| Project Name / American Family Children’s Hospital Location / Madison, Wis. Owner / University of Wisconsin Hospital & Clinics Total Floor Area / 298,714 square feet (491,725 square feet including parking levels) Number Of Floors / 6 floors clinical, 3 levels parking, 1 level mechanical Number Of Beds / 61 (designed for 85; one 24-bed floor is shelled) Construction Cost / $76.2 million (phase 1); $20 million (phase 2) Groundbreaking / March 2005 Opening / September 2007 (phase 1) and September 2008 (phase 2) |
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For a kid, anything boring or scary is almost unbearable, and hospital visits can be both. The Wisconsin theme of the new American Family Children’s Hospital (AFCH) in Madison, Wis., is designed to be fun and familiar to the children who are treated there.
The bright, cheerful, thoroughly non-institutional design by HDR Architecture Inc., Omaha, Neb., was developed to create a sense of normalcy and provide emotional support to children and their families while they are at the hospital. This type of environment helps children disengage from their fears, minimizing stress and anxiety and maximizing coping skills, says Mary Kaminski, AFCH director of patient and family services.
“Children are very in tune with their environment,” says Kaminski. In a new setting, “they get a sense of what might be perceived as threatening or scary. They’re very much aware of uncertainty or ambiguity.” The new AFCH facility is meant to welcome young patients in no uncertain terms.
The 250,000-square-foot building is adjacent to the University of Wisconsin (UW) Hospital and Clinics; it replaces a pediatric hospital with services in various areas of the UW hospital. Dr. Christopher Green, professor and vice chair of the department of pediatrics at the UW School of Medicine and Public Health, and AFCH medical director, says a separate location where caregivers are focused solely on treating pediatric patients promotes the development of better services for children.
Hometown atmosphere
Children are made to feel at home in the facility as soon as they walk in the front door. The lobby resembles a small town. The security desk at the entrance has a corrugated tin exterior, simulating a grain silo.
Visitors proceed to the “guest depot,” a welcome desk designed to look like a train station. A streetscape, complete with park benches and decorative light poles, continues past the hospital pharmacy and gift shop (in the guise of an old-fashioned drug store) to a parklike area centered on a large faux sugar maple tree.
A brightly-lit marquee, featuring the hospital’s logo in neon, fronts a real movie theatre where kids can enjoy films and videos. The lobby also includes a stage for live entertainment. A supervised play area for patients’ siblings is highlighted by a replica of the Fond du Lac lighthouse, a Wisconsin icon. The nautical theme of this area is continued by an aquarium inside the play space.
Patterned sheet vinyl flooring throughout the lobby carries the theme right down to kids’ toes. Tractor tire tracks lead to the security “silo,” gray flooring striped like a roadway runs along the “avenue” and footprints are etched into the beach-colored floor near the lighthouse.
Bob Holm, HDR senior professional associate, says these designs assist in wayfinding and are especially appealing to the youngest patients, who delight in following the paths. More patterns, such as leaves or clouds, are projected on the lobby floors and walls by theater lights at ceiling level.
The hospital’s diagnostic treatment center, where special procedures take place, and six rooms for day treatment are off the lobby.
The lobby is connected to the UW Hospital and Clinics by a bridge decorated with tiles honoring donors’ friends and family members.
Farmland clinic theme
The Wisconsin theme continues on the upper floors of the hospital, with each floor celebrating a different aspect of the state. The design of the second floor, which houses the hospital’s clinics, is based on Wisconsin farmland.
This floor is enlivened by a vibrant palette that tends toward primary colors. Windows along the waiting area overlook a wooded, residential neighborhood. Lake Mendota, a large lake near Madison, can be seen in the distance.
The farmland theme plays out in signage and artwork depicting barnyard animals, pendant light fixtures shaped like milk bottles, a tree house-inspired reading area, tractor-tire play forms and corrugated tin wainscoting. Benches and stools in the exam rooms are covered in vinyl upholstery with a cowhide pattern.
The exam rooms include chalkboards to occupy children waiting to see their physicians. Fiber-optic lighting in the ceiling of echocardiography labs and radiology rooms serves to distract patients from medical equipment they may find frightening.
A salon called the Positive Image Center is located on the second floor, along with the clinics. Here, children can learn how to use wigs, make-up and other strategies to become comfortable with changes to their appearance caused by medical conditions.
Honoring the lake
The third-floor surgical pavilion honors Lake Michigan. A nautical look is created through white bead-board wainscoting, an aquarium, a large glass mural of a lakeside scene and images of animals such as fish and turtles. Windows provide natural light and views. The colors used on this floor are more subdued and tranquil than those on the lower floors.
The surgical pavilion, which opened this September as phase two of the project, is designed to meet the special needs of families with children undergoing surgery. The playroom is designed for pediatric pre-op patients to conduct exploratory play in a mock-up operating room.
Private pre- and post-op rooms give families space to be together and talk with caregivers before and after surgeries. Private rooms increase patient confidentiality and reduce noise, producing a calmer atmosphere, says Green.
