Cover Story: Health Care Design: Architects of Change

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A gleaming new 10-story tower in Camden, NJ, stands as a beacon of health care reform that is apolitical, patient-centered and far removed from the purview of Washington. It represents health care reform we can see, feel and experience at the grass-roots level. It’s the noblest of all health care reform because it is measured in outcomes—by doctors, nurses, hospital administrators, family members … and most importantly … by patients themselves.

A stellar example of evidence-based design, Cooper University Hospital’s new $218 million Patient Care Pavilion embodies theories and concepts that are already reshaping the context in which 22nd century care will be delivered. It also happens to be the first Planetree Affiliate facility in the Delaware Valley.

“The Pavilion represents a number of forward-thinking forces within health care design,” says John Capelli, AIA and principal at Philadelphia-based EwingCole, the architectural firm responsible for the project. “There’s sustainable design, evidence-based design, the Planetree concept, and hospitality design—and then there is the functional and operational need to provide quality health care in a safe, clean facility. Our charge was to meld all those different forces into an uplifting, compassionate environment that supports and enhances the delivery of health care.”

The state-of-the-art Pavilion is equipped with 90 new private beds, an expanded emergency room, 12 new operating rooms, a new intensive care unit, and clinical laboratories. But EwingCole was further tasked with a less tangible, and perhaps even more creatively-challenging mission. The design of the 297,650-square-foot Pavilion (plus 79,350 square feet of renovated space) also had to support a complete rebranding of Cooper University Hospital at the patient, caregiver and community levels.

Vital to this reimaging was the use of a hospitality model, according to Saul Jabbawy, EwingCole’s director of design. “But not any hospitality design model,” he explains. “Not the rounded, fluffy furniture and warm fuzzy colors of traditional hotels. We wanted to move away from that and toward the W Hotels’ model. The thinking was hospitality, but completely non-traditional.

“The client was terrific about accepting something cutting-edge because it worked with their branding message—that Cooper stands for the delivery of high-tech, cutting-edge health care. But they also wanted to be very hospitality-like. Obviously the hybridization of those two concepts resulted in a very contemporary hospitality-based solution,” adds Jabbawy.

That synthesis is immediately evident to patients and family entering the Pavilion’s three-story atrium. Warm and welcoming, while exuding the understated elegance of a “less-is-more” hotel, the lobby is saturated with daylight.

A sense of peace and calm comes from natural and sustainable materials, including a healing garden with stands of willowy bamboo, terrazzo stone floors, and faux Zebrano wood millwork. Daylight streaming through window walls and skylights is deftly integrated with LED fixtures for maximum energy savings, healing properties—and drama.

The Pavilion’s W Hotels-sophistication comes from a white reading space punctuated with the sleek square profile of hospitality seating, as well as EwingCole’s innovative use of 3form resin panels made from recycled content. “The panels have a translucent quality that allowed us to lighten up the walls, add textural interest, and create different moods or ambiences with lighting placed behind the 3form,” explains Capelli. Indeed, lighting software controllers provide the ability to change the colors of resin-clad columns and walls for community events and programs.

As a Planetree-designated facility, Cooper University Hospital unites the design concepts of a healing environment with a patient-centered approach to delivering care. “Some concepts are basic: The design considers the patients’ well-being. The hospital is welcoming and accessible, provides clearly marked signs for direction, and comfortable family waiting rooms,” adds Capelli. But the Pavilion design also attempts to engage the senses and break down barriers like fear and stress.

“Arts and entertainment are important elements in Planetree,” says Capelli, noting that the atrium is designed to accommodate musical performances (including weekly concerts by a Cooper Hospital employee band) without disrupting the functional needs of the lobby. Evidence-based design influenced the selection of colors for accent walls and art, which are consistent from the lobby reception desk to medical floors.

“In the past there was the notion that color contrast in health care design was not necessarily a good thing—that people wanted a muted environment,” explains Jabbawy. “Now there is more and more research showing that color variations and contrast create visual stimulation that allows patients to exit their psychological mood and reconnect to their environment,” he reports, pointing to terra cotta and sky blue walls that complement artwork and add punch to various white and wood elements in play throughout the Pavilion.

“Another change in the health care industry is the idea that the family member has an active role in the care and recovery of the patient, and in Planetree that involves information and education,” notes Capelli. To that point, EwingCole’s design incorporates amenities like a medical library/health care information center, and an interpretive display program to help families understand the illness and what they can do to help in the caregiving process.

The design also addresses Planetree’s emphasis on accommodations for a family member to sleep overnight in the patient room, as well as accessible lounges on the unit where family and friends can rest, heat a meal or make coffee. “Spirituality is also part of Planetree, and we were asked to replace a rather small non-descript prayer room with a much more significant meditation chapel that can function as a true place of congregation,” adds Capelli.

Sustainability—another Planetree component—is also built into the design. EwingCole specified low-emitting, toxic-free materials and adhesives, as well as health care-specific carpets and other products made from recycled content. A sophisticated building management system by Johnson Controls utilizes specially programmed software to control HVAC throughout the day to save energy, and energy-efficient light fixtures are controlled by sensors and timers.

The entrance and new urban gardens are positioned closer to the Walter Rand Transportation Center, now a short walk across the street for employees who travel by train and bus to Cooper.

“On a global sense, we reused spaces and buildings while creating a more customer-oriented experience within an urban environment. That’s an important piece of sustainable design in terms of revitalization, reuse of our cities and urban cores. The U.S. Green Building Council considers these significant issues,” says Capelli.

Both designer and architect note a confluence of Planetree, sustainable and evidence-based design principles in the Pavilion’s patient rooms. Developed in conjunction with Cooper staff through full-scale mockup studies and computer visualization tests, the rooms are all private which, experience has shown, is a benefit to the patient and families. Features within the rooms that support a healing environment include access to daylight and window views of the Delaware River, use of natural materials, hospitality-style sleep sofas, club chairs, and either carpeting or faux wood tile floors.

Carpeting and sound-absorbing ceiling systems reduce noise levels in corridors, and decibel readers installed on patient floors assist in creating a quiet healing environment. Months of study and multiple visits to other hospitals resulted in innovations such as the placement of clinician hand washing sinks out of patient sight lines, and custom medical headwalls that avoid the feel of a typical hospital.

“I personally worked with the nurses for six months to be sure that all their requirements for the patient headwalls were actually fulfilled: All those gyrations are really important because that’s what keeps the rooms at Cooper from looking like any other medical rooms,” concludes Jabbawy. Indeed, that’s the kind of purposeful, client collaboration and dedication that is helping to shape the future of health care design.

Carol Tisch is a freelance writer, editor and marketing consultant based in Sarasota, FL. She was formerly editor-in-chief of Shelter Interiors magazine and Home Furnishings News (HFN), and has developed communications programs for commercial and residential design industry clients. She can be reached at tischcomm@aol.com.

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CLIENT COOPER UNIVERSITY HOSPITAL One Cooper Plaza Camden, NJ 08103 (856) 342-2000	PROJECT TEAM ARCHITECTURE & INTERIOR DESIGN EwingCole Federal Reserve Bank Building 100 N. 6th St. Philadelphia, PA 19106 (215) 923-2020 GENERAL CONTRACTOR Turner/HSC	MEP ENGINEERING EwingCole STRUCTURAL ENGINEERING EwingCole CIVIL ENGINEERING Land Dimensions Engineering MEDICAL EQUIPMENT PLANNING Medequip Intl. LANDSCAPING Cairone & Kaupp Inc. PHOTOGRAPHY Eduard Hueber/archphoto.com Halkin Photography, LLC