The new Scripps Critical Care Building, designed by Perkins+Will, was completed in September 2014 to serve residents of the seaside community of Encinitas, Calif. The project consists of a new, two-story critical care building and central energy plant, connected to and serving an existing 150-bed community hospital. Driven by an increase in emergency department patient volumes and a periodic lack of medical-surgical beds, the project provides additional capacity to solve both issues. Integrated into the master plan for the campus, this facility provides 26 treatment areas in a new ED on the first floor, and 36 new med-surg beds on the second floor, including six larger VIP rooms. The ground floor includes shell surge space and imaging areas for general radiography, MRIs, and CT scans associated with the ED. A new rooftop emergency helistop and trauma elevator serve the hospital complex.

The design concept for the building draws upon the surrounding coastal context of the community, situated between the Southern California foothills and the Pacific Ocean. On the east side (facing the hills), garden areas were created for public and staff in the zone between the existing hospital and the new building. Patient rooms on the east side look out over patterned roof gardens, covered with drought-tolerant local grasses and sedums. On the west side (facing the beach), curved wall elements reference the sails on the nearby coastal waters, serving to break up the linear facade and provide visual interest, as well as providing shading to windows on the floor below. The design also uses several natural materials associated with maritime lifestyles, such as sand-colored concrete and block, broken shells, blue and green glass, and hardwood surfaces invoking associations with nautical decking.

The site, located to the west of the existing hospital, is tightly bounded by the existing facility to the east, the access roadway to the south, existing parking to the west, and a new structure to the north. In addition, the site is envisioned as a major secondary entrance to the hospital for staff, families, and patients. In the future, master planning modifications to the internal organization of the existing hospital may mandate that this side of the building become a primary entrance to the facility. As a result, the central plant has been separated from the acute care building, creating an entrance plaza that can be developed in the future.

Landscaping is used as a significant organizing element, with gardens lined with bosques of seasonal trees in the open spaces between the existing building and the new. These linear gardens define circulation paths from adjacent parking areas, while simultaneously providing areas of respite for families and staff during stressful times by providing water features, artwork, and seating elements along the paths.