St. Anthony Hospital Gig Harbor, Washington

The design of the new St. Anthony Hospital furthers our mission to nurture a healing ministry and create healthier communities. Our values of Reverence, Integrity, Compassion and Excellence helped to shape the design of the facility, which synthesizes core programmatic elements, performance criteria, and design aspirations into a singular and elegant architectural expression. The hospital reflects both the maritime history of the communities served and a strong connection to the natural environment of the Pacific Northwest through integration of subtle and sophisticated nautical interpretations with a delightful spatial experience that revolves around the landscape and a central healing garden. Application of evidence-based design principals, incorporation of cutting-edge medical technologies, clear functional organization, and design for long-term flexibility enable us to provide the highest level of healthcare. The hospital truly embodies a partnership between the environment, people and place that together create a unique healing environment for the care of body, mind and spirit. Thank you. 窶認ranciscan Health System

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Introduction Prior to the completion of the new St. Anthony Hospital, the South Sound Region represented one of the largest population centers in the State of Washington without a central community hospital. As a result more than 3,500 emergencies and 4,000 patients requiring overnight care had to travel outside of the area for treatment annually. The 80-bed, 250,000 SF full service hospital in Gig Harbor addresses the need for critical healthcare services within this growing region, and provides quality care in a patient-centered environment that celebrates the local community’s Native American and maritime history, rich natural landscape, and the connection between nature, health and well-being. 5

Wetland Enhancement Corridor Restoration Area

ED Sculpture Garden

Pedestrian Spines

Riparian Zone

St. Anthony Hospital

Chapel Court

Conifer Grove Arrival Plaza

Healing Garden

Bamboo Grove

Medical Office Building Stormwater Feature

Deciduous Grove

Wetland

Power Line and Setback

Wetland Site–water Filtration Vaults (under parking)

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Sun Angles & Views

Storm Water

Emergency Access

Expansion

A pre-groundbreaking plant harvest event, conceived of and organized by ZGF, engaged the local community.

Site Integration and Preservation Integrating a hospital, medical office building, and parking on a densely vegetated, 30-acre greenfield site with steep grade issues posed a set of complex access, orientation, and preservation challenges. Project successes included: •

Conservation of three natural wetlands and a salmon stream.

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Preservation of natural landscaping on more than 50% of the property.

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Replanting of disturbed areas with indigenous plants.

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Organization of a pre-groundbreaking community plant harvesting event to remove vegetation from development areas, keep native plants within the region and strengthen ties with the local community.

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Design of a terraced-grade solution allows the hospital campus to function as an extension of the landscape, integrate nearby residential development, and accommodate a power line (with 200 foot setbacks) bisecting the site.

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Inclusion of a ‘green buffer’ along the perimeter of the site reduces visual and acoustical pollution. 7

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Program Featuring a 24-hour emergency department, the hospital is equipped to handle trauma cases and includes medical, surgical and critical care units; inpatient and outpatient surgery; a heart catheterization laboratory; diagnostic services (including MRI, CT scans, ultrasound and mammography); and physical, occupational and speech therapies. The main hospital is connected to the 95,000 SF Milgard Medical Pavilion which houses medical offices and the Jane Thompson Russell Cancer Care Center, an integrated cancer center offering programs for patients and families. The project also includes parking for 700 cars. 9

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Community, Context, and History

An art program features work from local artists inspired by interpretations of nature in the Pacific Northwest and the region’s Native American and maritime history. Original paintings, sculptures, and an array of other unique artwork are displayed in patient rooms, public spaces, and areas throughout the hospital to enhance the hospital’s healing environment and create a soothing effect for patients and visitors.

