Tech SavvySilicon Valley hospital embraces its environment

Article by Amy Eagle • Photography by Michael O’Callahan

Revised state seismic regulations prompted the constructionof a technologically advanced replacement facility at ElCamino Hospital, Mountain View, Calif., which is designed

to support patients and families, create operational efficiencies andadapt to future needs. The new building can withstand earthquakesand earth-shaking changes to clinical or operational practices.

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The urgent care area of El Camino Hospital’s emergencydepartment denotes comfortable efficiency.

PROJECT OVERVIEWPROJECT NAME El Camino

Hospital replacement facilityLOCATION Mountain View, Calif.TOTAL FLOOR AREA

469,304 square feetNUMBER OF FLOORS 5NUMBER OF BEDS 231PROJECT COST $480 millionCONSTRUCTION COST

$262 millionGROUNDBREAKING DATE

May 2006OPENING DATE

November 2009

PROJECT TEAMOWNER El Camino HospitalARCHITECT KMD ArchitectsGENERAL CONTRACTOR

Rudolph and Sletten Inc.INTERIOR DESIGNER

Millican JonesINTERIOR DESIGN CONSULTANT

K2A Architecture + Interiors MEP ENGINEERING Mazzetti

Nash Lipsey Burch (M+NLB)STRUCTURAL ENGINEERING

Thornton TomasettiMEDICAL EQUIPMENT PLAN-

NING RTKL Associates Inc.LANDSCAPING

Design + Planning at AECOM(formerly EDAW)

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not have to be widened toaccommodate the deliveryrobots, a welcome changefrom just a few years agowhen code officials consultedby KMD indicated this type ofequipment would require aseparate path marked offbeyond the standard corridorclearance. Matthew attributesthis to advances in technologyand the public’s comfort withit. According to Ken King, thehospital’s chief administrativeservices officer, patients nowexpect the same technologicalinfrastructure they have athome, at work and at theirlocal coffeehouse.

Accommodating changeTo create an environment inwhich technology and innova-tion will continue to thrive,the project team worked todesign a building that canaccommodate future change.They explored a number of

structural alternatives withengineers from the San Francis-co Bay area offices of ThorntonTomasetti. The decision to usea moment frame system ratherthan a braced frame gives thehospital open bays that can bemodified more easily. A braced frame has a lower

first cost, but King says themoment frame will pay for

Digital displays conveyhospital’s message

El Camino Hospital uses an integrated digital communica-tions platform with electronic art, messaging, wayfindingand scheduling systems that work together to engage,

soothe and inform patients, visitors and staff.Electronic artist Charles Woodman’s “American Diorama” is

installed in the surgical waiting room and the critical care unitfamily respite area. This 45-minute audio-video presentation syn-chronizes images and sounds from across the United States,from Cape Cod to California, across five screens. With its artistryand measured pace, the piece is meant as a calming diversionfor people in these two high-stress areas of the hospital.

Between each 45-minute presentation, the hospital may broad-cast its own videos of announcements, events or physicians dis-cussing their latest research.

This type of messaging is also incorporated into the digital art-work system by Roundtree Visuals, Emeryville, Calif., built intothe hospital’s public elevator lobbies. These pieces featurenature images and inspirational quotes that hospital staffers canenter into a central control panel and schedule to appearthroughout the day. They may also add announcements and mar-keting or branding messages.

The reams of paper tacked on public and staff bulletin boardshave been consolidated on digital billboards—five for communityannouncements, one for human resources and education mes-sages and one for donor and volunteer recognition. These serve tocelebrate accomplishments, inform people about upcoming eventsand educate themon health and hospi-tal-related issues.

The digitalwayfinding kioskshave interactive,three-dimensionalmapping animation.They are linked tothe hospital’sscheduling systemfor instant updatesof meeting, classand event timesand locations.

A digital displaynext to each meet-ing room in the hos-pital’s conferencecenter lists all activi-ties taking place inthat room during theday. These, too, arecentrally controlledand can be updatedautomatically.

From art to infor-mation, the entiresystem is designedto communicate thehospital’s messageclearly and beauti-fully. �

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TOP A surgery waiting area on the secondfloor features “American Diorama,” a 45-minute digital art piece.

