As in many of our nation's emergency departments, an exhausted facility and staff at Catholic Health System's St. Joseph Hospital in Cheektowaga, New York, were stretched to near capacity. Recognizing that 50% of all inpatient admissions enter through the ED further encouraged hospital leadership to undertake an examination of every facet of emergency care.

The operational work included a detailed analysis of the people and their processes, from future demographic considerations to determining the individual daily flows of staff and patients. An overlay of best practices and the latest technology for collecting/storing information, as well as performing diagnostic testing, were also added to the operational mix to produce the most efficient design parameters for this unique ED.

Project category: Addition (completed April 2005)

Chief administrator: James Millard, President & CEO, (716) 891-2400

Firms: FreemanWhite, Inc., (704) 523-2230; Kideney Architects, (716) 636-9700

Design team: Richard Dahm, AIA, ACHA, Project Team Local Architect (Kideney Architects); Eric T. Krempa, Associate AIA, Medical Planner; Troy Seanor, AIA, Project Architect for SDs and DDs (FreemanWhite, Inc.)

Photography: © Cavanaugh Photography

Total building area (sq. ft.): 17,000

Construction cost/sq. ft.: $382

Total construction cost (excluding land): $6,500,000

In light of a strategic goal to increase inpatient admissions, the ED entrance gained design importance. As a result, the entrance was enhanced with a dramatically modern and welcoming “face” in the shape of a large, copper bell encircled by blue, mirrored windows. The foyer design, which also sought a higher profile, features a spacious, two-story atrium with a soothing copper and aqua palette, comfortable furnishings, unusual materials, a relaxing water feature, and natural light from clerestory windows.

This ED is not only aesthetically appealing but can also accommodate 40,000 annual patient visits—doubling its previous ED and inpatient admission levels. Clearly, here is the quintessential healthcare outcome—when strategy, operations, and design join to produce a healing mesh of patient care and an award-winning design.