Scotts Hill Community Hospital: A Remarkable Place for Remarkable Care by LS3P

SCOTTS HILL COMMUNITY HOSPITAL

EXECUTIVE SUMMARY

GUIDING PRINCIPLES

DESIGN OPPORTUNITIES

MASTERPLANNING

Option A: Live-Work-Play Option B: Wellness Destination

OUR VISION

Option A: Beacon Option B: Estuary

EXECUTIVE SUMMARY

At our core we’re designers and problem-solvers. We couldn’t help ourselves; we’ve started exploring the design possibilities. We were excited to take the initial planning work completed during the CON application and imagine the opportunities for the site for this immediate project as well as for future expansion and growth. We partnered with Stewart to help expand on our ideas and further develop these concepts through landscape design to paint the big picture. See right for our four Guiding Principles that were identified to drive our decision making.

HEALING OASIS advances the patient experience

COMMUNITY

architecture of place

STEWARDSHIP of site

FUTURE

21st Century Planning + Resiliency 5

HEALING OASIS This site has the potential to become the new “front door” for New Hanover and is large enough to expand over time. By taking a holistic look at the site, masterplan, and opportunities, this hospital can advance what the patient experience at New Hanover looks like. This new facility can become a beacon of healing, an oasis for wellness which helps to dispel anxiety for patients and their families. 6

BUILDING COMMUNITY Taking a cue from our place in the Carolinas, one of our core tenets was to build on the local character and advance the local identity of the region. It is important to create a place that fits within its environment, and the surrounding architectural context exudes coastal Carolina architecture with big open porches to create shade and large overhangs to protect openings and windows. Live Oaks with dripping moss and large sand dunes speak to the coastal environment. Drawing on these elements will create a place that feels like home and will enhance the patient and staff experience. The architectural expression can embrace a contemporary language without being trendy. 8

SITE STEWARDSHIP Your new community hospital will fit within the existing coastal landscape, blending in with the pines to create a more relaxed, comfortable, appealing perception of healthcare with the community. The site design can welcome the public as well as the hospital community to explore and enjoy the grounds, making this place an asset and a destination, and building relationships with neighbors in the process. The design will preserve the site’s natural beauty, and advance your mission to transform the health of our community and create a remarkable patient experience. 10

THE FUTURE A resilient hospital must not only be hurricane ready, but it must also be ready to tackle unforeseen events such as the next pandemic. A resilient facility must also be nimble and flexible. We cannot continue to plan the same way we’ve done in the past, but we must look beyond into the unknown to develop a plan that can flex and adapt. A key strategy for flexibility is creating plug-and-play components of repeatable elements on a chassis that can adapt over the next 50-100 years. Within this structure, the facility must also provide a footprint that brings in daylight and views to nature from deep inside the building. 12

IDEAL LOCATION AND IMPECCABLE TIMING

In order to deliver a remarkable patient experience, we must first create a remarkable place. To that end, we have developed two masterplanning schemes and two hospital design concept options. Either masterplan option works with either hospital design concept. We began by understanding the context of the existing site and analyzing the surrounding scale and architectural elements which could influence the design. We know that the existing scale will evolve and change along HWY 17 as Pender and New Hanover County grow. The scale of development in the area is in transition, and we can help shape that transition with this site. SITE

We also identified potential roadblocks that will need to be addressed: 1. HWY 17 is noisy and will have a high volume of traffic as the surrounding context grows. 2. The hospital will be a much larger-scale facility than the current surrounding neighbors. 3. The site currently lacks community connection. Drawing from the site context and constraints and guided by our core tenets, we developed these masterplan and hospital design options. 14

DOWNTOWN WILMINGTON

MAIN CAMPUS 15 mile - 30min drive

The Crab Shack South Hill Baptist Church SCOTS HIL LOP ROAD

Community Connection

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High Volume Traffic

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Single Family Residential NHRMC Emergency Department

NHRMC Surgical Center

SCOTS HIL MEDICAL DRIVE

Coastal Prep Academy

MASTERPLAN CONCEPT A LIVE - WORK - PLAY

The “Live – Work – Play” masterplan is based on an urban density concept. Clear wayfinding through the site will be important in any design; we’ve focused the inpatient access at the south end of the site and the inpatient at the north west portion of the site to provide visibility and ease of ingress. 17

