St. Joseph Medic al C en t er
24553.00
St. Joseph Medical Center Towson, Maryland Architecture Engineering Interior Design
Guiding Light
S HO W CA S E T W O
CSD Architects in Baltimore and GS&P joined as partners for the design at St. Joseph Medical Center in Towson, Maryland. At issue was how to expand and reimage the facility to be more formal yet friendly, a task guided by the hospital’s patient promise, “Always expert. Always personal. Always faith-filled.” The team recognized the importance of a strong, calming entry, stress-reducing wayfinding, natural light, environmental garden elements, and religious iconography. The resulting spaces are elegant and inspiring, and provide St. Joseph an environment to match its level of care.
33
Sight lines into cardiac prep/recovery rooms allow nurses to keep a constant watch. Serpentine corridors accented with artwork and floor patterns carry patients and visitors through the hospital. Patient rooms are equipped with a sleeper sofa, a reclining sleeper chair, and privacy curtains. Staff has multiple areas for meeting and recording notes, including multiple computer locations for tracking patient status.
TEAM
Paul V. Braun, AIA
PIC
Nick Nicholson, AIA
PM
Derek Mott, AIA, LEED AP
PP
Kevin Kim, AIA / Julia Bradley Rayfield, CID, IIDA
PD
James R. Kolb, RA, LEED AP / Dennis L. Meikrantz
INTERVIEW /
ADD ’ L
P a u l B r a u n , J u l i a B RADLE Y R a y f i e l d
Explain St. Joseph Medical Center’s project focus. Paul: St. Joseph, at the time, had the number one heart program in the state of Maryland, but they had inadequate facilities that had not been improved for many, many years. This project’s focus was to create a new main entrance and to consolidate and improve the facilities for the Heart Program.
working through the options, and making the decisions and recommendations to the Steering Committee. It felt a little bit cumbersome in the beginning, but it worked very well in the end in terms of engaging key individuals within the organization and making them responsible for what actually happened.
always expert, always personal, always faith-filled
JULIA: From the top down, Sly often said to the team, “This isn’t my project. This is your project.” So I think she really tried to spread the responsibility out and give power to her staff to craft the project.
How did you approach getting started?
How did you proceed?
PAUL: Our main client and the person that really set up the project was the COO, Sly Moore. She was charged to manage the project and chose to work through several committees that would be responsible for various aspects of the project.
PAUL: At the beginning, we helped them create a vision for what they wanted the new patient experience to be. They came up with the Patient Promise — “Always expert, always personal, always faith-filled” — which became the mantra of the project. Throughout the process, they would always ask if a choice or decision was fulfilling the Patient Promise.
There were definitely more meetings than we originally envisioned.
JULIA: And we really checked decisions against this. Can we justify this decision by supporting some element of their promise? From there we developed a list of guiding words that we used throughout the remainder of the project in making aesthetic decisions right down to the paper towel dispensers. In some cases, it really did help us choose an option because it supported their guiding words.
Staff involvement isn’t unique, but why did the hospital believe it was important to have an unusually large number of people involved?
Many clients develop guiding principles and form committees to organize their processes throughout a redesign. What was unique about this experience?
PAUL: Sly really wanted to get these groups involved, making them responsible for analyzing the issues,
paul: I think it’s extremely unique that they never forgot the guiding principles. Every time we were together, it was
julia:
35
For instance, there was an Image and Identity Committee that got together twice a week and reviewed all design aspects of the project. There was also a Patient Access Committee that was responsible for changing the way patients access the system, receive care, and are greeted from the moment they arrive on campus.
