St. Bernard Parish Hospital

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SHOWCASE

After the Storm

St. Bernard Parish Hospital GRESHAM, SMITH AND PARTNERS

the ST. BERNARD PARISH HOSPITAL

CLIENT

Hospital Service District of St. Bernard Parish

LOCATION

Chalmette, Louisiana

MARKET

Healthcare

SERVICES

Architecture Civil Engineering Structural Engineering

TEAM PIC, PM, PD C. Scott McQueen, NCARB, LEED AP

PA, PD S. Robert Hamby, AIA, NCARB, EDAC, LEED AP

PC, PD Anna L. Ward Barnes, LEED AP

James D. Graham Dennis L. Meikrantz Ryan Sweeney, P.E. Tom Taylor

AWARDS

2013 IDEA Delta Regional Chapter Award of Recognition

n August 29, 2005, Hurricane Katrina struck New Orleans, Louisiana, producing sustained winds estimated at 125 miles per hour. Bordering the city’s Lower 9th Ward, St. Bernard Parish was all but destroyed when a massive storm surge (triggered by Katrina’s driving rains), breached the parish levees. At the heart of the tight-knit community, Chalmette Medical Center had managed to weather the Category 3 storm’s violent winds, but succumbed to the subsequent flooding that occurred the following day.

Helicopters evacuated 300 patients and hospital employees from the roof of the medical center as it was overcome by the rising waters.

When the waters receded, primary medical services for the parish were provided in a temporary clinic that was set up in a vacant Wal-Mart parking lot. In time, healthcare was delivered in a 22,000-square-foot mobile unit.

Damaged beyond repair, Chalmette Medical Center was ultimately demolished. Over time, the people of

the parish slowly started to rebuild and the population began to rebound.

However, officials feared that growth within the community would not continue without a hospital.

After several years, St. Bernard Parish secured both the funding and community support needed to build a new hospital. Ready to bring healthcare back to its residents, the St. Bernard Parish Hospital Service District charged GS&P with designing a three-story, 40-bed replacement facility that would not only withstand future disasters, but also reflect the community’s history.

“The project quickly became the centerpiece of the parish’s rebuilding efforts,” says Scott McQueen, GS&P principal-in-charge on the project, “and it didn’t take long for the design team to feel a deep sense of responsibility for the people of Chalmette.

We knew that this hospital was the next step to getting the community back on its feet.

“At first, we didn’t know where the new site was going to be located.

Eventually, the Meraux Foundation—

“The project quickly became the centerpiece of the parish’s rebuilding efforts, and it didn’t take long for the design team to feel a deep sense of responsibility for the people of Chalmette.”

— SCOTT MCQUEEN

The original site after Hurricane Katrina.

which put a lot of money into rebuilding the entire parish—donated a parcel of land to the Hospital Service District.”

The new site, however, also had a high risk of flooding. Yet the prohibitive cost of finding and purchasing an alternative property had the potential to end the long-awaited project before it even began. Aware of the importance of the project’s financial success, the design team moved forward with the new location.

A complete site evaluation was performed in an effort to understand the contextual structures, utilities, possible parking areas and access points throughout the available and adjacent properties. Major design implications included aspect and prospect views to the site, wind patterns, sun angles and other environmental factors.

“The site was three feet below sea level and four feet below Katrina’s high water marks,” explains McQueen. “To bring the site above the floodplain, we added 75,000 cubic yards of sand fill to the site, which

consisted of incredibly soft organic soil. A geotechnical report confirmed that if we tried to place the building on top of the existing soil, it would have settled anywhere from 19 to 23 inches over a period of time. We let the sand fill sit for several months so it would reduce any future settling. The final grading ultimately raised the existing grade of the site by four feet, which put it one foot above sea level.”

Adding sand fill to the site also helped protect the Gulf South Pipeline, which was buried approximately 12 inches below grade.

Additionally, by berming the entire site by four feet, the dangers of annual flood intrusion were mitigated.

A complete site evaluation was performed to understand the contextual structures, utilities and access points throughout the available and adjacent properties.

OR and patient rooms were built on the second and third floors to protect them from flooding.

Other essential systems, such as major mechanical equipment, were placed on or above the second floor.

