Gig Harbor, Washington

In designing St. Anthony, a privately funded hospital in the wooded area outside Seattle, the architects at Zimmer Gunsul Frasca (ZGF) asked themselves, “What would you want to see in a five-star hotel?” says ZGF interior designer, Anita Rossen. The comparison of hospitals to hotels is not so off-base: Evidence-based design principles now influencing the architecture of health-care facilities have been taking cues from the hospitality industry [record, August 2009, page 73]. While the research has benefited from hotel studies focused on reducing stress among travelers, the motive of the hospitals is not to convince inhabitants to stay longer at the lodge. By trying to create a hotel-like atmosphere with single-bed rooms, ample views of the outdoors, indirect lighting, soft colors, and textured fabrics, health-care facilities such as St. Anthony are speeding recovery time and shortening the stay of their patients.

Certain hospital features cannot be forsaken entirely — for example, the extensive use of washable floors instead of carpeting. Nevertheless, by adhering to evidence-based design findings, St. Anthony can claim an average stay of 2.6 days for its patients.

 

Program

ZGF, based in Portland, Oregon, as well as Seattle, was hired when the client, the Franciscan Health System (FHS), felt it should venture into a remote wooded peninsula to provide medical care to a population of 120,000. The FHS acquired 38 acres to accommodate a 256,000-square-foot, full-service hospital with 80 beds. Adjoining it is the 93,000-square-foot Milgard Medical Pavilion, which also includes the Jane Thompson Russell Cancer Care Center. While FHS’s parent group, Catholic Health Initiatives, undertook the funding for the $371-per-square-foot construction cost of the hospital, a developer, Frauenshuh Healthcare Real Estate Solutions, built the $172-per-square-foot medical office building. Nestled against a slope, it is connected to the main hospital by an enclosed pedestrian bridge and retains much of the hospital’s noninstitutional architectural vocabulary.

Solution

In designing the architecture and interiors of the hospital, the notion of “a walk in the woods” became a conceptual reference point. When arriving at St. Anthony, visitors encounter natural materials — such as quartzite stone tiles combined with a boak-wood veneer that clads the exterior walls of the steel-framed structure.

The L-shaped hospital sits on a slope so that those entering the lobby find themselves on a shiplike mezzanine overlooking a sitting area 14 feet below, where a double-height window wall opens onto a healing garden. In the garden, local planting, sculpture, a pond, and an outdoor café offer additional interaction with the outdoors.

Inside, the architects thought of designing the various spaces to evoke natural features, such as a glade or a clearing in the woods by means of details, materials, and lighting. Certain elements intentionally allude to the fishing culture of Gig Harbor. “We decided against literal motifs such as netting or anchors,” says Allyn Stellmacher, ZGF design partner. Instead, ZGF opted for more abstract references, such as sail-shaped translucent glass canopies at the hospital’s entrance.

The inclusion of wood paneling, stone fireplaces, and paintings and sculptures by local artists in public areas adds to the residential quality and the regional tone of the spaces. On top of that, the architects sited the hospital to take advantage of sun angles in the changing seasons so that natural illumination via skylights and windows (including ones placed at the ends of corridors) could cut down on energy expenditure. Such light sources also help provide patients and visitors with a sense of orientation, avoiding the clutter of signs common to hospitals.

While the architects do make use of fluorescent lighting, they have sought to mitigate its glare and deathly green tinge through a mix of cove lighting and other forms of indirect illumination. Similarly, they cut away acoustical-tiled ceilings at the edges to create reveals for lighting, and in certain public places have hung wood-slat ceilings to filter the light and buffer the sound.

Because of cost, vinyl floors appear more often than the more durable, less potentially toxic rubber flooring. Although ZGF notes that vinyl may not win green points, the design incorporates other means of promoting a sustainable environment — for example, the storm-water catchment system, as well as a storm-water detention pond and filtration system. Even the pond in the healing garden makes use of recycled water. Other energy-saving measures include a HVAC heat-recovery system that recycles heat generated from equipment.