MASTERPLAN CONCEPT A LIVE - WORK - PLAY

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The stage is set with Inpatient Health at the southend and Outpatient Health at the northend of the site. The 108-bed hospital connects to the existing emergency department, and surface parking is provided to both ends of the site. The main entrance drop-off road connects to Victoria Charm Drive and an interior road is added parallel to Pandion Drive to bring traffic in off the residential street. 18

Adjacent to the interior service road is a landscape buffer that meets the rezoning requirements while providing a natural barrier with boardwalks and trails across from the singlefamily residential houses. The ASC entrance road extends through the site, connecting back to Scotts Hill Loop Road. Extending existing places to gather into the site to create open public spaces which respectfully connect back to the community while providing a buffer at the site’s northern edge.

As the need and desire occurs, the northwest quadrant of the site can be further developed with outpatient facilities that tie back to the growth of the hospital. Extending connections across the site from east to west completes the urban street grid. As the site continues to develop, there will also be a need for parking decks which can occur at the lower levels of the MOBs as well as a larger deck at the core of the site, wrapped in retail and office.

As the site grows denser, there may also be a need for workforce and staff housing. By placing this housing at the northeast corner of the site, we can create connections to the existing residential fabric. Adding workforce housing will also aid in staff recruitment and retention.

Workforce housing will also make retail, office, research, and technology spaces more viable. Placing the research and technology hub in the southwest corner completed the Live-Work-Play concept. The site has great potential to create urban density with the hospital at its core.

THE VISION: NEXUS OF PREMIERE HEALTHCARE, WALKABILITY, AND UNMATCHED VIBRANCY The site has great potential to create a desirable urban density that forms “a city unto itself” with the hospital at its core. Scotts Hill will be the most walkable, vibrant, and urban place in the region outside of Downtown Wilmington. Marked by incredible public space and highly livable open green space—there won’t be an activity you can’t find, and there won’t be a place you’d rather be. This urban fabric will develop over a long period of time and evolve into a place where people can live – work – and play. ACCESSIBLE HEALTHCARE With the population shift moving towards urban areas, the healthcare campus of the future (dubbed “the healthcare village”) will play a more active role in the everyday lifestyle of a community, providing a mix of uses that are all driven by wellness. EXPERIENTIAL FOOD & BEV Scotts Hill will provide a unique place to showcase the best food and beverage in the region; a place where residents and visitors can gather together over local wine, farm-to-table food, and phenomenal atmosphere with great friends. RECREATION + WELLNESS Scotts Hill will create a recreation and wellness paradigm that is unmatched in Wilmington today. Punctuated by places to play formal sports, meet socially for yoga, gather together for kids to play on playgrounds—recreation and wellness is at the center of Scotts Hill. COMMUNITY + ENTREPRENEURSHIP Scotts Hill will also establish a district for community and entrepreneurship; not only a place the breeds innovation, but also a place that advances knowledge, skills, and the community that lives here. It’s a place targeted to providing opportunities for the people it serves, and hand-crafting a community purpose-built for it. 20

These concept images and renderings showcase the intent and sense of place for this urban live – work – play environment. Imagine staff and patients alike walking down the street to grab a bite to eat, take a spin class, or visit their specialist physician. Imagine a place that is active and interconnected with pocket parks and open spaces, with boardwalks and green spaces linking the urban grid together. Imagine a sense of energy, a general buzz that supports and lifts up the surrounding community. What if a hospital staff member’s spouse could live and work here, adding to the urban fabric? What if community events and gatherings could take place here? All these activities can be fueled by your hospital. What says “commitment to community” better than that? 22

MASTERPLAN CONCEPT B WELLNESS DESTINATION

The second masterplan option takes a different approach, providing a more symbiotic experience blending wellness and health with the local ecology. While this scheme may present itself as a less dense scheme, it can still house the full 500-bed hospital and supporting outpatient facility needs. 25

MASTERPLAN CONCEPT B WELLNESS DESTINATION

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We started with the same concept of creating clear wayfinding for both the inpatient and outpatient experience. The program, however, is much less dense than the Live-Work-Play option. The program will focus on the future growth of 500-bed hospital and the supporting outpatient and wellness retail needs.

