Project Specs
Project Name Children's Hospital of Pittsburgh of UPMC
Location Pittsburgh Floor area 900,000 square feet (hospital); 300,000 square feet (research building); 1.5 million square feet (total campus buildings)
Number of floors Nine (hospital); 10 (research building)
Number of beds 296
Project cost $625 million
Construction start date January 2006 (hospital); May 2006 (research building)
Opening date May 2009 (hospital); December 2008 (research building)
Project Team
Owner UPMC
Architect, interior designer and engineer Astorino
Hospital contractor Barton Malow/PJ Dick (joint venture)
Research building contractor Hunt Construction Group Inc.
Integrated systems contractor Johnson Controls Inc.
Art consultant James Gallery
In a $625 million project that involved the construction of a new hospital, research building and parking decks and the renovation, expansion and demolition of several existing buildings, University of Pittsburgh Medical Center (UPMC) health system replaced its entire pediatric hospital campus. The new campus of Children's Hospital of Pittsburgh of UPMC was built to have better technology, infrastructure, access and design in order to provide better care to patients and their families.
Sense of adventure
"We tried to make the architecture and the experience of the building an adventure in itself," says Tim Powers, AIA, senior vice president of Pittsburgh architecture firm Astorino.
Reasoning that children would be less anxious about visiting a building with which they were familiar, the designers worked to create something memorable to kids. Brick, stone and copper, materials prominent in local architecture, were given a modern expression in the design of the hospital's exterior, which can be seen for miles from the facility's 10-acre hilltop location. Powers reports that area schoolchildren enthusiastically identified the hospital in photographs. "That was what we were after. The kids are not afraid to go to that building," he says.
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| NOTHING TO HIDE: Clearly marked help areas, like this reception/greeter desk, were designed to ensure hospital staff are clearly visible to visitors. |
Unexpected pleasures
Inside the hospital, colorful murals and flooring, artwork and numerous windows provide visual interest.
During design, Astorino's associated research firm, fathom, which is also based in Pittsburgh, worked with patients, parents and staff to help them express what they wanted to experience in the new hospital, a technique fathom has since adapted and patented as the deep design filter method for design. Christine Astorino, fathom's founder and CEO, says end users may not be able to describe how they want a building to look, but "what they can tell you is how they want to feel."
One of the most important things the designers learned, Powers says, is that time is relative in a hospital. For patients—especially pediatric patients—it can seem to pass exceedingly slowly, while staff may feel there are not enough hours in a day. This can cause patients to believe they are not being attended to properly, while hospital personnel are stressed and overwhelmed.
To engage patients and visitors, "we built in unexpected pleasures or delights," says Powers. "As they move through the building, their sense of time becomes less of an issue."
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| TRANSFORMING CARE: Graphics like this butterfly motif in the outpatient lobby appear throughout the hospital to underscore the transition from an unbalanced state to a balanced one. |
The building's major delight is a 20,000-square-foot family resource center on the hospital's sixth floor that includes play space, a chapel, libraries, a music therapy room and school rooms. The four-story atrium features a 20-by-30-foot screen that can be lowered to display movies or sporting events, complete with a starry night effect that appears as the blinds are drawn. The sound system can be controlled on each floor of the adjacent bed units, to allow patients to view presentations from balconies that overlook the atrium. Just outside the atrium, a large terrace garden with playthings, grass and trees provides room for outdoor
activities.
On the patient units, a large central service core with a series of internal corridors helps maintain a peaceful environment for patients, parents and staff.
Campus improvements
The new campus was previously home to a former medical center. Because the operating rooms of the site's existing hospital were relatively new, one wing of that building was retained in the construction of Children's Hospital. The new and existing buildings were seamlessly adjoined, despite the challenges of matching the floor-to-floor heights of the older facility. Eleven of the 13 operating rooms were renovated and equipped with new medical technology.
Other existing campus buildings were renovated for office space, an employee fitness center and a Ronald McDonald House. The existing central utility plant was expanded. Overall, the project included over 800,000 square feet of new construction, 700,000 square feet of renovation and 700,000 square feet of demolition, according to Eric Hess, vice president and project executive, Children's Hospital.
