Attempt to comply with updated seismic standards from the State of California, and Marine Health Medical Center: Oak Pavilion It is a 265,000 square foot hospital that houses new inpatient, diagnostic, interventional and emergency services. Community members in Greenbra, California requested that the new building not detract from its surrounding landscape, inspiring biophilic design inside and out. Inside, patient rooms, waiting areas and staff lounges are organized around exceptional views, while the outside features several gardens. Additionally, solariums are provided in each nursing unit, an indoor/outdoor space that gives patients direct access to fresh air. The project was submitted to Design Showcase by Perkins Eastman. Here, Project Leader Jason Heim, Director and CEO of Perkins Eastman (Los Angeles), shares an insight into some of the design solutions the jury celebrated.
healthcare design: The community expressed its desire to build a building that blends in with the landscape. How did you handle the design to ensure that the structure was virtually obscured into the site?
Jason Haim: The project is located on a sloped site, which allows the building to appear smaller than it actually is. The four-story building bottoms are above grade at the western elevation, but the southern and eastern elevations are excavated from the hillside that connects to an existing five-story wing of the facility. This existing pavilion is closely connected to the lower level of the Oak Pavilion with a terraced garden filled with rocks and plants native to Northern California. This garden is located 40 feet from the public waiting rooms, connecting the new wing of the project to the existing wing of the health care center.
Stacking greenery on top of the building and using reflective glass curtain walls hides the project within the landscape, rather than building on top of it – so important to the Marin County community. The parking areas surrounding the Oak Pavilion have also been dropped a few feet away to allow the ground floor board to have views of the river area across [the street] and Mount Tamalpais instead of watching the front of parked cars.
The project used false rock retaining walls and a vast amount of native tree species and ground cover to help the building fit into its natural context. Roof gardens cover the majority of the lower level roofs to help provide pleasant views for patients but also for residents looking at Marine Medical Center from above.
The outdoor solarium is a standout feature. Where did the idea come from?
We wanted a way for the community to immerse themselves in nature and stay in touch with the beauty of Marin County, even when they’re in the hospital. With what we know about how nature contributes to wellness and our desire to create an architecture that embodies wellness – literally and figuratively – solariums were an ideal architectural solution to the deep human desire to connect with landscape, nature and context.
Inside, the vital response continues throughout. How did this goal affect the way interiors are organized?
We wanted patients, families, and staff to have as much access to natural light and views as possible, for a variety of important reasons. We know that access to natural light and landscaping contributes to a greater sense of wellness among patients and staff.
The project enables users to know where they are within the building at all times and have constant access to natural light and views, and the ability to interact with nature. Each patient unit has access to a solarium space or an indoor/outdoor living room. The living room can open to a large outside balcony which can open internally to the unit. This constant contact with daylight, aided by a guiding concept connected with nature (and repeated on all floors), improves the efficiency of the employees.
The patient experience is improved, specifically, by thinking through the controls and personalization. What elements of this approach distinguish you?
When patients and their families are able to make choices that affect their experience – things like room temperature, ability to get outdoors, lighting above the bed, etc. – it puts some of the controls back on the patient. When patients and their families feel more in control, research shows that their fears reduce some. Research shows that this can contribute to more positive outcomes.
With the doctor’s approval, patients – even if they are restrained with IV columns – can access the outdoors for fresh air. Patient bedside controls are provided for many features, including lighting and window shades. The advanced lighting and window tinting system includes automatic lighting levels for daylight, occupancy, shading, and preset controls for patient care.
It also concerns what is not in the room. Perkins Eastman has tried hard to provide enough support space for staff to store all the equipment and carts required for patient care outside of patient rooms and hallways – the idea being that by hiding those seemingly more clinical items, we can create a hospitality experience rather than a clinical one.
This project provided an opportunity to streamline operations as well. How did you enhance efficiency in care delivery?
The Oak Pavilion radically changes the workflow of existing patients and staff, allowing the building’s layout to enhance the functionality and operational efficiency of the hospital. Support services are stacked below surgery and served by lifts designated to transport supplies. Surgical recovery areas are six times larger than current areas and allow flexibility in both preoperative preparation and postoperative recovery. Due to the large unit sizes, we were able to have large scale nurse centers decentralized around the units. Support spaces are distributed in the middle of the floor, and can be accessed through staff-only corridors.
Jennifer Kovacs Silves is the editor-in-chief of Healthcare Design. It can be accessed at [email protected].