Engaging the close-knit South Sound community throughout the design process was a top priority for Franciscan Health System. As Gig Harbor is one of the few places on the west coast where the forest truly meets the sea, the regional culture boasts a rich maritime history set against a backdrop of deep wooded forests, panoramic landscapes, and breathtaking views to the water. Design of the hospital celebrates and weaves these unique attributes together to create a special experience reflective of the community—including an art program featuring work from local artists; placement of round HVAC vents to emulate the port holes of a boat; interior walls with wave-like patterns referencing the ebb and flow of the sea; and inclusion of a water feature within the healing garden that uses recycled water. 11

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Healing Garden The building itself is nestled into the greenfield site embracing a central healing garden visible from all main public spaces. Additional view gardens are tucked around the building perimeter, providing glimpses of nature from every possible angle. 13

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Exterior Materials Exterior materials incorporate an aluminum curtain wall system to maximize natural day-lighting, views, and a rich textural landscape composed of natural stone, poured concrete, wood panels and structural steel columns. The effect is warm and welcoming. 15

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Chapel Exterior and Materials Reflecting the faith-based mission of the client, a 600 SF chapel is a significant element of the hospital. Visible from the main entrance, the chapel is designed as a space of tranquility, available for contemplation and prayer for people of all faiths and denominations. The simply shaped chapel is surrounded by a shallow pool of water to reference nature’s healing power. A focal concrete wall in the middle of the pool establishes a strong sense of presence and grounding. A glass wall overlooking the water is flanked by vertical wooden louvers suspended at different angles from stainless steel pins to emulate fins on a boat. 17

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Chapel Interior Inside, a wood-paneled wall with exposed metal fasteners similar to those used in boat construction echoes the wood paneling on the hospital’s exterior. The choice of materials such as polished concrete flooring and wood clad walls create a simple, tranquil space. 19

Intended to suggest trees lining a path, the canted walls of the clinical waiting areas expose structural columns that run the length of the main circulation of the building.

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A Walk in the Woods The natural beauty of the wooded forests surrounding the hospital, and the connection between nature and a patient’s journey from sickness back to health, also became key themes in development of the design. Borrowing inspiration from Robert Frost’s classic poem ‘A Road Not Taken,’ the team identified the characteristics and experiences that define ‘a walk in the woods’. Concepts such as exploration, silent reflection, moments of pause and visual connectivity between interior and exterior landscapes emerged as strong design fundamentals. These desired experiences were then translated into a set of design strategies that were applied to interior-exterior relationships. Terms such as ‘clearing,’ ‘glade,’ and ‘filtering of light’ were used to describe the kind of relationship between the interior and exterior environments throughout the hospital including treatments for views, landscape design, and interior space planning which in turn drove material selection, lighting design and even room layout. 21

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Public Lobby Celebrating the community’s maritime history, blown glass pendant fixtures are an elegant representation of the glass floats used by commercial fisherman in the past. 23

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Influential Design Elements Wood clad reception desks mimic the wood planks used on piers and fishing boats. 25

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Healing Garden Views The layout of interior spaces and wayfinding are driven by views to the outside, providing a natural sense of orientation around the central healing garden. 27

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Bringing the Outside In Elements of nature are reflected on the interior by back-lit translucent acrylic wall panels containing natural grasses, wood slat acoustical ceiling treatments, and dome light fixtures that simulate skylights. 29

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Promoting Family Centered Care Patient rooms provide views of the lush wooded landscape and accommodate a patient’s family and visitors in a separate zone within the patient room that includes a closet, table, pullout bed, and phone. 31

The upper medical/surgical floors have views to the outside that overlook a canopy of green trees.

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Full-height glazing provides views of the natural surroundings and an exterior sculpture garden outside of the ED waiting area to help create a calming atmosphere.

Corridors in the medical/surgical unit have unobstructed views of nature, providing daylight and creating a ‘moment of pause’ for nurses and hospital staff.

Evidence Based Design Studies have shown that daylight and views to nature can speed a patient’s overall well-being, provide an uplifting environment and positive distractions. The hospital layout maximizes access to windows for staff, family and patient areas including views to the lush wooded landscape from all patient rooms and staff lounges. Panels of glass in the central core are strategically located to provide views of nature. Single patient rooms, one of the most effective evidence-based design strategies proven to reduce the spread of infection between patients, are incorporated into the design of the hospital. To further reduce hospitalacquired infection, the layout is organized by program adjacencies with separate circulation pathways for the public, staff and patients. The presence of family is proven to help alleviate patient stress and encourage healing. To this end, all medical, surgical and ICU rooms are designed to accommodate a patients’ family and visitors who wish to stay overnight, with wireless internet and other amenities enabling visitors to stay in touch with loved ones unable to be at the hospital. Research also shows that low-sound levels lead to reduced noise, stress and improved sleep. Design of the hospital addresses acoustics with highperformance ceiling tiles, sound-absorbing materials, quiet mechanical equipment, separation of service and utility corridors from family and patient corridors, and single-patient rooms. Indirect lighting, which is provided throughout the hospital, also supports improved sleep. 33

