Architect: John Van Rooy Architecture
Owner: Advanced Ear, Nose and Throat Specialists, SC
Contractor: Triad Construction Inc.
The owners of Advanced Ear, Nose and Throat Specialists (Advent) purchased a 10,000 sq ft 1960’s building on a highly visible address for their expanding medical practice. The building as purchased was most recently a fitness center with few interior walls. The exterior was orange painted masonry with few windows. The street facing façade was made up of storefront windows and a tacked on red mansard roof with a central single gable.
They desired a new facility as an iconic brick and mortar location to work in conjunction with their radio and television marketing and represent the cutting edge technology they used in their practice. They wanted a building that spoke to their brand as well as met their programmatic requirements of housing exam rooms, procedure rooms and their business headquarters. The interior experience was to be contemporary and welcoming. Their practice is split between Ear, Nose and Throat surgeons and Audiologists. These functions required significant efforts to accommodate acoustic isolation of all rooms, particularly the audiology testing suites.
To meet their needs the existing building was stripped to its structural shell and the street facing bay was completely removed so it could be reconfigured into a more desirable composition. The new southern portion of the street facade consists of a green tinted curtain wall tower with aluminum panels resting on a base of local cut limestone. The curtain wall uses airfoil louvers as both a compositional element as well as to harvest or block solar heat gain. The northern portion of the street façade is composed of a weathered steel rainscreen in large panels, fastened with exposed stainless steel structural rivets, all punctured by a large, continuous inset of butt glazed storefront. New openings were punched into the existing masonry on the rest of the building and limestone bases were added at their sills. The remaining masonry was re-painted white. The west elevation which faces the main parking area added a weathered steel and glass entry tower as well as new windows overlooking the main parking lot and new landscaped areas.
The interior brings an entry and lobby with large swaths of wire brushed, rift sawn, white oak in java stain complimented by light limestone accents that match that of the exterior. This touch of wood is picked up throughout the facility in the rift white oak doors also stained java.
The renovation improved energy efficiency with a significant increase in insulation at the walls, roof and incorporates new high efficient mechanical systems and LED lighting throughout.
Acoustic treatments including wall and door assemblies capable of providing an appropriate environment for the practice was paramount. Wall assemblies extend to the structural deck and consist of mineral wool insulation, multiple layers of gyp board, isolated NRC channels and acoustic sealants.
Photos: Alloy Photography
Whitefish Bay, Wisconsin
Architect: Johnsen Schmaling Architects
Owner: Dr. Mona Patel, DDS
Contractor: Design 2 Construct
Located along a mature retail corridor in a Milwaukee suburb, this project reinvents an abandoned commercial building and transforms the upper level into a state-of-the-art dental clinic. Originally an ordinary two-story infill building with windows only along the street, the demolition of an adjacent structure and subsequent creation of a small pocket park turned the building’s exposed firewall into a prominent blank façade. A young dentist acquired the dilapidated building with the intention to rehabilitate it for her practice. After gutting the existing building, large openings were cut into the existing firewall to animate the building’s appearance and increase visibility of the new ground floor retail space. On the upper level, a series of new floor-to-ceiling windows draw natural light deep inside the dental clinic, with their articulated wooden box frames adding warmth to the exterior. The new two-story lobby takes patients up to the entrance of the dental clinic, where a framed threshold leads into the light-filled waiting room and reception area. The smooth high-sheen ceiling plane, which contrasts with the exposed wood trusses above, guides patients to the five individual operatories that are marked by green panels and sequence of thin lighting strips, which help animate the hallway space. Sliding glass doors assure separation and privacy while allowing natural light to filter through. White-oak cabinets and green-lacquered surfaces add visual richness. Custom built-in cabinets and dental furniture in the operatories match the whites and grays of the interior surfaces, contributing to a deliberately quiet and serene ambience for patients.
Jury Comment: “This dental clinic stood out because of the clarity of the program and execution of all the details. The architect took what otherwise may be a pretty mundane experience and elevated it to an architectural experience. Just as dentistry is a science of exactness and rigor, this building exhibits those qualities in its architecture. As a whole, it is a very complete project that reinvents a non-descript commercial building.”
