• Sustainable health care design aims to construct efficient, environmentally friendly health care facilities while also improving patient comfort.
• The Hope Lodge in Houston is a home away from home for cancer patients and emphasizes the importance of daylighting in care.
• The VA Puget Sound Mental Health & Research Building in Seattle uses passive solar strategies to reduce HVAC use and recycles rainwater for a portion of its plumbing needs.

With the built environment responsible for approximately 40% of the world’s annual carbon emissions and the construction and design sector as a whole responsible for extracting more than 30% of the planet’s natural resources, it’s imperative that all buildings strive for improved sustainability. The health care sector is no exception.

Achieving sustainability in health care design is often easier said than done, as the very nature of health care facilities often requires that they consume more energy and produce more waste than the average building. This can require outside-the-box thinking and the need for innovative strategies to improve building performance and reduce energy load requirements.

What is Sustainable Health Care Design?

The third floor garden area at the new Stanford Hospital provides a place of respite. Photo by Will Pryce

Sustainable health care design is a subset of sustainable architecture dedicated to the design and construction of healthy, efficient, environmentally friendly health care facilities whose operations have a positive impact on both people and the planet.

WHO defines a sustainable health care facility as one that “improves, maintains, or restores health while minimizing negative impacts on the environment and leveraging opportunities to restore and improve it, to the benefit of the health and well-being of current and future generations.”

Sustainable health care design ultimately aims to reduce the overall environmental impact of the facility itself while at the same time improving social equity, patient comfort, and the productivity of health care providers. Strategies for achieving these goals typically include:

• Integration of renewable energy sources
• Implementation of daylighting solutions
• Inclusion of vegetation and green spaces
• Rainwater harvesting and reuse
• Installation of cool or green roofs
• Use of passive solar design principles
• Energy-efficient systems and appliances

Different types of health care facilities may have varied goals or methods when it comes to sustainability, but the foundational principles are the same. Here are 16 inspiring examples of sustainable health care design in action.

16 Sustainable Health Care Design Examples

1. Richard M. Schulze Family Foundation ACS Hope Lodge, Houston

The Perkins&Will Hope Lodge project was designed to locate all of the programs on the building perimeter and put the circulation route around the healing garden. Photo by James Steinkamp

Designed by Perkins&Will to the WELL Building Standard for the American Cancer Society, the Richard M. Schulze Family Foundation Hope Lodge acts as a supportive home away from home for cancer patients and exemplifies the importance of daylighting when it comes to designing sustainable health care facilities. Daylighting is an element that Kingspan Light + Air’s Neall Digert calls “the number one amenity we can apply to a building that drives human satisfaction and comfort.”

Featuring a footprint similar to that of the traditional cloister, Hope Lodge encompasses 64,000 square feet and includes two towers wrapped around a central healing garden landscaped with native plants. Large windows flood the interior with natural sunlight, drastically reducing the building’s energy consumption, while advanced air cleaning and water filtration systems ensure a healthy indoor environment for patients.

Aside from helping to reduce energy loads, daylight is also extremely beneficial from a health care standpoint. “Exposure to natural light has been proven time and time again to have numerous benefits for people, from visual comfort to psychological and neurological benefits like improving mood, reducing stress, enhancing the body’s immune response, and allowing for better sleep,” Tori Wickard, senior project architect at Perkins&Will, previously told gb&d.

All of the lodge’s communal spaces are positioned around the central healing garden, allowing patients to take in the natural sunlight and enjoy biophilic views. Biophilia is also present within the lodge’s interior, which evokes and fosters a connection to the natural world through the use of wood, earth-tone colors, and natural geometries.

2. Rancho Los Amigos Recuperative Care Campus, Downey, CA

Photo by Ric Berryman

Designed by GGA+ to LEED Gold standards, the Rancho Los Amigos Recuperative Care campus in Downey, California provides physical rehabilitation services to the greater Los Angeles County community in a mindful, sustainable manner. Encompassing 6.8 acres, the park-like Ranchos Los Amigos includes a central Recuperative Care Center, five residential treatment program buildings, and several outdoor spaces.

“Conceptually the GGA+ team referenced a farming village as a site planning prototype appropriate to the history and culture of the campus,” Staci Nesbitt, principal architect at GGA+, wrote in a previous gb&d article. “Respecting the rich context of existing mature trees at the site, the proposed plan created an informal and organic organization of the buildings and associated outdoor spaces.”

Due to California’s propensity for droughts and prolonged dry spells, Rancho Los Amigos also practices water-wise landscaping to reduce its irrigation needs and on-site water requirements. A gray water recycling system supplies water to the campus’ few grass lawn areas, and the rest of the property features hardscape elements and pollinator gardens seeded with native, drought-tolerant plants—all of which allow the site to double as a habitat restoration project.

Other sustainability features include the production of onsite renewable energy via photovoltaic panels, use of high-efficiency VRF mechanical systems, and advanced building-level energy metering. Reflective roofing PVC, prefabricated wall panels with high levels of insulation, and energy-efficient siding and windows further serve to reduce Rancho Los Amigos’ energy needs.

3. Cedars-Sinai’s Los Feliz Urgent Care Clinic, Los Angeles

A new urgent care facility in the Los Feliz/Silver Lake area has a mural from a local artist inspired by the indigenous people who lived there and the local flower marts. Photo courtesy of Cedars-Sinai

Situated in Los Angeles’ Los Feliz neighborhood and designed by Abramson Architects, the new Cedars-Sinai Urgent Care Clinic takes design inspiration from the area’s historic monuments and landmarks—namely the Samuel Novarro House and Ennis House, both designed by Frank Lloyd Wright—to match the diverse aesthetics and architectural styles of the surrounding area.

“Cedars-Sinai envisioned a building that is grounded in the neighborhood,” Zeke Triana, vice president of facilities and design at Cedars-Sinai, previously told gb&d. “You could never duplicate that building elsewhere in the community. It’s rooted in the Los Feliz/Silver Lake area and inspired by some of the beautiful architecture.”

Colorful murals were painted by local artists to reference the neighborhood’s iconic flower marts and pay homage to the region’s Indigenous peoples. The murals adorn the clinic’s street-facing facade, bringing life to the building and further grounding it within the community.

Non-structural matte black corrugated metal panels wrap around the clinic’s second floor exterior and serve as a rainscreen, helping to protect the building’s stucco finish and passively regulate temperatures. Large windows and a two-story atrium flood the interior with natural light to create a welcoming clinical environment.

“When you walk in, you feel the total environment has been curated for you, and the details really matter,” Triana says. “From how you access the campus to how you park to how you get to your destination to the artwork, landscaping, lighting—everything has been curated so you get that total experience. That really does create, we believe, an environment where healing can take place.”

4. Texas Children’s Hospital, Austin

The new Texas Children’s Hospital is being designed with a calming neutral palette and splashes of color. Rendering courtesy of Texas Children’s Hospital

Slated to open in 2024, the Texas Children’s Hospital will provide both women and children with a variety of medical services. The facility is designed to mesh with surrounding landscape and features outdoor spaces where both patients and staff can relax and enjoy the fresh air.

Maximizing natural light was also important to the developers, resulting in numerous windows to allow patients the opportunity to see outside and take in sunlight even if they can’t get outdoors.

Inside the hospital’s theme centers around Texas’s landscape, with each floor reflecting a different biome. A neutral color scheme was selected for its calming effect, with splashes of color adorning the common areas to draw engagement and serve as wayfinding. Interesting and interactive design details are included where children can easily see them, giving them something to focus on other than their fear.

“One of the things that is very important with a children’s hospital is not to be scary,” Jill Pearsall, senior vice president of facilities planning and development at the Texas Children’s Hospital, previously told gb&d. “We’ve engaged the flora and fauna of our themed areas to welcome them—a little salamander in the pavement or peering out from under the welcome desk. He’s there to teach them, to be part of that educational process, and to be diversionary. We don’t want them just sitting there worried about seeing the doctor or having a procedure.”

5. UCLA Health’s Calabasas Campus, Calabasas, CA

Inside UCLA Health’s Calabasas facilities. Photo courtesy of UCLA Health

UCLA Health’s Calabasas Campus expertly marries patient-centric design with sustainable architecture to create a health care facility that is both friendly to the people and to the environment.

Large windows allow natural light to illuminate the building’s interior and serve to provide views to patients, helping to reduce feelings of stress and anxiety. In rooms where windows are not possible, soft LED lighting is employed, as are biophilic elements like nature-themed artwork and natural materials.

One of the things UCLA wanted to ensure with the Calabasas Campus was long-term design flexibility. “After construction, whether one’s an exam room with an exam table and a hand-washing station or one has more furniture, we allow for flexibility along the way so if we determine we really need more exams than consults, we can convert that room easily,” Amy Kraft, director of UCLA Health Real Estate Planning, Design & Construction, told gb&d in a previous article.

Being able to easily convert rooms without necessitating a complete renovation is not only extremely convenient, but it also helps prevent future construction waste—reducing the project’s overall environmental footprint and life cycle impact.

6. Virtua Samson Cancer Center, Moorestown, NJ

The Virtua Samson Cancer Center in New Jersey. Photo courtesy of FCA

The Virtua Samson Cancer Center (VSCC) in New Jersey exemplifies how project teams can successfully repurpose an existing building for even more sustainable health care design.

Designed by Francis Cauffman Architects the VSCC is an inspiring example of how adaptive reuse may be implemented within health care architecture as a means of reducing waste. Originally built as an ACME supermarket, the VSCC now serves the community in another way, encompassing everything from radiation oncology to an infusion treatment and cancer administrative suite.

“Choosing to repurpose an existing building is a socially responsible and sustainable way to bring care closer to the communities that need it,” Aran McCarthy, principal of health care at FCA, previously wrote for gb&d.

To foster a sense of hope and healing while also prioritizing sustainability, VSCC uses high ceilings, vibrant artwork with nature scenes, and daylighting strategies to allow ample natural slight. Skylights are positioned above the building’s central concourse and the main gallery, helping to both improve internal wayfinding and the patient experience as a whole. A nearby garden further serves to connect patients to the natural world and is visible from the infusion treatment spaces.

7. Lucile Packard Children’s Hospital, Palo Alto, CA

A system of horizontal louvers and vertical fins breaks the building into smaller pieces, visually shrinking it for almost a residential feel. Photo by Steve Babuljak

Designed by Perkins&Will, the team behind the Lucile Packard Children’s Hospital in Palo Alto knows kids are often overwhelmed in hospital settings, which is why it practices patient-centric design to the highest degree. Spanning 521,000 square feet, the hospital is capable of housing nearly 150 patients.

“There was a lot of attention paid to the scale of the building,” Robin Guenther, sustainable health care design leader at Perkins&Will, previously told gb&d. “So the children won’t feel like it’s cavernous and like they’re lost in it.”

