United Hospital Center
Efficient and purposeful patientcentric design wins the community’s hearts United Hospital Center
Since opening in October 2010, United Hospital Center in Bridgeport, West Virginia, has collected high marks for aesthetics and functionality from patients, visitors, community and staff. The expansive 692,000-squarefoot, 292-bed replacement hospital, designed to meet the expanding healthcare needs of the growing regional population, is receiving rave reviews for its improved layout, separation of patient and public areas, and spacious private rooms.
Client
United Hospital Center Location
Bridgeport, West Virginia Market
Healthcare Services
Architecture Electrical Engineering Environmental Graphics Interior Design Landscape Architecture Master Planning Mechanical Engineering Plumbing Engineering Strategic Planning Structural Engineering PRINCIPAL-IN-CHARGE
Kenneth A. Priest, AIA, NCARB, LEED AP PROJECT MANAGER/Designer
C. Scott McQueen, NCARB, LEED AP Project architect/Designer
David J. Stewart, AIA, NCARB, LEED AP
Client interview with United Hospital Center’s President and Chief Executive Officer Bruce Carter, Vice President of Support Services Geoff Marshall, and Chief Operating Officer and Vice President of Patient Services Michael Tillman
N
ow that the hospital is open, what do you think?
Bruce Carter: The board and I are very pleased. We are impressed with how well it’s running and we’re receiving a lot of accolades in the community. When I make my rounds, the patients and the family members go out of their way to thank us for doing this for the community.
Project Coordinator
Andrew Holcomb, LEED AP Sejin Kim, Associate AIA, LEED AP engineering
A. Hunter Bogitsh, CPD, LEED AP James L. Daniel Gary L. Dauberman Jason B. Fukuda, P.E., S.E. Jon D. Long, P.E., LEED AP David V. McMullin, P.E., LEED AP Robert E. Oswalt, P.E. environmental graphics
Glenn T. Davis James R. Harding, SEGD interior design
Jane S. Skelton, IIDA, EDAC, LEED AP Kristen Vaughn, LEED AP
What do you hear the most?
Bruce: Most of the comments I get are about the inpatient rooms. In the old hospital, the rooms were semi-private, dark and dreary. The patients stared at a wall. There were visitors and staff coming and going, and there was hardly enough room for anyone to sit in a chair. The patients and family members repeatedly tell me that they feel better because the new rooms are private and spacious. They’re quiet. They can sleep. Also, I’m finding the glass is extremely important. They talk constantly about how bright the rooms are, and it just makes them feel better.
landscape architecture
Thomas G. Martin, ASLA AWARDS
Citation Award-Unbuilt Category, American Institute of Architects, Middle Tennessee Chapter Merit Award -Built Category, American Institute ofArchitects, Middle Tennessee Chapter
82
showcase 4
Geoff Marshall: I have several friends that have been patients in the hospital since it opened, and I’ve heard nothing but praise for the private rooms. They really like the way the
bed is angled toward the window and each room has a nice large glass area for outside viewing. Michael Tillman: People in the community also comment on how attractive the hospital is. They think the public spaces are incredible. The glass walls in the lobby provide views down each side, and then you turn around and see trees, hills and mountains. The inpatients very much appreciate the views of the beautiful scenery. They can’t help but notice it’s a stunning facility. Bruce: Yes, I’m getting a lot of compliments from the public that the building is more than just a big box that looks like any other hospital. It’s not just eight stories of brick. It’s an interesting building in the way it’s designed with curvature, with glass and with different textures and colors of brick and masonry. How do you usually get feedback from those who use the hospital?
Bruce: My practice, historically, has been to dedicate about two hours a day, at least twice a week, to go room to room and introduce myself. Now I do more than that. I visit the nursing stations. I see doctors in the corridors and talk with them. I see the staff and talk to the staff.
gresham, smith and partners
83
84
showcase 4
gresham, smith and partners
85
JUDGES’ COMMENTS
“...love the use and placement of color.”