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Daylit Recovery Areas Highly unusual in Phase I recovery areas, the Post Anesthesia Care Unit (PACU) recovery bays have views to the exterior and access to natural light. Rubber floors provide comfort under foot for staff and are more sustainable than vinyl which is typically used in these areas. 35

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Comforting Medical Equipment Rooms CT and MRI scan rooms utilize a natural palette and motifs meant to evoke a connection to nature. The rooms are planned for patient comfort with soft colors, wood grain cabinets, enclosed equipment, dimmer switches for lighting, and ceiling back-lit therapy panels to help create a relaxing experience. 37

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Emergency Rooms Windows in the Emergency Department rooms allow a ‘filtering of natural light’. 39

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Nursing Stations Nurse stations have direct line of sight into Intensive Care Unit (ICU) rooms with views of two rooms at one time and access to natural light. A glass panel between nurse station and patient care areas in the Emergency Room provides acoustic separation while maintaining visual connectivity. Nurse Stations in the medical/surgical unit have access to natural daylight and views, and a glass enclosed flex-room that provides space for private meetings and conversations while maintaining visual connection with the nurse stations and patient rooms. 41

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Other unique aspects of the hospital design include: •

Potential for Integrated Medical-Surgical Suites: Responding to the latest medical research and shifts in practice, the arrangement of the Catherization Laboratories adjacent to the Operating Room Suite provides flexibility for future integration of these traditionally disparate disciplines—allowing for more efficient use of staff and space and a higher level of sterility to increase patient safety.

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Potential for Step-Down Care: Atypical of a community hospital, full showers in the bathrooms of critical care rooms allow for step-down care when the hospital is not at full capacity and opens the door for a wider range of patient types.

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Future Expansion: The orientation and placement of the hospital and landscape plan takes future expansion into account for the Emergency and Diagnostic Imaging and Interventional departments, as well as the addition of a future bed tower.

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State-of-the-Art Medical and Information Technologies: Hospital design integrates the latest technologies to meet the goal of becoming a paperless hospital including wireless mobile charting stations to enable immediate access to patient records and treatment plans; a wireless Vocera communication system to provide a quiet patient environment; audio-visual capabilities in surgical suites to improve patient outcome; interfaced, multi-user conferencing equipment to enhance multi-disciplinary collaboration; and a picture archive computer system (PACS) for digital storage and management of medical images saves space, resources and time. 43

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Milgard Medical Pavilion and Jane Thompson Russell Cancer Care Center Connected to the hospital by an enclosed pedestrian bridge, the five-story Medical Pavilion echoes the architectural vocabulary and material selection of the hospital design. The west facade faces the garden to maximize daylight and views. Within the Medical Pavilion, the Cancer Care Center provides a welcoming and soothing environment using a palette with sea, earth and garden themes reflective of the region. To enhance the patient experience, a spa in the Cancer Care Center provides massage therapy, acupuncture, aroma therapy and other naturopathic alternatives. A Resource Center includes a “look good, feel better� area that provides wigs and other accessories to help patients feel good as they receive treatment. Counselors are also provided for private consultations. Conference and meeting rooms offer space for multidisciplinary physical meetings and conferences, support group meetings and educational seminars. A Nurse Navigator consultation room is provided to assist patients in scheduling and decision making for their course of treatment. 45

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The Pavilion also incorporates a 1,100 SF Mammography Clinic with a waiting area, dressing rooms, a mammography suite (including a low dose, digital diagnostic mammography unit) and support functions. The lobby and waiting areas are bathed in soft tones of blue and green to welcome and sooth patients. Hallways incorporate indirect lighting for a more intimate feel. A private hallway, dressing rooms and exam rooms have access to daylight via window transoms that provide privacy for the patients while giving them visual access to the outdoors. The Clinic was designed for future expansion as volumes increase.

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Landscaping rocks from Eastern Oregon.