A bright, open lobby welcomes patients as soon as they enter the facility, while nature-inspired artwork and educational murals adorn the walls, giving visitors the opportunity to learn about local wildlife and take their mind off of the reason for their visit.

This connection to the natural world is reinforced throughout the hospital, both inside and out, in a myriad of ways. Each patient’s room features a planter box outside its window and gardens wind through the property, many of which feature animal sculptures and play equipment for the children to enjoy.

8. VA Puget Sound Mental Health & Research Building, Seattle

The VA Puget Sound Mental Health & Research Building in Seattle. Photo by Ben Benschneider

The US Veterans Affairs (VA) helps approximately 9 million veterans and their families nationwide, with more than 110,000 of those veterans residing in the Pacific Northwest alone. To better serve the region’s veteran population, the VA commissioned Stantec to design its VA Puget Sound Mental Health & Research (MH&R) Building in Seattle.

At 220,000 square feet, the MH&R building features the labs and patient rooms one might expect from a medical research facility and also includes group counseling spaces, a landscaped plaza, indoor rock garden, other quiet spaces, and three green roofs. These roofs are visually pleasing to patients, aid in reducing the amount and flow-rate of stormwater runoff, and help absorb heat and carbon dioxide. They also serve to collect and store rainwater that is then reused for flushing the building’s systems.

The MH&R building also employs ground-level stormwater mitigation and recycling tactics to help conserve water. “In the landscape out on the site there are bioswales and various means of dumping the water into the landscape, rather than sending it into storm drains and making it Seattle’s issue,” Ian Lawlor, project director at Stantec, told gb&d in a previous article. “We use very efficient irrigation systems to reduce the amount of water that we’re spreading into the landscape.”

Large, energy-efficient windows allow daylight to illuminate the MH&R building’s interior while also providing views, reducing feelings of stress, anxiety, and paranoia in patients. Some of these windows are designed to be operable so as to facilitate natural ventilation and bring in fresh air. “You’re not only getting daylight, you’re getting air circulation on a passive level,” Lawlor says. “Our approach is one of passive first, active second.”

Exterior solar shades help prevent excessive solar heat gain while radiant floors help heat and cool public spaces, providing optimal thermal comfort and reducing energy loads throughout the year.

9. Blackburn Center, Portland, OR

Ankrom Moisan Architects designed the Blackburn Center for Central City Concern (CCC)—a nonprofit that provides social services for the homeless and other vulnerable populations.

The center includes long-term and temporary affordable single-occupancy housing units, public gathering areas, fitness rooms, therapy and rehabilitation spaces, medical exam rooms, and more. The six-story Blackburn Center is intentionally located in Portland’s Hazelwood neighborhood to provide a closer alternative to the CCC’s clinic in downtown Portland. This location was also chosen for its proximity to bus and light-rail services, eliminating the need for large, space-devouring parking lots and allowing the addition of a small gathering space outside the front of the building.

To make the space more welcoming and inviting to a population increasingly targeted by hostile spikes-and-studs architecture, the Blackburn Center sports a bright front plaza, home-like gabled roof, and uses natural daylight throughout the building. “We’ve remained very cognizant that this is a pathway for mental and physical support,” Mariah Kiersey, project leader and a principal architect at Ankrom Moisan, previously told gb&d. Fresh air is supplied by a tempered air system while operable windows and efficient ceiling fans help keep the center cool without extensive reliance on mechanical heating and cooling.

Energy-efficient slotted windows, solar shades, and a rooftop solar panel array help offset the building’s energy usage, resulting in lower operating costs for CCC. Blackburn Center is also working towards Earth Advantage Platinum certification, further solidifying its commitment towards sustainability in all its forms.

10. St. Mary’s Medical Center (formerly Vision Northland), Duluth, MN

Essentia Health’s new hospital in Duluth. Rendering courtesy of EwingCole

In Duluth, EwingCole designed Essentia Health’s Vision Northland Hospital, now St. Mary’s Medical Center, with sustainability and patient well-being at the forefront.

To ensure patients receive adequate exposure to natural light during the day, Vision Northland’s patient tower is clad in a glass envelope, allowing for nearly 360-degree admittance of sunlight throughout the year. Overall the facility uses low-VOC products and natural materials—including wood and stone—wherever possible.

Like the Texas Children’s Hospital, Vision Northland’s interior designers leaned very heavily into establishing a cohesive, nature-inspired theme in the facility’s décor and art, with plentiful photos and graphics. “These graphics highlight local landmarks, regional history, flora, and fauna native to the North Shore and familiar to the local community,” Maria Papiez, director of sustainable design for EwingCole, previously wrote for gb&d. “The graphics are tailored for each floor, some directly representing these elements and others in more abstracted patterns and colors. These beautiful images support patients, family, and staff by building familiarity and comfort and serve the essential purpose of wayfinding throughout the building.”

Biophilic design strategies were also implemented so as to foster an even closer connection to the natural world. Plants can be found throughout the hospital’s interior and a rooftop terrace provides patients with a direct link to the outdoors.

11. SCVMC’s Sobrato Pavilion, Fruitdale, CA

Santa Clara Valley Medical Center’s Sobrato Pavilion treats victims of traumatic brain and spinal cord injury in a LEED certified, eco-friendly rehabilitation center. Photo by David Wakely

The Sobrato Pavilion is a state-of-the-art health care facility designed by Stantec that treats victims of traumatic brain and spinal cord injuries. The LEED Gold project encompasses 370,000 square feet and includes rehabilitation rooms, a large-scale aquatic therapy pool, 168 single-occupancy patient rooms, and other amenities.

Sobrato Pavilion is connected to other existing buildings on SCVMC’s campus by a green atrium lobby that functions as a “conservatory space,” according to Alan Codd—a member of the pavilion’s design team. Ample daylighting strategies are implemented throughout Sobrato Pavilion, with each patient room featuring large windows, giving patients as much control as possible over their environment.

To maximize the Sobrato Pavilion’s energy savings, Stantec reached out to Arup to provide the building’s mechanical, electrical, and plumbing engineering services. “Health care is being very stringent [about energy consumption] on new constructions,” Jude Chakraborty, an associate at Stantec, previously told gb&d. “And as architects at Stantec, our advice helps guide those decisions. We’re getting them to where they should be, and things are looking good.”

Instead of a recirculating air system, the pavilion uses a 100% outdoor air heat recovery ventilation system to supply the interior with fresh air. Zone control technology with exhaust air valves and volumetric tracking supply was also implemented to reduce heating energy demand. Low-flow fixtures were also installed to reduce the Sobrato Pavilion’s water requirements. Arup estimates the facility’s energy cost savings to be approximately 33% and domestic hot water savings to be about 45%.

12. Taussig Cancer Center, Cleveland

Cleveland Clinic takes a holistic approach to design for patients’ well-being. Photo by Robert Benson Photography

Completed in 2016, the 377,000-square-foot Taussig Cancer Center in Cleveland is a master class in sustainable, patient-centric design. It is one of the many health care facilities owned and operated by the Cleveland Clinic Foundation, and it shares the nonprofit’s holistic approach to creating simple, welcoming, and practical medical spaces.

“Nothing is physically daunting about coming into the space,” Chris Connell, chief design officer at Cleveland Clinic’s Center for Design, previously told gb&d. “It doesn’t have to be extravagant architecture. These are very basic architecture principles that are very near and dear to our hearts but have a big impact.”

Designed by William Rawn Associates in collaboration with Stantec, the LEED Silver center includes traditional treatment and infusion rooms as well as patient amenities like a pharmacy, cafe, meditation space, music/art therapy, and more—all with ample daylight throughout the year. Skylights and high ceilings create an open, airy, and well-lit environment while floor-to-ceiling windows flood the center’s treatment rooms with natural light, giving patients and staff with a view to the green courtyard outside.

13. Maggie’s Centre Barts, London

Maggie’s Centre Barts cancer center in London. Photo courtesy of Steven Holl Architects

Next to St. Bartholomew’s Hospital and designed by Steven Holl Architects, Maggie’s Centre Barts is a welcoming space where people suffering from cancer and their families can receive emotional and social support.

Characterized by its matte-white finish and colorful inserts, the exterior is clad in polychrome insulating glass that minimizes solar gains and maximizes natural light, making it appear almost as though the building is glowing from the inside. Zoned LED lighting helps provide supplementary illumination in a controlled, efficient manner when necessary.

In an effort to maintain Maggie’s Centre Barts’ home-like feel, the design team elected to remove as many large mechanical systems as possible. It’s for this reason that the building uses natural ventilation strategies and sources its heat from the hospital next door. Exposed concrete was used to construct the center’s branching frame to leverage its high thermal mass, further reducing energy consumption. Inside the design team made extensive use of bamboo, with the walls, ceiling, and much of the loose and built-in furniture being built from this fast-growing, nontoxic renewable building material.

Maggie’s Centre Barts also boasts a green roof (something of a rarity in London) and a rooftop terrace, helping to improve the site’s overall air quality, ecological biodiversity, and stormwater management, while also fostering psychological well-being—an often overlooked benefit of urban green spaces.

“There are not just ecological advantages to having a green roof; it is also a nice thing for the user,” Dominik Sigg, associate at Steven Holl Architects, previously told gb&d. “The roof is on a slope so you can see it from the vantage point of the terrace, and it becomes part of the garden.” Both the green roof and terrace provide visitors with a connection to the natural world and offer spaces to participate in meditation, yoga, and other mindfulness activities.

14. Jack Byrne Center for Palliative & Hospice Care, Lebanon, NH

Photo courtesy of E4H

Designed by E4H Architecture and made possible by a $10 million donation from the Jack and Dorothy Byrne Foundation, the Jack Byrne Center for Palliative & Hospice Care in Lebanon, New Hampshire provides dignified end-of-life care while also serving as a hub for education and research on hospice and palliative care.

Completed in 2017, the 30,000-square-foot Jack Byrne Center encompasses 12 single-occupancy patient rooms, spaces for overnight guests, a kitchen, dining room, library, spa, meditation and exercise rooms, and more. Large windows supply the interior with natural sunlight while an earth-tone color palette, nature motifs, and natural materials like wood and stone serve as intentional biophilic design strategies, connecting patients with the natural world.

Prioritizing green building materials was a no-brainer for the E4H design team. “Why would we use products that emit toxic gas or are not friendly to the touch, if the environment that we’re creating is geared toward wellness?” Charles Rizza, associate partner at E4H, previously told gb&d.

To reduce the center’s carbon footprint and energy consumption, E4H elected to install a geothermal heating and cooling system, with an energy-efficient gas boiler acting as the building’s back-up power system. Combined with low-maintenance materials, these systems will allow the Jack Byrne Center to operate cost-effectively for years to come.

