It could be called “hometown cardiac care” in Plano, Texas, where a new 68-bed, 198,000-square-foot heart hospital, designed for exceptional performance and comfort, aims to meet the expectations of an affluent and educated population. Patients are grouped according to condition, with appropriate diagnostic and treatment equipment nearby, and all patient rooms are readily visible to nursing staff at all times; these were the driving concepts behind The Heart Hospital Baylor Plano. A rural hospital it isn’t—a collaboration of 86 North Texas cardiologists and the Baylor Regional Medical Center Plano, the new facility offers the latest in sophisticated, high-tech cardiac care in an environment both comforting to patients and super-efficient for staff. Recently, design principal John A. Castorina, AIA, of RTKL discussed creation and implementation of this compact yet stylish design with HEALTHCARE DESIGN Editor-in-Chief Richard L. Peck.

“The building was designed to maximize its occupancy of a 4.9-acre site, with an exterior design complementing yet differentiating itself from the design of nearby buildings. One of the most difficult exterior features to design is an entrance canopy that doesn’t look just tacked on, but rather is an integrated design feature. In designing this canopy we used an ascending helix which, as it rises, becomes the ceiling of the chapel, the auditorium and the dining room, offering expansive views to the gardens. It is the most identifiable feature of the hospital. The building, in general, plays off perspectives and vanishing points to accentuate volume, giving the perception of size even though the spaces are moderate in area

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“One of the main purposes of this joint venture between Baylor University and the cardiologists was to create a performance-driven design that would enhance the patient visit, increase patient safety, and maximize nursing. The desired performance criteria allowed us to create a nursing unit we call the bow tie, a very gently concave configuration stretching out on two sides, allowing nurses to visualize all patient rooms while standing in one spot. Nurses and patients can be easily located and communicated with in this space. Also the patients, for whom ambulation is very important, have a dedicated walking track that, again, is adjacent to central nursing and easily visualized, and free of passersby or medical machinery getting in the way

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“The bow tie design allows the widest part of the patient room to be inboard. There is enough space along the corridor side of the room for a toilet, a six-foot doorway for easy entry and exit of medical equipment, and a nursing care station. There is good visibility from the corridor, but the inboard toilet room creates a doorway vestibule for a greater feeling of privacy. There is space between every two rooms for satellite nursing stations, which have windows allowing easy visibility into the patient rooms. Patient rooms are equipped to handle all levels of care and can function as ICUs, if need be. The headwalls reveal the mechanics of its ICU capabilities yet are still compositional. Regardless of care needed, rooms are a generous 367 square feet to allow plenty of room for staff, families, and an array of medical equipment

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“The hospital is unique in that each floor is dedicated to a specific cardiac profile, with all the appropriate diagnostic and treatment facilities and patient care beds directly adjacent to each other. Emergency and imaging services are on the first floor, surgery is on the second floor, electrophysiology is on the third, and cardiac catheterization is on the fourth. Patients are assigned to the appropriate floor, which enables a concentration of staff, supplies, and equipment to be located in close proximity and eliminates cross-circulation. Because of the patient rooms’ universal design, patients remain in their assigned rooms throughout their stays

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“Extensive thought went into the ergonomic experience of the patient, particularly the patient lying in bed and having to stare at the ceiling. We emphasized strong geometric planes and indirect lighting that allows the ceiling’s appearance to change throughout the day, accentuating the curves and using a framed perspective to exterior views. The dining room offered us the opportunity to incorporate sculptural ceiling elements that create a dynamic environment, as well as help control noise. The idea was to create a more engaging environment.”

“The physicians’ library, located on the penthouse level, is a respite area, with computer access, lockers, and floor-to-ceiling windows that run along the entire space.”

“This facility is designed to be ‘paper-light,’ with IT, medical equipment, building systems, digital picture archiving, supply, and automated medication dispensing systems, all in a wireless environment. I have found, in my experience, that moves toward paperless are more feasible for specialty hospitals like this one because of the concentration of clinical disease profiles. A general hospital has so many disease profiles and varying data requirements that paperless may be harder to attain.”

“It’s important to realize that you can achieve a high-end appearance with limited dollars. It’s all in how you use the materials. The goal is to achieve a quality look by concentrating your dollars on spaces with the highest impact. For example, we used more paint than vinyl wallcoverings. Manufactured stone is used only around the chapel and classroom areas to bring richness to the main lobby. Terrazzo is used only for the first floor, and yet the same appearance and color palette is retained throughout the facility by using appropriately colored floor vinyl. The exterior features natural limestone that is echoed inside by tile that is more cleanable and is matched exactly for color. It’s all in using materials judiciously, with no dividing line between the architecture and the interior design. All design team partners work together in planning for performance and visual impact.” HD