Project category: New construction (completed February 2005)

Chief administrator: Jeffrey L. Susi, President and CEO, (772) 567-4311

Firm: Jonathan Bailey Associates, (469) 227-3900

Design team: Tom Dwyer, Principal-in-Charge; Johnny Lau, Project Manager; Nestor Infanzon, FAIA, Design Director (Jonathan Bailey Associates); Richard Zinser, PE, Structural Engineer (Zinser/Grossman Structural); Bruce Adams, General Contractor (Robins & Morton/Proctor)

Photography: Chris Casler Photography

Total building area (sq. ft.): 30,000

Construction cost/sq. ft.: $353

Total construction cost (excluding land): $10,600,000

Buckminster Fuller's geodesic domes—and geometry class, for that matter—teach us that spheres and circles are wonderfully efficient shapes for enclosing space. This simple truth informed the circular planning used for the $10.6 million expansion of the emergency department at Indian River Memorial Hospital, an institution faced with serving the needs of a rapidly growing population. Using fewer building materials than would be required for a box-shaped building with the same amount of space, Indian River's circular ED provides nearly 30,000 square feet of usable area designed to handle 55,500 patients a year. The old ED, meant for 25,000 patients annually, had been coping with more than 40,000.

Jonathan Bailey Associates' circular plan enhances circulation, takes advantage of adjacencies, reduces travel distances between patients and staff, and maximizes floor space given over to care. These ideas grew out of the planning process, as consultations were held between hospital staff and designers to ensure an ED design that would support the critical activities of doctors and nurses. Indian River required a design that would reasonably contain costs, streamline operations, and offer flexibility for adopting new technologies in the future.

The ED provides 21 private exam rooms with televisions, with the following dedicated rooms: two for respiratory isolation, two for obstetrics and gynecology, and one for orthopedics. Additionally, there are eight private convenience-care rooms with televisions, two large trauma rooms, two triage rooms, a four-bed observation room, a conference room that converts to an emergency operations center in case of disaster, two psychiatric assessment rooms, a digital radiology room, and a staff education room. For visitor convenience, there is a lobby with a children's play area, a private waiting room, and a new 169-space parking area.

Beyond function, creating an aesthetically pleasing healing environment was also an important consideration. Physicians and staff wanted a family-friendly atmosphere that would welcome visitors and comfort patients. Care was taken to provide natural lighting, appealing materials and textures, comfortable seating areas, and other conveniences. For anxious patients, the right environment can create a sense of calm, comfort, and confidence. Jonathan Bailey was one of the first architecture firms to take healthcare environments beyond the clinical to a new level of beauty and accommodation.

With its wide array of services and amenities, Indian River's new ED will serve the community well into the future, boosting capacity and giving staff and patients a functional and comforting atmosphere for the provision of care.