Aside from a plethora of sparkling new projects in this, our 8th annual Architectural Showcase issue, our contents include an article from construction giant Walter P. Moore on the age-old dilemma of “renovate versus build new” (p. 62). The article raises several questions worth exploring when evaluating old hospitals for upgrade in this high-tech day and age—for example, ceiling height to accommodate new technologic infrastructure, flexibility of floor space, and weight-bearing properties to accommodate new technologies among them. When all is said and done, conclude authors Young, Skolnick, and Sims, renovation can be at least as costly as building new, and with no guarantee of complete satisfaction.

But, as this issue was going to press, a study emerged from the New York architectural firm RMJM Hillier finding that New Orleans' famed and (post-Katrina) tragic Medical Center of New Orleans (aka “Big Charity”), built in 1938, is highly suitable for renovation. A news release describing the study cites several fortuitous features of the old hospital's design, lending it to successful renovation—an H-shaped footprint allowing good daylighting and views for all rooms, fully adaptable floor plates (except for a possibly undersized third floor), and a basically sound envelope and building structure. The release doesn't refer to the ceiling height/interstitial space question mentioned above, but HEALTHCARE DESIGN is getting the full report soon and plans to cover it in more detail.

Also interesting are some other factors cited favoring renovation of Big Charity: expected completion two years earlier than a new hospital would take and substantial savings in financing and lost revenue costs. And there's another rather big factor: listing of the hospital (along with its surrounding neighborhood) as one of America's 11 Most Endangered Historic Places by the National Trust for Historic Preservation. That, as experienced builders know, is a formidable determinant of future plans for any site or structure.

We look forward to exploring the “renovate versus build new” issue in ever-increasing depth over the next months and years. Sometimes it does seem as though replacing the old and dated with something shiny and new would be a no-brainer—who wouldn't want that? But this is one field that stubbornly refuses to conform to our “throwaway” culture. In healthcare design, there are good reasons for deep consideration of this choice, and a need for creative concepts in any event. HD



Richard L. Peck, Editor-in-Chief

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