Photos: John J. Macaulay
San Antonio, Texas
Architect: Kahler Slater
Owner: University of Texas System
Contractor: Vaughn Construction
The Center for Oral Health Care & Research (COHCR) is a freestanding 198,000 square-foot teaching clinic with 400 dental operatories aimed to improve the university’s ability to provide enhanced patient care, attract the best educators, provide innovative education through technology, and conduct clinical research supporting this top-ranked dental education program. The focus for this ground breaking facility is to provide the best oral health care for the region while enhancing user experience through the design of this dynamic and welcoming light-filled clinic.
COHCR is located in San Antonio, Texas north of the existing University of Texas Health Science Center campus. The project is positioned near the University’s medical center and is built as a critical part of the research-based campus that eagerly anticipates growth. Through research, it became paramount that the proximity to the existing campus would bolster synergies between these facilities. In addition, the location offers a powerful visual connection back to the main campus while synergistically providing opportunities to take advantage of views to the distant tree-lined foothills.
The solution is carefully responsive to history, site, climate and program. San Antonio has a rich history of architecture that is responsive to the hot and humid region. This scalable clinical education building is no exception.
Very early in the design, the team understood the limitations of not having large public spaces (i.e. Lobby, Café, etc.), allocated to the total program. Utilizing a courtyard concept defined by two stacked L’s, two floors of specialty clinics and two floors of pre-doctoral clinics, creates a stunning open space that serves as public domain both visually and physically. The interior spaces lining this courtyard were carefully considered to enhance the user experience within the facility. Family members, students, and educators all take advantage of this xeriscape courtyard enjoying the enhanced breezes as they funnel through the aperture above.
The materiality of the building is in keeping with the established neighborhood. The team incorporated corrugated metal panel to intentionally break the stack; first, to reinforce the stacked L’s parti and second, to illustrate that the base and piers are an extension the earth while the delicate metal panels become part of the sky.
The uniquely unpretentious composition, rich with historic reference and integrated materiality, creates an environment meticulously designed for impactful education and positive patient experiences.
Photos: Tre Dunham and Mark Menjivar
Architect: Dental Associates
Owners: Dr. Thomas Manos & Cynthia Manos and Interstate Partners LLC
Contractor: Berghammer Construction Corporation
The client, a group dental practice, sought a building site to serve its expanding patient base near Waukesha. The model of the organization is to house general dentistry and specialty care in one facility. A highly visible stand-alone location with adequate parking was required for a dental clinic to house 53 operatories.
The irregular site is located at the intersection of two major thoroughfares in Waukesha, but only has access from an internal street. Because of the obtuse angle of the intersection, the site was best utilized by a building that was not rectangular.
Two distinct wings of the building were devised to house the major functions of the practice- general dentistry on one side, and specialty care on the other, organized around a taller central public space. The building needed two “front” facades- one that faced the busy intersection and another that provided an entrance oriented toward the internal street. The obtuse angle of the intersection allowed for an interesting volume to connect the two wings. 18’ tall glazing allows views completely through the central volume.
Because of the high number of dental operatories, the design strives to break down the program into smaller clusters of chairs, which are then used as building blocks to generate the form.
Responding to the need for a quick construction schedule, precast panels were devised as the major structure of the building. Brick was cast into the panels and multiple surface finishes were used to create patterns on all facades. The client has been building a brand through the construction of multiple facilities, and certain elements are used consistently to distinguish the brand- cut stone, dark fenestration, warm brick and metal panels.
The building responds well to a peculiar site, and takes precast panel techniques to a high level of finish. This large-scale building provides comfort and reassurance to individual patients through the use of human scale and a warm palette of materials.
Photos: Robert Popp
Owner: Access Community Health Centers
The 22,500 square foot facility includes maternal and prenatal care services, pediatric care, adult and chronic care, dental care, behavioral health services, pharmacy and patient resource services.
Given the available land and related zoning ordinances and development requirements, it was necessary to stack the desired program on two floors. Storm water management requirements had to be balanced with the parking requirements. Urban design guidelines required the building to address the street, which created priorities with how these various requirements would overlay on the building and site design. It also was necessary to accommodate the arrival and departure of patients via the public transportation system, which added “program” and “building” space to the landscape, and its interaction with the streetscape.