PREVENTING FUTURE STORM DAMAGE

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To prevent history from repeating importance were the OR and patient itself, one of the Hospital Service rooms, which were placed on the District’s key goals was to design the second and third floors respectively. hospital so flooding couldn’t cripple One department that had to the facility. To achieve this, the team remain on the building’s first levcarefully programmed the three-story el due to access concerns was the building to withstand the devastating emergency department. However, effects of a hurricane. the team’s design concept of raising “Our team explored many differsurgery to the second floor would ent options to raise the hospital to an allow the associated prep and PACU elevation where floodwaters couldn’t bays to serve as a makeshift ED intrude,” says McQueen. “However, should the building’s first level because cost prevented us from fully become unusable. protecting the entire structure, we In addition to custom space worked with the hospital to come planning to maximize the building’s up with a solution that protected safety and efficiency, the entire faciliessential services and equipment ty was designed to be impact resistant. within the project budget. We placed “One of our major goals was all of the engineering items—from air to build a stronger hospital for the handlers to switchgear to the hospicommunity, and just about everything had to be impact tal’s fuel tank—16 feet above the base resistant,” says “It was our job to flood elevation, on GS&P senior the second level of architect and design a hospital the building. That project team that was built to last.” way, if water infilmember Rob trated the facility, Hamby.

“For —ROB HAMBY only items not esinstance, glass had to be lamisential for critical nated, and we specifically designed operations would sustain damage.”

Although the parish would refor potential wind loads. In addition quire the hospital to close under exto raising the facility, 80-foot piles treme flooding conditions, the GS&P were driven down into the ground team designed the new facility so it just to support the columns and the could be up and running as soon as edge of the building. We knew the the waters receded. Each department community couldn’t emotionally or was analyzed for its programmatic financially afford to go through the flexibility and degree of public access, same thing again, and it was our the cost and mobility of its related job to design a hospital that was equipment, and the types of wall and built to last.” floor finishes required. Of primary

A neutral brick color was used to give the hospital a contemporary feel.

RE-ESTABLISHING THE PARISH’S IDENTITY Though the people of St. Bernard Parish certainly live with the memory of the catastrophic flooding, the community still sees water as something to celebrate. For this reason, the team developed the unique design concept of a river that passes through the main form of the building and provides circulation between departments.

“We didn’t want to ignore the fact that the flood happened, so that’s essentially where the idea came from,” explains GS&P project coordinator Anna Barnes. “We used the river as a concept because one of the main elements of the Creole culture is water. The people have always lived on the water and have always embraced its challenges, so it’s not something they’re just going to turn their backs on. The overall design concept uses the river as a divider, but it can also be seen tying the structure back together, integrating its various parts and pieces.”

The glass curtain wall, which forms the exterior of the river, provides patient rooms and public spaces with ample sunlight and sweeping views. The distinctive architectural concept also enhances wayfinding, helping visitors circulate through the hospital to major departments and patient rooms. The bend of the river—as it passes through the building mass—cradles most of the facility’s public and social areas.

To understand the hospital’s desired image for the exterior of the new building, a visioning session was conducted between the owner and the design team. This process helped to develop a baseline for discussions and resulted in a cohesive design with buy-in from all parties.

“We went through several options on the brick color,” says McQueen.

“The one thing the owner didn’t want was for the brick color to resemble mud. Everything was covered with mud after Katrina, and they were

The interior design actively encourages community pride through the use of natural materials and a two-story graphic of Lake Borgne and surrounding bayous.

SHOWCASE SIX

Barnes. “We used wood in the ceilings and main lobby spaces, which was in keeping with the conceptual relationship of the bayou. In addition, we incorporated a huge, twostory wall graphic of the parish that shows Lake Borgne and the bayous that surround it.

“We also tried to bring in as much natural light as possible and maximize the surrounding vistas,” stresses McQueen. “We placed large windows at the ends of the corridors and used a lot of glass in the patient rooms.

From the building’s third floor, you can clearly see Lake Borgne and the river on the other side. It’s a wonderful view.”

S T. B E R N A R D P A R I S H H O S P I T A L

understandably very sensitive to that type of shade. We eventually settled on a neutral brick color, which gave the exterior a modern feel that was in keeping with new construction that was beginning to dot the landscape.

The entire area was starting to take on a more upscale, contemporary flavor, which we wanted the hospital to follow.”

