Building Strength Crystal Clinic unveils $100 million hospital dedicated to orthopaedic + reconstructive care By Mark Watt | Photos by Kendall Ristau / Hall + Merrick
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n late October, project partners, stakeholders and local officials gathered to celebrate the opening of Crystal Clinic Orthopaedic Center at 3557 Embassy Parkway in Fairlawn. The $100 million, 165,000-square-foot facility is one of the world’s only hospitals dedicated exclusively to orthopaedic, musculoskeletal and reconstructive care, representing Crystal Clinic’s vision to serve as a national destination for specialized care. The landmark project signals a significant investment in the region for Crystal Clinic, which is ranked #1 in Ohio and in the top 20 of the more than 6,000 hospitals in the nation for major orthopaedic surgery and joint replacement surgery (CareChex/Quantros Analytics).
Fulfilling a vision
The project was a long time coming, according to Chief Nursing and Operations Officer Holli Cholley, RN,
BSN, M.B.A. “Crystal Clinic initially started this project back in 2008 with the goal of building a destination hospital for specialized care,” she says, noting that it was first proposed to be located near downtown Akron. When the economic downturn occurred in the fall of that year, leading to soaring interest rates, those plans were placed on hold. Several years later, the physicians and hospital resumed their plan to construct a freestanding facility, identifying a suit-
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Photo by Mark Watt
With 12 operating rooms and 60 private patient rooms across three floors, the hospital offers orthopaedic surgery, reconstructive/plastic surgery and inpatient post-surgical care, as well as physical therapy and diagnostic radiology imaging services. It also includes a QuickCare facility to provide immediate, specialized walk-in urgent care for sports and orthopaedic injuries. Among the more than 250 healthcare professionals now operating onsite are 33 orthopaedic surgeons, specializing in cervical, lumbar spine, shoulder, elbow, hand, wrist, hip, knee, foot and ankle care, as well as pediatrics, while five plastic surgeons offer advanced reconstructive surgery for cancer patients, trauma patients, those living with congenital deformities and more. The state-of-the-art hospital serves as the epicenter of the physician-owned clinic system, which also operates an ambulatory surgery facility 0.3 miles down the street, along with 13 additional ambulatory and outpatient physician clinics in the region.
DESTINATION FOR SPECIALIZED CARE Equipped with 12 operating rooms and 60 private patient rooms across three floors, Crystal Clinic Orthopaedic Center is one of the world’s only hospitals dedicated exclusively to orthopaedic, musculoskeletal and reconstructive services.
able site within Embassy Corporate Park near the Interstate 77 and Route 18 interchange. The leadership team issued requests for proposals to engage consulting partners in 2016. To see its vision through, Crystal Clinic selected the team of Minnesotabased Hammel, Green & Abrahamson (HGA) as design architect, IKM Architecture as architect of record and Turner Construction as construction manager. It also engaged Healthcare Performance Partners as a consultant to help implement Lean management processes throughout the design/construction project. “From the beginning, we focused our energy on creating a welcoming,
comfortable environment that would operate as efficiently as possible,” Cholley says. “The Lean process helped
“From the beginning, we focused our energy on creating a welcoming, comfortable environment that would operate as efficiently as possible.” Holli Cholley Crystal Clinic Orthopaedic Center us to examine all of our everyday activities to find ways we could eliminate waste and ensure that the new building
would create the best overall experience for patients and caregivers alike.” This enabled the design team to develop a purpose-built facility that would not only accommodate Crystal Clinic’s existing processes, but also improve efficiencies to minimize wait times for patients, require less steps for staff and improve circulation for all building users. Further, the use of cloudbased three-dimensional BIM (building information modeling) allowed designers to interact and work on the same plans concurrently, which helped in working through even the smallest details to reduce challenges onsite. Kevin Ott, senior project manager with Turner Construction, says the
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INVITING FAÇADE Deep inset windows, a variety of earth-toned bricks and reflective glass combine to provide a dynamic exterior presence along Embassy Parkway.
Lean delivery approach was highly successful in keeping the project running efficiently, from early sitework, through groundbreaking in June 2018 and ultimately project completion in July of this year – five weeks ahead of schedule and under budget. Detailed, weekly meetings with key design and construction partners kept the project focused throughout, he notes. “In those weekly meetings, the foremen would stand up and tell everyone what they were working on, when major deliveries were planned and so on,” Ott says. “It was a very team-minded, open, collaborative environment. The goal was to identify any constraints or obstacles and eliminate them far ahead of time. We’d plan six weeks out, which allowed us to keep things running smoothly with little to no surprises.”
Crystal Clinic Orthopaedic Center (Fairlawn, OH)
Introducing a hospitality concept
“At the start of the design, we were asked to create a destination hospital,” says Jes Skaug, senior designer with HGA. “Early on, we looked around at the marketplace and one thing that came to mind was the idea of hospitality. The major competitors in the area have a focus on more high-tech and sterile types of environments. We wanted to take an opposite approach with our interpretation of a destination hotel, with a focus on the overall patient experience and creating a sense of warmth
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HEALTHCARE MEETS HOSPITALITY Eschewing the stark interior environment found in many healthcare settings, Crystal Clinic embraced a warm, hospitality-centered approach with design elements and material choices more commonly seen in boutique hotels.