Prairie patient units
The hospital’s inpatient units are on the fourth and fifth floors.
The fourth floor holds a 21-bed pediatric intensive care unit and a 16-bed inpatient unit designed for children who must remain in the hospital for extended periods, such as those being treated for cancer.
This floor has a soothing prairie theme, featuring waving grass, wildflowers, ladybugs and grasshoppers. Five sleep rooms sponsored by the Ronald McDonald House, a laundry room, two family lounges and an exercise room are provided to make life easier for parents.
The Bone Marrow Transplant Unit on the fourth floor includes a specialized room that will be used for the treatment of neuroblastoma, the fourth most common type of cancer in children. This room is lined with 4 inches of lead to contain the high doses of radioactive material used in metaiodobenzylguanidine (MIBG) treatment, a program that is under development at the hospital.
The room is equipped with monitors and a closed-circuit audiovisual system that will allow nurses and family members to observe and interact safely with a child during the first 24 hours of treatment, when minimal contact is required because of heavy radioactivity.
A room for parents is provided next to the treatment room. The hospital reports it is one of only five children’s hospitals in the nation with the facilities necessary to provide this type of care.
There are 24 general care inpatient rooms on the fifth floor, which has a north woods theme expressed through imagery like ferns, branches and leaves from native Wisconsin trees and a fireplace in the waiting area.
All the inpatient rooms on both the fourth and fifth floors are private. At almost 300 square feet, they are twice as large as the hospital’s former pediatric patient rooms. Every room includes a family zone with a sleeper sofa, desk and Internet access for parents. At parents’ request, the designers included plenty of storage space for family members.
Jim Hohenstein, AIA, HDR design principal, says surveys conducted during the design process revealed that parents prefer storage space over such amenities as in-room refrigerators. “So there’s a whole built-in wall in the family area for that purpose,” he says.
A mirror that matches the theme of each room’s floor hangs on the wall across from the patient bed. The outer edge of the mirror glows like a nightlight, a detail Christi Doney, HDR interior designer, says alludes to an element a child might associate with home and find comforting.
The rooms also include large nurse servers that make linens, medications and other supplies conveniently accessible to caregivers.
The bathrooms were placed on the outboard wall of each patient room to provide space for the nurse servers and decentralized nurses’ stations at the inboard wall. The bathrooms have sliding doors and are arranged so that the toilet is located next to the door. This design enables caregivers and parents to take advantage of space within the patient room to assist children in getting to the toilet.
The sinks in the patient bathrooms are spacious, with shallow bowls that are sloped on one side, so infants can easily be bathed in them.
A separate hand washing sink for caregivers is located in the staff zone of each patient room, near the door. Previously, caregivers and patients shared a single sink in the patient room. “I washed my hands in the same place the patient brushed her teeth,” says Green. The new design is more hygienic and more private for parents and children who wish to place personal items like hairbrushes next to the sink.
A rounded front to the building provides panoramic views from the patient rooms of the hospital’s tree-lined neighborhood. With few exceptions, rooms are positioned to face this direction, rather than toward the rest of the hospital complex. Rooms that face back toward campus buildings do so at an angle, to improve the view.
A balcony on the fifth floor allows patients, family members and staff to get some fresh air while enjoying the outdoor scene. The balcony is shared by a family kitchen and dining area and the fifth-floor playroom. A laundry room is available to parents on the fifth floor, as well.
A substantial play area and a school room that is staffed full-time by three teachers from the Madison Metropolitan School District are located on the fifth floor. A separate playroom and school are on the fourth floor, for patients who require an infection-controlled environment.
“Playrooms are important because the work of children is play, and so we try to integrate that into every aspect of their lives when they’re in the hospital,” says Kaminski. Schooling opportunities allow children to keep up with their peers and return to their lives with as little disruption as possible when they leave the hospital, she adds.
Staff spaces
Hohenstein says the design team wanted to provide staff with nice spaces of their own in the building in recognition of the high stress involved in taking care of patients, especially children.
The corner of each patient floor has a staff lounge with views of the neighborhood and Lake Mendota. High-end refrigerator manufacturer Sub-Zero, which is based in Madison, provided refrigerators for the hospital, giving the lounges a touch of luxury. Lactation rooms are also available to staff members.
Workspaces and meeting rooms for residents are located throughout the hospital. Residents also have their own lounge and locker room.
Green says the natural light and the views from the hospital’s many windows make the building a pleasant place to work. He notes that one resident has even indicated that the new health care facility was a deciding factor in choosing to attend the UW medical program.
Community partnership
The new building has also given the hospital greater visibility in its community, Green says. In the design of the facility, the hospital strove to be a good neighbor through features such as locating the mechanical level between the hospital’s fourth and fifth floors, which helps control noise and gives the building a more attractive roofline.
The facility also includes several spaces for local outreach, such as a health library; a safety center, where area residents can learn how to use equipment such as bicycle helmets and child safety seats and purchase this equipment at low cost; and a community meeting room.
High standing in the community expands opportunities for care. It also provides a focus for fundraising, which is an important part of any children’s hospital operation, says Green.