Commentary

With regard to Modern hospital design, Alvar Aalto’s Paimio Sanatorium (1933), in a forest in Finland, has long served as a design paradigm owing to its serenely spectral white volumes, interior spaces filled with daylight, and the integration of the building block with cantilevered outdoor balconies. St. Anthony shows a similar desire to connect to nature and make use of daylight, albeit without necessarily depending on Aalto’s clinically white (with splashes of color) surfaces. Interestingly, St. Anthony’s natural materials, rugged exterior surfaces, massing, outdoor stairs, and organization around a common space recalls the later, softer Modernism seen in Aalto’s Säynätsalo Town Hall (1952). The connections to both of these significant works explain why St. Anthony seems to bring together both the hygienic and the humane. Although it is not quite like a hotel (limited carpeting, no lamp shades, and too many metal machines), you might well want to stay more than average time of 2.6 days.

Total construction cost:
March 2009 (St. Anthony); December 2008 (Milgard Medical Pavilion)

Gross square footage:
256,000 square feet (St. Anthony); 93,000 square feet (Milgard Medical Pavilion)

Architect:
ZGF Architects LLP
925 Fourth Avenue
Suite 2400
Seattle, WA 98104
Phone: 206-623-9414
Fax: 206-623-7868
www.zgf.com

People

St. Anthony Hospital Owner: Franciscan Health System

Milgard Medical Pavilion Owner: Frauenshuh Healthcare Real Estate Solutions

Architect:
ZGF Architects LLP
925 Fourth Avenue
Suite 2400
Seattle, WA 98104
Phone: 206-623-9414
Fax: 206-623-7868
www.zgf.com

Personnel in architect's firm who should receive special credit:
Allyn Stellmacher, AIA, LEED AP, Design Partner
John Mess, AIA, LEED AP, Project Manager
Connie Holloway, AIA, LEED AP, Project Architect
James Harman, AIA, Healthcare Architect
Barbara Anderson, RN, MN, Medical Planner
Mark Gesinger, LEED AP, Design Team
Gordon Metzger, Design Team
Carlos Bres, LEED AP, Design Team
Craig Rizzo, Design Team
John Barton, Design Team
Brandon Choi, Design Team
Anita Rossen, Interior Designer
Andrea Bellon, Interior Designer
Julianna Mitchell, LEED AP, Interior Designer
Shelly Engels, LEED AP, Interior Designer
Dena Guiliani, IIDA, Associate AIA, Interior Designer
Christine Fournier, Interior Designer

Interior designer: ZGF Architects LLP

Engineer(s): (for St. Anthony Hospital)
Structural: PCS Structural Solutions

Mechanical: CDi Engineers

Electrical: Coffman Engineers

Civil: DOWL Engineers

Engineer(s): (for Milgard Medical Pavilion)
Structural: PCS Structural Solutions

Mechanical: ACCO Engineers

Electrical: DW Close Co.

Civil: DOWL Engineers

Consultant(s)
Landscape: SiteWorkshop

Other: Owners Representative: Hammes Co.

Other: Medical Equipment Planner: ZGF Architects LLP / Catholic Health Initiatives

Dietary: Edward Don & Company

General contractor: Sellen Construction

Photographer(s): Doug J. Scott; 360-422-5909

Renderer(s): ZGF Architects LLP

CAD system, project management, or other software used: AutoCad, Sketchup, 3D Studio Max

 

Products

Exterior cladding
Masonry: Terrazzo and Stone Supply
Metal/glass curtainwall framing: Kawneer
Concrete: Kitsap Ready Mix
Wood resin panel: Parklex
Concrete Block: Eastside Masonry Products
Metal Panel: Centria

Roofing
EPDM: Firestone

Metal: Centria

Windows
Aluminum: Kawneer

Glazing
Glass: Technical Glass Products, Hartung Glass Industries, Northwestern Industries

