Kaiser Permanente Puts Its Template To The Test In Oregon
For decades, Kaiser Permanente (Oakland, Calif.) had been serving the metro Portland, Ore., area through its Sunnyside Hospital on the southeast side of town, and several medical office buildings (MOBs) on the west side, including Sunset Medical Center. But as the population began to grow, the organization set out to build a new hospital on the existing Sunset MOB property in Hillsboro, Ore., to help it further serve this expanding community.
“It was a combination of growth to increase membership and an ‘if you build it, they will come’ scenario,” says Matthew Miller, project director, Kaiser Permanente.
Plans called for the new Westside Medical Center to include a 126-bed hospital, 110,000-square-foot medical office building, utility plant, and parking structure. But, first, Kaiser Permanente had to figure out how to put its template hospital campus on a site that’s half the footprint of what it would normally select for a project this size. In addition, the 15-acre campus sits within a residential area, with apartments and condos on two sides, and office buildings and a regional shopping mall on the other sides.
“Being surrounded by all those community uses shapes the design,” Miller says.
To improve the aesthetics of the campus, designers started by replacing Kaiser Permanente’s typical 20-acre surface parking lot with an eight-story parking garage. Designers lowered it one story and then covered the above-ground structure with metal screens and planters on each level to create a “green wall” effect. Along the sidewalk, an undulating serpentine wall with seating areas further softens the structure and becomes an inviting respite for residents and patients alike.
The entry sequence was also modified to better account for pedestrians and cars. Similar to an airport, cars use a normal arrival loop for drop-offs, then return back on a circular drive to go into the underground parking entrance. The pedestrian-friendly campus also houses walking paths, a parcourse, and a landscaped park for hosting community events.
Designers utilized the natural contours of the site to orient the campus, locating the loading dock and materials handling services at the lower end of the site and off a commercial road. This location eliminated the need to create a 20-foot-deep pit and access ramp normally required to access this basement level, while diverting traffic to a wider street away from the residential area. The site modification also allowed designers to turn an existing sunken area near the front of the campus into an outdoor courtyard with a seasonal water feature.
Like a good neighbor
With all its projects, Kaiser Permanente relies on a template design approach called Total Health Environment. The set of standards (or key experiences, as the organization calls them) was developed by its facilities planning design group and touches everything from sustainable building strategies and layouts to color palettes and wayfinding.
The overriding goal is to provide a branded experience across Kaiser Permanente’s network of 37 hospitals and 600 medical offices across the country. However, the approach does allow for some flexibility—a good thing, considering the challenges associated with the location of its 38th hospital.
For example, the template hospital calls for two patient tower wings that are triangular in shape and attached to a rectangular diagnostic and treatment block for the OR, ED, labor and delivery, and imaging services. Adapting the large template design to a smaller community hospital program led designers to forgo one patient tower by moving the cafeteria, laboratory, and inpatient pharmacy from the hospital’s ground floor and into the adjacent MOB. In place of these departments, a 20-bed ICU was added.
The allotted space for the second tower now serves as a landscaped area on the site, while in the future, “we have a complete footprint of that second tower available to build another four stories of patient rooms should the need arise,” says Thomas Thompson, senior associate and project director at AECOM (San Francisco).
“Each template sits on the site differently, but ours got extra attention because of the smaller site and some requirements from the city,” Miller says. “And just because you’re using a template doesn’t mean there isn’t an opportunity for design to happen.”
One of those opportunities arose from the desire to bring in more natural light and views to nature at the facility. The template calls for punched windows along the single-loaded corridor in the diagnostic and treatment block, but here, designers replaced them with a glass curtain wall. “When you see the glass and it’s lit up, and you can see the art inside, it says, ‘Come on in,’” Miller says.
Another first on display here is a “retail mall” just inside the MOB’s rotunda entry, where services such as the welcome desk, main public elevators, check-in for clinic appointments and surgery, outpatient pharmacy, waiting area, gift shop, coffee bar, and restrooms are gathered in one large, open space rather than in separate spaces off corridors.
“A lot of hospitals, you walk in the door and you have no idea where to go or what’s going on,” Miller says. “We wanted a better experience.”
Making the details matter
To give its facility a noninstitutional look, Miller says Kaiser Permanente focuses on extending design details from the front door all the way back into the staff and patient spaces.
“Hospitals have a tendency to put a lot of attention and energy at the lobby, and then sort of forget about color and the warmth of wood as you get back into the patient care spaces,” Miller says. “If it was important in the lobby to use color, then it’s important to use in the patient rooms, too—probably more important.”
These touches include artwork on the walls in the staff corridors, giclee prints on canvas in the patient rooms, and floor-to-ceiling wall graphics next to each exam room. To encourage staff, patients, and guests to use the stairs, designers added windows in the stairwells where possible and installed 10-by-20-foot, floor-to-ceiling graphics of outdoor activities at the landings.
The interior design is also reflective of its location in the Pacific Northwest, with each floor carrying a specific theme—forests, water, wildflowers, and mountains/long-distance views—with corresponding wall colors, flooring, carpeting, and artwork. Kaiser’s signature round, glass two-story rotunda houses a hanging glass sculpture of gingko leaves, another nod to the facility’s location. Inside the MOB, the main corridors are carpeted for a warmer aesthetic, with changes in the pattern serving as subtle wayfinding. Signage and artwork are also coordinated at each decision point.
The patient rooms include an interactive bedside console that hangs on a lightweight boom at the patient’s fingertips. The touch-screen device controls the lighting, TV, movies, and music, and connects to room service, as well, for food ordering. On the footwall, an electronic white board integrates staff notes, medical records, and patient information.
Miller says a willingness to think about details and try new things helped lead to better results at Westside Medical Center. “Architecture is not a static business,” he says. “Obviously, you save a lot of time with a template. We figured it saved us 18 months. But it doesn’t mean you can’t think while you’re doing it.”
For more on Kaiser Permanente's art program for Westside Medical Center, read "Art Plays Starring Role At Kaiser Permanente’s New Oregon Hospital."
Project source list
Completion date: August 2012
Opening date: Aug. 6, 2013
Owner: Kaiser Permanente
Architecture and interior design: AECOM
Contracting and construction: Andersen Construction
Engineering: m+nlb (Mazzetti Nash Lipsey Burch)
Anne DiNardo is senior editor of Healthcare Design. She can be reached at firstname.lastname@example.org.