing demand for services and to continue to be the regional center for emergency and critical care medicine,” Varner continues. “Our goal was to offer the latest in advanced technologies while taking the time to design everything with our patients and their families in mind.”
Two months and more than 20 design charettes later, the decision was made. The team opted to build a new addition in front of the existing hospital, creating a new inviting front door and facility entryway.
Design and construction dilemmas
According to Means, the most challenging aspect of the project was blending the core of the existing Centra Lynchburg General Hospital with a new modern tower.
Given the aging nursing population in the area, the use of ramps to connect the old with the new was a key consideration. “We connected our new building with the existing buildings at the basement, first, and second floors with minimal use of ramps,” Means says. “Our goal was to create seamless floor-to-floor connections without severe inclines.”