15. Family House, San Francisco

The Family House, completed in 2016, was designed by Leddy Maytum Stacy Architects. Photo by Bruce Damonte

Designed by Leddy Maytum Stacy Architects (LMSA) to LEED Platinum standards, Family House—owned and operated by the nonprofit of the same name—provides temporary free housing for low-income families whose children are being treated at the nearby UCSF Benioff Children’s Hospital.

The building can accommodate 80 families and is constructed from low-VOC materials. It’s designed using eight “neighborhoods,” each with 10 guest rooms with shared facilities to foster relationship-building while making efficient use of the space available.

“Instead of building 80 apartments with their own kitchens with refrigerators, sinks, cooktop, and dishwashers, we were able to build eight larger kitchens that could be shared amongst the cluster of families,” Gregg Novicoff, associate principal for LMSA, previously told gb&d. “Sharing resources allows for building less and furthers the building’s goals of creating community—where each of the families might have been making meals in the privacy of their own apartment, now they share in making food cooperatively.”

Family House relies on daylighting to bring natural sunlight into 100% of the public spaces and utilizes motion-sensor lighting, Energy Star appliances, a solar hot water system, and a cool roof to reduce energy use by 48%. A continuous filtered outdoor air ventilation system supplies the building with fresh, clean air while a low-pressure, high efficiency irrigation system delivers water to the biodiverse green roof, minimizing the loss of water through evaporation.

16. Khoo Teck Puat Hospital, Singapore

Photo courtesy of International Living Future Institute

Khoo Teck Puat Hospital (KTPH) is as much a garden as it is a health care facility—incorporating biophilia in almost every aspect of its design. In total, 18% of the hospital’s floor area accounts for blue-green space, with 40% of that space being publicly accessible—characteristics that helped KTPH earn the first-ever Stephen R. Kellert Biophilic Design Award. The project was designed by Robert Matthew Johnson Marshall (RMJM) Architects in collaboration with CPG Consultants.

Greenery extends from the hospital’s central courtyard into the open-to-sky basement and up into the upper levels of the buildings, with balconies featuring scented plants to bring the experience directly to patients’ bedsides. Multiple rooftop gardens—and even one rooftop farm that provides produce for the hospital kitchen—can be found across the campus. These plants help improve air quality, mitigate stormwater runoff, cool the surrounding air, and attract crucial bird and insect species.

The plentiful plants aren’t just good for the environment, though. They’re great for patients, too. “With Khoo Teck Puat we see that biophilic design elements and attributes should not only be considered as part of the design process, but also as part of the healing process,” architect Stephen Kieran, a juror for the Stephen R. Kellert Biophilic Design Award, told gb&d in a previous article. Studies show access to vegetation and green spaces has a calming effect on the mind and reduces feelings of stress, which can in turn help lower blood pressure, heart rate, and cortisol levels.

KTPH also adopted the existing stormwater pond adjacent to the initial build site, converting it into a park that now serves the greater community. Native plant species were introduced to help clean the pond and foster biodiverse habitat growth, while walking trails were established in order to link the pond to the hospital and a nearby residential development.

Due to the KTPH’s V-shaped layout, breezes are able to first skim over the stormwater pond before bringing cool, fresh air to the hospital’s patients via natural ventilation. KTPH’s subsidized ward tower is also oriented so as to make the most of prevailing North and South East winds, reducing mechanical ventilation loads by approximately 60%.

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• Stanford Hospital at 500 Pasteur Drive received LEED Gold certification in 2022.
• Going forward Stanford aims to achieve LEED Gold for every major renovation and construction project.

Stanford University in Palo Alto is home to one hospital system that’s continually exploring the evolving territory of sustainable health care design. Modular construction is one big topic they’ve focused on recently.

Modular design allows spaces to be easily reconfigured depending on what a clinic needs. Offices can become exam rooms or exam rooms can become treatment rooms without the need for large, costly, and material-intensive renovations.

As part of their recent modular construction efforts Stanford Health Care is increasingly turning to vacuum-based plumbing. These systems are easier to reconfigure than traditional gravity-based plumbing and use less water, which is more sustainable and sanitary.

In all building projects Stanford is looking for environmentally friendly and sustainable building materials, flooring, and furnishings—even if that means a larger upfront cost.

“It’s a bit of a learning process as we go, as greener materials become available,” says Molly Fries, Stanford’s interim director of operational excellence. “We do look at things from a life cycle analysis perspective, moving away from just looking at the first cost.”

Photo courtesy of Stanford

Going forward Stanford aims to achieve LEED Gold for every major renovation and construction project. They first received the certification at a new hospital completed in 2019. “It’s quite unusual for a hospital to achieve that,” says Helen Wilmot, Stanford’s chief facilities and sustainability officer. “Stanford is definitely ahead of the curve.”

But achieving LEED certification requires far more than just reducing waste and using greener materials. “The infrastructure is where it’s at. And for a health care building that’s the hardest part,” Wilmot says.

Hospitals face particular challenges when it comes to their heating, ventilation, and air conditioning systems. Hospital HVAC systems are highly specialized to control disease spread. Wilmot says some Stanford facilities have 20 individual zones, all with their own regulated humidity, temperature, airflow, and air pressure.

Designing a system that can accomplish those tasks while also being energy-efficient is difficult. “We have very sophisticated designers to help us with that. We’re asking them to think how to make it more sustainable,” Wilmot says.

Natural gas is another obstacle facing hospitals wanting to go green. In health care settings natural gas is primarily used to make steam, which is used to sanitize medical instruments, cookware, and dishes. The steam is created in an onsite steam plant often powered by natural gas. “We use a lot of natural gas,” Wilmot says. “Producing steam with electrification is not standard.”

She says creating more sustainable systems requires designers, architects, general contractors, and subcontractors to be familiar with health care–specific building needs. And once the facility is built engineers must be trained to keep these innovative systems up and running. “It has to be an entire flow of change that occurs. All the parties along that chain have to be committed,” she says.

As a large academic medical center, Wilmot says Stanford bears a responsibility to lead the way. “We are meant to be a role model for how it is we address human planetary health,” she says. “We cannot do it alone. The architects have to do it with us. The contractors have to do it with us. The suppliers have to do it with us.”

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• When constructing hospitals for the modern age, sustainability and patient-centric design go hand-in-hand.
• Daylighting, green spaces, and comfortable furniture are just a few comforting design elements.
• The Lucile Packard Children’s Hospital in Palo Alto is an inspiring example of patient-centric design in action.

It’s no secret hospitals and medical facilities can be incredibly stressful, for both patients and their families. And while there’s no way to completely eliminate that stress, an effectively designed hospital can help to reduce and mitigate it.

But what exactly does patient-centric design look like? And how can it be realized within the parameters of sustainable building? Let’s take a look at a few hospital design elements that help ease patients’ minds and make them feel at home.

Patient-Centric Hospital Design Ideas

In recent years hospital architects and designers have started to move away from the sterile, stark cavernous rooms and corridors of the past, preferring instead to prioritize patients’ well-being and design facilities that incorporate nature, comfortable furniture, natural lighting, and other welcoming elements.

These are some of the design elements architecture teams are telling us they love.

1. Comfortable Waiting Areas

Embra is modern, freestanding, modular community seating from Interwoven, a brand of Kimball International. Photo courtesy of Interwoven

Upon stepping inside a hospital, one of the first things a patient or visitor sees is the reception desk and waiting room—and it is these places that are often the most stressful parts of a visit.

Waiting can be incredibly anxiety inducing. To help patients mitigate this stress, waiting rooms should be comfortable and provide positive distractions. This can be achieved through the inclusion of large windows to provide daylight and views outside, art, murals, or interactive spaces for visitors to focus their attention on, and comfortable furniture.

Kimball International focuses in large part on comfortable furniture and offers a wide variety of flexible options for medical facilities. Their Embra and Whitaker Health product lines of modular, freestanding community seating are easily reconfigured and look more like something you’d find in a living room than a hospital—and that’s on purpose.

“Think about those community spaces as more than just a space to come in and wait for 20 mins before the doctor calls you into the clinic,” Kim Montague, Kimball International’s executive director of applied research and partnerships, previously told gb&d.

2. Ample Daylighting

The Hope Lodge Cancer Center relies on large windows and other daylighting strategies for the majority of its daytime illumination. Photo by Peter Molick

While it’s often not possible to illuminate every room in a medical facility with natural light, design experts say special care should be taken to include daylighting solutions wherever possible.

This is especially true for reception areas, patient rooms, waiting rooms, and any other communal rooms in which patients and their families/visitors may spend considerable time. Natural daylight has obvious benefits from a sustainability standpoint, but it can also help boost psychological and physical health.

“Exposure to natural light has been proven time and time again to have numerous benefits for people, from visual comfort to psychological and neurological benefits like improving mood, reducing stress, enhancing the body’s immune response, and allowing for better sleep,” Tori Wickard, senior project architect at Perkins&Will, previously told gb&d.

Indeed, studies have shown that patients who are treated in facilities that prioritize daylighting over electric lighting heal faster and experience less pain, resulting in shorter hospital stays.

3. Internal Wayfinding Tools

Hospitals, especially large ones, often have sprawling, complex layouts that can be difficult to navigate, adding to the stress patients and visitors may feel. For this reason it is important to include appropriate, intuitive wayfinding tools that allow even first-time visitors to find their way with ease.

Historically, signage and maps have been the preferred wayfinding methods in hospitals—and while they certainly have their place, excessive use of these tools can become distracting or even overwhelming, especially for visitors whose first language isn’t English or who don’t speak English at all.

Using images and symbols for wayfinding purposes can prove invaluable in this regard, as many symbols are universal, and our brains process images much faster than words. Incorporating graphics and color-coding can also make wayfinding simpler and less daunting for younger patients or visitors who aren’t in a clear headspace.

If all else fails, using prominent signage to direct visitors and patients to common areas is an easy way for them to find someone who can point them in the right direction. After all, most modern hospitals have visitor support staff, information desks, or even interactive kiosks that can help people find the room they’re looking for.

4. Welcoming Clinical Environments

It’s one thing to design waiting rooms, reception areas, and patient rooms to be warm and inviting, but these characteristics should also extend to the hospital’s clinical areas whenever possible.

Often imaging suites, blood-draw stations, and other clinical rooms designed for conscious procedures lack the welcoming design elements found in other parts of a hospital, adding to patient stress levels. For this reason clinical areas should incorporate daylighting and contain positive distractions—think art, murals, photos, and the like—to facilitate a calm environment.

5. Theming

The design options for patient rooms are endless with Koroseal’s wallcovering capabilities. Photo by Kenneth Petersen

Another way to make patients feel at home is by establishing a coherent theme through art, murals, and wallcoverings. Nature is an excellent and widely applicable theme that can be tailored to specific environments, providing a sense of familiarity and locality to combat feelings of anxiety and stress.

