Time-tested success

The American College of Healthcare Architects’ (ACHA’s) Legacy Project Award recognizes groundbreaking projects that redefined at the time what designers, health care organizations and the general public understood about what a hospital or clinic could be, and introduced innovations or supported breakthrough delivery of care concepts.

With its emphasis on time-tested success over momentary design trends, the award honors health care architecture that demonstrates superior planning and excellence in design performance over an extended period of time, and remains of enduring significance.

The competition requires that the project be submitted by an ACHA Certificant, Fellow or Emeritus. It must be built and continuously occupied as a patient-oriented health care facility in good condition for at least 15 years. For the 2015-2016 cycle, projects occupied no later than Dec. 31, 2000, were eligible.

The project may be new construction or a significant addition to an existing campus. Minor additions or interior remodels are not eligible. The project may be one building or a related group of buildings forming a single project.

This year’s award recognizes Northwestern Memorial Hospital’s (NMH’s) $580 million replacement facility for inpatient and ambulatory care, which was opened in 1999.

Now known as NMH’s Feinberg/Galter pavilions, the redevelopment project centered on consolidation, innovation and enhanced care delivery in a unique environment that did not feel like a hospital. It is the result of 10 years of planning, design and construction with “Patients First” as the driving force.

As with all Legacy Project Award winners, NMH’s project recognizes the rich exchange of planning and design concepts by qualified architects engaged by enlightened clients to serve their surrounding communities. 

Legacy Project Award - Northwestern Memorial Hospital Feinberg/Galter pavilions

Northwestern Memorial Hospital (NMH) achieved a major milestone in May 1999, when it opened the $580 million replacement facility for both inpatient and ambulatory care — on time and on budget — on its Chicago campus.

The project was the result of more than 10 years of planning, design and construction with the “Patients First” philosophy as the driving force.

The hospital infused this focus and criteria into the redevelopment project, now known as NMH’s Feinberg/Galter pavilions. Planning centered on consolidation, innovation and enhanced care delivery in a unique environment that did not feel like a hospital.

Cutting-edge project

The NMH replacement facility provides both inpatient and outpatient services. The redevelopment project consolidated nine buildings spread across a three-block radius into the new 2.2 million-square-foot facility. Among its key features:

Building organization. The facility is organized on a public/diagnostic podium that spans two blocks in the heart of the city. Rising from the eight-story podium — comprising public space, diagnostic, therapeutic and support services — are two towers, nine floors of inpatient units with 492 private rooms — 92 for intensive care — and a 14-floor ambulatory care tower that consolidated all ambulatory services and physician offices.

Integrated ambulatory care model. NMH provides a consolidated, single location for ambulatory care/faculty practice space. At more than 1 million square feet, the facility brought together disparate services into a common care delivery model. The floor plan accommodates flexibly sized clinics and circulation for separate patient experiences. Upon entry, the patient moves quickly to elevators and is brought directly to diagnostics or physician practice space, separate from that of inpatients.

Project information

Project type: New construction

Facility type: Inpatient and ambulatory care

Total building area:2.2 million square feet

Cost: $580 million
Project completion: May 1999

Architect of record: Ellerbe Becket (EB)/HOK/VOA Associates joint venture

Mechanical-electrical-plumbing engineer: Environmental Systems Design (ESD)

Civil engineer: Globetrotters Engineering Corp.

Landscape design: Jacobs Ryan

Structural engineer: HOK

On-stage/off-stage. By nature of its configuration, elevator placement and circulation system, the separation of patients from service has led to an enhanced visitor experience, including ease of wayfinding and access to daylight deep into the floor plate, and efficient movement of physicians and staff between the ambulatory care and inpatient services.

Private rooms. NMH designed the inpatient rooms with distinct zones for family, patient and caregiver. The hospital adopted today’s standard in the 1990s by providing family member sleeping accommodations within the patient room. Built into every room is a generous, foldout couch, providing a family member with a comfortable single bed for an extended stay with views to the city.