Michael: We don’t have to request it. It’s a small community, so when I’m at the gas station on Saturday I’m likely going to receive feedback. What was your design intent for the mechanical and electrical portions of the new hospital?
Geoff: Before GS&P was on board I knew that we needed to design an infrastructure that could support future growth and not be an eyesore. Renovations over the years had caused our mechanical spaces to be very tight, cramped quarters to work in. We also wanted to keep a clean roof line and we didn’t want to see air handlers, fans and equipment sitting on the roof. With this design we put all of the air handlers and mechanical equipment in one location on the third floor. This allowed for additional floors to be added to the patient tower over time and the staff could easily service all the units in one area. Although you can’t completely avoid seeing evidence of the equipment in a facility like this, we think we did pretty well. Our roof looks nice. It’s neat and orderly and much of that is attributable to having the mechanical room where we could keep the equipment out of view. Not only is it
86
showcase 4
more efficient for my staff to maintain, it’s going to offer us the ability to expand and remodel down the road much easier than we would have in the old building. I think this is probably the best layout I’ve seen. From a functional standpoint, how is the mechanical system working at the hospital?
Bruce: One of the things that has really impressed the CFO and myself is our utility costs. We almost doubled the size of our facility but our utilities haven’t gone up near that much. We were really concerned about that when we started trying to forecast utility costs for this year. Geoff: We’re very pleased with the infrastructure we have in this building. In fact, everything’s working a little better than I really expected. I’ve heard horror stories from other facility managers that have dealt with major issues when they opened new buildings, but we’ve been through half a cooling season and an entire heating season and I can honestly say we’ve not had any major issues. What other changes did you make?
Bruce: We’ve always had a comprehensive accredited cancer center but because it was so scattered people
didn’t perceive it as such. The cancer center now has its own entrance and identity, and everything is in one place, which is also convenient for the doctors and specialists. Also, the mall concept in the front is working very well by keeping the public circulation separate from patient circulation. All of the outpatient departments are in front of the first floor, which helps the public quickly get where they need to go. People just park in front and walk in. That’s what outpatients want — walk in the door, get their tests and walk back out. They don’t want to wander around and go to three different departments. I would say that the objectives that we established for efficient circulation are working. Did you specifically focus on functionality and the separation of patient rooms from public areas in the early stages of design?
Michael: Yes, we wanted to value the patient’s privacy and separate public and private areas. We had bad experiences with the old facility because patients in hospital gowns were made to wait right in front of visitors accompanying a friend or family member. By separating the areas, the design provides a kinder environment for the patients.
ABOVE: All 292 patient rooms have angled beds to allow direct views outside to the north central West Virginia countryside. LEFT: The modified race-track design of the patient tower breaks up the long, straight corridors. Soft wall sconces cast light onto wood panel tree silhouettes which accent the walls between patient rooms.
gresham, smith and partners
87
Departmental adjacencies are strengthened through vertical and horizontal location. Major departments are placed at the facility’s perimeter so that expansion can occur without major disruption.
The building façade is made up of multiple layers creating a hierarchy of walls. The architectural form of the building is reinforced by the path leading through the gardens. Along this path are areas of respite for staff and family members. 88
showcase 4
In addition, one of the big underlying focuses was to make sure that no patient would look out his or her window and see another wing of a patient unit. That really drove the linear shape of the building, and it’s one of the reasons we are receiving such positive reviews. What has surprised you about the new building?
Bruce: Just the other day, I got a compliment about the emergency department (ED). The new ED is a decentralized pod system and quite a bit larger than the old configuration. Before, we just had a long hallway full of treatment rooms surrounding a nursing station, and now it’s quiet and patients have a great deal of privacy because they’re not off the corridor. It was initially challenging to get use to, but the patients and staff now seem to prefer it. I got a compliment last week from an amazed patient. She said to me, “Well, your volume must be way down, because it’s so quiet, there’s hardly anybody here.” And I said, “No, actually, our volume is going up.” She was stunned. So the reaction of the patients in the pod system is the same reaction you get in the patient units. Michael: Our wait times in the ED are the best they’ve ever been.