Structural Glazing:  United Reliance Engineering PTE LTD

Doors
Entrances: Nabco Entrances Inc

Metal doors: Steel Craft

Wood doors: VT Industries, Architectural Wood Doors
Fire-control doors, security grilles: Cornell (folding fire door), Cornell (Overhead fire door)

Special doors (sound control, X-ray, etc.): Nabco (ICU sliding doors)

Overhead roll down doors: Cornell

MRI Door: ETS Lingren

Hardware
Locksets: Corbin Russwin
 
Hinges: Architectural Control Systems Inc.(electrical hinges), McKinney, Rixson

Closers: Norton, LCN

Exit devices: Architectural Control Systems Inc., Corbin Russwin

Pulls: Corbin Russwin, Trimco

Security devices: HES, Rixson, Architectural Control SystemsInc.

Sliding door hardware:  Hager

Transitions: Pemco

Occupancy Indicators:  Tice Industries

Auto door operators:  Nabco

Cabinet hardware:  Richelieu

Interior finishes
Acoustical ceilings:
Armstrong
9-Wood

Suspension grid: Armstrong

Cabinetwork and custom woodwork: Beaubois Architectural Woodwork

Paints and stains:
Manufacturer: Kelly Moore

Wallcoverings:
Clinical Spaces: InPro Corporation
Clinical Spaces: Forbo
Kitchen: Marlite FRP

Paneling: Fabricator/Installer: Beaubois Architectural Woodwork

ChapelWood walls: 9 Wood

Resin Panels:
Lobby/Waiting, Dining/Cafe, Clinical Spaces: 3Form
Clinical Spaces: Lumicor

Column Wraps:
MOZ Designs (Lobby/Waiting)

Sculptural Panel:
Modular Arts (Lobby/Waiting)

Fabric Panels:
Knoll Textiles (Lobby/Waiting)

Plastic laminate:
Nevamar (Dining/Cafe, Clinical Spaces)
Wilsonart (Dining/Cafe, Lobby/Waiting, Clinical Spaces)
Formica (Dining/Cafe, Lobby/Waiting, Clinical Spaces)
Pionite (Public Restrooms)

Special surfacing:
Terrazzo: North American Terrazzo, Inc.
Floor and wall tile (cite where used):
Daltile (Clinical Spaces)
Ann Sacks (Public Restrooms)
Atlas Concord (Public Restrooms, Dining/Cafe)

Stone:
Petal Granite and Marble (Lobby/Waiting)
American Slate Company (Lobby/Waiting)

Window Film: 3M

Solid Surface:
Formica (Public/Waiting)
Avonite (Dining/Cafe, Public/Waiting)
DuPont Corian (Clinical Spaces, Public Restrooms)

Resilient flooring:
Installer: Rubenstein
Toli (sheet vinyl)
Johnsonite (sheet vinyl)
Mannington (VCT)
Permagrain (vinyl tile)
Nora Rubber (rubber flooring)
Resilient base & accessories: Johnsonite

Carpet: Shaw Contract

Carpet Tiles:
Shaw Contract
InterfaceFLOR Commercial

Interior Finishes Other:
Interior Window Treatments:
Fabricator/Installer: Pamela's Interiors, Castec

Cubicle Curtain:
Fabricator/Installer: Pamela's Interiors
Architex

Shower Curtain: Standard Textile

Furnishings
Office furniture:
Office desks: Mfg- Herman Miller; Product- Ethospace
Files and shelving: Mfg- Herman Miller, Product- Ethospace
Office seating: Mfg- Haworth, Product- Zody Task Chair; Mfg- Herman Miller, Product- Caper side chair

Reception furniture:
Fixed seating:
Fabricator/Installer: Beaubois Architectural Woodwork
Dining/Cafe: Loop textiles, Momentum Textiles
Clinical Spaces: Bernhardt, Sina Pearson Textiles
Public/Waiting: Arc Com, Architex, Maharam, Momentum Textiles