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With the addition of outpatient buildings, providing surface parking that works within the existing site context creates a “parking in the park” experience for both staff and patients alike. This breaks up the sea of surface parking required and creates a more organic parking experience. When you arrive and get out of your car, you walk across boardwalks through bioswales and pines to enter the facility of your choice.

Drawing the ecology through and between the buildings will connect the facilities with landscape features focused on blurring the lines between the indoors and outdoors.

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Connecting the site with boardwalks and trails will encourage movement through the site, and will create a park-like setting not only for the patients and staff but also the community at large. This will be a place that encourages healthy lifestyles and preventative healthcare by reducing stress and anxiety and encouraging exercise and wellness.

The density and height will occur at the center of the site as to respect the surrounding residential and low-scale context. While this campus is less dense than the previous masterplan scheme, its true healthcare program capacity is the same. This site will exude wellness and connection to the landscape and outdoors. It will nestle within the pines creating a respectful healthcare environment to its neighbors and community beyond. 27

THE VISION: NEXUS OF PREMIERE HEALTHCARE, WALKABILITY, AND UNMATCHED VIBRANCY The density and height will occur at the center of the site to respect the surrounding residential and low scale context. While this campus is less dense than the previous masterplan scheme, its true healthcare program capacity is the same. This site will exude wellness and connection to the landscape and outdoors. It will nestle within the pines, creating a respectful healthcare environment to its neighbors, with boardwalks and trails intertwining and connecting across the site and out into the community. It will be a wonderful place to work, or to experience as a patient and family member; even better, it will be a wonderful environment for the community at large. These concept images evoke a sense of commitment to the environment, to a healthy lifestyle, and to a place that puts preventative care and the user experience first. Surrounded by landscape and nature, the buildings nestle into the environment in a graceful way as if the landscape evolved around the built environment and not the other way around. Imagine long boardwalks connecting parking to different facilities; areas with string lights for community activities; children riding bikes; families fishing and enjoying the outdoors. And at the heart of these activities is a hospital and outpatient care that promotes healthy and preventative lifestyles, encouraging the community to live healthy lives. 28

COMMUNITY HOSPITAL DESIGN CONCEPT A BEACON

In conjunction with the masterplanning concepts, we also developed two different Phase 1 hospital schemes. Both of these schemes can fit nicely within either of the masterplanning options. Both schemes apply the same four core tenets, but in very different ways. 31

This “Beacon” option presents itself as a billboard to the community. Early design sketches and thinking show a two-story base with patient floors floating above. Phase 1 of this site will connect the hospital to the existing emergency department and will create a clear path to the hospital. The drive to the ED will be shifted slightly so that there is a choice to turn left to lead to the existing ED. Boardwalks will connect the parking to the main entrance. A formal vehicular court at the front of the hospital accommodates patient drop off, and a secondary vehicular court at the rear accommodates patient pickup. The central utility plant is in a place for easy connection to the future planned growth. In Phase 1, surface lots will provide the required parking needs for the hospital. 32

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This option provides a very compact and efficient footprint. The D&T block is split on two levels and the patient floors float above the mechanical floor. An entry court defines front door to the hospital and connects back to the public elevators for ease of wayfinding. Expansion to 500 beds can easily be accomplished over several phases, and the bed count per phase is flexible. Keeping site stewardship in mind, this building footprint only touches 8.5% of the full site. Ease of wayfinding was at the forefront of this concept. The efficient and compact footprint places all the front-facing public spaces on the ground level with the “First Impressions” and “Dining” straddling the front door. The front door is easy to find whether on foot or from the car, as it is centered at the front of the entry court. Additional entry points are located at the dining courtyards and patient pickup at the rear of the public spine. Staff and service enter at the east side of the facility. 34

PHASE 1: 108 BEDS

FULL BUILD OUT: 500+ BEDS

PROGRAMMATIC RESPONSE FUTURE TOWER FUTURE GROWTH

OPERATING ROOMS

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STAFF STAFF/SUPPLY PUBLIC

STAFF/SUPPLY SPECIAL PROCEDURE & SUPPORT

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The second floor houses the surgical and procedural spaces with plenty of room to grow plan north and connect into future towers. All corridors are fed with ample daylight.