“A lot of healing spaces and medical spaces are shifting their focus to provide a positive human experience,” Amy Sweeting, product manager at Construction Specialties, told gb&d in a previous article. “Health care designers are creating environments that lessen the anxiety that people have sitting inside waiting rooms and lobby areas and instead promote positivity about going to the doctor or waiting for a loved one.”

Construction Specialties’ line of Acrovyn Wall Coverings + Panels, for instance, can be embedded with digital imagery and photos of nature scenes and local landscapes, while Koroseal Interior Products offers a range of highly-customizable wall coverings that can incorporate organic patterns, textures, greenery, and other biophilic elements to invoke the natural world.

6. Intentionality of Color

In a similar vein, picking and choosing interior color schemes with intentionality is crucial to making patients—especially those who are children—feel comfortable and at ease with their surroundings.

Neutral and earth tone color palettes are ideal for usage in waiting rooms and common areas, as cool, muted colors have a calming effect on the human mind, but splashes of color and accent walls can also help to draw focus and brighten up a room. In general you’ll want to stay away from bright, bold colors, even though these may be used sparingly and appropriately in areas for children.

When used correctly, adhering to a color scheme can even aid in navigation and wayfinding.

7. Accessible Green Spaces

The Perkins&Will Hope Lodge project was designed to locate all of the programs on the building perimeter and put the circulation route around the healing garden. Photo by James Steinkamp

Of course, biophilic design strategies in color and décor have their limits, and nothing beats actually experiencing nature outdoors, which is why having easily accessible green spaces is integral to fostering patient well-being.

Gardens, terraces, and accessible green roofs invite patients, their families, other visitors, and staff to access fresh air and interact with the natural world in a more intimate manner. Studies show that access to these sorts of green spaces can actually improve psychological health and reduce stress, which in turn helps patients recover faster and makes hospital employees more productive.

8. Use of Sustainable Materials

Nothing says “we care about your health and well-being” like constructing a hospital from sustainable materials that won’t leach harmful chemicals or toxins into the air over time.

Taking care to design medical facilities using materials that are Red List-free—or = products that do not include any chemicals deemed concerning by the Living Building Challenge—ensures patients will not be exposed to volatile organic compounds or other potentially damaging materials during their medical stay.

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“We define wellness as a state of being and a process that aims to achieve a whole person’s health, or in this case, a patient’s,” Maria Papiez, director of sustainable design for EwingCole, previously wrote for gb&d. “To support that process, optimizing the materials surrounding patients and making up the indoor environment is the highest priority.”

What’s more, sustainable materials like wood and stone are an easy way to incorporate biophilic design strategies and foster connections to the natural world.

9. Ensure Dignity Upon Discharge

Lastly, it’s important for patients to feel confident and dignified upon being discharged from the hospital, especially if they are using mobility aids for the first time or are still recovering from surgery or a procedure. Often this looks like having a dedicated exit specifically for patients who wish to leave discreetly or with added privacy, as opposed to the main entrance.

A separate exit can also have the added benefit of easing the minds of patients who are entering the hospital for the first time.

Examples of Patient-Centric Hospital Design

Now that we have a better idea of some of the hospital design elements that make patients feel at home, let’s take a look at a few real world examples.

Texas Children’s Hospital Austin Campus

Creating outdoor spaces for rest and rejuvenation for both staff and patients was a critical part of the Texas Children’s Hospital’s design. Rendering courtesy of Texas Children’s Hospital

Designing with patients in mind is important for any medical facility, but even more so when designing a children’s hospital. The Texas Children’s Hospital campus in Austin is shaping up to be the perfect example.

Slated to open in 2024, the Texas Children’s Hospital will provide both women and children with a variety of medical services. The facility is designed to mesh with surrounding landscape and features outdoor spaces where both patients and staff can relax and enjoy the fresh air.

Maximizing the admittance of natural daylight was also important to the developers, resulting in numerous windows being installed to allow patients the opportunity to see outside and take in sunlight even if their condition doesn’t allow them to venture outdoors.

A waterfall stair inspires playful interaction for young patients. Rendering courtesy of Texas Children’s Hospital

Inside, the hospital’s theme centers around Texas’s landscape, with each floor reflecting a different biome. A natural, neutral color scheme was selected for its calming effect, with splashes of color adorning the common areas to draw engagement and serve as wayfinding tools. Interesting and interactive design details are included where children can easily see them, giving them something to focus on other than their fear.

“One of the things that is very important with a children’s hospital is not to be scary,” Jill Pearsall, senior vice president of facilities planning and development at the Texas Children’s Hospital, previously told gb&d. “We’ve engaged the flora and fauna of our themed areas to welcome them—a little salamander in the pavement or peering out from under the welcome desk. He’s there to teach them, to be part of that educational process, and to be diversionary. We don’t want them just sitting there worried about seeing the doctor or having a procedure.”

Lucile Packard Children’s Hospital

Photo by Steve Babuljak

Designed by Perkins&Will, the Lucile Packard Children’s Hospital in Palo Alto, California knows that kids are often overwhelmed in hospital settings, which is why it practices patient-centric design to the highest degree. Spanning 521,000 square feet and capable of housing nearly 150 patients, the Lucile Packard Children’s Hospital isn’t exactly small, but it’s not intimidatingly large, either—and that’s on purpose.

“There was a lot of attention paid to the scale of the building,” Robin Guenther, sustainable healthcare design leader at Perkins&Will, previously told gb&d. “So the children won’t feel like it’s cavernous and like they’re lost in it.”

A bright, open lobby welcomes patients as soon as they enter the facility, while nature-inspired artwork and educational murals adorn the walls, giving visitors the opportunity to learn about local wildlife and take their mind off of the reason for their visit. This connection to the natural world is reinforced throughout the hospital, both inside and out, in a myriad of ways—each patient’s room features a planter box outside its window and gardens wind through the property, many of which feature animal sculptures and play equipment for the children to enjoy.

Essentia Health’s Vision Northland Hospital

Essentia Health’s new hospital, Vision Northland, is a 950,000 square-foot hospital designed with patients’ well-being in mind. Rendering courtesy of EwingCole

Located in Duluth, Minnesota and designed by the EwingCole architectural firm, Essentia Health’s Vision Northland Hospital puts sustainability and patient well-being at the forefront.

To ensure patients receive adequate exposure to natural light during the day, Vision Northland’s patient tower is clad in a glass envelope, allowing for nearly 360-degree admittance of sunlight throughout the year. Overall the facility uses low-VOC products and natural materials—including wood and stone—wherever possible.

Like the Texas Children’s Hospital, Vision Northland’s interior designers leaned very heavily into establishing a cohesive, nature-inspired theme in the facility’s décor and art, making extensive use of photos and graphics.

“These graphics highlight local landmarks, regional history, flora, and fauna native to the North Shore and familiar to the local community,” writes Papiez. “The graphics are tailored for each floor, some directly representing these elements and others in more abstracted patterns and colors. These beautiful images support patients, family, and staff by building familiarity and comfort and serve the essential purpose of wayfinding throughout the building.”

Biophilic design strategies were also implemented so as to foster an even closer connection to the natural world. Plants can be found throughout the hospital’s interior and a rooftop terrace provides patients with a direct link to the outdoors.

The post 9 Hospital Design Ideas That Make Patients Feel at Home appeared first on gb&d magazine.

• Texas Children’s Hospital is building a new campus in Austin meant to be a beacon of healthy, sustainable design.
• The new 52-bed facility is scheduled to open in 2024 with intensive care units, operating rooms, a sleep center, emergency center, diagnostic imaging, urgent care, and more.
• Outdoor spaces, lots of windows, and a neutral palette with splashes color are core parts of the design.

Some of life’s most emotionally charged moments happen in hospitals. Births, deaths, treatments, recoveries, milestones—they happen moment by moment in every hospital around the world. Traditionally interior design in hospital settings has focused on efficiency and safety, essential components of health and healing. But with a growing emphasis on healthy spaces and sustainable materials across the design industry as well as on treating the whole person in medicine—including mental and emotional health—hospitals have begun to evolve from the inside out, creating unique and healing experiences that go far beyond the physical.

“The materials industry has caused that shift,” says Jill Pearsall, senior vice president of facilities planning and development at Texas Children’s Hospital. “Manufacturers have either been forced to change what they put in their materials or chosen to be more sustainable. And I think that’s a good thing. They’ve forced us as facility owners to adopt new products that are better for the environment—better for the internal environment and better for the global environment. The paint, carpet, flooring manufacturers—they’ve changed their ways, and we’ve adapted because it’s what’s available and because it’s the right thing to do.”

Creating spaces that heal patients—that’s what hospitals have always striven to do. And with new data on how essential the built environment is to physiological health, not to mention the health of communities and the world, it just makes sense on even the most practical level, Pearsall says. Add in a layer of new regulation in places like Austin, Texas, where Texas Children’s Hospital’s newest campus will be located, and you have the recipe for some truly innovative changes in the industry. “We’re required to meet the two-star rating for the Austin Energy Green Building (AEGB) program. We are going to not only design this facility to meet that two-star or higher level, but we are also going to layer in an educational program within the campus, designed to teach people what have we done to be sustainable, to be respectful of the environment, and hopefully even teach kids that those things are possible.”

Designing Welcoming Environments

Creating outdoor spaces for rest and rejuvenation for both staff and patients was a critical part of this design. Rendering courtesy of Texas Children’s Hospital

Planning for this ambitious project in Austin began at the height of one of the worst medical disasters in modern history, but that didn’t temper the enthusiasm. By March 2020 Pearsall and her team were putting their heads together (while remaining safely distant) to craft a truly innovative space.

Slated to open early 2024, this $485 million campus will include a 365,000-square-foot, 52-bed facility designed to serve both women and children with neonatal and pediatric intensive care units, operating rooms, epilepsy monitoring, a sleep center, an emergency center, advanced fetal interventions and surgery, diagnostic imaging, acute care, and urgent care. Next door, a 170,000-square-foot outpatient building will focus on subspecialties like cardiology, oncology, neurology, pulmonology, fetal care, and others.

“Looking at the pediatric growth in this area of Austin, as well as the women of childbearing age, we really saw that the drive for us to go into Austin was to bring in specialists on that higher acuity of care—heart programs, neurosurgery programs, high-risk women’s programs—bringing that to a place where, right now, those patients have to go to Dallas or Houston or San Antonio for those services. Bringing that high expertise of many of our clinical programs to central Texas was important.”

Equally important was imagining the kind of people who would eventually use the space and designing it to fit them. “Health care in general has evolved over many years to adopt hospitality-type character and feeling,” she says. But for this kind of hospital, it was a unique challenge. “Having worked at both an adult hospital and a pediatric environment, I have learned pediatrics are special. You need to respond to very small children as well as patients up to 18 or older. So we had to consider the breadth of ages and the need to bring in a little bit more joyfulness.”