The Patient Centered Medical Home Model provided principles for the planning and design response, centered on the integrated care team for primary and specialty care. Because this program has the highest volume of patient visits on a daily basis, these exam and consultation spaces were organized on the first floor. Daylighting and views in the integrated care team space also allowed the exam and consultation rooms to be organized internal to the floor plate, promoting easy wayfinding for patients and an efficient operational process and flow.
Conversely, the dental care spaces were placed on the second floor with the dental treatment spaces organized around the perimeter of the floor plate as evidence based research indicates daylighting and views for dental treatment spaces does significantly reduce patient stress and increases positive perceptions of their encounter.
Photos: William Fritsch & Loren Zemlicka
Architect: HGA Architects and Engineers
Owner: ThedaCare Community Health Network
Contractor: Boldt Construction
The site is a rural and suburban field on the edge of Berlin, Wisconsin, a pre-Civil War small town filled with historic wood-framed houses. Rural roads leading to Berlin are lined with these white, steep-pitch gabled wood-framed farmhouses with orange brick fireplaces.
The 43,000 SF single-story nursing home accommodates 40 short-term, long-term and memory care residents and is designed to evoke a home-like and comfortable feel. The facility includes a memory care wing, a wing for more active residents, visitors and administration wing, as well as a dining, kitchen and support services wing. Not only does this maximize operational efficiencies by creating individual communities that share common spaces, but it creates a more intimate feel for the one-story sprawling structure.
To solve the problem of making a very large one-story institutional building look “like home”, the local vernacular wood-frame house form was adopted and repeatedly used to break down the scale of the building and to imbue an intimate residential character. Resident rooms, living and dining spaces as well as the entry lobby were articulated as white, steep-pitch gabled houses with dark roofs and double-hung windows. These “houses” are connected with a neutral flat-roofed connective building containing all services and circulation. White picket fences, common in old Berlin, are used to allow residents to spend time outdoors in a controlled environment. A series of carefully configured courtyards can be used by residents, and are seen from single-loaded circulation spaces inside. Major interior spaces such as dining spaces, living rooms and the entry lobby have cathedral ceilings up into the gabled roofs, with white-washed wood trusses and decking exposed. Planks of wood grain flooring are used extensively throughout the facility, redolent of the wood floors in all of the local houses. Orange clay brick, identical to that found in older local houses, was used for living room fireplaces for both wings, recalling the powerful memory of the hearth as a symbol of home.
Photos: Darris Lee Harris Photography
Arlington Heights, Illinois
Architect: Hoffman Planning, Design & Construction, Inc.
Owner: Lutheran Life Communities
Contractor: Walsh Construction Company
The $51.6 million repositioning of Lutheran Home began with the addition of MyRehab Center—an 81,000 sq. ft., rehabilitation center/transitional care center—to its skilled nursing facility, Olson Pavilion. Designed to provide first-class therapy and rehabilitation services, MyRehab Center is an excellent example of how healthcare environments are changing to be more contemporary and welcoming. With an abundance of windows, the 78-unit facility offers a significant amount of natural light throughout—specifically in the lobby and therapy gym. All 26 resident rooms per floor offer the comforts of home, while a few select suites include a spacious living area complete with chairs, wardrobe, and sleeper/sofa so family can easily stay overnight to give support. Common areas, such as the dining and living rooms, provide more accessible and warm home-like spaces. A state-of-the-art therapy gym—which includes a mock apartment for practicing independent tasks done at home—is a key feature of MyRehab Center.
A primary design goal for MyRehab Center was to continue the residential architectural features of the campus while complimenting the institutional character of the adjoining Olson Pavilion. This was accomplished by introducing a modern healthcare attribute to bridge the two design styles together. In addition, with MyRehab Center designed to appeal to short-term clients (many possibly younger in age) instead of the typical, older long-term resident, the project encompasses a more transitional and contemporary design.
Although connected to Olson Pavilion, MyRehab Center has its own parking area and upscale lobby that contains smaller, cozy meeting spaces for patients and visitors and offers a retreat-like hospitality entrance to the community with is stone and flooring materials. A gateway to Olson Pavilion, the lobby’s exterior and interior are blended through the use of an impressive curtain wall system. The facility includes a secondary entrance that provides a discreet and private access point for receiving admissions and other emergency and medical personnel.