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| THINK VISUAL: The hospital's four-story atrium provides a gathering place for families and patients. It features a two-story projection screen and access to a rooftop garden. |
Substantial road and intersection improvements were undertaken to prevent the access issues that plagued Children's Hospital's previous site, which had little parking and a single entrance drive located off a very busy street. The new campus has separate parking areas for inpatients, outpatients and staff, with elevators that lead to the appropriate hospital locations. The parking decks for visitors and staff are connected on two levels; gates between the decks can be opened to create more parking spaces for either group, as necessary. Hess says he is happy to report these measures have largely solved the hospital's access problem.
The new campus design has also improved access to the hospital's research center. Research facilities were located three blocks from the old facility; the new hospital and research center are connected by a bridge. This proximity leads to much more collaboration between researchers and patient caregivers, Hess says.
A conference center on the third floor of the research building is used to host large meetings, symposia and outreach events like the citywide spelling bee. Researchers and those at the conference center can walk directly across to the hospital's dining area and outdoor garden space.
'Truly world-class'
People require a lot from hospital design. "It's not just about giving them a waiting room to sit in," Powers says. "It's about giving them spaces [for] life-changing events." At Children's Hospital, "each and every aspect... was designed to improve the patient environment," from the parking lots to the patient rooms, Hess says.
"Our campus is truly world-class, and I believe that we've designed and built a new Children's Hospital that is unparalleled among pediatric hospitals nationwide," he adds.
"The kids actually like being there," Powers says.
"As an architect, it doesn't get any better."
| Sidebar - Design features robust infrastructure |
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The infrastructure of Children's Hospital of Pittsburgh of UPMC is considered a critical component of patient care. Art Bell, P.E., mechanical department manager for Pittsburgh-based architecture firm Astorino, says the engineering systems were designed to ensure the building does not experience "failures that result in conditions that are unfavorable to the children." From an engineering standpoint, this meant installing equipment that was reliable, maintainable and, where appropriate, redundant. "You can't shut a hospital down; it operates 24 hours a day, 365 days a year. You have to be able to maintain equipment on the fly," Bell says. The hospital's five major air handling systems are headered together so that proper airflow can be provided throughout the building at all times—a design that also lowered noise levels, as air moves through the larger ductwork required for this system at a lower velocity, producing less sound. The major systems in the central plant have built-in redundancy, such as extra pumps and chillers standing by to be used in the event of a failure. The hospital's chilled water piping system has valve-capped connections that can readily attach to additional chillers, cooling towers and pumps as future needs dictate. The central utility plant was constructed with space for two more chillers and their appurtenances. New chillers or boilers can be brought into the utility plant through an overhead door that is designed to accommodate large equipment. The air handling equipment located near the hospital's heliport includes racks for carbon filtration units to be installed if diesel fumes from helicopters become a problem. Air filtration throughout the hospital and an independent air handling system for the bone marrow transplant, hemotology and oncology ward are designed to assist in infection prevention and control. |
| Sidebar - Technology plays key role |