Tasked with reflecting the community while celebrating the history and culture of the parish, the design team used images of the regional landscape and local historic figures throughout the hospital’s interiors.

“Although the appearance of the parish was in a state of flux, the interior design encourages community pride,” says McQueen. “No matter what direction people move in, they will be reminded of their home, its past and its present value in their lives.

“The color and form of the interiors were also rooted in the natural environment of the region,” adds

The first diagram simplifies the building shape into two conceptual parts: the building mass and the “river,” which passes through the building’s main form and provides circulation between departments.

The second diagram breaks the river form down by program. The bend of the river cradles most of the facility’s public and social areas. The verticality of the lobby allows for intuitive navigation of the hospital’s three floors.

The glass curtain wall, which symbolizes the river on the building’s exterior, provides the patient rooms and public spaces with ample sunlight and sweeping views.

GLASS CURTAIN WALL

1, 2, 3: The glass curtain wall provides an abundance of light and enhances wayfinding. 4: By moving all mechanical equipment 16 feet above grade, the design team was able to ease fears that these components could be lost in the event of another flood.

5: The exterior’s modern feel is in keeping with new construction beginning to dot the landscape. 6: The area where the “river” bends, like the city of New Orleans, is the life and nexus point of the hospital. The activated corner is a place of public entry and defines the hospital lobby.

3 4

1 2

6 5

REBUILDING THE POPULATION With much of the parish’s buildings, amenities and local infrastructure destroyed by the flooding, the new hospital became an icon for residents to rally around. A symbol of progress and recovery, the community’s new medical center needed to bolster a recovering economy, and give evacuees a reason to move back home. To do this, St. Bernard Parish Hospital would have to deliver exceptional and progressive medical care.

In an effort to create an advanced medical facility that could attract world-class health professionals, the GS&P team utilized best practices in their design work. With no current staff available from whom to draw opinions, the design team decided to start with a blank slate.

That way, no matter who staffed

the future hospital (or what their individual practice styles were), the medical environment would be easy to navigate.

“Because the hospital had zero staff and had yet to hire new administrative staff, nurses and physicians, we had an opportunity to utilize all the best practices we knew that highlighted patient safety and staff efficiency,” says Barnes. “Starting with a blank canvas enabled us to focus on what we knew worked best from a planning standpoint.”

“And we tried to keep things standardized as much as possible,” adds McQueen. “We placed particular emphasis on providing same-handed work spaces to the hospital staff and clinicians. That familiarity between patient rooms can greatly reduce

medical errors, as opposed to mirroring the room layouts. We located the sink beside the bed in each patient room so staff can wash their hands, and patients can see them wash their hands, which is important. We also designed the rooms to have large windows that let in plenty of natural light and provide a connection to nature, which reduces stress and promotes healing.

“This new hospital is the catalyst for bringing people back to the parish because they’re not going to return to a place where there’s no quality healthcare. The community now has a cutting-edge medical facility that will undoubtedly bring back former residents and attract top-tier medical staff.”

The grand opening for St. Bernard Parish Hospital was held almost seven years after Hurricane Katrina ravaged the previous facility. The invigorated community came together to celebrate this milestone.

Three weeks after the opening, the hospital was tested by the onslaught of Hurricane Isaac.

The building was able to function during power outages, high winds and flooding.

—SCOTT MCQUEEN

outages, high winds and flooding, and it sustained no significant damage,” says McQueen. “The emergency generators we put on the mechanical platform on the second floor worked beautifully, so the hospital was able to keep power throughout the hurricane. One of our primary goals was to create a robust building and a safe environment for the people of St. Bernard Parish. Surviving the storm in such a big way proves we did just that.”▪

SHOWCASE SIX

Featuring emergency, surgery, diagnostic imaging, pharmacy, laboratory and support services, St. Bernard Parish Hospital opened its doors seven years after a colossal storm surge destroyed the previous facility.

The 109,000-square-foot hospital’s ability to withstand extreme weather and water conditions was soon tested when Hurricane Isaac barreled into Louisiana’s Gulf Coast.

“The new facility remained fully functional during major power

S T. B E R N A R D P A R I S H H O S P I T A L

“The community now has a cutting-edge medical facility that will undoubtedly bring back former residents and attract top-tier medical staff.”

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