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and hospitality that we didn’t see elsewhere in the region.” That approach informed design decisions throughout the project, from space planning and scale choices to the color palette and material selection. “That can be seen in the way patients enter the building and simply how they’re welcomed and greeted by the staff,” Skaug says. “It’s a matter of developing a sense of comfort and lowering blood pressure by creating a sequence for patients, creating lounges that are more to a hotel scale and positioned next to windows with views to nature outside and introducing materials and warm color tones that you might find in a boutique hotel. The richness of the color palette is quite sophisticated compared to what we typically see in healthcare facilities.” Even some of the most subtle differences made an impact, says Tami Greene, principal with IKM Architecture. “The ceilings are higher than in typical medical facilities – 11 feet in family waiting areas and patient rooms – and the doors in public spaces are tall as well, from eight to 10 feet high. That helped to stress the verticality of the spaces and make them feel larger and more open.”
Exterior impression
Accessing the building from Embassy Parkway, guests can find a parking space on a surface lot totaling nearly 400 spaces or be dropped off at a cantilevered porté-chochére entry area. 60
Although the structure is sizeable, it’s designed to feel approachable with its steel and concrete frame wrapped in textured masonry and glass. “The hospital is brick, which is compatible with other buildings in the office park, but we detailed it in a unique way to give it more presence and a stronger identity,” Skaug says. “We have a good deal of visibility on the parkway with the main entry facing south toward the parkway. We’ve taken advantage of that with a very dynamic, compositional element, combining glass that is quite reflective with very deep inset windows to create a sculptural effect upon entry.” While upper levels incorporate a variety of lighter, earth-toned bricks, the first floor features rich, black masonry that reduces the perceived height of the structure.
First floor
Passing through the front doors, the hospitality design concept becomes apparent with a sense of openness and the introduction of material choices that bring to mind a boutique hotel. Flooring is a mixture of multi-colored carpeting and dark gray tiles in a herringbone pattern, while walls are a warm, wood laminate with lighting provided by a mix of pendant fixtures and inset LED lights within the ceiling. To the east are a pair of solid stone reception counters, where guests can check in Properties | December 2021
INVITING ENTRANCE A spacious, two-story lounge and waiting area is furnished with a variety of soft seating, bar-style high-top counters and low-set tables, with a set of doors nearby opening to a landscaped outdoor lounge.
upon arrival. A small, open waiting area lays just beyond, partially obscured by a series of angled privacy walls. To the west is a spacious, two-story lounge and waiting area furnished with a variety of soft seating, bar-style hightop counters and low-set tables. An adjacent café features painted black walls and a small dining area, with a set of doors nearby opening to a landscaped outdoor lounge.
The balance of the first floor is comprised of clinical areas for pre-admission testing as well as the QuickCare Clinic. Patient rooms throughout incorporate sliding barn doors, which maximizes usable space. Shared technology resources include a general x-ray room, ultrasound, a CT room and procedure room. A dedicated MRI room incorporates an illuminated ceiling with a nature-themed design, while multicol-
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ored, indirect LED lighting is concealed along the room’s perimeter. “When patients are nervous, giving them a little control during this time matters a lot,” Green says. “Patients can choose between different color light settings or select music to listen to.” Ott says the MRI room is one example of identifying potential efficiencies through proper planning. “From a constructability standpoint, we laser-scanned
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ILLUMINATED IMAGING A dedicated MRI room incorporates a backlit ceiling with a nature-themed design, while multicolored, indirect LED lighting is concealed along the room’s perimeter.
this room, prefabricated everything offsite in a clean setting and then brought it here in a box truck,” he explains. “If we would have done it onsite, it would have taken six to eight weeks. Instead, we installed it within two weeks.”
Second floor
Overlooking the first-floor atrium lounge is a second-floor pre-op waiting area, which includes a walkout balcony with views of surrounding trees, a nearby pond and the patio below. From the waiting area, patients are transitioned into a series of pre-op rooms along a wing on the building’s west side. Rooms are arranged in pods of five, with five rooms per corridor and support functions situated in the middle. Nearby, the building’s 12 operating rooms are arranged in a U-shape with a central sterile processing unit in the middle for efficient decontamination and sterilization of instruments. The ORs are equipped with advanced technologies to enhance surgery success and aid in post-surgical recovery. These include a Stryker robotic surgical arm for knee and hip replacements, plus ExactechGPS computerized navigation for joint replacement surgery. Elsewhere, along the southeast corner of the second floor, are a series of administrative meeting rooms, equipped with state-of-the-art audio/video systems and teleconferencing technology.
