The things of children's imaginations are endless-mystical creatures, sports fantasies, outer space adventures; the list goes on and on. Trying to cater to all of them is nearly impossible, but a safe bet is that most children, at some point in their youth, will dream of a time of valiant knights, dragons, and the ever-present, iconic stone castles. Such was the thinking behind the innovative new Castle of Care at Sanford Children's Hostpial in Sioux Falls, South Dakota, a EwingCole-designed facility that aims to inspire hope and healing by bringing children's imaginations to life with castle-like architecture and artwork.

“The process started with us looking at not only what we wanted the building to look like, but who were the architects we worked with in the past, who were the architects we wanted to work with in the future, how did we make this unique, how did we send a message of hope and healing, and at the same time project the strengths we knew we had in the breadth and depth of the services,” says Jan Haugen-Rogers, MA, RN, vice-president, Sanford Clinic. “That's how we ended up with the CEO [Kelby Krabbenhoft] coming up with the idea for a castle.”

Rich Adcock, executive vice-president, Sanford Children's Hospital echoes that sentiment: “Somewhere along the way when Krabbenhoft thought about this, he wanted the children's hospital to be something that, 30 years later, a grown-up remembers being in the children's hospital very vividly. He didn't want them to remember a cold, dark building or the tough illness that they may have had to battle. He wanted something that gave them hope.”

But creating such a facility was not all fun and games. Although the immediate aesthetic is a light-hearted, children's castle-colored by wall murals, original pieces of artwork, castle-themed decorations, and other playful touches-serious consideration had to be given to the adult population that works and gives a significant part of their lives to providing what Adcock and Haugen-Rogers assert is the primary goal of the facility: “royal service.” Careful attention was paid to both the interiors and architecture to create distinct on- and off-stage environments that allowed the staff to occasionally remove themselves from the vibrant interiors of the facility.

As important as creating such areas of respite for the staff, was ensuring that, while the children experience a hopeful and fun environment, the patient rooms and clinical areas were still appropriate. “Our clinic is set up to ensure that, as [patients and families] experience a visit with a clinician, that it is as efficient as possible,” says Haugen-Rogers. “When you walk in you have an environment that's comforting to families but at the same time, it's very clinically appropriate and efficient for children.

“There are a lot of amenities that make it feel a little bit like a home and hotel but at the same time, it is very clinically appropriate because the rooms are divided as such that there is always very specific space that is for family and a clinical space.”

According to Adcock, this was one of the most important aspects of the facility; a duality that would enable staff to operate efficiently, families to feel cared for in an appropriate setting, and children to be inspired by the extravagant interiors. “We wanted to, through the art and the architecture, really facilitate the healing process,” he says. “It's kind of breathtaking for people when they walk through the door, but if you stop and pay close enough attention, you'll be able to notice a very efficient place. We did everything from using Lean principles like spaghetti diagrams to count footsteps or figure out where you need the appropriate fax machines and data connections. We tried to make sure that we found the right complement of both functional, as well as aesthetic functions.”

Jeff Viere, Imagery Photography

And the Sanford Children's Hospital Castle of Care has proven to effectively meet all of those goals. Staff productivity and ownership as increased-as measured by staff surveys-and there's no denying the unique environment and uplifting spirit of the facility itself. So while there may not be dragons to slay, the work being done at the hospital is undeniably epic. HD

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Healthcare Design 2009 September;9(9):78-79