Like most New England community hospitals, Exeter Hospital had been designed to meet immediate needs, but several decades of growth and expansion had eventually caused campus gridlock. Reorienting the campus enabled vehicular and pedestrian access to be clarified, which created easy access to the high-volume outpatient services and allowed for critical growth for all key patient care services.

The first need was to separate disparate patient populations and services and bring the high-volume ambulatory services to the front door. Next, practically every acute care department was in need of renovation and expansion. Limited land resources and challenging topography meant that a master plan was critical.

A complex phasing plan was developed to implement this transformation. Phase I of a comprehensive master plan involved the new construction of 110,000 square feet for outpatient-focused services. The cornerstone of the Outpatient Care Center is the new Ambulatory Surgery Center, which is the new home of a comprehensive cancer care center, endoscopy suite, and women's health center.

Several unique design features distinguish this facility, the most notable being the highly visible four-story central lobby. Serving as the crossroads to all medical services, it offers direct access into the Outpatient Care Center, the new medical office building, and the central core of the acute care hospital.

Next, a new service wing was created for material management, central medical records, and food services, freeing up valuable real estate for acute care expansions and relocating the loading docks to a discreet section of the campus.

Project category: New construction & Remodel/Renovation (completed September 2006)

Chief administrator: Judy Rines, Director of Materíl and Construction, (603) 580-6676

Firm: JSA, (603) 436-2551

Design team: Todd Hanson, AIA, Principal-in-Charge; Robert Corson, AIA, Project Manager; Robert Strickland, AIA, Healthcare Designer; Katelyn Galante, IIDA, Interior Designer; Mark Moeller, AIA, LEED, Building Designer

Photography: Dan Gair/Blind Dog Studios; Bruce Martin Photography

Total building area (sq. ft.): 189,000 (new); 100,000 (renovation)

Construction cost/sq. ft.: $237 (new); $131 (renovation)

Total construction cost (excluding land): $44,800,000 (new); $13,100,000 (renovation)