- THE MAGAZINE
Prior to the completion of the new St. Anthony Hospital, Washington’s South Sound region represented one of the largest underserved population centers with no central community hospital. Today, the new full-service hospital in Gig Harbor provides all critical healthcare services needed to support this region.
The approach to design focused on the inherent connection between nature, health and well-being -- with nature playing a lead role in the creation of a healing environment.
Integration of a hospital, medical office building, and parking on a lushly forested, 30-acre second growth forest with steep topography issues posed a set of complex and interrelated access, orientation and preservation challenges. Project successes included conservation of three onsite natural wetlands and a salmon stream; a stormwater catchment system that filters and returns all site runoff to the wetlands; preservation of more than 50 percent of the existing property landscape; and replanting of disturbed areas with indigenous plants. Further, a layered terraced-grade design solution allows the hospital campus to function as an extension of the landscape, integrate with nearby residential development, and accommodate important regional utilities (overhead power with 200-foot setbacks) bisecting the site on the Kitsap Peninsula.
The fundamental concept for interior wayfinding is based on a connection to the natural environment. All public and staff transition nodes orient to natural light and views. In this way, nature acts as the primary intuitive cue to wayfinding. A secondary advantage to this is the reduction in quantity of interior signage thereby “de-cluttering” the visual pollution of the interior environment , which can be a significant impediment to creating a healing environment.
Orientation in the hospital is anchored in an impression of a building delicately carved into the forest. Nestled amongst the trees and a central healing garden, nature is visible from public and private spaces. Additional smaller gardens are tucked around the building perimeter providing glimpses of nature in key program areas and bridging the edges between the natural and built environments. The materiality of the building consists of a contrasting texture of stone, wood, concrete and glass to blend with the natural setting.
Connections to nature—literal and symbolic—are made throughout the building. Direct views of the garden from public areas offer visual respite with seating extending onto a patio for patients, visitors and staff to enjoy the garden from the inside and outdoors. A shallow pool of water surrounding the chapel references nature’s healing power. The upper medical/surgical floors overlook a canopy of green trees, and a 15-foot long canoe carved from cedar, mahogany and spruce spans a two-story wall in the main public lobby. Elements of nature are further reflected on the interior through backlit translucent acrylic wall panels containing natural seaside grasses, interior walls with wavelike patterns referencing the ebb and flow of the tides, and dome light fixtures that simulate skylights. The interior palette is soft and neutral to compliment and draw attention to the beauty of the natural surroundings.
The hospital is designed to provide total immersion in a variety of natural light experiences. Celebrating the contrast between spaces helped define programmatic function and character as they work together to form a strong whole environment. The diverse northern seasonal sun azimuths and altitudes, ever changing overhead sky, and the reflective and filtering effects of the surrounding forest all play a role in tempering and lifting the experience of patients and caregivers. The embrace of a clinical environment married to the external world (not shielded from it) creates a simple and calming presence to compliment the art and science of healing. In addition to the physical and emotional benefits, the extensive crafting, reflecting, filtering and bathing in volumes of daylight combined with high-performance automatic and personalized lighting controls helps minimize artificial illumination, reduce electrical use, and provides a comfortable patient experience that acknowledges the daily circadian rhythms.
Natural light and the connection between nature and a patient’s journey from sickness back to health were obvious themes in the development of the design. Borrowing inspiration from Robert Frost’s classic poem “The Road Not Taken,” the team identified characteristics and experiences that are encountered during “a walk in the woods” such as exploration, silent reflection, and moments of pause. Environmental experiences such as a “clearing,” “glade,” “canopy” and “filtering of light” were used to transform the relationship between the interior and exterior environments throughout the hospital.
Light and levels of illumination help define these intended experiences, distinguish points of transition within the hospital, and lead one along the path of exploration upon entering each new space. Similar to the ample light exposure at a forest edge, the hospital layout maximizes windows and access to daylight around the building perimeter. The main public lobby is bathed in light through its garden meadow connection. Public corridors in the lobby and inpatient units provide a dappled light experience where the tree canopy allows for spills of light along the path.