S HO W CA S E T W O
The hospital had a very dated entry that looked like an old Carmike movie theater, where you came in and immediately looked for a person to ask for help. There was no guiding architecture to lead you. Nothing was terribly intuitive except if you picked up a whiff from the cafeteria and knew food was to the left. The graphics were poor, and there were signs stuck all over the place to make up for the lack of leading elements in the building. julia:
brought up. A lot of times you create the guiding principles at the beginning of a project and include them in a presentation, and unfortunately, they get lost in the day-to-day production of a project. But with St. Joseph Medical Center, it really was their basis for making decisions. I agree. We were lucky to have a client who made decisions and stuck to them. They didn’t waffle; a decision was made and we went forward. They were also really good about respecting professionals on the team. They listened to what we said and didn’t second-guess us too much. When they didn’t like something we showed them, they told us and we changed it, but we still kept our roles as designers, architects, and engineers. They truly were responsive to us. julia:
S HO W CA S E T W O
paul: Even though it curves, the sweeping corridor creates a very welcoming new main entrance and fluidly connects the parking structure, medical office building, and the new public elevators that serve the seven floors of patient care.
And, along the way, visitors see the Heritage Wall. Describe its design.
paul: CSD had been on campus at St. Joseph for several years. They enjoyed a very strong relationship with the hospital, and were very committed to St. Joseph’s vision and mission. They contacted us because they had seen the Levinson Heart Hospital project and knew that we had the experience that the hospital needed. One of the main reasons we were ultimately selected was because the selection committee saw that we had good chemistry and could work collaboratively.
Initially, we were asked to create display areas for collections from their 100-year history, such as old medical instruments and nun habits. They had quite a large collection, and we debated the need to dedicate a five-foot display space for a nun’s habit or a two-foot case for a stethoscope. The hospital hired a consultant who does a lot of donor walls, and they took some of the hospital’s images and photographs and used a specialized technique that looks a bit like a hologram. It’s quite amazing. It consists of multiple layers of glass, cut and illuminated at different angles and degrees to give depth and highlight extremely detailed images. The wall is made up of these windows that convey the history of the hospital from the convent days through present day. The medium in which they’re done is very unusual and eyecatching, and you’re immediately drawn into it.
How did you go about creating such an elegant visitor-friendly space?
What other elements did you include to create a soothing, orientating environment?
First, the building desperately needed a strong orienting presence. We created what we call “the Great Wall of Towson” and a beacon on top of the elevator tower to create an obvious main entry. On the interior, we opened up floors so that you have visibility from the main entry circulation up to other floors, and a grand staircase that invites you up. By opening up the building, we made wayfinding really easy because everything leads off this main circulation concord.
paul: One element that ended up surprising me was how well the natural spaces create a very dynamic progression through the space. Before entering, visitors encounter a reflecting pool. The second-floor lobby offers a great vista to a beautiful Japanese garden. And then you go around the corner to the cafeteria and there’s another rooftop area. It’s a very nice sequence of welcoming and unique spaces.
GS&P partnered with CSD Architects on this project. How did that come about?
36
by Michio Ihara, and from there you can choose to go to one of two key areas: surgery or cardiac care.
julia:
JULIA:
Every inch of green space is supported by the guiding words Bring the outdoors in, allowing natural daylight to penetrate deep into the space. We kept coming back to those words anytime we had to decide where to put a window. julia:
When you step into the vestibule, the first thing you see is the front desk. We even went so far as to design a slightly different transition surface than you normally see — there wasn’t a right angle on it. Everything was very smooth so that your first contact with a surface in that building was comfortable and welcoming, which set the tone for everything else. Then we curved the circulation corridor, which instinctively leads you in that direction. Along the way, you pass living rooms, instead of waiting areas, which are comfortable, friendly, and non institutional. Ultimately, you come to the rotunda, with its captivating hanging sculpture
The new design also incorporates quite a bit of religious iconography, more than most religiously affiliated hospitals. Was this also part of the Patient Promise? Julia: There has always been a lot of iconography, even in the old building when it used to be a convent. We didn’t want to be trite or put crosses or anything in the floor, but
Upon entering the main lobby, visitors are greeted by intimate seating areas and a Heritage Wall. The Heritage Wall consists of eight windows, each telling a piece of St. Joseph Memorial Hospital’s history over the last 100 years. Initially requested to create display cases showcasing old medical instruments and nun habits, the team found an alternative solution that etches images and photographs into different materials. Using a special technique, artisans use different degrees of depth and varying values of light to create final images that resemble glowing holograms.