You mentioned a 10 percent increase in patients. Do you feel that is directly attributable to the new hospital?
Michael: A lot of that growth has been through the emergency department, which is up about 10 percent. We have very low wait times compared to national numbers, and 18 to 20 percent of patients who show up in the ED get admitted. So when our ED visits go up, our admissions go up. Most noteworthy is that we closed the second quarter 2011 with the highest patient satisfaction percentage we’ve ever had. Do you feel the new hospital has helped recruit physicians or nurses?
Michael: Absolutely. Physicians who walk into our new facility immediately recognize this building looks nothing like the community hospital they left. So we’ve hired a lot of doctors since we opened. It’s just impressive when they walk in.
Also, we’re one of the biggest vascular sites in West Virginia, and that’s primarily accomplished by two vascular surgeons. We have a high-tech operating room, which is a combination of an X-Ray room and an operating room. The doctors jokingly call it the vascular surgeon’s football field because it’s so big. That state-of-the-art room has definitely helped attract vascular surgeons. We recently recruited another vascular surgeon, and I credit the state-ofthe-art facility and design for helping attract him. So, after half a year of operation, how much do you credit the design with the hospital’s success?
Michael: In the beginning, we were looking for a design firm with experience in efficient design as it relates to staff operations. We wanted a company that had an understanding of efficient operational flow and didn’t just rely on clients to say, “This is how we should do it.” GS&P proved they definitely have this understanding.
...we doubled the size of our facility and our utilities haven’t gone up near that much.
gresham, smith and partners
89
90
showcase 4
gresham, smith and partners
91
JUDGES’ COMMENTS
“...great integration of interior design with architecture.”
For example, if you walk into our facility, the surgery and outpatient care are all located on the second floor. It’s a beautiful flow because the patients walk in from the lobby and arrive at a 40-bed, large outpatient prep discharge area. Then they walk another 10 paces and are next to the surgical rooms. Walk 40 paces to the right and they are in recovery. Walk 40 paces to the left and they are in the cath labs and other specialty areas. The flow works extremely well for the patients.
ultimately I think GS&P gave us an excellent design that functions very well. I appreciate what they did and UHC is very pleased with their work. I’m happy to share that with anyone.
Bruce: It’s like night and day. It’s not just a marginal improvement. It’s much more than I ever expected. I think the building is beautiful and it’s something we are proud of, but
TOP LEFT: Small seating areas located outside of the elevator lobby feature views into the multi-level sculpture garden and outdoor seating areas. TOP RIGHT: Located on the garden level, the cafeteria utilizes the same tree module seen on the upper floors, here depicted in paint and linear tile. This interpretation of the world beyond the windows provides changing, though familiar imagery as one travels the length of the long circulation space. BOTTOM: The main reception desk is located immediately off the front entry vestibule. Differing levels of soffits and rich materials draw the visitor in from the main entry to the reception and registration area.
92
showcase 4
gresham, smith and partners
93
ARCHITEC TURE
ENGINEERING
INTERIORS
PLANNING
Gresham, Smith and Partners provides design and consulting solutions for the built environment that contribute to the success of national and international clients. For more than 40 years, GS&P has focused on enhancing quality of life and sustainability within communities. GS&P consists of industry-leading professionals practicing architecture and engineering design as well as scientists and highly specialized planning and strategic consultants in Aviation, Corporate and Urban Design, Environmental Compliance, Healthcare, Industrial, Land Planning, Transportation and Water Services. GS&P consistently ranks among the top architecture and engineering firms in the United States.
showcase.greshamsmith.com
Š Gresham, Smith and Partners 2011