Two years ago, Nashville-based Gould Turner Group (GTG) was presented with a challenge. Rapides Women's and Children's Hospital in Alexandria, Louisiana, was feeling the pressure of a competing facility undergoing a renovation through an addition to its existing structure. “Rapides felt like their facility was really in need of a facelift,” says Tiana N. Lemons, IIDA, director of interior design for GTG. “They had a good basis for the building and a nice face, but they really needed to update it.”

Lemons had worked with the Rapides Regional Medical Center on previous projects and was asked to take a look and see what she could do to attract people to its women's and children's hospital, rather than to the competing facility. An interior renovation was presented as the most suitable solution, says Linda S. Marzialo, AIA, ACHA, president and CEO, GTG. “It was a very cost-effective way for them to really change the image of their facility, to change it to what they wanted it to be in terms of being welcoming, colorful, and lively.”

Expectations for the space

The firm was charged with bringing a fun and whimsical feel to what had become a rather outdated space, and to design it in a way that was appealing to both women and children. “The hospital wanted to give it a totally new look. The existing facility had green and white marble floors, brass light fixtures, and a lot of planters that had been abandoned because they had too many plants to take care of. The building was built in 1987, and I've been told that the architect tried to model the design after some well-known garden hotel atrium designs, so this existing four-story space has that look,” Lemons says.

However, those project goals came with a limited budget of an initial $1 million for 65,000 square feet of space, so a master plan was developed that included additional interior renovations to be completed beyond the original scope of the project, as funding became available. In the end, $2.6 million was committed for the project and all of the design changes included in the plan, including patient areas beyond the atrium, were completed in April 2011.

The atrium of the building boasts a good number of windows and a variety of odd architectural shapes that together presented distinct design challenges from the outset.

Design challenges and solutions

The atrium of the building boasts a good number of windows and a variety of odd architectural shapes that together presented distinct design challenges from the outset. “That was one of the design challenges the facility gave me: ‘How can you make this go away? How can you make this space feel differently and not have people focus on the architecture of the space?’” Lemons says. In addition to structural issues that had to be overcome, some concessions also had to be made simply due to budget constraints, such as working with the existing molded, white door frames that have a residential feel to them. The frames in addition to the vast use of white in the space created a very sterile environment. “The challenge was how do we make this feel like a warm, inviting space? Fortunately, white is easy to work with. It's better than having something else to deal with, such as having an unattractive wood to try to design around,” Lemons adds.

To liven up the atrium, bright, bold colors were brought in through serpentine patterns in the floor, fabrics used on furniture, and coordinating art pieces. “We used those bright colors in the main lobby area just because it was such a large space. As you go into the building and go back into the women's area, those areas have a more adult feel to them,” Lemons says. The overall use of color in the lobby was a very intentional piece of the design plan, an effort to reduce patient stress and provide a positive distraction. “This harkens to the fact that hospitals are becoming more and more a place for wellness and less and less a place for just illness. That's really a transformation that the healthcare industry has undergone overall, and I think this project responds very well to that,” Marzialo says.

The high-traffic area also required careful selection of materials, such as laminate flooring that is both easy to maintain and helps with the acoustical problems presented by the previous marble flooring. Furnishings feature all vinyl fabrics in a multitude of patterns and colors to avoid looking sterile while also remaining highly cleanable. A variety of seating options also were incorporated to allow family groups to sit together and those with physical impairments to have appropriate options. Railings were replaced on the stairwells to meet ADA requirements, and wayfinding was created through the use of design elements, such as glass tile accents at public elevators and a floor design that creates a natural flow toward destinations.

A sense of rejuvenation was incorporated into the space beyond the colors and materials used. An abandoned café was brought back to life and made an integral part of the lobby. A gift cart area also was established, while a family communications center was created to provide Internet access to visitors and bring an overall modernization to the facility.

The project scope within the lobby included a renovated administration/reception area and a new layout for the administrative office and consult area, while a new information/security desk also was added. The planter/water feature was renovated, making the planter smaller and adding an art glass surround. To incorporate a visual element in the lofty height of the four-story atrium, a 30-foot mobile art piece by Matthew Richards was installed, bringing the bright colors of the furniture and floor upward into the ceiling area.

In order to achieve the desired results without interrupting the daily functions of the hospital, the renovation was completed in phases, with the facility remaining fully operational throughout the course of the project. Oftentimes, work was completed after hours and only a few patient rooms were closed down at one time, for example.

The payoff of renovation

The eventual $2.6 million budget allowed the Rapides Women's and Children's Hospital to complete the range of interior design renovations that were originally included in the GTG master plan, with the lobby renovation inspiring the remainder of the work. “This lobby project really turned out to be a jumping-off point for a more extensive interior renovation of the facility,” Marzialo says. Elements of the lobby were carried through to other points of the facility, including the LDR and postpartum areas, but with softer colors. The pediatric floor, on the other hand, is more whimsical and showcases the floor pattern from the lobby that is carried through there as well.

“I call it renovation for a recession, because it was a very cost-effective way for the hospital to change its image and market what they want to be, what they are,” Marzialo says. Lemons agrees, adding that she's seeing many facilities today choose to explore smaller-scale renovations rather than take on more cost-prohibitive projects. And, as exhibited by the Rapides project, the changes, though small, can still be quite evident.

“It's relatively economical, and it's very visible. It makes a big impact on a facility and along the way, these interiors also tend to help improve other big concerns that hospitals may have, such as wayfinding and infection control. It's not just the look, although that's certainly a big part of it,” Marzialo says.

As for creating that look, Lemons says it's imperative in an interior renovation to be sensitive to creating an environment that will have longevity for the facility and be easily adaptable when it's time to spruce it up once again. “I try to design and leave behind
for the next generation of designers-the next person to touch this building or me, if I touch this building in the next 20 years-the ability to go in and change the fabrics, change the cubicles, or change the paint color. I want to leave behind things that are going to be there and stand the test of time. That's what I try to do, and I think that's what we did here. You have accent colors, but the paint can always be changed. You still have that great foundation there that can be worked with in the future,” she says. HCD For more information, please visit Gould Turner Group's website at or the Rapides Regional Medical Center's website at To watch a video of images capturing the “before and after” of the Rapides Women's and Children's Hospital renovation, click on this link. Healthcare Design 2011 May;11(5):35-41