FUTURE MECHANICAL

STAFF/SUPPLY PUBLIC

PUBLIC USE ROOF TOP COURTYARDS

The D&T block and the patient tower are separated by the interstitial mechanical third floor. This floor also provides an opportunity for community engagement spaces that spill out onto roof top courtyards.

FUTURE GROWTH

LAB

SUPPORT STAFF/SUPPLY

IMAGING

FIRST IMPRESSIONS & CENTRAL ADMIN

DINING

The front porch connects the public programmatic spaces at the front of the hospital as well as the existing ED, and daylit corridors connect departments. 36

PATIENT PICKUP MATERIALS AND STAFF ENTRY PUBLIC

DINING COURTYARD

The public circulation follows the front porch and leads patients and family members through the 1st floor to the public elevators.

FUTURE TOWER

PORCH STAFF/SUPPLY

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MED SURG (12 BEDS)

PUBLIC STAFF/SUPPLY

The ICU beds are located on the fourth floor directly above the surgical elevators, easily expandable to the plan east into the med/ surgical units as needed. The future tower can be connected at the public and staff elevator core when needed.

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RG MED SUDS) (24 BE

STAFF/SUPPLY

MED SURG (12 BEDS)

PUBLIC STAFF/SUPPLY PORCH

The remaining floors of med/surgical beds are stacked above on the fifth and sixth floors, carrying on the same design approaches. Porches that exemplify the coastal Carolina aesthetic are located at both ends of the unit to provide an outdoor experience for staff, patients, and family alike.

KEY CORR. VIEWS TO DAYLIGHT PUBLIC ENTRY

PUBLIC CIRCULATION

STAFF ENTRY

STAFF CIRCULATION FRONT PORCH

SERVICE ENTRY

A clear staff circulation, separate from the public circulation, connects back to the existing ED.

RESILIENT AND HURRICANE READY DESIGN

Imagine a place that welcomes you to the site while also reflecting the New Hanover brand. The front porch and entry court encourage both vehicular and pedestrian traffic to arrive at the front door, creating clear wayfinding. Special moments carved out of the site create elements of surprise. A large oak tree with hanging lights creates a buffer from the vehicular traffic and the front porch; imagine siting on the front porch in a rocking chair as you wait for a loved one.

This scheme re-examines some very old ideas about the built environment and its relationship to landscape. We wanted to create an oasis that connects people with nature while destigmatizing the traditional institutional feel of a hospital. The landscape connects you with a pulse of life.

The patient experience is carefully considered at every level. The pedestrian and vehicular circulation are separated by creating boardwalks through a pine forest with tall grasses and ferns to provide a buffer at the pedestrian level. This pedestrian movement through the site reduces stress and anxiety as you approach the front door of the hospital. The boardwalks all lead up to the front door, first passing the outdoor dining café, where gardens intertwine the natural landscape of the coastal Carolinas with marshes and pines. This creates a very vibrant scene at the front door of the hospital. The rooftop gardens outside the community engagement spaces provide opportunities to get outdoors without going all the way down to grade. This strategy also provides elevated terraces during storm events and can be used by staff, patients, and the community at large to promote healthy lifestyles

COMMUNITY HOSPITAL DESIGN CONCEPT B ESTUARY

The “Estuary” option takes a more biophilic design approach. The Estuary scheme evolved out of a sketch which pulls the site landscaping through the building, creating internal courtyards throughout. The facility is gently placed within the surrounding landscape and draws the landscape through the building through a series of courtyards.

