While our impulses hesitate to call it an “industry,” that is, for better or worse, what the miscellany of medical services that economically represent the healthcare discipline precisely comprise. The most unconditionally trusted and urgently relied-upon institution fixed to this field is, perhaps, the hospital. Because of this surplus of invested confidence, it is important for the industry to maintain a constant cycle of experimentation and innovation. And with an added responsibility to incorporate environmental sustainability, the pressure on industry thinkers practically increases twofold. In a profession duty-bound to the revival and rehabilitation of human health, it is dually important that they themselves save energy to devote to the revival and rehabilitation of their own places of treatment. Here, Vincent Caruso explores three health centers that are remodeling the set of standards that define what it means to be involved in healthcare by strengthening the connection between the patient, the facility, and the environment.
Lentz Public Health Center
Gresham, Smith and Partners
NASHVILLE, TENNESSEE
Upon entrance, guests are welcomed with the sunlit greeting of a spacious, upbeat lobby teeming with fresh air and natural light.
Trampled under time’s merciless march, the aging Lentz Public Health Center building looked fairly unhealthy in its 50th year, suffering functional maladies any standing structure would so long as periodic upkeep and routine general maintenance were sufficiently ignored. Languished due to age, unmanageable water infiltration due to wilting, and air quality deterioration due to water infiltration, the facility nursed a daisy chain of issues that teetered on challenging the presiding department’s very name.
With the aim of dramatic rehabilitation for optimal and progressive patient care, as well as reaching the ever-raising bar for environmental sustainability, the health center succeeded in landing a public-private partnership that catalyzed the development of an entirely new structure. Every decision that guided the design process was made with heed paid to its potential environmental impact. Surpassing building code requirements, the HVAC system supplies 30% more outside air than what bureau paperwork commands. The percentage that comprises inside air, meanwhile, is subject to the efforts of a radon mitigation system that eliminates completely the silently lurking carcinogenic gas that is known to trespass.
The hospital offers better accessibility with sidewalks, a bus stop, and a B-cycle kiosk—Nashville’s bike share program.
The design, in addition, offered a fresh approach in dealing with the patient’s relationship with their environment. Upon entrance, guests are welcomed with the sunlit greeting of a spacious, upbeat lobby teeming with fresh air and natural light. In the clinic devoted to treating contagious diseases, a special HVAC system is employed to provide patients with 100% outside air supply. Collectively, these efforts rendered the facility, in its completed form, remarkably high performing and green-efficient. Lentz Public Health Center has registered for LEED certification and is anticipating Silver status.
Bridgepoint Active Healthcare
Stantec Architecture / KPMB Architects / HDR Architecture / Diamond Schmitt Architects
TORONTO, ONTARIO
The new Bridgepoint features a green roof (pictured here), as well as a ground floor that’s a publicly accessible “Urban Porch” with a Tim Hortons, Shoppers Drug Mart, multipurpose auditorium, library, and access to two outdoor terraces.
Much has changed in the field of medicine since the construction of Old Don Jail and House of Refuge, the edifice that now plays host to Bridgepoint Active Healthcare in Toronto, Ontario. Evolutionary stages that hospitals have welcomed since Old Don’s heyday range from the commonsensical—such as desegregation and the smoking ban—to the more science-specific—like the discovery of DNA and introduction of vaccine treatments. More recently, in harmony with the awakening of our collective green consciousness, the industry has been actively engaged in research focused on the various ways patients may be affected by the very facilities they’re occupying.
This 464-bed building is the largest and most advanced facility of its kind in Canada and features a therapy pool, labyrinth, rehabilitation studios, and other therapy areas.
In the wake of a severe smallpox outbreak, Toronto made haste to transform The House of Refuge into an ad hoc medical isolation center in response to the unforeseen pestilence. And while the wooded seclusion—central to the facility’s treatments—was viewed as progressive for its time, the consensus of leading thinkers in the industry has swung out of favor of such practices. Rather, it has been suggested, the framework of medical treatment centers should pursue an environment that promotes the comfort of both privacy and unchallenging engagement with the community. Ultimately, the patient’s psychosocial condition, a factor once excluded from healthcare provisions, is boosted and patient outcomes are enhanced.
Salutogenesis is a concept that was hatched by Aaron Antonovsky wherein attention is shifted from exploring the causes of negative conditions to probing the sources of patient health, healing, and happiness. The approach has stood sturdily against time’s current, and it was embraced as dictum in renovating Bridgepoint’s wellness warrant. To succeed in institutional optimization, ironically, it was important to reduce the ambience of an institution in its stigmatized general sense. Imperative to this was encouraging social interaction among patients with access to public recreation areas such as a therapy pool, a sky garden and green roof, and a meditative labyrinth. Although many rooms in the former Old Don haunt didn’t have windows at all, in each patient room, remarkably large windows with views overlooking Don River Valley have been installed, uniting the patient with the familiar stomping grounds before them.
Courtyards at different grades, each with a character of its own, provide patients and visitors with places to rest in solitude or to meet in groups. These courtyards also provide an ongoing fundraising resource for Bridgepoint, as each is sponsored by an individual donor.
Mercy West Hospital & Medical Center
Champlin Architecture, Architecture Field Office, AECOM
CINCINNATI, OHIO
Mercy Health knew that in order to serve more people, they needed to provide a new state-of- the-art facility located on a major expressway with high visibility access.
To most, suggesting that access to healthcare is a matter of grave importance would be a stultifying statement of the obvious. Even more obvious? The consideration of healthcare accessibility in terms of physically identifying or entering the concrete structure that is the patient treatment center; it’s so exhaustively minute and semantic that the notion resides justifiably far away from our collective understanding of “accessibility” in these terms. In the case of Mercy West Hospital & Medical Center, however, the obstacles plaguing the facility—the remote location and uncertain visibility—were two handicaps made priority in the hospital’s redevelopment.
With the intention of advancing progressive patient care measures as well as bedecking the facilities with state-of-the-art technologies, it was important that the hospital’s geography be tantamount in quality to the care offered by the institution. Migrating to remarkably more advantageous acreage, the untouched bucolic landscape upon which the center now rests gifts Mercy West with a newfound existence as eye candy to the commuters of traffic-heavy I-74. Buttressed by an 80-foot slope, the hospital’s design cleverly allows the capture and permeation of abundant natural light throughout the expanded interior of Mercy’s seven-story structure—a bond to nature that is increasingly found to be not supplemental, but necessary, to the patient experience.
Designed to current accessibility standards, the site and interior design no longer impede those with physical disabilities.
The eco-consciousness demonstrated by the refreshingly sensible design of the hospital has been invitation to praise and recognition since its doors reopened in 2013. Aloft the heads of Mercy occupants, for example, hovers 100,000 square feet of green overcast. While providing shelter from the mood swings of Mother Nature, the roof of the building reduces the use of energy with the installation of solar “tubular skylights.” Additionally, triple-paned glass insulation controls the thermal condition of the hospital, reducing the dependency of patients’ comfort on excessive energy consumption.