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Before they could lift a hammer Pearsall and her team needed to decide how the campus would fit into both the ecosystem and the culture of the region. “We looked at this facility as one that might need to be slightly different. Austin is a less formal, more casual environment. We really considered, how does it align with the green building program and how does it align with Austin?”

Naturally they looked to the landscape for design inspiration. “We approached the design of the exterior as being synergistic with the central Texas environment.” That meant using materials and patterns that evoked the warm Texas limestone while maintaining a low profile on the horizon, mirroring the vast flat plains of the state’s Blackland Prairies to the east, and attempting not to obstruct the views of other buildings nearby (what Pearsall calls being a good neighbor).

This meant creating outdoor spaces on campus designed for rest and rejuvenation for both staff and patients. “Austin has nicer weather than Houston, so we wanted to take advantage of that. We wanted to incorporate respite spaces like boulder seats where people could just sit and breathe the outside air and escape the stresses of the day-to-day. Those elements also fit into Austin’s green building program goals.”

It also meant windows—lots of windows—letting in vast amounts of light and creating opportunities for patients and staff to absorb the beautiful Texas scenery from inside. “Engaging the outdoor environment, engaging daylight, really looking at how to terminate corridors, making sure the daylight comes in and that people there have an opportunity to see if it’s raining or not outside.”

We have caverns, waterways, limestone ridge, woods, highlands, horizon, Texas sky.

Inside, the facilities’ design would be highly themed, reflecting the unique landscape of Texas, building on the Texas Children’s Hospital brand, and educating the public about sustainability and the natural world. “We worked with our board of trustees to select a theme to brand the building and the campus. We selected ‘central Texas landscapes’ as the theme, so each floor of the facilities would reflect a different stratum. We have caverns, waterways, limestone ridge, woods, highlands, horizon, Texas sky.”

The team was very intentional about color choices, keeping the overall palette neutral and calming, with splashes of color in areas of interaction like welcome desks and waiting areas. This was all part of keeping the wayfinding simple and less stressful. “People have enough stress just being there. Even if it’s for a happy experience of having a baby, it’s still very stressful.”

Pearsall and her team made a special effort to think of their littlest patients in the design process as well. “One of the things that is very important with a children’s hospital is not to be scary,” she says. “We’ve engaged the flora and fauna of our themed areas to welcome them—a little salamander in the pavement or peering out from under the welcome desk. He’s there to teach them, to be part of that educational process, and to be diversionary. We don’t want them just sitting there worried about seeing the doctor or having a procedure.”

The team also put special emphasis on scale, keeping in mind that locating the most interesting design elements up high might not engage their littlest visitors as much. Pearsall calls these intentional details “breadcrumbs” and hopes to use them in future interactive programs designed to make the health care experience more approachable for children. “We’ve discussed having a selfie passport so kids can wander around and take selfies at different stops and fill out their passports—all to engage their curiosity and prove the hospital isn’t necessarily a miserable place.”

Using Healthy Materials

The new Texas Children’s Hospital is being designed with a calming neutral palette and splashes of color. Rendering courtesy of Texas Children’s Hospital

Beyond the look and feel of the new campus, the inner workings will focus not only on meeting the two-star rating from the AEGB program, which guides companies to design, build, and sustain healthy facilities for Austin communities, but also add an educational component that could impact generations.

From simple materials choices like using low-VOC paints to larger decisions like installing cooling towers that will collect condensate water into a pond for site irrigation, every component of the new campus’ green footprint will be a potential learning experience for visitors. Even access drives on the campus have been carefully designed to be pervious, allowing water to flow through and replenish the local water supply—a critical need in the arid landscape of central Texas. “We can teach visitors about the life cycle of that water, the need for conservation, while at the same time getting them interested in some cool engineering.”

The new cafeteria will be cavern-themed with an acoustical wood ceiling, designed to draw visitors both indoors and out for dining. The team also has a plan for the menu to be educational. Rendering courtesy of Texas Children’s Hospital

One often-overlooked opportunity to educate and reduce a facility’s environmental impact is in its use of food. The cafeteria itself will be cavern-themed with an acoustical wood ceiling, designed to be a fun, educational space that draws visitors both indoors and out for their dining experience. Pearsall and her team also have a plan for the menu. “Part of our food service program will be to engage local farmers in our supply chain. All of that will be part of the educational process as well … We want to celebrate our two-star rating but also really share knowledge with the community for future generations.”

Rendering courtesy of Texas Children’s Hospital

In fact, one of the early challenges the team faced in planning for such a large campus was keeping in mind the need for future expansions and regulations. The site includes an existing wetland area and is located over the Edwards Aquifer, one of the most prolific artesian aquifers in the world. Austin also requires that new structures be solar ready. Preserving as many of the trees as possible on the 24-acre site was yet another concern. Although these issues were all addressed in the current plan, Pearsall and her team wanted to make sure future changes didn’t set them back. The best green designs, after all, are future facing.

For this the team developed a comprehensive master plan, considering things like solar footprint, sun angles, parking, connectivity, water, and energy needs—all to preserve and even improve upon the successes of their designs in the coming decades. “So when I’m no longer there and other generations come to make changes, they know how and why, where and when to put the next building and so on,” Pearsall says.

The year 2024 might be a long way off yet, and there’s still much to do, but Pearsall is already looking forward to seeing the smiling faces of patients and families as they enter campus for the first time. “I love seeing the brightness of their eyes, the excitement. That’s the best reward I get. It really is.”

The post The New Texas Children’s Hospital Design is Making the Wait Less Scary appeared first on gb&d magazine.

• Rancho Los Amigos Recuperative Care Campus provides help to those who’ve experienced physical trauma with therapeutic care and permanent supportive housing.
• The stand-alone campus consists of a Recuperative Care Center building and five residential treatment program buildings that treat and houses 130 clients.
• The design is conceived as a series of semi-private connected healing gardens.

Rancho Los Amigos Recuperative Care Campus, a stand-alone campus within the much larger context of the Rancho Los Amigos Historic Campus in Los Angeles County, sets the standard for rehabilitation care and is the first campus of its kind to be integrally designed around landscape.

The program consists of a central clinic-like Recuperative Care Center (RCC) building and five Residential Treatment Program (RTP) buildings to help individuals who have experienced physical trauma to heal and move forward through therapeutic care and permanent supportive housing.

Rancho Los Amigos, which means “Friends Ranch” in Spanish, takes its inspiration from its own rich history as a working farm. This rich history still informs the Rancho Los Amigos National Rehabilitation Center’s culture of delivering medical rehabilitation services. The landscape design, as well as the architecture, amplifies the already strong sense of community and the deep reliance and connection with nature as a
healing tool.

Photo by Ric Berryman

Conceptually, the GGA+ team referenced a farming village as a site planning prototype appropriate to the history and culture of the campus. Respecting the rich context of existing mature trees at the site, the proposed plan created an informal and organic organization of the buildings and associated outdoor spaces.

Conceived as a series of connected semi-private healing gardens, the landscape and site development became central to the project design. The 6.8-acre project site is a serene, parklike setting and is hard at work as a habitat restoration with a pollinator garden plant palette and other California-native and drought tolerant landscaping.

A series of outdoor spaces for intimate social interaction and light activities like gardening and grilling can be found within these pollinator gardens. Existing large tree specimens were preserved onsite, with training in tree trimming, care, and maintenance central to this restorative landscape and woven into the residents’ daily routine. Minimal irrigated grass lawn areas, concrete sidewalks, and connective decomposed granite pathways provide a coherent, organic framework for the restorative habitat to flourish.

New site lighting and public art works further enhanced the landscape. Paved areas for staff and facility parking utilized cool-coated asphalt to reduce heat island effect. Targeted water infrastructure included a gray water irrigation system.

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To support this outdoor healing environment, new site infrastructure included the installation of all new underground site utilities, including water, gas, sewer, and a new stormwater retention and filtration system. Other sustainability building measures included onsite renewable energy production through use of photovoltaic panels, advanced, low-E, high efficiency VRF mechanical systems, and advanced building-level energy metering.

Photo by Ric Berryman

Though the project has been LEED Gold-certified, the new campus contains a number of elements and environmental qualities not found on the LEED checklist. The primary focus of the project was removing the institutional feeling of facilities generally developed within a health care context and replacing it with a residential environment that promotes healing and housing stabilization.

The environmental quality of the Rancho Los Amigos campus is further enhanced through highly accessible, inclusionary design considerations for those learning to live and thrive with their new physical ability challenges.

Interior finishes focused on maintenance and durability while maintaining a level of residential comfort through color, texture, and rhythm. Furniture and fixtures were carefully chosen for performance and safety for client and staff equally. Internal layouts of buildings were developed to encourage social interaction, security, and visibility.

Photo by Ric Berryman

The buildings are structurally traditional, constructed of both site-built wood framing and offsite-built wall panels, lightweight concrete flooring, with fully insulated, energy efficient siding, glass and glazing, asphalt shingle that emulate a residential typology used at sloped roof and use reflective roofing PVC for flat roof, and other complementary low maintenance building materials.

Project Credits

Project: Rancho Los Amigos Recuperative Care Campus
Location: Downey, CA
Architect: GGA+
Client: County of Los Angeles Department of Public Works
Size: 22,000 square feet
Status: Completed 2021
Sustainability: LEED Gold

Ali Barar and Matt Moreseth contributed to this article.

The post Rancho Los Amigos Puts the Focus on Sustainability appeared first on gb&d magazine.

• The right lighting, comfortable seating, and beautiful views are just part of what makes patients comfortable.
• Design leaders at Cedars-Sinai were surprised by some of the input they got from making mockup rooms.
• Each Cedars-Sinai facility strives to emphasize an appropriate sense of place in its community.

The right colors, comfortable and patient-centric lighting, and access to the outdoors are some of the ways the design team at Cedars-Sinai makes patients feel at home in their designs.

“We want our patients to feel comfortable and confident when they walk into a Cedars-Sinai facility, knowing they’re going to receive the highest and most advanced level of care,” says Zeke Triana, vice president of facilities and design at Cedars-Sinai. Triana worked as an architect specializing in health care design for many years before joining Cedars-Sinai nearly 15 years ago.

Part of the Community

A new urgent care facility in the Los Feliz/Silver Lake area has a mural from a local artist inspired by the indigenous people who lived there and the local flower marts. Photo courtesy of Cedars-Sinai

Triana says the design team puts patients at the center of everything, and they want their locations to feel true to the neighborhoods they’re in. A new urgent care facility in the Los Feliz/Silver Lake area—a lively retail area—is one example, he says. “Cedars-Sinai wanted to be part of that neighborhood and to feel like they truly belonged there,” he says.

As such, the new building’s architecture makes reference to some of the area’s known monuments—like the Griffith Observatory and Frank Lloyd Wright’s Hollyhock House. “We created our own block pattern inspired by Frank Lloyd Wright and the Hollyhock House, and we used some of the colors from the Hollyhock House to color this block. It’s sort of a greenish-blue color, something Frank Lloyd Wright never did, but we combined color and the textile block pattern to create the base of this urgent care.”