The facility is rotated for optimal orientation for sun exposure to minimize heat gain. The program layout responds to the landscape and unique site by allowing for future growth and a variety of entrances for staff, materials, patients, drop-off and discharge. Like the previous design option, all phase 1 parking is surface parking. The parking is separated by bioswales and natural landscaping and connects back to the hospital through a series of boardwalks. The central utilities plan is located outside of future planned growth. 50

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Patient floors and vertical circulation are separated to allow for complete bifurcation. Allowing for future dedicated virus response and flexibility. Program layout responds to the landscape and unique site by allowing for future growth and a variety of entrances for staff, materials, patients, drop-off and discharge.

Phase 1 acknowledges the current scale of the surrounding area and responds to the landscape. Each subsequent phase adds additional height as the surrounding context grows vertically over time. Compact planning is essential to the success of the site long term. The hospital is designed to grow with the surrounding area and population.

500 BED FUTURE 6.5 ACRES FULL 500 BED BUILD OUT 10% OF FULL SITE

PHASE 1 ACKNOWLEDGES THE CURRENT SCALE OF THE SURROUNDING AREA AND RESPONDS TO THE LANDSCAPE. EACH SUBSEQUENT PHASE ADDS ADDITIONAL HEIGHT AS THE SURROUNDING CONTEXT GROWS VERTICALLY OVER TIME

PHASE 3 252 BEDS

PHASE 2 BUILD OVER SURGICAL SUITE 144 BEDS EXISTING EMERGENCY DEPARTMENT

PHASE 1

COMPACT PLANNING IS ESSENTIAL TO THE SUCCESS OF THE SITE LONG TERM. THE HOSPITAL IS DESIGNED TO GROW WITH THE SURROUNDING AREA AND POPULATION

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The most exciting parts of this scheme are the interior courtyards that bring daylight deep into the hospital and provide a moment of respite for staff, patients, and family circulating throughout the facility. The building extends into the landscape and the landscape extends into the building, creating a place of wellness and healing.

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PATIENT PICKUP MATERIALS AND STAFF ENTRY

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COVERED DINING FIRST IMPRESSIONS & CENTRAL ADMIN

The programmatic department adjacencies are such that First Impressions and Dining are located right off the main entry drive. The public side of the pharmacy and lab are located off the public connector between the front door of the hospital and the existing ED. 54

Patient floors and vertical circulation are separated to allow for complete bifurcation, allowing for future dedicated pandemic response and flexibility. The mechanical floor is again lifted off the ground, creating a more resilient design.

MAIN PUBLIC ENTRY

The surgical and procedural spaces are also located on the first floor to maximize the planning efficiency between the ED and ORs. The upper floors provide covered patient pickup area and a covered loading zone and staff entry point without the need for canopies, and wayfinding is easily identified with separate staff and public corridors.

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The ICU beds are located closest to the surgical elevators and can easily expand into the med /surgical unit if needed.

KEY CORR. VIEWS TO DAYLIGHT PUBLIC ENTRY

PUBLIC CIRCULATION

STAFF ENTRY

STAFF CIRCULATION FRONT PORCH

SERVICE ENTRY

A front porch wraps around the face of the hospital providing shade on hot summer days and protection from the elements on inclement weather days. The vertical circulation is clearly split between public and staff/ service needs. 55

This design is also resilient and hurricane ready. The building and site are designed in harmony with the site to withstand future storm and flooding events and remain operational during and after extreme weather events. The building extends into the landscape and the landscape extends into the building, creating a place of wellness and healing.

RESILIENT AND HURRICANE READY DESIGN

This concept respects the surrounding residential context, and the scale is humane. By creating moments of calm and beauty, the proportion and arrangement of spaces and the way light moves along the façade and moves through the building is quite elegant. It creates a more relaxed counterpoint to traditional healthcare buildings.

The contemporary language is stated without being trendy. The materials, while durable and resilient, create a pattern that reflects the soft cedar shake found on many coastal homes. The large overhanging porch creates a way to stay cool and dry as patients and staff maneuver around the building. There is no “back” to this building, all sides have been thoughtfully curated. Boardwalks intersect the pine forest, marshes, and dunes creating an. The landscape invites clients as well as non-clients to enjoy and explore the grounds.

SCOTTS HILL COMMUNITY HOSPITAL VISION PLAN 2021 66