Third floor
The third floor is comprised of patient rooms for those admitted after surgery. All rooms include views to the
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DISTINCTIVE DETAILS Rich color choices and materials enhance the hospitalityinspired design throughout, from waiting areas (top) to patient rooms (middle). Some corridors even include built-in benches, allowing patients to take breaks as needed during physical therapy (bottom).
outside, with vistas of the hospital’s landscaped, tree-lined grounds for those on the perimeter of the building. Interior rooms surround a central courtyard with a live roof, including three Japanese maple trees and annual flowers. To minimize views from one room to the other, the courtyard incorporates a decorative screen system, featuring a series of Corten steel privacy fences that are designed to rust over time into a natural patina. “The courtyard is going to be a showpiece, especially at night with the combination of vegetation, the steel screens and colored LED light systems,” Ott says. Patient room corridors feature wall sconces, inset LED strip lighting and floor-to-ceiling windows. “We’re in
“The richness of the color palette is quite sophisticated compared to what we typically see in healthcare facilities.” Jes Skaug HGA a beautiful, park-like setting and the floor-to-ceiling windows allow nature into the patients’ rooms,” Cholley says. “Since opening, the patients have really enjoyed recovering in a restful space that supports the healing process.” Built-in benches are placed along corridors, supporting Crystal Clinic’s goal of getting patients back to everyday activities after surgery, quickly and safely. “As soon as patients have recovered from their anesthesia, we often get them up and started on physical therapy,” Cholley says. “If they get a little lightheaded during that walking time, they can sit down and rest on the built-in benches and get their feet under them before we resume.” 64
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REINFORCING RECOVERY A number of third-floor inpatient rooms surround a central courtyard with three Japanese maple trees and other vegetation, plus a series of Corten steel privacy fences that are designed to rust over time into a natural patina.
Inside, patient rooms resemble hotel lodging with muted color palettes, smart TVs and private, tiled bathrooms with anti-slip flooring. Each room contains a closet with a safe for personal belongings, as well as a couch that can be converted into a bed for patients’ guests. Many rooms feature framed photographs of nature scenes taken by one of Crystal Clinic’s doctors. “Outside each room is a mounted electronic tablet that tells staff whether a room is occupied or needs cleaned, as well as other information to communicate between each nurse or provider,” Cholley says. Also located on the third floor are physical therapy facilities, including a set of stairs, a bathtub and a mock automobile that can be set at different heights to emulate cars, SUVs and trucks. Here, patients can practice common activities in a safe environment before heading back home.
Successful operation
“This project was a great experience and so refreshing,” Greene says. “Not only was it because of a great owner, but also the project management skills of Turner. It was so well organized and because of that, the overall morale at the meetings was very positive which you don’t always see on construction sites. It was a huge team effort.” Ott credits the trade workers who made the project possible. “We had 1,085 different trade workers on this job and they worked with and
around each other really well throughout,” he says. “The hospital treated those workers well too. They provided a food truck for us on a monthly basis, for instance. Extra things like that helped to create an environment where the trades wanted to come here and work because they were treated above and beyond what they may be used to.” Cholley notes that the Lean process was integral to the project’s success. “You may think you do a good job at something and run things efficiently, but it helps to step back and take a really good look at your processes to see where improvements can be made,” she says. “It made a big difference for this project. “We actually adapted that construction project management approach when performing the move from our previous facility at St. Thomas Hospital and into the new hospital. We planned six weeks ahead and also had very few surprises or constraints along the way. When the time came, we’d take two ORs down, start the move and continue to work. And then we’d do two more, and then two more. It was a coordinated effort that allowed us to move into our new hospital seamlessly over one weekend and be ready for 30 surgeries on the first Monday we opened.” Skaug, of HGA, summarizes. “It’s great to hear that the patients and caregivers are providing positive feedback,” he says. “We worked hard to create a premier patient experience that’s unique and differentiated in the marketplace and that’s what we did.” P
SidePlate Steel at CCOC The Crystal Clinic Orthopaedic Center’s structural steel frame design implemented “SidePlate” moment connections, comprised of 1,220 pieces of steel, for a 1,000-ton structural steel-frame building. By utilizing dual 80-ton cranes, the building was erected in six weeks. Kelley Steel was able to erect an average of 41 pieces of steel over the six-week installation. By utilizing SidePlate connections, the project was able to achieve an 11% reduction, totaling 70 tons, in structural steel beams and columns, equating to an overall savings of $400,000, versus a more traditional extended end plate moment connection system. SidePlate System is a patented process of designing moment frames, developed in direct response to the devastation caused by the 1994 Northridge earthquake in Los Angeles, California. SidePlate’s technologies are designed to protect structures against natural and man-made disasters, including earthquakes, blast attacks and progressive collapse. In a conventional design, vertical bracing or moment frames are the two options for resisting wind and seismic lateral loads. While vertical bracing is efficient, it leads to interferences that limit the ability of the architect and owner planning. These interferences can be eliminated and allow for an open floor plan through the utilization of moment frame designs, making them popular in the healthcare industry. The most conventional moment connections are complete joint penetration welds, bolted flange plates, and bolted end plates. SidePlate has however developed an alternative system for moment frame designs that reduces the steel tonnage, requires fewer moment connections and offers 30%-40% stiffer frames than the conventional designs. Also, depending on the project’s member sizes, design criteria and building layout, SidePlate can save 0.75 to 2.5 psf of steel weight and often a reduction of moment connections by 10%-40%. –Kevin Ott (Turner Construction) www.propertiesmag.com 67
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