ST. ANTHONY HOSPITAL PENDLETON
Hospital entry check-in.
ST. ANTHONY HOSPITAL PENDLETON
OWNER
St. Anthony Hospital, Catholic Health Initiatives LOCATION
Pendleton, Oregon OPENING DATE
December 2013 DESIGN SCHEDULE
September 2011 – August 2012 CONSTRUCTION SCHEDULE
May 2012 – September 2013
ARCHITECT ZGF Architects LLP
OWNER’S REPRESENTATIVE The Healthcare Collaborative Group, Inc. / Kirk & Associates
CONTRACTOR Sellen Construction
CONSULTANTS Lean Healthcare West / ZGF Architects LLP Coughlin Porter Lundeen MECHANICAL | ELECTRICAL ENGINEER AEI Engineers, Inc. LANDSCAPE DESIGN Site Workshop LLC / ZGF Architects LLP GEOTECHNICAL Shannon & Wilson ACOUSTICAL Sparling VERTICAL TRANSPORT Lerch Bates LIGHTING DESIGN AEI Engineers, Inc. / Pivotal Lighting FURNITURE Dynamic Interior Designs / ZGF Architects LLP EQUIPMENT Jan Levine LEAN DESIGN
STRUCTURAL ENGINEER
PHOTOGRAPHER Benjamin Benschneider
SIZE HOSPITAL
105,200 SF
54,000 SF 30 beds (4 ICU, 5 LDRP, 16 Med Surg, 5 Obs) SURGERY 4 ORs, 6 PACU, 15 Pre/Post IMAGING MRI, CT, Radiology, X-ray, Ultrasound, Mammography, Nuclear Medicine, Respiratory Therapy MEDICAL OFFICE BUILDING BEDS
Emergency EXAM ROOMS TRAUMA
COST
10
1
$45 million
OVERVIEW The new 105,200 SF hospital replaces an aging 250,000 SF six-level facility located on a different site in downtown Pendleton. With 25 inpatient beds and outpatient services located on one-level, the hospital provides a broad range of care common to a rural, critical access hospital. The new facility is 58% smaller than the one it replaced. All program needs were met using a Lean planning and design process that minimized waste and optimized adjacencies and flow to improve outcomes and enhance patient-centered care. Sited to maximize natural daylight and encourage wellness both indoors and out, the hospital is centered around a healing garden which is the emblematic heart of the Pendleton community. The building’s interior and exterior design complements the indigenous colors and materials found in the local natural environment. ZGF also designed the adjacent and connected 54,000 SF two-story medical office building shell and core with material elements to reflect the hospital’s architecture. The project was delivered using Integrated Project Delivery (IPD), bringing together the Healthcare Collaborative Group, ZGF Architects, Sellen Construction, and sub-consultants to maximize schedule and cost efficiencies and minimize waste.
GUIDING PRINCIPLES Ten guiding principles drove the design of the hospital, care model, site, overall exterior, interior design and materials palette. • Deliver patient-centered care: ‘The Patient is King’ • Create a community destination that enhances the patient experience • Provide clear, intuitive wayfinding • Establish a strong connection to nature and the community • Connect to Catholic Health Initiatives’ mission and values • Establish an efficient building and operations • Technologically advanced design • Facilitate a collaborative and integrated practice • Support the value of all staff • Express a healing environment inside and out
A RICH HISTORY & CONTEXT Since its inception in 1901, St. Anthony Hospital and the Sisters of St. Francis have provided the Pendleton community with high-quality healthcare in a patient-centered environment. That tradition continues with the opening of the new critical access hospital to serve the physical, mental and social wellbeing of patients, staff and the community. St. Anthony is a part of Catholic Health Initiatives (CHI), a national nonprofit health organization with headquarters in Denver, Colorado. The faithbased system operates in 19 states and includes 74 hospitals, 40 long-term care, assisted and residential-living facilities; two community health organizations; and home health agencies. As a modest rural critical access hospital with strong ties to the community, the planning and design process directly involved the community to create a highly efficient patient-centered and locally personalized care environment. The new hospital reflects the character and personality of the people and spirit of pastoral Pendleton, Oregon known for the Pendleton woolen mills established in 1909 and annual Round-Up rodeo, one of the ten largest rodeos in the world.