Landscape The design team worked closely with the landscape designer to ensure a seamless relationship between the natural and built environments. Consequently, the landscape is organized into three zones on the hospital campus: the Woodland Zone (primarily forested), Riparian Zone (primarily wetlands) and the Hospital Zone (including a variety of landscaped plazas, courtyards and gardens). These zones are weaved together to create

Stone Mason, Ed Lockett, with healing garden stone.

the impression of a hospital campus delicately carved into the forest. Natural elements that are encountered during a ‘walk in the woods’ are incorporated into the landscape such as raw logs, stones, water and native conifer trees and plantings. Wood is further used as an architectural element in outdoor benches and decking in the central healing garden to provide a restorative and contemplative atmosphere for patients, visitors and staff. Walking paths and private seating provide areas for private reflection or confidential conversations in the beauty of nature. 49

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Overall Sustainability The hospital was designed according to LEED and Green Guide for Healthcare guidelines in order to achieve a healthy and high performance healing environment. Sustainable features include: Water Conservation and Re-use •

A stormwater catchment system filters runoff

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helped to control erosion, slowly dispersing filtered storm water back into the greenbelt. •

gypsum,

During construction a one million gallon storm water detention pond and filtration system

Promoting Alternative Transportation •

public pedestrian path and nearby park-

using recycled water.

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and staff. •

landscape and create a soothing atmosphere.

the hospital and one at the medical office building.

Extensive use of natural light minimizes

Automatic shut-down of garden and non-

Site Integration and Preservation •

reduce electrical loads.

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remove vegetation from development areas,

An innovative HVAC heat recovery system

keep native plants within the region and

recycles steam and helps meet part of the

strengthen ties with the local community.

hospital’s heating needs. •

Materials and Resources •

extension of the landscape, integrate nearby

Low-VOC paints, adhesives, sealants, and

residential development, and accommodate a power line (with 200 foot setbacks)

Rubber flooring (in lieu of vinyl) reduces the

bisecting the site.

need for damaging cleaning chemicals while maintaining strict hospital infection control standards.

Design of a terraced-grade solution allows the hospital campus to function as an

carpets reduce harmful fumes. •

Organization of a pre-groundbreaking community plant harvesting event to

lighting reduces light pollution. •

Replanting of disturbed areas with indigenous plants.

needs to be managed by users. Downward focused exterior and signage

Preservation of natural landscaping on more than 50% of the property.

Where possible (e.g. dining area, patient rooms) daylighting controls allow energy

Conservation of three natural wetlands and a salmon stream.

essential lighting during non-peak hours helps

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Two locally-served transit stops are integrated into the new hospital; one at

loads.

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Bike parking spaces are provided for visitors

the region, integrate the building into the

overhead lighting and reduces electrical

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and-ride.

Interior and exterior material palettes celebrate nature. Stone and wood, reflecting

Nature trails throughout the wooded hospital campus adjoin with an existing

The healing garden includes a water feature

Energy and Atmosphere

During construction separate containers were provided for concrete, metal, wood,

returning it to the wetlands.

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Inclusion of a ‘green buffer’ along the perimeter of the site reduces visual and acoustical pollution. 51

St. Anthony Hospital

Ground Floor Milgard Medical Pavilion

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Ground Floor St. Anthony Hospital

First Floor Milgard Medical Pavilion

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First Floor St. Anthony Hospital

Second Floor Milgard Medical Pavilion

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Second Floor St. Anthony Hospital

Third Floor Milgard Medical Pavilion

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Third Floor St. Anthony Hospital

Milgard Medical Pavilion

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Fourth Floor St. Anthony Hospital

Milgard Medical Pavilion

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Owner: 

Franciscan Health System 

Architect: 

ZGF Architects LLP 

General Contractor:  Developer: 

Seattle, Washington

Sellen Construction 

The Hammes Company 

Structural Engineer: 

Civil Engineer: 

Seattle, Washington

Seattle, Washington

PCS Structural Solutions 

Mechanical Engineer:  Electrical Engineer: 

Tacoma, Washington

CDi Engineers 

Lynnwood, Washington

Coffman Engineers 

DOWL Engineers 

Tacoma, Washington

Seattle, Washington

Redmond, Washington

Landscape Architect: SiteWorkshop  Seattle, Washington Owner, Medical Office Building: 

Frauenshuh Healthcare Real Estate Solutions 

Minneapolis, Minnesota

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