Moving into the hospital’s central core (comparable to the experience of walking deeper into an old growth forest) natural light is present yet dampened. Panels of glass in the central core are strategically placed to allow penetration of daylight, and windows in emergency rooms allow a filtering of natural light. Cove light fixtures support this concept creating focused blades of asymmetrical light similar to the indirect light present in woodland glades. In areas in the hospital where equipment requires heavy shielding and does not allow daylight, soft lighting and color tones are used to evoke a connection to nature and embrace the positive attributes of being in a dense forest.
The allocation of resources was informed by a long-term investment strategy aimed at maximizing environmental, economic and social performance. This involved thoughtful consideration of first cost versus operational costs to maximize viability and longevity of the building, which is anticipated to experience ongoing growth over time.
Flexible planning for future expansion, operation and integrated care delivery systems was applied to eliminate waste and reduce costs while optimizing operational efficiencies, investment in the site, and the long-term sustainability of the hospital. The arrangement of the Catherization Laboratories adjacent to the Operation Room Suite provides flexibility for future integration of these traditionally disparate disciplines – allowing for more efficient use of staff and space and a higher level of sterility to increase patient safety as well as shared patient prep and recovery and staff spaces. The orientation and placement of the hospital and landscape plan also takes future expansion into account for the Emergency and Diagnostic Imaging and Interventional departments as well as the addition of a future bed tower.
To enable the long-term goal of becoming a paperless hospital, the design integrates the latest technologies and infrastructure, including wireless mobile charting stations and a picture archive computer system (PACS) for digital storage and management of medical images to saves space, resources and time. Investment in an innovative HVAC heat recovery system enables the hospital to recycle steam to help meet a component of the hospital’s heating needs on an ongoing basis.
Careful attention was also given to material selection with special attention to durability and maintenance. For example, rubber flooring (in lieu of vinyl) provides comfort under foot for staff and reduces the need for harmful cleaning chemicals while maintaining strict hospital infection control standards. Terrazzo floors, provided and installed by local suppliers and craftspeople, present a long-lasting flooring material in public spaces, and stone tiles on the building exterior provide a beautiful and durable protective envelope.
Investment in the local community was an important part of the long-term decision-making strategy. Consistent with the Franciscan Health System’s mission of nurturing a healing ministry and creating healthier communities, the new hospital reflects an investment in the community’s welfare and well-being through its function, location and a design that celebrates the region’s valued maritime history and connection to the natural environment of the Pacific Northwest.
The design of St. Anthony Hospital is focused on enabling its steward, the Franciscan Health System, to meet is service mission and manage the ongoing sustainable operation and evolution of the hospital. The aspiration for this new community home is to reinvent the notion of a hospital from a simple response to need to one of holistic vision and complimentary health. It is hoped that St. Anthony Hospital will serve as an example in its community of preserving the natural attributes of its geographic setting, providing illumination and guidance, and demonstrating best investments in the life and well-being of our vital communities.
Project Name: St. Anthony Hospital
Location: Gig Harbor, Washington
Gross square footage: St. Anthony Hospital, 256,000 GSF; Milgard Medical Pavilion, 93,000 GSF
Total construction cost (excluding land): St. Anthony Hospital,$95 million; Milgard Medical Pavilion, $16 million
Number of floors: St. Anthony Hospital: 5 floors; Milgard Medical Pavilion: 4 floors
Number of beds: St. Anthony Hospital: 80-beds; Milard Medical Pavilion: NA
Date Completed: St. Anthony Hospital: March 2009; Milgard Medical Pavilion: December 2008
Hospital Owner: Franciscan Health System
Owner’s Representative: Hammes Co.
Medical Pavilion Owner: Frauenshuh Healthcare Real Estate Solutions
Architect: ZGF Architects LLP
General Contractor: Sellen Construction
Environmental Consulting: NA
Interior Designer: ZGF Architects LLP
Mechanical Engineer: CDi Engineers
Electrical Engineering: Coffman Engineers
Structural Engineering: PCS Structural Solutions
Civil Engineering: DOWL Engineers
Medical Equipment Planner: ZGF Architects LLP/Catholic Health Initiatives