ABOVE Hospital entry and connected two-level Medical Office
Building. RIGHT Scenes from Pendleton including the woolen mill and annual Round-Up rodeo. Design features were inspired by the community’s rich history and setting.
SITE DESIGN The facility sits on a 92-acre greenfield site with a challenging topography defined by a 150 foot grade change. The natural terrain of rolling grassy hills, with an abundance of loess, caliche soils and basalt rock outcroppings, inspired the siting and design. The interior and exterior design complements the indigenous colors of the surrounding landscape. The building is sited at the top of the slope to take advantage of natural daylight which filters into numerous interior spaces. The hospital and Medical Office Building are connected around a healing garden offering therapeutic views for patients, the public and staff. The space has also become an inviting gathering spot for the Pendleton community. ABOVE Hospital and connected Medical Office Building embrace
the healing garden. RIGHT Formal hospital entry.
Healing Garden The healing garden builds upon the natural landscape with a composition of boulder outcroppings, native plants and an active man-made stream. The central siting of the garden creates a strong visual connection from inside the building. Texture, color and natural movement between outside-in invites peacefulness upon entry into the building and as patients, visitors and staff move along the hospital’s main corridor. A meandering pathway, free of steps or stairs, facilitates greater mobility for all users and creates a softer approach to the building while the rippling sound of water cascading down the hillside, pooling in a pond at the lower patio and cafeteria, provides a restorative quality.
RIGHT Healing garden views toward hospital and Medical
Office Building.
Chapel The architectural expression of the chapel integrates into the landscape design. In the late afternoon, a cross carved into a sliding wood panel on the interior of the chapel is lit by the setting sun when slid across the keyhole window. The mood is sculptural, contemplative and reflective. From the exterior, the integration of site, landscape and structure manifests a calming visual quality.
ABOVE Inside the chapel, looking out toward the healing garden. RIGHT View of chapel from healing garden. OPPOSITE RIGHT View
into chapel from central corridor.
EXTERIOR PALETTE The building suggests ‘rustic elegance’ in reference to the regional setting. The Pendleton community is very connected to their heritage and wanted a design that would celebrate that history paired with a modern program and materials indicative of quality healthcare delivery and patient-centered care. The materials palette highlights the tones of the local landscape. The mottled purple natural slate was selected to reference the stone outcroppings found around Pendleton. At the entry, dark grey concrete masonry and metal panels create a formal experience. The entry drive to the hospital runs alongside the healing garden. The prevalence of floor to ceiling glass is intended to provide an inviting entry to the community. Large full height windows throughout the building provide big sky views of the seasonal transition of colors and sky. The connected medical office building is designed to compliment the hospital’s palette. The structure is simple, offering an elegant juxtaposition of dark and smooth textured concrete block.
ABOVE Healing garden. RIGHT Formal entry view and
design details.
Fireplace and seating outside main entry lobby.
LEAN PLANNING Lean planning holistically considers all hospital functions while placing equal emphasis on function, program, and experience, and identifying opportunities for minimizing waste, and improving efficiency, throughput and patient outcomes. ZGF led the hospital through seven Integrated Design Events (IDE), held over a combined total of twentyone days, to complete design by bringing together a diverse team comprised of hospital staff, board members, the hospital’s CEO, and the design team to look at typical patient scenarios and opportunities for improvement. For many of the participants, this was their first introduction to Lean planning. Teams were tasked with mapping current operations with the goal of improving future operations and enhancing patientcentered care. Using tools such as full scale mocks-ups and table top scale model exercises, changes to location of service lines and room layout were considered and re-worked. Floor plans were altered in real time so the entire group could visualize the impacts of modifications. By the end of the fourth IDE, the floor plan was synthesized and finalized for the user groups and leadership to review and sign-off on before the design team departed Pendleton. Subsequent IDE events focused on refining the design using mock-ups, models and virtual models that helped the hospital team prototype and refine room details in tandem with operational improvements. Guided by a ‘hospital improvement leadership team,’ staff continued to work throughout the design process to develop new organizational and supply chain models to help right-size the design. Prior to opening, employees spent time at the new hospital running clinical vignettes and disaster drills to refine processes and services before seeing patients in the new facility.
