A typical hospital is an assault on the senses, says Mackenzie Skene, a partner in the Seattle office of architecture firm NBBJ. Hospitals are noisy and chaotic. When designing the new University Medical Center New Orleans (UMC) with local firm Blitch/Knevel Architects, Skene says, team members constantly asked themselves, “Does it have to be that way?” So, instead of visual cacophony, the first thing a visitor or patient will notice when entering the 42-foot-high, daylight-filled lobby, with its gleaming white terrazzo floors and public art, is aesthetic calm.
This hushed environment is all the more remarkable considering that the medical center, with 446 beds—almost all in private rooms—and 19 state-of-the-art operating rooms, is the successor to the state-owned Charity Hospital, which cared primarily for the poor and uninsured. After Hurricane Katrina—when Charity’s basement flooded, and staff and patients were stranded there without power or supplies—the imposing Art Deco structure at the edge of the Central Business District was shuttered. Some say it was closed unnecessarily, but others contend that the almost 80-year-old building—which had outdated equipment and open wards with as many as 10 beds to a room—was long overdue for replacement, even before the devastating 2005 storm.
The new $1.1 billion facility opened last August and serves as the region’s only level-one trauma center. It was built largely with funds from the Federal Emergency Management Agency and the State of Louisiana, and it sits about half a mile from the still-vacant Charity in an expanding medical district in the Mid-City neighborhood. Though owned by the state, UMC is run by a private nonprofit operator. And to make the finances balance out, the facility will need to attract privately insured patients. But officials insist that the institution’s goals are unchanged. “Our mission remains the same—to serve all patients,” says Peter DeBlieux, UMC’s chief medical officer. The architectural challenge, says Skene, was to make everyone feel welcome, regardless of their ability to pay.
To do so, the design team arranged UMC’s programmatic elements into five- and six-story blocks, reducing the massing of the undeniably large 1.6 million-square-foot complex. Its most public face is oriented toward Canal Street—one of the city’s major boulevards—where three L-shaped volumes contain patient rooms. Beyond is a diagnostic and treatment building, which houses operating rooms, the emergency department, imaging, and laboratories. And attached to this, through the glass-enclosed entry pavilion, is an outpatient clinic.
The facades are highly articulated, to give them texture as well as scale. Tall and narrow precast concrete panels clad the patient-room towers and the diagnostic and treatment building, some of which have pronounced aggregate, while others are smooth. One edge of each panel is slightly thicker, producing a subtle play of light and shadow. The windows between the panels, whose positions shift from floor to floor to create a syncopated rhythm, incorporate several types of shading devices, including mesh, vertical fins, and a horizontal frit.
Plazas and gardens with water features, tall grasses, and bamboo, interspersed among all the programmatic components, act as the connective tissue for the complex. Inside, spaces are arranged to take full advantage of these outdoor environments, which are reminiscent of the famous courtyards found throughout the city of New Orleans, says Jose Sama, NBBJ’s lead designer on the project. Accordingly, the architects placed the conference facilities, which help further UMC’s role as a teaching hospital, at the base of the diagnostic and treatment building so that receptions and other events can spill outside when the weather permits. The patient rooms, as well as some treatment areas, have views of the gardens and plazas, further taking advantage of the therapeutic benefits of these outdoor oases.
Other patient-room features are becoming the new normal in hospitals: a sofa that converts to a cot for family members; several types of electric illumination for ambient, task, and exam lighting; and draperies and perforated roller blinds that can be adjusted to control the views and the sunlight. In one departure from current health-care trends, designers opted not to hide the connections and mounting plates for monitors, call lights, and other equipment that typically accumulate on the wall behind the bed. Instead, designers have managed these elements by arranging them on plastic-laminated panels that include an abstracted pattern inspired by the ironwork balustrades commonly seen throughout New Orleans.
Elsewhere in the complex, surface treatments unusual for health-care environments include corners protected with a highly impact-resistant material made of paper and resin stained a warm walnut brown and typically used for countertops. The terrazzo floor found in the lobby extends to all public spaces, and even some back-of-house corridors where gurney traffic is expected to be heavy. These were chosen, says Janet Dugan, NBBJ’s lead for the project’s interiors, for their durability. But their effect is a pleasing contrast to the antiseptic finishes of most hospitals.
Features that are less apparent but nonetheless critical address disaster mitigation. The UMC complex is configured so that all facilities essential to patient care are located on the second floor or higher, at least 21 feet above base flood elevation. The ambulance ramp can be accessed by boat if the surrounding streets are inundated. The glazing should survive hurricane-force winds and the impact of air-borne debris. In addition, the emergency power and other building systems are designed so that the medical center can operate for up to a week without outside support or supplies. The complex is considered so robust that DeBlieux worries about having the safest building in the city. If it becomes a destination for those seeking shelter in an emergency, he says, “we will be struggling to care for the people we need to.”
How the medical center will perform in an emergency naturally occupies New Orleanians’ minds. But other metrics will indicate UMC’s success, including the facility’s day-to-day operations and how well it balances its commitment to the poor and uninsured with its need to attract the more affluent. Since it has only been open a year, it may be too soon to say. But it is clear that the hospital’s physical environment matches the high level of care its staff aspires to provide all its patients.
NBBJ — Mackenzie Skene, partner in charge;
Jose Sama, Janet Dugan, Eric Hanson, principals;
Dave Owsiany, senior associate
Blitch/Knevel Architects — Ronald Blitch, Ken Knevel, partners; Marty Tovrea
AECOM (structural, m/e/p, civil),
Torre Design Consortium (landscape)
Skanska-MAPP Joint Venture
State of Louisiana
1.6 million square feet
Gate Precast, Jackson Precast
Soprema, Johns Manville
Arborite, Abet Laminati, Formica, Treefrog, Wilsonart