IMAGES COURTESY OF RTKL

Not for many years has the healthcare industry been so beset by uncertainties. The widespread economic decline and the unknowns of healthcare reform have many hospital leaders taking a wait-and-see attitude when it comes to building new facilities.

On the other hand, such factors as advances in technology, overcrowding, competition, and shifting demographics-all of which have sparked the healthcare building boom of the past decade-are still as pressing as ever. Plus, while some healthcare providers are looking at staffing reductions over the short term, healthcare is still being touted as one of the few bright spots in the nation’s employment picture. The industry saw a net gain in jobs in 2008, and the Bureau of Labor Statistics forecasts strong employment growth through 2016.

As all sectors of the economy look for ways to weather the current economic downturn, the ever-present need for medical care and the sizeable healthcare employee base could be much needed drivers of development for cities, commercial interests, and health systems. That’s what makes a planning approach taken recently in two Midwestern cities of particular interest. For these projects, the architectural and planning firm RTKL combined urban planning with healthcare planning and design to stimulate medical, commercial, and residential growth.

In Michigan, this holistic approach was employed to plan a healthcare village for McLaren Healthcare Corporation. In Illinois, it was used to revitalize a 640-acre state medical district. Healthcare facilities serve as the economic engine for these developments, but retail, office, and park-like areas are integral to the plans. They provide nearby shopping, business, and recreation benefits to the large workforce at the hospitals, as well as to nearby residents and hospital visitors.

Healthcare village

The 74-acre site for the healthcare village in Clarkston, Michigan, was originally zoned for an industrial office park. McLaren Healthcare Corporation wanted to develop a new campus on the location-a campus with both health and retail elements. Accordingly, RTKL merged its expertise in urban planning and hospital facilities planning to create a mixed-use village, with healthcare, rather than retail, as the anchor.

The approach convinced the Board of Trustees for Independence Township to rezone the parcel to allow for the healthcare village. The mixed-use components will provide tax revenue, and the project is expected to bring 3,000 to 4,000 new jobs to the area.

The three-phase master plan envisions a new town center with eight healthcare facilities and several mixed-use retail/office components to be constructed over seven to ten years. A healing garden, a rain garden, and a village green are also in the plan. In recognition of the importance of ecological sustainability, the project incorporates green planning principles, such as on-site storm water management, and it will be designed to meet LEED certification criteria.

Three-phase plan for village development

Phase I of the healthcare village master plan consists of a comprehensive cancer center, a medical office building (MOB), and a mixed-use retail complex with shops, restaurants, a bank, and professional offices. In Phase II, an acute care hospital, a heart center, and an MOB will be built. Phase III will see the addition of a health sciences building and another MOB plus, if warranted, the hospital will be expanded.

The cancer center, the healing garden, and an MOB are nearing completion, while the retail design has just received Village approval to proceed. The project has proven so popular and successful that additional parcels are being considered for inclusion in the planned urban development (PUD).

Illinois Medical District

A somewhat similar approach was taken in developing a master plan for the Illinois Medical District at Springfield. The Illinois General Assembly created the medical district in 2003 in an attempt to reverse a trend toward urban decline in a high-profile area near downtown. RTKL subsequently was selected to develop a master plan for enhancing the quality of living, shopping, and working within the 640-acre parcel of land.

The new medical district is located on Springfield’s near-north side, adjacent to the Illinois Capital District. It encompasses Southern Illinois University School of Medicine and two acute care hospitals: Memorial Medical Center and St. John’s Hospital. These large institutions anchor the district and make healthcare second only to state government as a source of employment in the area.

The core challenge of the planning project was to achieve two somewhat disparate goals. The first: foster growth of the medical industry in the district. Second, preserve and enhance existing residential and retail areas that are within the district, while creating opportunities for new developments.

The medical city

Medical districts typically incorporate medical institutions that are, in themselves, medical “cities.” These large institutions have the attributes and life cycle of a city. Old buildings are surrounded by newer facilities that are, in essence, their suburbs. The districts are heavily populated and require transportation, parking and distribution systems for goods and services. They have long-term land use and development plans that take into account criteria very similar to urban plan development.

Operating under state law, the new Illinois Medical District at Springfield was required to develop a master plan for land use to promote healthcare, health science, medical research, and emerging high-technology enterprises within the district. At the same time, keeping the historic character of local neighborhoods intact and creating a user-friendly place where people would want to work, shop, and live was an essential requirement.

RTKL was able to offer a combination of medical planning and urban planning services to create a master plan that successfully addresses this multifaceted goal.

Community participates in planning

Planners took the unusual step of encouraging the community to participate in the planning process. Community input was important not only to the content of the subsequent plan, but also for the morale of residents in historic neighborhoods who previously had been kept in the dark and were often at odds with developments in the district. As a result, two strong homeowner associations participated in an advisory group for the project.

Through a series of visual preferencing workshops with nearby residents and other key stakeholders, the planning team learned that participants wanted the new development to embrace community and focus on creating a village-type setting that would maintain the historic character of Springfield. For example, the residents favored integrated town centers organized around public squares and plazas rather than conventional strip retail development. As for office buildings, they preferred home/office-type buildings and small commercial office buildings rather than high-rise buildings. Through these workshops, the local residents and stakeholders started to feel the real dynamic of urban planning, and they came to “own” the solution as they saw their ideas take form.

Long-term results

Once all information was gathered from stakeholders and the public, RTKL created a master plan to:

• support the development and conservation of livable neighborhoods;

• strengthen primary health facility anchors within the district;

• leverage public/private catalyst projects into new mixed-use projects;

• provide direction for infill development between downtown, the medical district, and surrounding residential neighborhoods; and

• initiate a framework for implementation.

The long-range benefits for both the medical industry and the residents include a revitalized central community; a network of green spaces for recreation; preserved and strengthened residential neighborhoods; and an improved transportation framework.

Combining urban and healthcare planning

Revitalizing urban areas and planning health facility development are typically seen as two separate undertakings. But RTKL’s experience combining urban and healthcare planning proves that the two can work hand-in-hand to create economically viable settings that attract businesses and consumers, create jobs, and become places where people want to live and work. McLaren Healthcare Village and Springfield Medical District are each well-positioned to become medical destinations and workplaces of choice for a large number of healthcare employees who value the convenience of nearby shopping, recreation, transit, and residential areas. HD

Daniel C. White, AIA, LEED AP, is a Vice-President in RTKL’s Healthcare group. He can be reached at

dwhite@rtkl.com.

Alan C. Wilson, AIA, ACHA, is also a Vice-President with RTKL and can be reached at

awilson@rtkl.com. Healthcare Design 2010 September;10(9):30-35