ABOVE Typical patient room. RIGHT Using spaghetti diagrams
to assess program adjacencies, and full scale mock-ups to refine design, the team evaluates care scenarios.
Lean Design Outcomes: Eliminated over half of the space (58%) of the former hospital while reducing waste, optimizing care delivery, and improving staff satisfaction and the patient experience. Revised registration process to reduce wait times. Medication delivery streamlined to provide ondemand medications to patients without overstock or pharmacy wait time. Improved centralized sterilization processes for surgery and all instrument and equipment sterilization minimizing space requirements for storage and equipment.
ABOVE Stairway connection between first floor and ground level
of hospital. ABOVE RIGHT View into patient room and Emergency Department team corridor. OPPOSITE ABOVE Surgery prep and recovery corridor of patient rooms. OPPOSITE RIGHT Team space in typical patient room corridor.
Surgery and procedural environment standardized for all patients from pre- to post-procedure to ensure standard of care for patient safety and allow shared services between what was once multiple “departments” to minimize space use and patient travel distances. 90% increase in staff engagement scores relative to the hospital’s parent company index. Caregivers are able to do their job more efficiently and spend more time at the patient’s bedside providing care.
INTERIOR DESIGN The interior is designed to be patient friendly, warm, and provide clear wayfinding. The design concept establishes a clear and compelling connection to the regional landscape, big sky, and adjacent rolling wheat fields. Centered at the heart of the site, the presence of the healing garden is experienced throughout much of the building. The palette is based on the Pendleton landscape and includes subtle variations to reflect the nuances of harvest, growing season and the progression of the seasons. The foundation is the straw-colored landscape, which is then layered with aspects of Pendleton’s regional context through finishes, textural changes, and an art collection reflecting the community’s personality. Key moments are created with focused openings providing abundant daylight and inside-outside connections to the landscape. Upon entry into the lobby and check-in, a focal fireplace and gathering space feels more elegant lodge than sterile hospital. Full-height windows initiate an immediate connection to the healing garden and landscape. In the chapel, low windows provide views toward a rock garden and cascading stream. All patient care is intentionally located on one level so that visitor and patient circulation is intuitive and easy to navigate from the central lobby entry point. Staff and service entries and interdepartmental circulation are distinctly separated from patient and public flow. The integration of interiors and planning is evident in the clear and natural wayfinding.
ABOVE View into a family waiting space in the childbirth wing. RIGHT Artwork reflects the local Pendleton community along the
main access corridor. OPPOSITE ABOVE Indoor/outdoor fireplace and seating in the main entry lobby. OPPOSITE RIGHT Staff meeting space located on ground level near the cafeteria.
Medical Office Building The two-story 54,000 SF Medical Office Building (MOB) shares a main entry lobby with the hospital to provide a seamless portal for patients—many of whom use the hospital’s outpatient services as well as the services and clinics located in the MOB. There are physicians’ offices and clinics in addition to hospitalbased services such as Infusion, a Sleep Lab and Administration. A gift shop and coffee bar are also located in the shared entry lobby.
ABOVE Infusion bay in Medical Office Building. Stairway connection
between first and second floors of MOB. RIGHT View into main entry lobby from outdoor seating and fireplace.
GROUND LEVEL HOSPITAL
0'
15'
30'
LEVEL 1 HOSPITAL + MEDICAL OFFICE BUILDING
N
N 60'
0'
0'
Patient Care Patient Support Circulation Staff Support Chapel Public Amenity Medical Office Building Building Support Shelled Space
LEVEL 2 MEDICAL OFFICE BUILDING
15'
30'
60'
15'
30'
CONTACT Leslie Morison 925 Fourth Avenue, Suite 2400 Seattle, WA 98104 206 521 3481 leslie.morison@zgf.com WEBSITE www.zgf.com TELEPHONE EMAIL
Printed on recycled paper. 1403