The new ED at Duke University Hospital creates a gateway to campus and nearly doubles the capacity of this Level 1 Trauma Center to accommodate 90,000 annual visits. The first project phase adds 42,000 square feet and the second renovates 23,500 square feet of existing space. The project features two fully equipped x-ray rooms, a food-service area, a forensic patient facility, and electronic medical charting in each room. Four new triage rooms and four new trauma centers ensure high-quality care under the most emergent circumstances.

The facility takes a holistic approach to family centered care and was designed with separate accommodations for children and adults, each with a planning model customized to its operational goals. An extended series of simulations were done to measure patient experiences against national benchmarks.

The design team made efforts to keep staff and patient areas clearly separated throughout the facility. A peripheral hallway creates a circulation path for patients to enter exam rooms while remaining separate from the staff core. In the central staff core, alcoves store important equipment without blocking circulation.

Project category: Addition (completed May 2006)

Chief administrator: Malcolm Isley, Assoc. Vice-President, Duke University Hospital System (919) 286-6580

Firm: Perkins Eastman, (212) 353-7212

Design team: Jeffrey Brand, AIA, Project Manager; Duncan Reid, AIA, Architectural Team Member; Paul Green, Architectural Team Member; Shane Walton, Architectural Team Member; Pamela Basch, Architectural Team Member; Maureen Carley, Interior Designer

Photography: ©2007 Eduard Hueber/ArchPhoto

Total building area (sq. ft.): 37,000

Construction cost/sq. ft.: $486

Total construction cost (excluding land): $18,000,000


The Pediatric Emergency Department sought a traditional model with combined staff and patient circulation to enable patient interactivity and immediate observation by family for quick assessments. Wood finishes create a warm, friendly atmosphere with child-sized furniture and shelves for toy storage. Murals, signs, and tiles on the bathroom floor feature scenes of mountains, beaches, and sea creatures. The Pediatric ED contains 18 beds, two critical-care rooms, isolation rooms, a separate entrance, and a waiting room.