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Children's Hospital of Pittsburgh of UPMC is using technology in creative ways to care for patients and to make their hospital stays more pleasant. At the new facility, the hospital has implemented fully-integrated electronic medical records, and the operating rooms (ORs) feature advanced video monitoring and communications equipment. The OR system includes multiple high-definition monitors in the surgical field, endoscopic cameras for use in minimally invasive surgeries and cameras in the surgical lights. Eric Hess, vice president and project executive, Children's Hospital, says that compared to the hospital's former facility, "We went from a Yugo to a Ferrari." The hospital can now record and transmit surgical activity for classes, conferences, consultations and other uses. For example, surgeons at Children's Hospital perform living-related donor transplants in which an organ is obtained from a relative of the patient. During these procedures, the surgical team can maintain audio and video contact with medical personnel at a hospital two miles away where the organ is harvested. The system also is put to use during surgeries that require specialists to attend only a portion of the operation; a physician can monitor a procedure from his office and enter the suite when needed. During the design of the new building, Children's Hospital engaged a team from Carnegie Mellon University (CMU) to explore the use of technology in improving the patient experience. The CMU students developed interactive electronic game kiosks located in the hospital's waiting areas and a playroom; they have since formed a company called Electric Owl Studios, based in Pittsburgh, to market the customizable kiosks to other pediatric centers. Patients and visitors at Children's Hospital can also enjoy video games and on-demand movies through the hospital's patient entertainment and education system, or borrow laptop computers available for use at the facility. |
| Sidebar - SPEC SHEET |
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PRINCIPAL DESIGN MATERIALS Acoustical ceilings: Armstrong World Industries Inc. Brick/masonry: Mankato Kasota Stone Inc. and Trenwyth Industries Carpet: Interface Inc. Composite metal panels: Centria and Kawneer North America Cubicle curtains: Architex International and Maharam Door hardware: Hager Companies, Ingersoll Rand Security Technologies, Pemko Manufacturing Company Inc. and Rockwood Manufacturing Co. Doors: Ingersoll Rand Security Technologies (metal) and VT Industries Inc. (wood) Drinking fountains: Elkay Manufacturing Co. Emergency lighting: Bruck Lighting Systems Inc. and Cooper Lighting Fabrics: Arc|Com, Architex International, Brentano Inc., CF Stinson, Carnegie, Steelcase Inc.'s DesignTex, Jhane Barnes Textiles, Maharam, Momentum Group, Pallas Textiles and Patty Madden Inc. Glass/glazing: Pilkington North America Inc. Insulation: CertainTeed Corp. and Monoglass Inc. Indoor Lighting: Acuity Brands Lighting Inc., Cooper Lighting, Lightolier and Lithonia Millwork: Formica Corp. and Wilsonart International (laminate) and DuPont (solid surface) Paint: PPG Industries and Sherwin-Williams Co. Partitions: ClarkWestern Building Systems and LaFarge Roofing: Tremco Inc. Sheet vinyl: Altro, Forbo Flooring Systems and Toli Specialty lighting: Winona Lighting Toilets and sinks: Kohler Co. Vinyl composition tile: Forbo Flooring Systems and Sincol Vinyl wall covering: Maharam Washroom accessories and ADA compliance equipment: Bradley Corp. Washroom partitions: Yemm & Hart Ltd. PRINCIPAL FURNISHINGS Cafeteria seating: Vecta Cafeteria tables: Versteel Casework: Giffin Interior & Fixture Inc. Conference tables: KI and Steelcase Inc. Files and shelving: Richards-Wilcox Inc. (file rooms); and Gressco Ltd. and Steelcase Inc. (play areas) Lounge seating: Carolina Business Furniture, Coalesse Inc. (formerly Brayton), David Edward and Nemschoff Inc. Office desks and seating: Steelcase Inc. Patient over-bed tables: Nurture by Steelcase Patient room seating: Nemschoff Inc. MAJOR MEDICAL EQUIPMENT Anesthesia machines, bone densitometry, central station and telemetry monitoring, diagnostic imaging equipment and pediatric radiation distraction environments: General Electric Co. Dialysis machines: Fresenius Medical Care EEG monitoring: Natus Medical Inc. Equipment booms: Skytron Minimally invasive surgical suites, OR lights and booms and surgical navigation: Stryker Linear accelerator: Varian Medical Systems Inc. Pharmacy automation: CareFusion Corp. Power injectors: Medrad Inc. Preclinical imaging: Bruker Biospin and Siemens Corp. Procedure lights: BerchÂtold Corp. Sterilization equipment: Steris Corp. Sterotactic system: Elekta INFRASTRUCTURE HVAC controls: Johnson Controls Inc. HVAC units: Johnson Marcraft and McQuay International Alarms: Johnson Controls Inc. and Notifier by Honeywell Fire and life safety: Grace Industries Inc. and Nelson Firestop Products Intercom, paging and call systems: Stentofon USA Locks: Ingersoll Rand Security Technologies Security: EasyLobby Inc., Johnson Controls Inc. and Pelco Inc. Information provided by Astorino and UPMC. |
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Amy Eagle is a freelance writer based in Homewood, Ill., who specializes in health care-related topics. She is a regular contributor to Health Facilities Management. |
This article first appeared in the November 2009 issue of HFM.
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