Operational efficiency: humanistic response “ THE HEALTHCARE INDUSTRY IS EVER CHANGING,” is an assertion made in countless articles and lectures over the past twenty years. While there is truth to that statement, it is really what is changing in the industry that keeps shifting. In an era defined by continual advancement in process and technology, and also by streamlined cost and efficiency, change will now be defined by designers’ ability to effectively implement new tools and diverse expertise to recognize the opportunities in these advancements. The future of healthcare architecture lies in the ability to create value for our clients. This value exists at the nexus of our capacity to simultaneously design buildings and systems, while completing both in one synchronized workflow. To accomplish this, design teams must be able define the problem using the same universal language as our clients. At Payette, we are driven by design and fascinated by research and big data. We believe design lies at the intersection of art and science. However, over the next 50 years, the science of design will focus on recognizing and deciphering our clients’ key issues through a quantifiable analysis. Innovation will involve adapting previously proven processes to individual situations, understanding that each client, given their specific focus, patient mix, physical situation and philosophy, will be optimized only through a customized approach. Whether it includes new developments in service line processes, recognizing how changing demographics will significantly alter the demands facing our clients or how institutions best use their space, new models will be shaped through creative adaptation that will have a transformative impact on how we design facilities for the future.
DESIGN PHILOSOPHY Payette’s design process is fluid and uniquely shaped for each client. As stewards of our clients’ resources, we believe we have a responsibility to lead. As each project constitutes a significant financial investment, it is imperative that each opportunity is fully realized by creating spaces that are aesthetically inspiring, operationally flexible and financially responsible. We understand that operational outcomes will be significantly influenced by the physical structure of the building and the level of control we now have over these parameters is greater than ever. Where we were previously dependent on intuition and anecdotal evidence, today’s tools allow for exciting new levels of discovery and precision. Underlying our design process is our view that healthcare architecture involves a deep dive into the culture of each institution and the particulars of place. We think of hospitals as small cities that need streets, boulevards, parks and neighborhoods to provide a sense of organization and structure. Furthermore, we are passionate about bringing nature deep into healthcare settings, linking clinical spaces with nature and natural light. We believe that there is great value in doing this and work diligently to organize clinical spaces around a sequence of internal green spaces that can take the form of healing gardens for cancer infusion, green roofs or hanging gardens in a high rise urban environment. To fully achieve success, we feel design teams should be smaller and driven by experienced senior staff, with a diverse makeup of expertise ranging from traditional design and building science to operations and planning. Our system is not one of manufactured efficiency but one that utilizes LEAN concepts to create value at each step and move the process forward consistently with each engagement. We know our clients’ time is valuable and we appreciate the financial impact of staff time to integrate with the design team and, ultimately, speed to market. Payette is engineered to create a functionally successful, award-winning project every time we engage our clients.
INTEGRATING RESEARCH AND DESIGN Scientific inquiry drives our practice. Everything about our firm is exploratory. Deep dives in research analysis, site observations and benchmarking are critical to our initial setup and nothing is more indicative of our teaming structure than our Building Science Department: an in-house team of Building Scientists tasked with exploring the future of the structured environment. Simply put, the department studies how buildings perform and how people use them. Integrated fully into each and every design, these individuals bring a level of rigor and data-driven expertise uncommon in the design industry. Building systems, materials and energy usage are optimized for each solution model as we embrace the challenge of delivering the highest performing facility for an inherently demanding building type. We’ve conducted numerous research projects led by our Building Science Department, including an AIA Upjohn Grant that supported our research to better understand thermal bridging and the performance of façades. Our investigation quantified the effects of thermal bridging in commercial façades and then proposed alternative solutions to improve performance. One of our ongoing research projects focuses on natural ventilation options for healthcare environments. With industry initiatives like the 2030 Commitment, along with other sustainable design initiatives, hospitals must find ways to reduce their energy consumption while continuing to provide increased levels of patient comfort and care. Our research is aimed at identifying relevant design and patient care issues, and outlining safe and effective approaches for incorporating natural ventilation into the healthcare setting. We’ve found rigorous research informs early design decisions, which can greatly impact the energy savings potential of a project.