Interior architectural heritage. The hospital moved from a richly textured, highly detailed interior environment to a more contemporary building. NMH elected to use the interiors of the new building to meld its heritage with an expression of timelessness into the interior architecture of the project.

Sustainable materials. As an early adopter, NMH insisted on natural and sustainable products. For instance, 75 percent of the flooring is naturally based linoleum, which cushions feet, is easily maintained and environmentally friendly. Major public areas have terrazzo, a durable, time-tested flooring product, ideal for high-traffic areas.

Daylight and wayfinding. NMH pioneered the use of daylight to enliven the patient experience. It places public circulation on the outside of the building, allowing for incredible views of the city at the lower levels and of Lake Michigan on the upper levels. Waiting rooms, elevators and other prime, public functions are organized along this pathway, providing warmth, wayfinding and daylight.

Art program. NMH committed early to the belief that art contributes to the healing mission of an academic medical center. It initiated a comprehensive art program, selecting landscape/pastoral works, and strategically placed art in public spaces where patients wait and in diagnostic areas where hours are spent.

Good neighbor. The hospital sits in a mixed-use, dense, downtown Chicago neighborhood. Working closely with the neighborhood association, NMH developed massing, exterior materials palettes and window fenestration sympathetic to its context and respectful of surrounding building view corridors.

True to its vision

NMH continues as the primary teaching hospital for Northwestern University's Feinberg School of Medicine. The building, conceived as a flexible facility, has evolved over time; yet, it holds to the primary design vision, brand and experiential qualities from 1999. Evolving qualities include:

Building organization. The NMH podium has provided conference and public services and circulation. Building upon the Patients First commitment and open campus philosophy, these offerings have expanded, transforming the public-side podium into a vibrant neighborhood retail hub.

Flexibility/adaptability. The two-block long, eight-story shared diagnostic and therapeutic podium effectively supports both inpatient beds of Feinberg and outpatient services of Galter, and enabled the Galter bed expansion project, which opened in 2011. Built to hospital standards, only minor modifications were required at Galter for the addition of 48 beds plus 12 observation beds, and the relocation of a 29-bed inpatient behavioral unit. There also is room for an additional expansion.

Adapting to emergency department (ED) volume increases, a 2010 renovation of the Feinberg mezzanine provided relief with additional treatment bays. Today, plans are underway to further expand the ED footprint on both the first and mezzanine levels, matching an innovative care-at-arrival delivery model on one and adding a clinical decision unit to the mezzanine.

Today, NMH has 62 operating rooms (ORs) in four locations. Beginning in 2012, NMH systematically began renovating and incorporating leading-edge technology in all its ORs that, ultimately, will make all ORs technologically linked across the Northwestern Medicine system.

Urban fit. Part of the third planned development in Chicago established by Northwestern University in 1914, NMH has continued to evolve and grow. Today, of the 12 million square feet on the medical campus, NMH controls more than 5 million. The front- and back-of-house circulation has proven its value: It has expanded beyond the hospital to interconnect a growing network of patient care, education and research buildings.

The hospital is working with the city to enhance the campus neighborhood, responding with consistent architecture, streetscape, signage and setbacks to give the campus a sense of place within the broader city context. 

Legacy Project Award jury:

David Allison (chair), FAIA, FACHA, alumni distinguished professor and director of graduate studies in architecture and health at Clemson (S.C.) University

Bill Hercules, FAIA, FACHA, president of WJH, Orlando, Fla., and member of the ACHA board of regents

Bill Karanian, AIA, ACHA, principal at the S/L/A/M Collaborative, Glastonbury, Conn.

Michael H. Covert, FACHE, president and CEO at Catholic Health Initiatives’ (CHI’s) St. Luke’s Health, Houston, and senior vice president of operations for CHI

Francis Pitts, FAIA, FACHA, OAA, founding partner and president of architecture+, Troy, N.Y.