Sailing into the future

Project specs
Project Jersey Shore University Medical Center
Location Neptune, N.J.
Total floor area  433,400 square feet
Number of floors   3
Number of beds  108
Construction cost $238 million
Project cost $300 million
Groundbreaking May 2006
Opening date  July 2009

Team Members
Owner   Meridian Health
Architect and Interior Designer  WHR Architects
General Contractor L.F. Driscoll Co.
MEP Engineering   PWI Engineering
Civil Engineering  Dewberry-Goodkind Inc.
Structural Engineering  Birdsall Services Group
Medical Equipment Planning   Genesis Planning
Landscaping   Melillo + Bauer Associates
LEED and Sustainability Consulting   The Sheward Partnership

The renovation and expansion of Jersey Shore University Medical Center (JSUMC), Neptune, N.J., is intended to transform patient care at the facility and help set the hospital's future course.

Thus far, it's a sound one. The 433,400-square-foot, $300 million, Leadership in Energy and Environmental Design (LEED) Gold-certified facility opened July 2009, nearly $4 million under budget and six months ahead of schedule.

Design inspiration

Early in the design process, while watching the wind fill sails to guide boats along the local shoreline, the project's lead designer recognized a powerful symbol for the health care facility. Tushar Gupta, AIA, NCARB, principal, WHR Architects, Houston, says the metaphor of a sail impacted the evolution of the building's architecture. A sail is represented in the swirling, stylized design of the hospital atrium.

The medical center's exterior palette of brick and metal panels integrates the building with existing campus structures, while the atrium provides a new, forward-thinking aesthetic. The coastal imagery continues in the main lobby and adjacent public concourse, with ceiling material evocative of wood planking; flooring that subtly represents sand, shore and water; and retail space aligned along one side of the concourse to suggest a boardwalk atmosphere.

The entire building's interior design takes its themes from the area's four major natural elements—the shore, the water, the garden and the sky. "We tried to find materials that replicated textures and elements that you would find within each theme," says Sherri Shafiei, IIDA, associate and interior designer, WHR. Textured wall panels were installed to indicate aspects of each of these elements, such as the horizontal sky, falling water, moving sand and growing plants. Gail Sterling, FIIDA, AAHID, principal and senior designer, WHR, says the panels helped give dif­ferent spaces interest and identity without exceeding the project's art budget.

Nursing neighborhoods

On each patient floor, a large picture of a different local scene is installed at the elevator lobby, providing a memorable wayfinding aid. Floor-to-ceiling windows at the end of each corridor also lend visual cues for locating oneself in the building, as well as natural light to enhance the fresh feel of the interior color palette, which is based on soft white and sand tones. Raised ceilings and indirect lighting at the nurses' stations break up the length of each corridor.

The patient units were developed with regard for the needs of aging nurses and patients. As the baby boomer generation ages, "The acuity level … is going higher and higher," says Gupta. "So while we're designing a medical-surgical unit, we're almost leaning toward attributes of a step-down or critical care unit."

There are 36 beds on each floor, divided into three groups, or neighborhoods, of 12. Four of the 12 rooms in each neighborhood were designed for higher acuity patients. Each neighborhood is supported by a hybrid nurses' station system that includes a central nurses' station and four decentralized charting areas, two on each side. The central station gives nurses space for collaboration, communication and social interactions, while the charting areas enable them to work close to patient bedsides.

To minimize walking distances, each neighborhood has its own supply space, medication station and staff break area.

The rooms were built with a nested toilet configuration, with the patient bathrooms located next to one another between every two rooms. This design gives nurses at the central station clear sight lines into eight of the 12 rooms in a neighborhood, through windows built into the patient room doors.

The nested toilet layout also allowed for the inclusion of wall-to-wall windows in the patient rooms. This creates a more soothing environment for patients and their families. Staff also benefit from the natural light that filters into the unit from the patient rooms, through the glass in the pa­tient room doors.

The neighborhoods are differentiated in the interior design with aqua, green and blue accent colors related to the themes of the water, garden and sky, respectively.

Tested design

The corridors of the patient units are carpeted to help control noise. Caregivers tested the carpet—and the rest of the units' interior design—in an existing unit at JSUMC. On the test unit, doctors and nurses expressed a preference for clear glass in the patient room doors, for better visibility than the textured glass used in the original design. Because the clear glass did not bother patients, the design was changed accordingly.

Construction mock-ups also yielded important design information. The location of the hand-washing sink in the patient room was based on research indicating hand-washing compliance increases when the sink is placed in the path of the caregiver; this design was tested and approved by JSUMC staff in the mocked-up patient room.

As a member of the Center for Health Design's Pebble Project, JSUMC will continue to test and report aspects of the design, such as the effects of decentralization in the
nursing neighborhood on interdisciplinary communication patterns, quality of care and patient safety.

Just before the new hospital opened, 100 departmental managers and hospital administrators, including JSUMC president Steve Littleson, spent the night in patient rooms to evaluate the design from a patient's perspective. The next morning, Littleson says, "My overall thought was we deserved to feel really good about what we did."

Patients seem to agree. JSUMC admission volume is up 8 percent this year. The building "has changed the complexion of our campus completely," says Littleson.

Amy Eagle is a Homewood, Ill.-based freelance writer and a regular contributor to Health Facilities Management.