The new center also has a mural from a local artist inspired by the indigenous people who lived there and the local flower marts. “Cedars-Sinai envisioned a building that is grounded in the neighborhood,” Triana says. “You could never duplicate that building elsewhere in the community. It’s rooted in the Los Feliz/Silver Lake area and inspired by some of the beautiful architecture.”

Triana says the hospital’s designs celebrate the region’s diversity, as each facility is designed to belong. “When you walk in, you feel the total environment has been curated for you, and the details really matter,” he says. “From how you access the campus to how you park to how you get to your destination to the artwork, landscaping, lighting—everything has been curated so you get that total experience. That really does create, we believe, an environment where healing can take place.”

Patient-Centric Design

Cedars-Sinai is building a new hospital at Marina del Rey to replace an existing hospital there. The new design was inspired by the colors and landscape of the coast. The exterior’s windows appear in different colors, so when the sun hits the glass, the building exterior almost appears as waves or a beautiful sunset. Rendering courtesy of Cedars-Sinai

In all of its designs, Cedars-Sinai strives to think about the patient. At the new urgent care center, high ceilings and plentiful windows provide a feeling of openness with views of the observatory. Cedars-Sinai is also building a new hospital at Marina del Rey to replace an existing hospital there. The new design was inspired by the colors and landscape of the coast. The exterior’s windows appear in different colors, so when the sun hits the glass, the building exterior almost appears as waves or a beautiful sunset.

“It’s that local context that we felt was important. It makes it of the neighborhood,” Triana says. “That level of what I’ll call design sophistication is what we are after—where people then begin to feel proud of their health center in their community. It’s not cookie-cutter.”

Using local colors, inspiration, and even materials also helps to ground the project in the neighborhood while reflecting the hospital’s values. “It’s timeless, it’s diverse, it’s advanced and sophisticated. That’s the total environment we’re trying to portray. We hope that makes people at ease, makes them a little bit more comfortable, and reduces anxiety,” Triana says.

Testing Patient Design

For the new Marina del Rey hospital, architects had the opportunity to build a hospital from scratch and get feedback with mock patient rooms. Photo courtesy of Cedars-Sinai

For the new Marina del Rey hospital, architects had the rare opportunity to build a hospital from scratch and get feedback with mock patient rooms. That feedback ranged from layout—staff stood inside an ER exam room and asked architects to rotate the bed and head wall 90 degrees so they could directly face the patient’s head from the doorway—to where electrical outlets were placed. “We have a patient advisory council that provides input on our designs or mockup rooms,” Triana says. “By incorporating that into the design process we have a better outcome.”

The council includes everyone from architects to nurses, physicians, and other health professionals. The design team mocked up several types of exam rooms for the new hospital. Some surprising discussion centered around placement of the toilets—should they go nearer the window side of the room or nearer the hallway? Triana was surprised to learn people wanted the toilet on the exterior wall. That placement provided enough room for a large window while giving patients more access to their clinical team. “They didn’t want to be isolated from the nurses,” he says. “That surprised us because when you have the opportunity to have this fantastic view twice as big in your room we thought they’d choose that, but actually because they’re there for different reasons—it’s not like a hotel—they wanted the balance between the view and visibility to the clinical team.”

It’s that kind of feedback that will ultimately make the high-tech rebuild of the current two-story, 50-year-old hospital a success. The new hospital is scheduled to open in 2026. Triana is grateful for the experience. “If we had not done that we’d build this hospital, and it wouldn’t be what they wanted. It was our philosophy to build it right the first time.”

Sustainable Details

Adult waiting rooms are infused with soothing lighting and seats safely distanced from each other. Photo courtesy of Cedars-Sinai

Green design is also part of the Cedars-Sinai mission. The new Marina del Rey hospital is being designed to LEED Gold standards, but Triana says they’re also actively working to make their existing buildings more sustainable. “There’s a lot that can be done with existing buildings to improve the environment. Part of our social responsibility is not just looking ahead to new buildings but looking back at what we can do at our existing stock.”

Lighting across Cedars-Sinai–owned facilities has been updated to LED, with many fluorescent lights eliminated. Air conditioning turns off when not in use. They completed a successful water project, filtering underground water to use for industrial purposes like in their energy center cooling towers. The program saves millions of gallons of water and has garnered awards from the Los Angeles Department of Water and Power. “It’s those opportunities—not just a shiny new object like a new building—but there are more opportunities in these areas we would like to continue to explore,” Triana says. The underground water project also had a three-year payback.

Triana emphasizes that good planning in design doesn’t cost more and can save a lot of money in the long run. Part of Cedar-Sinai’s philosophy is to use what’s available—including natural light. “How can we utilize exterior windows and natural light and try to bring as much controlled daylight into a space, so you can reduce dependency on artificial lighting, even LEDs? How can you use what’s available to you in a passive way to design your space?”

Wayfinding and what Cedars-Sinai calls intuitive access is another part of making health care facilities more patient-centric. “It goes beyond just signage,” Triana says. Cedars-Sinai even has an app. Photo courtesy of Cedars-Sinai

He uses his own office in LA as an example. When the team had an opportunity to design a new interior space for their department, they chose not to put offices along the perimeter window, where there are 360-degree views from the 20th floor. “We wanted to bring as much daylight as deep into the space as possible, so everybody had access to natural light and these spectacular views,” Triana says. “Designing these open floor plans you see in office spaces really do create a very pleasant environment. That’s all available to you—and it’s free if you think about it. You just have to design it right.”

They also chose simple materials, letting the beauty of the views and natural light do the work instead of competing with the area’s natural splendor. “We introduced some lighter colors into the space and simple artwork. It’s incredible. We walk people through our space and they think we spent a lot of money, but we didn’t,” he says. “You don’t need marble and stone and elaborate materials anymore in an office setting.”

The same conversation happens when designing across their facilities. At Marina del Rey, they were particularly interested in saving energy. They ultimately decided to use chilled beams, essentially running cold water piping instead of forcing cold air to cool the space. “Forcing air through a ceiling requires a higher floor height. When you’re using a chilled beam, it can be a lower floor height, so the overall height of the building is less—so you’re using less materials on the exterior wall and so forth.”

Future Health Care Design

Triana says Cedars-Sinai was the first to provide all private rooms in the 1970s to patients. “Now it’s part of the expectation, and in fact it’s part of safe clinical care.” He says the group’s decisions look at what most promotes health and recovery, and that’s evolved to include things like diversity of place and sustainability. “Our patients in Los Angeles demand these things of us.”

It’s hard to design a building in LA that’s not sustainable, as the city has committed to all new buildings being net zero carbon by 2030. “The net zero pledge made recently will further enhance that, but it’s just part of good design now—being responsible. All of those things didn’t used to be part of the vocabulary for patient care, but I think that’s what’s exciting about the intersection of architecture and its impact on health outcomes.”

The post Designing Flexible Health Care Environments for Patients appeared first on gb&d magazine.

• EwingCole designed a 950,000 square-foot hospital in Duluth, Minnesota.
• The team attempted to reduced embodied and operational carbon through design and material selection.
• The project draws on biophilic design, which can accelerate recovery time, benefit sleep cycles, and improve cognitive performance.

When Essentia Health partnered with EwingCole to design its new hospital in Duluth, Minnesota, they presented them with a monumental task: revolutionize the health care delivery system in northern Minnesota with a facility that invigorates a local economy and supports a growing health care need across the region.

An expert in health care design and no stranger to large-scale, commercial, and sustainable projects, EwingCole’s design team envisioned a facility that supports increased patient volumes as well as the natural fabric of the surrounding environment. After in-depth exploration, planning, and discussions with stakeholders from staff and administrators to community members and patients, the design team developed a high-performing hospital with an aesthetically modern, streamlined design that weaves into the fabric of the surrounding landscape and urban layout.

At 950,000 square feet, the $800 million Vision Northland (VN) spans several city streets and consolidates critical health care services, creating innumerable opportunities for Essentia Health. Positioned on the banks of Lake Superior, the building’s interior and exterior design is inspired by both the natural and urban textures of Duluth. The exterior brick along the building podium mimics the surrounding neighborhoods, while the patient tower exterior fritted glass resembles the fog rolling off the lake. Inside, its patient-centric interiors are designed to foster positive patient outcomes with natural materials and nature-focused imagery and by consolidating critical care components such as adaptable inpatient rooms, procedure rooms and OR platforms, and flexibly planned outpatient spaces.

Values-based Design

VN is founded on Essentia’s values of creating healthier communities with its roots in sustainability. Essentia’s administration believes that health care facilities should support the health and wellness of an entire community, not just through its services but through the relationship between the built environment and the surrounding ecology.

To meet Essentia’s specific sustainability goals, EwingCole relied on several frameworks to serve as toolkits of proven market-appropriate strategies, resulting in what the team called the Vision Northland Sustainability Criteria. This specifically tailored framework allowed the design team the flexibility to navigate between building program needs and sustainability performance goals. These strategies will reduce energy consumption, water usage, and VN’s embodied carbon footprint and create an interior environment that supports patient health and wellbeing.

Future Climate Performance Improvement

Rendering courtesy of EwingCole

Hospitals are among the top two energy consumers by building type. To mitigate VN’s impacts on carbon emissions from operational energy use and life-cycle costs, EwingCole integrated energy modeling at the earliest design stages. Everything from the exterior envelope to the HVAC systems and lighting was selected based on rigorous simulation performance modeling.

An integrated team consisting of EwingCole’s architects and engineers and an envelope consultant and envelope fabricator came together to make sure that the building envelope performed as designed. Envelope performance is critical with a building of this scale, located in an extreme weather environment like Duluth. A full-scale mockup of the building envelope was constructed and rigorously tested to allow the team to detect even the smallest amount of air and moisture infiltration which left unchecked could significantly affect the building’s overall energy performance and indoor air quality.

As a result of these efforts, the design team achieved a 24% reduction in energy consumption and a 26% reduction in energy costs.

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These savings are part of a targeted strategy to reduce operational carbon – or the carbon emitted from running the building. To further reduce the building’s overall carbon emissions, the design team turned to a reduction in embodied carbon—emissions from the manufacturing, transportation, installation, maintenance, and disposal of building materials. The embodied carbon footprint is established on day one, while the operational carbon footprint accrues over time. Even with the continuous growth of the operational carbon footprint, embodied carbon makes up over half of the total carbon emissions from a new building in the first 20 years of operation. By focusing on reducing operational and embodied carbon, we can drive down built environment GHG emissions further than ever before.