Another significant design feature of the project was the ability to not only blend into the existing campus, but the surrounding neighborhood as well. The facilities on the Lutheran Home campus already contain a mix of residential to institutional design styles, which makes for a unique setting. Since MyRehab Center would be squarely located in a residential area, many residents expressed concern prior to the start of the project about the appearance of the finished facility and its ability to blend into the neighborhood. Others worried about the possibility of the facility having a negative effect on the value of their homes.
Much effort was spent examining the entire campus setting, from its facilities features to the surroundings neighborhood. Elements studied included setbacks, landscaping, material selections, and architectural style. A critical component of the design of MyRehab Center was specifying the use of residential windows and other non-institutional looking features, such as mansard asphalt, shingle roofs, dormers, downspouts, and brick. Upon completion of the design, resident concerns were put to rest.
Architect: HGA Architects and Engineers
Owner: KLMK Group
Contractor: Turner Construction
This new regional medical facility in northwestern Kentucky includes a nine-story inpatient tower, three-story diagnostic and treatment building, transitional care unit, emergency department and various other specialty and outpatient facilities. While the 162-acre site offered convenient access to residents and space for future expansion, special design solutions were required to address seismic and flood plain issues. The design of the undulating building elements and healing environments that flow through the 477-bed hospital were inspired by the nearby Ohio River. Internal courtyards bring light into the building and provide views that create calming distractions. The exterior features simple forms and natural materials, with the buildings connected at shared common spaces. Glass is used to emphasize important areas, such as the south façade of the tower. The facility incorporates many sustainable elements, including daylighting, green roofs, stormwater bioswales, native plants and restoration of the adjacent flood plain. It is the first hospital to be designated as a Certified Audubon International Signature Sanctuary. The facility is designed to reduce operational costs, improve the workplace environment, engage the community and optimize patient care.
Jury Comment: “While this project is large in scale, the design concept provides clarity by breaking down and unifying the distinct programmatic elements. There is a nice use of materials, both inside and out. The interior spaces are lovely and gracious. The patient room is wonderful – very soothing and nurturing with a beautiful view. It’s exquisite.”
Photos: Halkin|Mason Photography
Owners: SSM of Wisconsin & Dean Health System
SSM Healthcare of Wisconsin (SSM) and Dean Health System (DHS) formed a partnership in the community of Janesville, Wisconsin, with the goal of providing greater access to coordinated healthcare in a patient-centered environment. The Owner desired to engage a single team to program, plan, design and deliver a comprehensive community medical campus, located at the intersection of Interstate 39/90 and Highway 11 on the southeast side of Janesville. The project includes a 163,000 square foot, 50-bed hospital and a 150,000 square foot clinic. The hospital program includes: 50 private rooms, including an intensive care unit, medical-surgical care, labor delivery recovery and postpartum rooms; emergency department, surgery, diagnostics, laboratory, pharmacy, support and food services, administrative and public spaces. The clinic programs include exam and treatment spaces serving primary and specialty care, including oncology in an outpatient, patient-centered medical home model. To the extent possible permitted by building codes and licensure requirements, the team was challenged to integrate functions, increase flexibility and efficiency, and maximize business occupancy type spaces over institutional type spaces to conserve costs while emphasizing a patient-centered design aesthetic over an institutional environment. The campus was also master planned to grow to a 200 bed hospital and double the size of the clinic.
The site had been identified by advance planning (completed by the same team, 10 years earlier) to align the real estate goals and objectives with the organization’s strategic plan, ensuring the right services were in the right location for the right cost at the right time. Implementation of the project on this site was done by validation of the strategic plan in concert with site master planning to ensure the future expansion needs were not compromised by the current program. The planning and design team had to address stacking of the program in order to minimize the footprint of development on the site while preserving prominent features of the existing landscape. Daylighting and views and orientation of the program on the site had to be coordinated with points of access from the adjacent interstate and highway.
