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New Swedish / Issaquah campus improves patient care, decreases energy use

By Carole Kassir-Garcia, Medical Construction Design
September / October 2011

In July, the first phase of a new full-service Swedish / Issaquah healthcare campus (the first hospital built from the ground up in 25 years in King County, Washington) opened its doors to the public. The campus was designed with two key challenges in mind. The first was to create buildings that significantly cut energy usage across the new campus. The second was to create an architectural design that aligned with patient and community needs.

The design team succeeded on both accounts: The medical center campus located in Issaquah, Wash. is now considered the most energy efficient medical campus in the region, and possibly the nation. In addition, innovative interior design and modern layout maximizes space, allows for efficient patient flow and supports wayfinding.

Sustainability
Hospitals have unique and intensive energy requirements such as the need for lighting and heating 24 hours a day. Significant energy is consumed by ventilation systems, sterilization of tools, laundry, food preparation and use of other medical equipment. Energy savings not only improves the overall sustainability and environmental impact, but has the potential to dramatically lower a hospital’s bottom line.

Early in the design process, the project team participated in design meetings to gather ideas for how to achieve the project’s sustainability and energy-efficiency goals. The use of building-energy simulation software determined which efficiency measures would be most useful to meet the project goals.

Through the process, it was determined to orient the hospital to get full sun on three sides with a basement area that receives full daylight; a benefit for staff and patients. Research has shown the human body best recovers from illness in environments that include an abundance of natural lighting so this layout was a natural fit. In addition, high-performance glazing in energy-efficient frames and exterior/interior-shading devices result in less artificial lighting and energy consumption.

One challenge associated with any new building is the addition of an impervious area to the environment created by the addition of paved roads and concrete, which modify the soil surface and decrease water re-absorption into the ground. Keeping this in mind, the building’s footprint was consolidated by stacking “floor plates,” which reduces the building’s footprint and associated impervious space.

Finally, community design standards dictated the minimal use of galvanized steel and copper on the exterior of the buildings in order to protect the local aquifer from heavy metal runoff. A large green roof provides additional stormwater holding capacity. All other roofs are light-colored, reducing heat absorption by roofing material and increasing energy efficiency with the buildings.

Architecture and Interiors
The project team endeavored to create a campus that served the health and wellness needs of the community. Interior elements were added to create a defined look and feel of each public and private space in the complex improving patient wayfinding. The design also encourages social interaction with common open outdoor spaces, promotes pedestrian-friendly street design, and strikes a balance of proportion and scale for an institutional building located in a master-planned community setting, enriching and connecting with the neighboring communities.

To achieve this, the team created a central, unifying and orienting public space with an atrium, known as “the commons,” that acts as an interface between the medical office building and the hospital. Joining these two buildings together reduced the exterior envelope without significantly compromising day lighting or view.

The atrium directs patient flow from the entrance of the building and incorporates retail functions and food services. A living room-like waiting room with a fireplace is a dramatic introduction to the campus. This area is adjacent to an open courtyard for families and visitors to relax outdoors. The outdoor courtyard space offers tranquil views and is accessible to pedestrians located in between the hospital wings. A ceiling extends from the indoor living-room space to the exterior of the building, creating shelter for outdoor seating even in poor weather. Ceramic metal halide lights illuminate the seating area and recessed LED lights illuminate the stairway and outdoor pathways.

Circulation in the atrium is based on parallel arcs that flow east to west and north to south. Vertical access is streamlined by using only one public elevator bank that leads to the medical office building and hospital. Waiting areas and atrium views are oriented to relieve stress while a pedestrian bridge separates the hospital from public and private (clinic) spaces.

The hospital’s brand was emphasized in the design as it relates to the patient journey, the infrastructure and elements needed to support it. For example, brand colors were used on the walls and on the front of greeting desks. Both light and dark wood were used on the entry portals and iconic lighting and ceiling treatments with inverted “L” and “U” elements (part of the hospital’s branding) greet patients when first entering the departments.

The visual continuity from outside to inside plays off light and shadows. The transparent and translucent elements merge creating a graceful environment in the atrium. Interior elements blend color and nature to emulate the natural surroundings. A wood-winding trail in the terrazzo floor adds an intuitive wayfinding element that guides the patient from the front door to his or her destination. Similar and repetitive elements always mark the first patient interaction with hospital staff.

Lighting Pathways
Cutting-edge technology such as LED-based lighting was used inside and outside the hospital. Lighting design and public spaces focused on creating an environment that is supportive emotionally and physically to patients and their families. Colored light was used as a tool to trigger emotions and to create a sense of identity in clinical spaces. Dynamic indoor lighting assists the patient flow through seamless changes in brightness, color and warmth.

Other lighting elements create a sense of mood and ambiance. A metal grass sculpture is back lit with LED lights on a concrete sheer wall in the atrium. The sculpture sways in the wind creating rhythm and add a human-scale element. At night, a cove-mounted linear fluorescent asymmetrical light highlights the ceiling and accentuates the shape of the atrium. After dark, the ceiling can be seen through the high windows and creates a lantern-like appearance. The building’s main access point, the entry canopy and the combination of interior and exterior lighting create a sense of arrival and identify the “front door” even when dark.

Ambient experience is a patient-centered healthcare solution to guide and enhance both patient experience and workflow for clinical staff, with integration of light, image, sound technologies and spatial design.

Built by comprehensive planning and design processes, the medical center is designed as an innovative, sustainable and flexible complex that combines extensive green-building practices into a high-performance medical setting. The project team was able to integrate advanced technologies and processes that significantly reduced energy consumption, lower overall operating costs and enhance patient care at the same time.