The chapel is particularly stunning. Describe some of the elements that went into that design.
The most understated, but elegant, piece is the backdrop for the altar. Originally, it had been a mosaic tile, slightly concaved partition with a 1960’s abstract cross design. We covered over the tile and did a Venetian plaster treatment on the concave wall. It is now creamy white with a new cross on top, which is gorgeous.
The former chapel was unrefined, had bad lighting, and was made of concrete exposed aggregate with very unattractive 1960’s-style stained glass that looked like plastic. It Julia:
37
felt like a religious bunker with all the concrete and brick. So we proposed three very different looks: a Gothic-inspired look, a modern theme, and a transitional look. The chosen design, transitional, incorporated beautiful sapele wood to cover the concrete and to create frames around the stainedglass windows. The sapele is super-sophisticated, minimalistic, and elegant all at the same time. We also brightened up all the ceilings and put in new lighting. It feels much more like a church, but is also modern with very simple moldings.
S HO W CA S E T W O
we did do some subtle things. The light fixtures in the patient rooms, for example, have a very small LED fixture that shoots out beams in a quiet starburst or cross design, depending on how you interpret it. People with a strong Catholic faith will probably see a cross, while others may see more of a starburst. We tried to incorporate faith-based icons in a tasteful, sophisticated way to complement the other really beautiful Catholic and religious-based works of art throughout the campus.
38
S HO W CA S E T W O
A visitor’s first impression of the hospital is now formed by the “Great Wall,” a 45-foot-high concave precast wall that creates a welcoming gesture for the facility. The wall is carved over the entrance lobby and frames the glass skylight canopy and reflection garden.
Moving forward, what are some lessons learned from working with St. Joseph that you might apply to other projects? Julia: I would say the overall process is one that I would like to follow again. Having the guiding principles and a client who wanted to participate made it work. In future proposals, I will go much more in depth as to the number of meetings the client anticipates. If a client is not as forward with their own ideas, I’m going to encourage them to develop their own guiding principles so that we can help them balance their decisions. For me, that’s a lesson learned in terms of how to be successful with a partner.
Now that the project is finished, what gives you the most sense of pride?
For me, it was more the journey and the relationships developed. I had less of a hand in the design work, but I feel proud for the people that were involved in creating a beautiful hospital. Paul:
I tend to identify with the user of the space I’m designing. Even though an executive might be my client on paper, in my heart, my client is always the person trying to find their way, or the patient coming there for treatment. There is such an improvement in the facility from the staff, visitor, and patient standpoints. I would hope that they walk through there with ease. What we created is understated, sophisticated, timeless, and hopefully is a much easier facility to get through. So I’m most proud of touching the lives of all those people who will go there every day. ■ Julia:
Paul V. Braun, AIA, has devoted his entire career to the planning, design, and management of projects serving healthcare clients and healthcare providers across the country. Paul served as the principalin-charge for the project, leading the overall delivery of professional services. Julia Bradley Rayfield, CID, IIDA, is a senior interior designer with 15 years’ commercial design experience. Julia led the interiors team, crafting the image of the facility and setting new standards for the hospital to expand throughout its campus.
The former chapel was unrefined, suffered from bad lighting, and was made of concrete exposed aggregate with 1960’s-style stained-glass resembling plastic. The team proposed three very different looks: a Gothic-inspired look, a modern theme, and a transitional look. The final solution, transitional, covered the concrete structures with beautiful sapele wood paneling, improved the lighting, and brightened the ceilings. Originally, the altar backdrop was a washed-out mosaic tile with a 1960’s abstract tau symbol. The design team chose to cover over the tile with an understated, but elegant, Venetian plaster treatment and install a new cross accentuated by indirect lighting.