This project, the largest expansion of the Holy Cross Hospital in its 40-year history, involved the addition of 210,000 square feet of new space and the renovation of 155,000 square feet of existing space. The result is a complete transformation that has doubled the size of the original hospital, strengthened and expanded clinical programs, enhanced patient privacy and safety, improved access and ease of movement within the hospital and on the campus, and created a calm and welcoming environment for patients, visitors, and staff.

This 346-bed, 470,000-sq.-ft. teaching facility is the largest acute care facility in Montgomery County, Maryland, as well as the largest single-site Catholic provider of obstetric services in the United States. The original hospital, built in 1963, was severely hampered by a dysfunctional site with limited parking. Wayfinding was unclear, vertical circulation was inefficient, there was no separation of staff-patient-visitor circulation, and services were constrained by its original inpatient-focused structure, with a limited number of single-patient rooms, an inefficient, overcrowded ED, and limited ambulatory facilities.

To address these issues, a master plan was developed for the hospital based on six strategic initiatives: Senior Services, Maternal-Child Health, Emergency Care, Surgical Services, Ambulatory Services, and a new Cancer Institute. The hospital then embarked on a four-year, multiphase modernization plan, beginning with the design and construction of a two-story acute care vertical expansion and renovation that tripled the number of private patient rooms. The new construction also includes an expanded replacement ED, a new Education and Conference Center, a new North Tower entry, and a Physicians' Specialty Office Building (PSOB).

Project category: New construction & Remodel/Renovation (completed September 2005)

Chief administrator: Kevin Sexton, President and CEO, (301) 754-7010

Firm: SmithGroup, (202) 842-2100

Design team: Phil Tobey, FAIA, FACHA, Principal-in-Charge; Michael Kang, AIA, Design Principal; Patricia Haley, AIA, MBA, LEED AP, ACHA, Project Manager; Sylvia Frayne, Project Architect; Su Sie Lim, AIA, Project Architect; Melissa Tello Poole, Project Architect

Photography: ©2006 Prakash Patel

Total building area (sq. ft.): 210,000 (new); 155,000 (renovation)

Construction cost/sq. ft.: $243 (new); $110 (renovation)

Total construction cost (excluding land): $51,000,000 (new); $17,000,000 (renovation)

The new entrance gives a clear sense of hierarchy and order to the entire complex. Major circulation elements have been significantly improved, anchored by a dramatic new glass-enclosed concourse that extends the length of the facility, bringing in abundant natural light. A new outdoor healing garden, outdoor seating rooms, and terrace walkways provide respite for patients and staff.

In clinical areas, new patient units offer a more appropriate healing environment for patients and their families. Most patient rooms are now private, with rooming-in capabilities for family members. A spacious, centralized nurses' station accommodates physicians, nurses, social workers, and other allied health professionals to facilitate a team approach to care. Space is also provided for social support and respite, including a soothing, homelike patient and family lounge.