Chairs:
Conference Room Seating: Mfg- Stylex; Product- Zephyr
Staff Conference Rooms: Mfg- Allseating; Product- Inertia
Staff Lounges: Mfg- Brandrud, Product- Work Haven LoungeSeries; Mfg- Herman Miller, Product- Caper
Lounge Seating Mfg- Cabot Wrenn, Products- Tuscany, Lumos, Lisbon; Mfg- Carolina; Product- Retrospective; Mfg- National; Product- Eloquence; Mfg- Coalesse, Product- Passarelle
Cafeteria Seating: Mfg-Leland International, Product-Parfait II
Lobby Seating: (see above)
ED Waiting: Mfg- Nurture, Product Malibu too
Chapel Seating: Herman Miller
Benches (Lobby, Public Wait areas) Mfg- Bernhardt, Product-Laurel; Mfg- Cabot Wrenn, Product- Lumos II
Patient Guest Chair: Mfg- Geiger International, Product- Impromptu
Patient Extra Side Chair: Mfg- Cape Seating, Product- Bolsa
Patient Room Seating: Mfg- Nurture, Product- Malibu too
Nurse Seating: Mfg- Dauphin, Product- Adjust; Mfg- HermanMiller, Product- Aeron Stool; Mfg- Haworth, Product- Zody

Tables:
Conference tables: Mfg- Fixture’s Furniture, Product- Saturn
Cafeteria tables: Mfg- West Coast Industries
Staff area tables: Mfg- Fixtures Furniture, Product: Table

Upholstery:
Mfg- ArcCom, Patterns- Aria, Biltmore, Illusion, Kalahari, Palatine, Topiary, Vibe
Mfg- Architex, Patterns- Delight, Hazel, Kassel, Pique, Sprinkle, Tegan
Mfg- HBF, Patterns- Boucle Check, Wiggle Room
Mfg- Knoll, Patterns- Abacus, Coco, Fibra, Regard
Mfg- Loop, Patterns- Alpina, Cyprus
Mfg- Maharam, Patterns- Design, Sudden, Venn
Mfg- Momentum, Patterns- Boom, Lustre
Mfg- Pollack, Pattern- Software
Mfg- Unika Vaev, Pattern- Straight Arrow

Other furniture (use additional sheet if necessary):
Patient Room Family “Guest Center”: Mfg- Brandrud, Product- Revive
Guest Side Chairs: Mfg- Nurture, Product- Switch; Mfg- Cabot Wrenn, Product- Tuscany
Occasional Tables: Mfg- Cabot Wrenn, Products- Interval, Lumos; Mfg- Carolina, Product- Retrospective
Mfg- Nurture, Product- Malibu too
Lectern: Mfg- Egan
Exterior Table & Chairs: Mfg- Landscape Forms, Product- Wellspring

Lighting
Interior ambient lighting: FocalPoint, Louis Poulsen, Portfolio, Techlighting, Bruck, Corelite, Lumiere, Con-Tech, Belfer, Hessamerica
Downlights: Portfolio, Spectrum, Wila, Halo
Task lighting: Prudential, Metalux, RSA Lighting, Zumtobel, ETS Lingren, Nulite, Vode
Exterior: Lumiere, Bega, Quattro, Lumec, Winonaled, Ametrix,
Emergency lighting:  Sure-Lites
Surgical Lights:  Skytron

Conveyance
Elevators/Escalators: Schindler (elevator)

Plumbing:
Sinks:  Kohler, Eljer, American Standard, Elkay
Faucets:  Chicago Faucets
Flush Valvues:  Sloan
Water Closet:  American Standard
Mop Sinks:  Fiat Model
Shower:  Symmons
Drinking Fountain:  Haws

Add any additional building components or special equipment that made a significant contribution to this project:
MRI: Toshiba
CT: Toshiba
R&F: Toshiba
Ultrasound: Toshiba
Nuc Med: Philips
Patient Monitoring: Philips
Patient Beds: Stryker
Linear Accelerator: Varian
CT Simulator: Toshiba
Morgue: Mopec
Chemistry and Hematology: Beckman Coulter
Central Sterile: Steris
ICU Booms: Steris
Surgical Integration: Skytron