Structural materials, such as concrete and steel, make up the most significant fraction of embodied carbon in buildings. Reductions in the embodied carbon of concrete targeted replacement of Portland cement, the concrete component responsible for much of its embodied carbon. Cement substitutes reduced embodied carbon and improved the performance characteristics for certain uses of concrete in the foundations. For the steel, the team focused on validating high recycled content and optimizing member sizing and quantity. The building form was optimized based on a series of wind tests. As the form was refined to reduce wind resistance, the structural system could also be refined, requiring less steel volume to support the building.

Supporting Healthy Environments

When designing sustainable health care facilities, EwingCole’s team focuses on overall human wellness as much as building energy performance. We define wellness as a state of being and a process that aims to achieve a whole person’s health, or in this case, a patient’s. To support that process, optimizing the materials surrounding patients and making up the indoor environment is the highest priority. To this end, the team focused on three large-volume, high-contact material categories: the ceilings, flooring, and wall protection.

For each category, two additional criteria were used to evaluate materials for inclusion in the project: VOC emissions testing and material ingredient disclosure. Volatile organic compounds (VOC) can be emitted, or off-gas, from building materials, negatively impacting air quality and human health. VOC emissions testing verifies that select materials produce little to no emissions. Products were also selected based on their material ingredient disclosures. Like a nutrition label on a food product, these disclosures show the exact chemical makeup of each product, allowing the team to review potentially hazardous ingredients and determine which materials are more appropriate for the space.

Nature is Healing

Rendering courtesy of EwingCole

Our mental and physical health is directly tied to our connection with the natural world. Research shows that being in or directly viewing nature can accelerate recovery time, benefit sleep cycles, and improve cognitive performance. This is a key driver behind the exterior glazing of the patient tower. VN’s glass envelope provides nearly 360-degree access to natural light, supporting patients’ natural circadian rhythms, the body’s internal clock and an essential component of every person’s health and wellbeing. One of the key features of the design, the outdoor roof terrace, provides patients and visitors with the opportunity to take in breathtaking views of Lake Superior and connect them with the outdoors without leaving the building site.

Biophilic design, which supports our innate connection to nature, was also a guiding strategy for VN. The design team included an abundance of opportunities for plant life within the hospital and the use of natural materials such as wood and stone. But biophilic design goes much deeper than just greenery. Less obvious aspects of biophilic design include space layout. We may not cognitively recognize certain layouts as “natural,” but they are also innate to us. For example, having places of refuge and comfort and seeing out into the space around us allow inhabitants to relax and reduce stress levels.

Environment, Economy, Equity

Rendering courtesy of EwingCole

From day one, the support of regional industry, craft, and economy was a primary goal for Essentia Health. Selecting materials based on the three pillars of sustainability—environment, economy, and equity—helped the design team meet this goal. Sourcing regional materials supports the community that Essentia Health serves, building local economies and pride of place. It also reduces travel distances for materials from the manufacturing site to the installation site, cutting GHG emissions and protecting the environment.

For the biggest impact, the team focused on selecting larger volume materials to source regionally, rather than only small-volume specialty pieces that are more commonly locally sourced. The glass curtain wall was manufactured by a company 230 miles from the VN site. Creating a custom glazing system often involves a global supply chain of multiple manufacturers and many transitions from one location to another. EwingCole selected a single-source, local manufacturer that could pull many manufacturing process steps together in one location, decreasing transportation emissions and supporting the local economy.

Additionally, most of the acoustic ceiling panels in the building—nearly 1 million square feet of them—are manufactured roughly 30 minutes away from VN, reducing travel time and GHG and supporting the local economy. Lastly, the structural steel is all sourced in the United States. Steel is a commonly recycled product, and because the material was US-sourced, the design team was able to scrutinize its sourcing and contents, leading to the procurement of 90-95% recycled steel.

Spirit of Place

Ensuring that the new hospital was of its place and embedded in its community was also a high priority. As discussed above, that spirit of place comes into VN through its access to nature, views of nature, and nature within the building. It is also the foundation of an extensive interior graphics package. These graphics highlight local landmarks, regional history, flora, and fauna native to the North Shore and familiar to the local community. The graphics are tailored for each floor, some directly representing these elements and others in more abstracted patterns and colors. These beautiful images support patients, family, and staff by building familiarity and comfort and serve the essential purpose of wayfinding throughout the building.

The post EwingCole Incorporates Biophilic, Patient-Centric Design at This Duluth Hospital appeared first on gb&d magazine.

• Hord Coplan Macht and William Rawn Associates renovated the Johns Hopkins School of Nursing.
• The new design emphasizes collaborative workspaces, natural light, and sustainable materials.
• Students’ own health is also built into the design—with a large stair system that encourages walking.

Connection. In an age of separation, the 2020 renovation to the Johns Hopkins University School of Nursing aimed to bring people together.

Codesigned by Hord Coplan Macht and William Rawn Associates, the building upgrade was meant to open up the school not only to students but also the Johns Hopkins and Baltimore community at large. As it was, “The school was inward-focused, in a long, skinny building,” says Paul Lund, principal at Hord Coplan Macht. “It was hard for the school to play a reciprocal role within the broader campus context and within the city itself. A lot of the school’s research projects involve working with different agencies and groups within Baltimore, so there are lots of nurses going out but no way to invite people from the community in.”

Even if someone was invited, it was easy to get lost: Standing on the street looking at the original building, you could barely see the front door.

A double skin curtain wall system was used in the facade to not only control heat gain and glare but also allow a high level of transparency. It was an environmental choice, one that also ties back to the building’s theme of connectivity. Photo by Robert Benson Photography

One of the first design decisions was to make a grand entrance worthy of the best master’s program for nursing in the country, of which it is. Big letters announce the school now, with a clearly defined welcome area both inside and out. “It seems like a small thing, but making the building accessible and open—telling people that it’s okay to come visit—was important,” Lund says.

Inside the remodeled Johns Hopkins School of Nursing. Photo by Robert Benson Photography

To figure out how else they could improve the student experience, the design team conducted a lengthy feasibility study before any building took place. “We met with students, faculty, and staff,” says Sam Lasky, principal at William Rawn Associates. “We spent time just listening to people.”

After months of listening, what they learned was students thought the building felt dark. They wanted access to researchers and faculty but felt there was a barrier between them. The team also discovered the School of Nursing operated on an active, group-based learning model, where students often had to meet up to work outside of class, but because of the long, thin shape of the building, there was no large central gathering space that enabled them to do so.

“A lot of students don’t necessarily live nearby, so if you come, you’re there for a long period of time,” says Sam Lasky, principal at William Rawn Associates. During the design phase, the team thought, “How can this feel like a home away from home?” Photo by Robert Benson Photography

“Students were having to have their study groups on the fire stairs,” Lasky says. As such, the main focus of the renovation became creating a variety of spaces both inside and outside the classroom where students and staff could learn together, collaborate loudly, or study quietly.

One of the main features of the project is what Lund and Lasky refer to as “the hub,” a light-filled atrium of dedicated student space. “One of the things we uncovered in our research is that it’s so important for students to get a sense of belonging and learn from each other,” Lund says. The hub has levels of privacy with huddle rooms and open seating and also overlooks the coveted courtyard—one of very few open, natural spaces in the area. For that reason, the transparent facade was intentional: Even if students had their noses buried in textbooks, the design team wanted students to be able to look up, soak in the daylight, and see the greenery outdoors. “A lot of elements of what we did were based on a research project we were involved with on biophilia, which showed that biophilia reduced student stress and increased student cognition,” Lund says.

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But mental health wasn’t the only type of wellness the team paid attention to. Students’ cardiovascular health was also taken into account—a fitting concept for a health-minded building. Instead of adding another elevator, the team put in a large stair system that snakes its way throughout the school—a design element that encourages walking and also directly inserts you into the flurry of the student experience.

Students at the renovated Johns Hopkins School of Nursing enjoy the outside green space. Photo by Robert Benson Photography

Health care, even outside of a hospital setting, is an intense experience after all. In a time when there has been an eagle-eye focus on frontline medical workers, the updated School of Nursing serves as an educational safe haven nurturing the next generation of nurses. “The students here were so incredible, with so much energy, vitality, and enthusiasm,” Lasky says. “It was a privilege to build a building that would help them maintain that incredible generosity of spirit.”

Site plan. Drawing courtesy of Hord Coplan Macht

Project Credits

Name: Johns Hopkins School of Nursing
Location: Baltimore, MD
Completion: 2020
Size: 42,000 square feet
Architects: William Rawn Associates & Hord Coplan Macht
Structural Engineer: Hope Furrer Associates
Civil Engineer: RKK
Contractor: Gilbane AV/IT: Spexsys
Interior Designer: Hord Coplan Macht
Lighting Consultant: Mag-Lighting Design
Landscape Architect: Hord Coplan Macht

The post Johns Hopkins School of Nursing Renovation Designed Around Connection appeared first on gb&d magazine.

• UCLA Health plans for the future with comfortable spaces that offer easy transitions.
• The Calabasas facilities are one recent example of how modern, flexible furniture fits into design.

Flexible floor plans and a feeling of home are among the key design decisions that set UCLA Health facilities apart.

“We’ve been designing ambulatory clinics across Los Angeles for over 10 years now, and each community is unique. We are in the beach communities, we are in the suburban communities, and each one has a different look and feel,” says Amy Kraft, director of UCLA Health Real Estate Planning, Design & Construction.

What doesn’t change, Kraft says, is the quality of the design and the commitment to making people feel comfortable. Patients going to UCLA Health facilities know what to expect. “We want the patient, upon first arrival, to come in and have the confidence that they are at the right place because of the surrounding environment,” Kraft says.

Much work has been happening across UCLA Health facilities lately, including at the Calabasas facilities, with multiple tenant improvement projects completed recently—from a relocated primary care facility to new ophthalmology suites, an OBGYN and urology center, pediatrics, and more.

The Details

While beachfront communities may have more bright colors compared to slightly more timeless designs in suburban areas, Kraft says all of UCLA Health’s facilities are designed to be modern and comfortable. Beyond cheerful colors, comfortable seating and lighting round out every design, and UCLA Health continues to look for ways to make patients feel more relaxed during their visits.

Kraft says seating needs to be durable, stand up to cleaning supplies, and be considered across populations, as elderly or bariatric patients might need a little more help getting up, for example. “We don’t want to necessarily have a bariatric chair; we want them to feel comfortable as well.” She says UCLA Health strives to include furniture like loveseat type options, too, to provide various seating and something to please everyone.

Overhead, lighting is just as important to the experience. Inside Calabasas, hanging glass pendants warm up a light-filled lobby space with large, plentiful windows. The area near the entrance gives patients and their loved ones another place to wait, work, or socialize in between appointments. “Maybe they go to advanced imaging at one point and they see their primary care physician later, and they need to spend a half-hour in between appointments,” Kraft says. “Here they can do so in an environment that allows them to relax.” High tables near windows overlooking rolling hills provide a bit of respite and more of a coffee shop feel, where they can enjoy a snack. “It’s a way to make that area feel special and make it a living room type environment,” Kraft says.

