Clark/McCarthy JV Provides Updated, Patient-Focused Atmosphere at Stanford University Medical Center
A new state-of-the art adult hospital at the Stanford University Medical Center in Palo Alto, California, is designed to address advances in medical technology, increase capacity, and meet current seismic safety standards, while providing patients a positive atmosphere for healing.
The new 824,000-square-foot facility, scheduled for construction completion in 2018, features amenities and services focused on the health and well-being of patients, as well as advanced diagnostic, therapeutic and surgical technologies. It will house an additional 368 beds (bringing the total to 600 on site), state-of-the-art diagnostic and treatment rooms, 20 operating rooms and 8 interventional radiology/image guided rooms, and a new, expanded emergency department more than twice the size of the current area.
The hospital is part of the Stanford University Medical Center Renewal Project, an extensive endeavor to build larger, more modern facilities for the advancement of medical research, the training of the next generation of physicians and scholars, and to meet growing demands on the hospitals. The renewal project encompasses Stanford Health Care, Lucile Packard Children's Hospital Stanford, and Stanford University School of Medicine.
Designing with Evolution in Mind
The new hospital was designed by Rafael ViÃ±oly Architects in conjunction with Lee, Burkhart, Liu Inc. The project's joint venture contractor is Clark/McCarthy, which comprises Clark Construction and McCarthy Building Companies.
Rafael ViÃ±oly Project Director Harold Park says that in meeting the need for a new hospital, Stanford Health Care wanted a module that could expand and grow. "A facility like this will always be evolving, and it's important to think of how it will need to evolve externally. The ideal is to design a universally efficient module that helps minimize the costs of renovation and structural changes."
Park says his firm worked closely throughout the design process with Lee, Burkhart, Liu Inc. - who have worked on many health care facilities in California and thus provided valuable expertise - as well as both the university and hospital administrations at Stanford Health Care.
"On the more subjective design aspects, we worked with smaller groups throughout the design phase - individuals who understood Stanford's architectural traditions," he adds. "The cantilever design of the upper floors, for example, addresses the fact that the rest of the campus is low. We didn't want a building that jutted out and looked too massive; instead, it blends into the landscape. The lower floors are in keeping with the standard campus height standards, and colors are similar to other structures. Even materials followed this vision, with limestone and concrete for the solid base and much lighter, with a lot of glass, above."
The Stanford Health Care project joins a long list of Clark/McCarthy joint ventures over the past 15 years. McCarthy's Greg Schoonover, the Project Executive, comments, "Many of these larger projects are joint ventures, and Clark aligns very well with us on these projects. We view this as a one-company approach, which works well for us and is actually an advantage. It allows us to draw from our management pools from two companies with extensive health care experience."
Adds McCarthy's Rich Henry, "A joint venture approach is driven by a combination of size and complexity. This is a mega-project, and it requires a lot of resources. Stanford Health Care brought us in early on, and the major subcontractors were brought on board shortly thereafter, since this is such a complex project. The design team, Stanford Health Care, Clark/McCarthy, and the sub-contractors and engineers co-located very early on at an adjacent location to maximize both collaboration and coordination of the project design."
Preparing for Seismic Events
The project was spurred in part by new seismic safety standards, says Bert Hurlbut, the Stanford Health Care Vice President in charge of construction for the new hospital. The current hospital, which was constructed in 1959, cannot easily be brought up to state-mandated seismic standards. As Hurlbut explains, "In addition to meeting seismic safety requirements, Stanford Health Care wanted to make improvements that will help the health system accommodate new medical technology and increase its capacity. The best course of action to provide a safe, modern hospital with adequate capacity for patient care was to build a new facility."
Along with the cantilevered upper floors, one of the hospital's most unique and innovative components, especially for a project of this size, is its base-isolated design. A system of 200 base isolators will allow the hospital to withstand an 8.0 magnitude earthquake, Hurlbut reports. The technology means the hospital building resists earthquake forces by using isolators, which decouples the building from the ground and absorbs the ground motion, and thus the building will not sustain the typical damage one expects when a large earthquake strikes.
The project launched with an official groundbreaking in May of 2013. Foundation work was completed in 2014, followed by steel installation in 2015. The exterior construction was completed in 2016, and interior construction, equipment installation and activation activities are to be completed in 2018.
The innovative design aspects brought their share of construction challenges. Schoonover reports, "Base-isolated projects require much more coordination. Minimum dimensions had to be maintained, and a lot of mock-ups were created and presented. With currently over 700 tradesmen on the job, information flow is one of the biggest challenges."
Henry adds, "A lot of time was spent between the teams to minimize any interruptions or the effects of construction in the area to ongoing hospital functions. The project sits adjacent to the front door of an existing health care facility with over 30,000 visitors a month. Plus, there was another large project going on at the same time, just down the street at Lucile Packard Children's Hospital Stanford."
More Light Adds to Warm Welcome
The building features a structural steel frame, concrete foundations and patient rooms enclosed in a double-glazed curtainwall system. The curtainwall system consists of two planes of dual glass, with blinds in between them. These blinds can be adjusted by the building's automated management system to balance patient comfort and energy consumption.
All 368 patient rooms will be single occupancy, with large windows that provide extensive natural light. The rooms are housed in four pavilions topping 180 feet, which thanks to their cantilever design, appear suspended above the first two floors of the hospital.
When patients and visitors first arrive to the hospital, they will be greeted by a light-filled, open atrium with a glass-domed ceiling. As the heart of the hospital, the atrium is designed to warmly welcome patients and provide a calming first experience, says Hurlbut. "The hospital will feature natural light, rooftop gardens, the latest innovations in green technology, and amenities and services focused on the health and well-being of patients. Every detail of the facility has been meticulously planned to create an environment that promotes healing while reducing stress on patients, families and visitors."
The Goldman Family Gardens are undoubtedly one of the most interesting features incorporated into the design of the hospital. As Hurlbut explains, "The gardens will provide a soothing sanctuary filled with light, art, music and the healing power of nature. The Gardens were incorporated into the design of the hospital to promote healing and offer patients, visitors and staff a place of outdoor respite."
ED Expands for Increased Use
As for expanded hospital capabilities, the vastly enlarged Emergency Department is perhaps the most important feature of the new Stanford Hospital. Emergency Department visits at Stanford Medicine are growing by five to eight percent a year. The current ED was designed to treat 40,000 patients a year; Stanford Medicine is now seeing nearly double that number of patients. That number continues to grow as Stanford Health Care expands, the Bay Area grows, the population ages, and more residents are receiving medical insurance.
"We took this opportunity to create an efficient layout, along with an emotionally supportive environment in the new ED. The new layout will have separate zones for patients with different need levels, and these zones are organized according to the way patients move through the department.
"As the only Level-1 Trauma Center between San Francisco and San Jose, the ED serves the most acute trauma patients locally and regionally. This means that patients brought here after a serious injury have immediate access to trauma surgeons, operating rooms, and highly skilled specialists."
The new Stanford Hospital has presented Stanford Health Care a rare and valuable opportunity to design and build one of the most advanced hospitals in the world, from the ground up. Planned entirely around the unique needs of patients, the hospital will deliver a new model of care focused on convenient access, comfort and coordinated care. In its innovative design and its extensive amenities, the hospital will provide a model for meeting current and future health care needs.
Says Schoonover, "It's been a great job to work on - a once in a lifetime opportunity to help provide world-class health care to this community."