Such support will help make future hospital growth possible. The building can hold two additional floors. There is also a shelled floor above the fifth floor. This is slated to become an inpatient unit, with a river design scheme that will carry on the hospital’s Wisconsin theme.
Because when it comes to feeling better, there’s no place like home.
Amy Eagle is a Homewood, Ill.-based freelance writer and contributor to
Health Facilities Management.
| Sidebar - Construction Up Above + Care Down Below |
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As construction was under way for the American Family Children’s Hospital in Madison, Wis., the University of Wisconsin (UW) Hospital and Clinics actually began operating a new emergency department beneath the children’s hospital structure. American Family Children’s Hospital is located on the site of a former surface parking lot adjacent to the main UW hospital. The new emergency department extends partway into one floor of a tri-level parking deck built beneath the children’s hospital. Both the emergency department and the children’s hospital were built by Madison-based J.H. Findorff & Son Inc. The emergency department began receiving patients in June 2006, over a year before the September 2007 opening of the children’s hospital. “We were still constructing the building while they were operating the emergency department down below,” says Jim Yehle, Findorff senior project manager. “We were setting structural steel and placing decks on the upper levels [while] on the lower levels we were done, complete, certified, occupancy-ready to bring in ambulances and emergency personnel.” The topmost level of the children’s hospital parking garage serves in part as the main entrance, parking area and ambulance turnaround for the emergency department. As the children’s hospital continued to rise above the parking garage and emergency department, the construction team and hospital personnel were careful to separate construction and emergency traffic. A distinct emergency entrance was clearly marked on the site to prevent ambulances and other patient traffic from entering the construction zone. Emergency helicopter landings were temporarily relocated during construction of the children’s hospital to provide adequate clearance for the project’s tower crane. “It was just part of the coordination to make sure everybody was happy and comfortable,” says Yehle. |
| Sidebar - Spec/Sheet |
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/ Project Team / Owner: University of Wisconsin Hospital & Clinics Architect: HDR Architecture Inc. General contractor: J.H. Findorff & Son Inc. Interior designer: HDR Architecture Inc. Mechanical/electrical/plumbing engineering: Affiliated Engineers Inc. Lighting design: Affiliated Engineers Inc.’s Pivotal Lighting Design Structural engineering: HDR Architecture Inc. Medical equipment planning: University of Wisconsin Hospital & Clinics Civil engineering: Graef, Anhalt, Schloemer & Associates Inc. Fire safety contractor: J.F. Ahern Co. Nurse call contractor: Select Sound Service / Principal Design Materials / Acrylic wall coating: Triarch Back-lit nurses’ stations and ceiling trellises: 3form Inc. and Steelcase Inc.’s Designtex Carpet and carpet tile: Interface Inc. (carpet and carpet tile) and Shaw Industries Group Inc. (carpet) Cast stone: Owens Corning Ceiling: Armstrong World Industries Inc. and Chicago Metallic Corp. Curtain wall and windows: Kawneer Doors: Algoma Hardwoods Inc. Door hardware: LaForce Inc. (hardware) and Sargent Manufacturing (locksets) Fabric-wrapped panels: Maharam Flooring: nora systems inc. (sheet rubber), Polyflor and Teknoflor (sheet vinyl) Lighting: ANP Lighting, Birchwood Lighting Inc., Bruck Lighting Systems Inc., Cooper Industries Inc., Electronic Theater Controls Inc., Focal Point, Indessa Lighting, Litecontrol and Visa Lighting Natural stone: Architectural Granite & Marble Inc. Roof: Firestone Building Products Signage: ZD Studios Textured plastic coating: Zolatone Tile: Dal-Tile Corp. and Imagine Tile (graphic tiles) Wall protection: Construction Specialties Inc. Wallcovering: Kenmark Inc., Steelcase Inc.’s Designtex and York Wallcoverings Window treatments: MechoShade Systems Inc. / Principal Furnishings / Casework: Advanced Technology Inc., Formica Corp., October Company Inc.’s Chemetal, Panolam Industries International Inc. and Wilsonart International (laminates); DuPont and North Star Surfaces (tops) Conference tables and patient room sofa bed: KI Lounge seating: Global Upholstery Co. and KI Office desks: Techline USA Office seating: HON Co. Patient beds: Stryker Corp. / Major medical equipment / CO2 laser: Lumenis EEG monitoring system: Cardinal Health (formerly Viasys Healthcare) Imaging system and cardiac monitors: Philips Healthcare Microscopes: Leica Microsystems and Carl Zeiss Inc. Neuro ultrasound unit: Aloka Inc. OR tables: Maquet Inc., Mizuho America Inc. (previously Orthopedic Systems Inc.) and Skytron Surgical system: Alcon Inc. / Infrastructure / Building management system and custom air handling units: Trane Electrical equipment: General Electric Co. (switchgear, distribution panels and switchboards) Elevators: Braun ThyssenKrupp Elevator Generator: Caterpillar
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This article first appeared in the November 2008 issue of HFM.
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