Evidence-based design (EBD) informed the design solution, and centered on developing a strong connection to nature to reduce anxiety and stress for patients, speed the healing process, improving patient experience and employee satisfaction. The campus was designed to highlight views to the natural surroundings and incorporate nature within through a variety of natural elements and earth-tone decor. Design features include the “Town Square” which is the main point of entry and connection of all program elements to the Healing Garden beyond. A variety of oversized and floor-to-ceiling windows are strategically place to afford scenic views of Janesville’s landscape and exterior healing gardens. Paint, furniture, and other interior elements draw on natural color palettes, patterns, and textures. Local artists were commissioned to create pieces to make the space feel warm and familiar to patients, and to serve as a positive distraction. One example is a sculpture that was designed for the Pediatric department. This tree evokes a park environment, is symbolic of growth, honors Janesville’s identity as a “Tree City” and is an effective way-finding landmark. Design of the treatment spaces utilizes an on-stage / off-stage approach, reinforcing the patient experience while maintaining efficient and functional space for staff and support services.
Photos: William P. Wright and PHOTOSMITH
Architect: HGA Architects and Engineers
Contractor: The Boldt Company
The new regional cancer center on the northern edge of Appleton reflects the goal to deliver compassionate patient-centered care in a highly integrated and collaborative way. The building is outward focused, taking advantage of the surrounding diverse ecosystem to enhance the healing environment for patients and visitors. Connected to an existing ambulatory care clinic with some shared services, the new center offers a full spectrum of care, including advanced medical and radiation oncology treatments and procedures. An exterior courtyard is an organizing element, separating the two buildings while providing a centralized place for people to use throughout the day. The use of natural exterior materials helps the new building fit into its setting. Scale, texture and rhythm work together to create interest and humanize the building for patients. Moving through the building, views to the exterior and light make it feel less institutional. Various elements are used to provide positive distractions and give patients a greater sense of control. The radiation vaults, often intimidating and overwhelming, are wrapped in panoramic nature scenes with variable lighting that patients can change to suit their preference. Peaceful gardens, a walking trail and water features offer areas of respite for patients and staff. A large staff collaboration area is a unique and innovative work space in which physicians and staff discuss and develop coordinated strategies for each patient, enhancing efficiency and patient care.
Jury Comment: “Oncology is really scary, and this building makes if feel less scary. It feels of a human scale. The material pallet is reassuring. Its asymmetrical plan allows the building to take advantage of the landscape, and there is something comforting about that. The architect is trying very hard to be reassuring through design, illustrating the role architecture can play in healthcare and the healing process.”
Photos: Paul Crosby Photography
Florida Hospital | Sanford-Burnham Institute
Architect: Flad Architects
Owner: Florida Hospital
Contractor: Brasfield & Gorrie, LLC
Built on a small urban site, the TRI is a landmark building for Florida Hospital and the signature building in their new Health and Research Village, a mixed-use development of research facilities, clinics, commercial buildings, and residential housing. The new research institute portrays a high-level image and identity along the primary street, yet creates a sense of privacy for clinical volunteers entering the building.
The framework for the exterior development, based on the planning module and a series of horizontal regulating lines provided a simple yet elegant expression. Visual interest relies on the massing of the building and the use of materials with color and texture to provide scale and character, all complimented by the use of required functional building elements such as the stairs and sun-screens as detailed accents. A limited pallet of sand colored terra-cotta, white precast wall panels, glass curtain wall, and trapezoid shaped metal panels of varying shades of blue, acting as a reflection of the Florida sky, make up the skin of the building.
The exterior of the building has a transformative nature as day turns into night. The terra-cotta and glass enclosed staircases that visually anchor both ends of the building act as lanterns at night in the urban landscape. The building’s main street façade, made up of stainless steel sunscreens, shifts from a solid form to a more transparent appearance at night revealing an illuminated curtain wall that visually hints at the research discoveries occurring within.
The building is organized in an ‘L’ configuration creating a landscaped arrival court in the middle of the site for volunteers to access the building in privacy. An outdoor room, complete with a garden and water feature, acts as the forecourt to the main entry which opens into a modest two-story lobby. In the center of the lobby, an ornamental staircase connects the first two floors and runs along a feature wall with a two-story interactive digital display focused on the mission and science within the facility.
The research institute was designed with sustainable measures and standards in mind for achieving LEED Gold certification. In addition to providing local materials, light colored roofing, and a reduced impact on the site, daylight and views played an important role in the interior development of the building, providing access to almost every habitable space. This required the adoption of stainless-steel sun shading devices that not only provide a practical application, but give the building a unique exterior aesthetic. An outdoor terrace at the second level was also provided for volunteers and staff and is bordered on either side by green vegetated roofs.
Photos: Jim Roof Creative