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Emergency, hospital expansion blends latest design, function with sustainability

Location: 401 Bicentennial Way, Santa Rosa

Owner: Kaiser Permanente Santa Rosa

Description: 146,400-square-foot expansion of hospital’s North Wing

Completion: October 2010

Architect: Jason Brabo, TLCD Architecture, Santa Rosa

General contractor: HMH Builders Inc., Sacramento

Project cost: $233 million

[caption id="attachment_27993" align="alignleft" width="150" caption="The new tower (click to enlarge)"][/caption]

SANTA ROSA -- Kaiser Medical Center Santa Rosa’s newly opened hospital wing blends the latest in medical technology and environmentally sustainable, health-conscious building materials with architectural design elements that are proven to promote healing. If that sounds like something straight out of a hospital marketing brochure, there’s actually hard data to back it up.

In the same way that health care providers rely on evidence-based medicine derived from patient results to inform clinical decision making, evidence-based design draws upon scientific research about the connection between physical surroundings and patient outcomes. The approach is gaining popularity in health care architecture in an effort to improve patient and staff well-being, speed the patient healing process, reduce stress and increase safety – all of which help contain health care costs.

It’s only one of the many carefully thought out and executed aspects of Kaiser Santa Rosa’s recently completed $233 million expansion project.

“The hospital expansion was designed and constructed to be a comfortable and reassuring environment with state-of-the-art medical technology, efficient layout and close patient/medical staff relationships,” said Jason Brabo of TLCD Architecture in Santa Rosa. “Through every step of planning, design and construction, the needs of patients, their health care providers and the community were the priority.”

Mr. Brabo was part of a project team that included representatives from Kaiser and HMH Builders Inc., a Sacramento–based general contractor. Using the “design-assist” method, the team worked through the expansion project’s design, construction and cost issues collaboratively ahead of actual construction activity to minimize change orders and manage costs.

[caption id="attachment_27994" align="alignleft" width="150" caption="One of the new operating rooms (click to enlarge)"][/caption]

The project team met with staff members of 34 different hospital departments numerous times to elicit their input and involve them in the decision-making process. Evidence-based design encompasses considerations that blend function, access and visual appeal, such as orienting all patient rooms to be in close proximity to distributed nursing stations rather than a single centralized one, installing operable windows in patient rooms to allow outside airflow and selecting interior materials and colors to evoke a warmer, more home-like environment. Kaiser even brought in a consulting firm to work with employee groups on selecting contextually appropriate artwork, paintings and photos created by local artists.

“Evidenced-based design quantifies and measures a design’s performance,” explained Mr. Brabo, who is TLCD’s health care practice leader. “Research reveals there a lot of things that can improve healing. Visual connection to the outside world really does work. So do more home-like surroundings. Making people feel more comfortable in the hospital reduces their stress and helps them heal faster.”

The marriage of evidence-based design and the design-assist approach also served the hospital’s sustainability goals. Situating the new wing in the loading dock’s former location kept additional excavation to a minimum and the overall expansion within the existing hospital property footprint. Selecting sustainable materials and finishes such as recycled cotton-fiber insulation instead of fiberglass, doors made of agrifiber straw, formaldehyde-free casework, acoustical ceiling tile made with recycled materials, recycled ceramic tile and rubber flooring, and vinyl-free carpeting provide a nontoxic, all-around healthier environment for both patients and staff.

Some of these changes such as rubber flooring instead of high-gloss linoleum raised concerns among hospital facilities and engineering staff about maintenance and operation issues, leading to tours of other hospital facilities that have successfully incorporated these newer materials.

[caption id="attachment_27995" align="alignleft" width="150" caption="One of the new patient rooms (click to enlarge)"][/caption]

Kaiser took the design-assist approach a few steps further by meeting with the hospital’s surrounding neighbors to identify potential disruptions such as dust and noise during construction. As a result, the project included erecting a temporary sound wall and removing construction waste to address their concerns. Most of the construction waste -- 775 tons -- was diverted from landfills through recycling.

As part of the project’s planning process, Kaiser also researched overall community demographics to ensure that expanded and new health care services were actually needed. For example, the new wing features an interventional radiology (IR) suite where minimally invasive diagnostic and treatment procedures can be performed using imaging to guide the process, similar to cardiac cathertization. IR was not available previously in Sonoma County.

The five-story, 146,400-square-foot hospital wing nearly doubles the hospital’s capacity and houses an expanded emergency department and intensive care unit along with the IR suite, an in-house MRI, a nuclear medicine center and 93 additional patient beds for a total of 173 beds.

The new wing is part of a multi-phase expansion and renovation for Kaiser Santa Rosa that began in 2002. Earlier phases of the project included:

Relocating the hospital support building where the hospital loading dock and facilities staff were previously located to a newly constructed building connected the hospital though an underground tunnel.

Constructing a central utility plant with new cooling towers, a medical gas yard, two emergency generators and chillers to accommodate the expansion.

Upgrading various internal network systems including medical gases, information technology, fire alarm, nurse call and building control to incorporate new technologies as part of integrating the new wing with the existing hospital facilities.

Renovating the existing hospital in preparation for the expansion project.

For the final phase of the project still to come, vacated areas in the older parts of the hospital will be renovated.