BUILDING SCIENCE METRICS Building science is the data-driven investigation of building systems, materials, envelope and operational energy usage in order to optimize a building’s performance and minimize its environmental impact. As stewards of our clients’ resources, and with conviction in our responsibility to lead, we embrace the challenge of delivering the highest-performing buildings for our inherently demanding market sector. Take a look at how our healthcare projects perform on average:
33%
REDUCTION IN ENERGY USE COMPARED WITH A TYPICAL HEALTHCARE BUILDING
22%
REDUCTION IN WATER USE OVER CODE REQUIREMENTS FOR A TYPICAL HEALTHCARE BUILDING
23%
OF THE BUILDING MATERIALS ARE RECYCLED CONTENT
100%
OF THE BUILDING MATERIALS ARE LOW VOC
22%
EQUIVALENT BUILDING AREA OF OPEN SPACE PROVIDED
Space Typologies
Children’s Hospitals
Surrounded by cacophonous architecture, loading docks and residual urban conditions, the patient tower brings a quiet dignifed silhouette and focus to the streetscape, while capturing the vitality and energy of one of the world’s best children’s hospitals through the animated Art Wall and Pocket Park. James Mandell Building | Boston Children’s Hospital Boston, Massachusetts
“… children and families in central Pennsylvania will have a world class pediatric facility to match the comprehensive and compassionate care they have come to expect from us.” — Harold L. Paz, CEO, Penn State Hershey Medical Center & Health Systems Children’s Hospital | Penn State Hershey Medical Center Hershey, Pennsylvania
Ambulatory Care
Fluid programmatic requirements necessitated a flexible framework for the building configuration. Clinical departments abut research space so that either may grow. Clinical boundaries can flex between specialties. The clarity of circulation and consistent use of a modular planning approach allows for an adaptable environment. Ambulatory Care Center | University of Massachusetts Medical School Worcester, Massachusetts
Cancer Centers
“By bringing our cancer researchers and clinicians together under one roof, we have created an environment that will support the translation of scientific discoveries into meaningful advances in patient care.” — Harold L. Paz, CEO, Penn State Hershey Medical Center & Health Systems Cancer Institute | Penn State Hershey Medical Center Hershey, Pennsylvania
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The revitalized Wallace Tumor Institute is now the clearly identifiable front door for the Comprehensive Cancer Center. The project, a nucleus with a sense of place and cohesive identity, reverses a 30 year trend of dispersing multidisciplinary research efforts to the expanding campus periphery. Wallace Tumor Institute, Comprehensive Cancer Center University of Alabama at Birmingham Birmingham, Alabama
Imaging Modalities
Movable ceiling-hung equipment allows the room to transform from an operating room into an imaging suite while the patient remains stationary on the table. Ceiling booms supporting monitors, anesthesia equipment and lights swing aside to clear the immediate magnetic field. Then the MRI glides on an overhead track and the patient and room are ready for imaging. The kinetic qualities of the Suite are captured on the floor where the arc of the operating table’s rotation and the limits of the magnet’s Gaussian surfaces are vividly rendered in a palette of colors derived from the facility’s cutting-edge equipment. Advanced Multimodality Image Guided Operating Suite Brigham and Women’s Hospital Boston, Massachusetts
The overlay of the magnetic field patterns provided singular areas where the new MRIs could be located on the site. These positions shaped the project both internally and externally, introducing an unexpected geometry when overlaid with the existing context. The sloped site presented the opportunity to shift the mechanical space below grade while expressing the concrete foundation as an integrated form. Center for Surgical Innovation | Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire
Campus Planning
The primary organizing devices of the flexible framework plan are the Gateway and the Campus Green, which will provide a new public face and identity to the Health Sciences Center. A green oasis in an urban desert, these new elements represent the first step in renewing the campus and investing in the surrounding community. Health Sciences Campus Framework Plan | Temple University Philadelphia, Pennsylvania
The landscape sequence and progression choreographs the visitor experience from the urban to the natural. People filter into the hospital from the plaza view or enter the Healing Garden, both a place of reflection and focal point. The Healing Garden starts with formal architecture, celebrating the structure of the hospital combined with the natural world. As one moves from the main entry through the Healing Garden towards the Park, the experience becomes more natural. Fifth XiangYa Hospital | Central South University ChangSha, Hunan County, China
The focus of the patient room is a Family Nest. It symbolizes the hospital’s commitment to creating a healing environment, focused on the individual, which promotes a strong sense of respite.
Where we stand: rankings and awards Building on its proud history, our firm continues to emphasize strong design. We produce architecture of consistently high quality and sophistication. We have become one of the nation’s most award-winning architects for healthcare and high technology science and research buildings.
2015
AIA National Healthcare Design Award
Ranked 3rd in Design; 9th Overall by 2014
Architect Magazine’s The Architect 50 Annual Ranking
2013
145
12
11
7
4
AIA National Healthcare Design Award for Innovations in Planning and Design Research AIA and National Design Awards
Boston Society of Architects Healthcare Facilities Design Awards Excellence in Planning & Architecture Awards from SCUP / AIA-CAE
AIA / Modern Healthcare Awards
Awards for Sustainable Design and Green Practices
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