The design team strives to make warm, comfortable spaces like these, but sometimes they’re given the added challenge of no windows. When a windowless room arises they emphasize artwork that invites your mind to wander, and they add soft lighting and natural materials wherever possible. “We try to create an environment you’d want in your home, where you feel like you’re in a quality, comfortable environment,” Kraft says. Interior waiting rooms without natural light incorporate textured walls and added carpet tiles so you feel not like you’re in a clinic space, but in a higher end environment where you’re just waiting your turn, Kraft says.

Changing Nature of Design

Photo courtesy of UCLA Health

Since the introduction of electronic medical records years ago, the exam room has changed greatly. Design began to emphasize the need for a physician to face the patient rather than have their back turned while entering information into a computer, for example. At first the computer was on the wall, then it moved to a small desk. Kraft says the need for flexibility continues to be great.

“The patients might sit on the exam table for an exam or sit in a chair at a table across from you to discuss next steps or a treatment plan,” she says. “We’ve also gone from private offices for doctors in a primary care setting to what I refer to as hubs, like a hoteling environment where you grab a computer in between patients and do your charting in a huge room as opposed to going back to a private office.”

Much conversation continues around how telehealth is changing the design of clinic environments, but the practitioners Kraft and her team speak with say they’re not necessarily willing to dedicate space solely to telehealth. It all comes back to that flexibility, as they find they can use an exam room both for telehealth and in-person. “We’ve been outfitting our clinic exam rooms with computers for years, and now you incorporate the camera into those technologies and make sure that room is a multipurpose room. That seems to be where our clinic design direction is headed now, which is not a huge leap from where we were before,” Kraft says.

Space Planning

Photo courtesy of UCLA Health

Often design comes down to what space is available, and UCLA Health is always working to minimize patients’ wait time. “Space is always a limiting factor, especially in Los Angeles,” Kraft says. “We always have to be creative with how we use the space, making sure we provide enough staff support space but also enough storage for the clinic environment, and then enough flexibility.”

Sometimes a patient is not just seeing a doctor or nurse during their visit; they could also be speaking with a financial counselor, social worker, or dietitian during any given appointment. Kraft and her team look at continued ways to make that process even smoother. “Do you want that patient to sit in the exam room and have those various groups rotate through? Do you move the patient to a consult type room that maybe is a little more of a conference room environment or small living room? Those are always the challenges we face in each of our clinics—how are we going to maximize our efficiency and yet provide that patient-centered care for all of our populations?”

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At UCLA Health you’ll find a variety of patient-centric spaces at Calabasas and beyond. They approach spaces by planning for a variety of rooms with the same footprint. “After construction, whether one’s an exam room with an exam table and a hand-washing station or one has more furniture, we allow for flexibility along the way so if we determine we really need more exams than consults, we can convert that room easily.” Kraft says the growth of the flexible floor plan is one of health care design’s biggest successes in recent years.

“When you’re going in for a clinic appointment, there are times when you’re nervous or you’re unsure of what’s going to happen next. If we can put you at ease, in an environment that feels calm and comfortable, so you feel you’re at the right place for whatever’s about to happen next, then I’ve done my job,” Kraft says. “To me it’s more about creating a feeling for the individual patient that they can take that deep breath and focus on the reason they’re there.”

The post Flexible Health Care Design in Action at UCLA Health appeared first on gb&d magazine.

• FCA transformed an old grocery store into a health care facility for Virtua Health.
• The 66,000-square-foot Moorestown, New Jersey prioritizes natural light and helpful wayfinding.
• FCA designed the “White Box” as a comforting entryway using semi-opaque white panels.

The pandemic caused a myriad of national disruptions. One of the largest, and perhaps most impactful, was a widespread economic slowdown that caused a shift to e-commerce and online shopping. Meaning big-box retail chains had to quickly assess what to do with their large, now underutilized, storefronts and prioritize efforts into an online presence over a physical one.

As a result, many stores have become vacant without lease renewals. The silver lining? A substantial opportunity for adaptive reuse in commercial real estate—especially for the health care community.

New builds can take up to three years to bring into fruition, whereas the adaptive reuse of a retail center can be turned into an accessible health care facility for a local community in just several months (depending on the scale of the project). This opportunity presented itself at a time when health care systems across the nation were seeking ways to bring care closer to the communities they serve.

The transformation from a big-box store to a health care center is a sustainable way to repurpose existing buildings. It’s also a convenient approach to deliver projects to market faster than with a traditional new building project. Adaptive reuse in commercial real estate saves time, money, and resources––which lends to a brighter, more environmentally friendly approach to the future of retail real estate. Not to mention, if this works in health care, just imagine how other industries could benefit from the renovation of underutilized retail space.

Recognizing Potential for Adaptive Reuse in Commercial Real Estate

The “White Box” represents cancer in a patient’s life. Just as cancer is not a normal, everyday event, the “White Box” is not an everyday entry point. Its semi-opaque white panels create one uniform object that can be seen from the street. The front elevation is at odds with the roadway and sidewalk, jutting out at the left edge, instead of being parallel. The front elevation is imbalanced and off-center, with three vertical columns that hold up a misaligned upper mass. Photo courtesy of FCA

When choosing the best space for an adaptive reuse commercial real estate project, many factors must be considered. From location and access to adequate onsite parking and the building’s potential for adaptability, it’s important to note not every empty store has the ability to transform, but many do in fact have great potential.

Health care organizations looking to undertake an adaptive reuse project, particularly when transforming empty retail stores to health care centers, must ask specific questions, including: How much of their business has shifted to remote telehealth interactions, and how much routine care will stay that way when the pandemic has passed? In other words, at what level does this space need to support a hybrid patient pattern? How do they safely interact, greet, process and efficiently treat those patients who are present in-person? In what ways do patients need differing levels of care and interaction?

When repurposing a building, it’s also important to consider the local zoning approvals needed. One of the attractive elements of this type of development, adaptive reuse, can be the simplified approvals versus new-build construction. If you are not disturbing the land and creating any additional parking or other site elements, the land development approvals process, which could take several months for a new building project, could be substantially simpler.

Ensuring a Community-Centric Design

The transformation from local stores to health care centers will allow medical resources to seamlessly integrate into communities that are underserved. The need to locate this space away from acute care campuses has grown and become even more important now that hospital space is being reserved for severely ill patients.

One of the aspects this most recent pandemic has brought to light is that many impoverished neighborhoods, which were impacted very hard by COVID-19, lacked the access to patient care that can be found in other communities. Therefore, acquiring and consolidating multiple physician practices in the same neighborhood location has become a priority for health systems.

Branding these facilities so they are recognized as part of the larger system of care is also critical to their success. Branding is especially important because it builds trust and customer loyalty. Overall, the fast speed of adaptive reuse projects alongside the growing need for health care across the country will provide more people with better, closer, and timely care.

Transforming into a Health Care Facility

Rooms in the Moorestown, New Jersey facility designed by FCA prioritize natural light and views of nature. Photo courtesy of FCA

While the framework may be there, it is not a simple task to turn an empty shop into a high-functioning health care facility, but it is a worthwhile one. Exterior cosmetic upgrades, interior demolition, and careful strategic modifications will make a substantial difference in building design.

When considering a building for an adaptive reuse commercial real estate project, the existing exterior may require a bigger investment to re-brand in order to have the type of impact one might be looking to achieve with the facility. Cosmetic upgrades like highlighting windows and entry points or changing exterior stucco colors can have a big influence on success of the center, as can signage and adding wayfinding elements like canopies and lighting.

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Infrastructure is another significant component to analyze. This includes the existing mechanical, electrical, and plumbing systems. These systems should be studied for service life and replaced or upgraded for efficiency. It is essential to think ahead about the location, space, and connection to electrical systems especially in medical spaces that may require an emergency generator to be installed. This all goes back to the longevity of a project.

Additionally, the core and shell of the building must be understood. Many supermarkets and big-box retailers have high bay construction, which means it can be 24 feet of clear height on the inside. That’s great for easy installation of mechanical systems, but expensive to hang people-level ceilings, in addition to conditioning the spaces above.

The roof construction can be very lightweight and not suitable for supporting rooftop systems so it is important to investigate early. Many exterior walls are generally a single width of masonry with insulation in the exterior coating.

Time and money will need to be invested for an energy-efficient shell, but it’s generally quicker, easier, and cheaper to upgrade existing walls than to build new ones.

Case Study: Virtua Health, New Jersey

FCA used natural and diffused light throughout the cancer center’s design. Photo courtesy of FCA

When Virtua Health wanted to rezone and repurpose a former ACME supermarket into a cancer care center, they turned to our team at Francis Cauffman Architects (FCA) to tackle the adaptive reuse in commercial real estate.

The old supermarket was near Virtua Health’s Health and Wellness Center in Moorestown, New Jersey. The new facility accommodates radiation oncology, an infusion treatment suite, a cancer administrative suite, and a third party infusion practice.

Sitting directly across from Virtua’s Health and Wellness Center, the 66,000-square-foot space was reimagined to promote a sense of hope, serenity, and healing, with high ceilings, windows that let in natural light, and vibrant artwork featuring scenes found in nature. Biophilic design was also emphasized, as a new garden is visible from the infusion patient treatment spaces for another connection to the outdoors.

Skylights are used in the central circulation concourse where each destination entrance is located. The design team strategically placed treatment rooms, taking into consideration those patients who are sensitive to natural light versus those who aren’t.

The building’s previous structure had very high ceilings, prompting a challenge for smaller rooms that require acoustical privacy. A substructure was implemented to allow the ceiling and lighting to be suspended from it, minimizing the need to construct full-height walls to the full height of the structure.

Long-Lasting Health Care Facilities

The Virtua Samson Cancer Center, designed by FCA. Photo courtesy of FCA

Buildings with future growth or expansion capabilities should be considered great candidates for adaptive reuse in commercial real estate. Creating a treatment space that has the most flexibility for the longterm is very important because physicians and their care delivery models change over time.

In order to create a long lasting health care facility, it is necessary to align the program needs with the available space, and to account for the available space’s potential for future growth. These spaces need to be agile, whether it’s an ambulatory surgery center that has potential for a future eye practice, or a cancer program that could have future immunotherapies that may need infusion spaces. The ability to expand into adjacent spaces with minimum impact on the facility as a whole is an important consideration.

The Future of Adaptive Reuse in Health Care

Health care professionals and organizations across the country have found themselves with an unprecedented and remarkable opportunity to consider repurposing existing retail buildings for a better future for the health care industry. Choosing to repurpose an existing building is a socially responsible and sustainable way to bring care closer to the communities that need it. The speed at which a building can be repurposed allows for healthcare facilities to be developed quickly and more efficiently. Understanding the particular building and its advantages and limitations ahead of time, will make the investment and outcome for the community that much greater.

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