BOTTOM A digital nature wall display inthe third-floor elevator lobby, which fea-tures a view to the roof bamboo garden.

Supportive environmentKMD Architects, San Francisco,designed the low-profile facilitywith a gently curved front that“reaches out to the communi-ty,” says Nancy Jones, designdirector with Novato, Calif.,interior planning and designfirm Millican Jones.The exterior curve is echoed

in the main lobby’s ceiling andflooring patterns. Curves andelongated arcs throughout thebuilding — down corridors, inarchitectural gestures abovenurse stations, along the top ofpatient room casework — com-pose a repeating melody andcountermelody in the design,

says Jamie Millican, IIDA, CID,Associate AIA, principal, Millican Jones.In the main lobby, a two-

story glass wall showcases acourtyard garden, one of sev-eral gardens included in thedesign. Stretched fabric ceilingforms and high-impact, wash-able, fabric-wrapped acousti-cal panels along the walls helpmaintain a quiet environmentin the open public space.A concourse leads to the

existing hospital, which hasbeen renovated for outpatientand support services thatrequire a lower seismic per-formance rating than that

needed for acute care. Retailspaces along the concoursehave window displays, ratherthan open storefronts, to cre-ate a more elegant backdropfor the garden and simplifywayfinding. “We deliberatelylimited the exposure to visualnoise” that might unduly dis-tract patients or visitors, saysMillican.

Technology and innovationEl Camino Hospital bills itselfas “The Hospital of Silicon Val-ley,” and Popular Science mag-azine dubbed it the “mostadvanced facility ever.” Auto-mated robots deliver supplies

in the building, patients canregister using biometric scan-ners, and patient beds in thecritical care environments cantranslate common hospitalphrases (such as “What is yourpain level?”) into 24 languages,among many other sophisticat-ed clinical and communicationsystems in use at the hospital.Rob Matthew, AIA, LEED

AP, EDAC, principal and direc-tor for health care facilities,KMD, says the hospital’s high-tech equipment andoperations were integratedinto the building design with-out compromising the layout.For example, the corridors did

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COMING UP GREEN

A two-story gardenlounge on the

ground-floor con-course adds a touchof nature to thehigh-tech patientcare environment.

Nature enhances pa tient and staff comfort

Connecting the inside and outside world was akeynote of the design of El Camino Hospital,according to Rob Matthew, AIA, LEED AP, EDAC,

principal and director for health care facilities, KMD.“When you are in an environment in which people may

be in a state of anxiety, being able to have respite areas,views to natural settings and the ability to focus some dis-tance away, rather than being in an enclosed environment,is really important. Not just for patients but for staff, sothey can collect themselves,” he says.

The hospital has been described as “the perfect blendof technology and comfort,” says Ken King, chief adminis-trative services officer, El Camino Hospital. The facility islocated on a 41-acre parklike site with views of the SantaCruz mountains, the city of San Jose and nearby foothills.The site has over 1,300 trees, 300 of which were addedduring the hospital’s construction. Thirty heritage treeswere relocated on-site in the course of the project. Park-ing areas are tucked in among the trees.

A courtyard garden is the focal point of the main lobbyand concourse; this garden is accessible at ground level offthe hospital’s dining area. A terrace garden and meditationgarden are also available to patients, visitors and staff.

Another courtyard garden serves as a visual bufferbetween patient units. This garden is designed to helppeople relax as they enter the units; it also provides awayfinding cue.

Where a direct connection to nature was not possible, the designers emulated one. In thehospital’s below-grade dining room,stylized nature scenes on glass pan-els by Cheryl Gordon of K2A Archi-tecture + Interiors, San Francisco,are backlit with a gradually brighten-ing sunrise effect that repeatsroughly every 20 minutes. As JamieMillican of interior planning anddesign firm Millican Jones explains,“It’s a gesture of hope.” �

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SPEC SHEETPRINCIPAL DESIGN MATERIALS Carpet:Bentley Prince Street Inc. and MohawkIndustries Carpet tile: Mohawk Industriesand Tandus Group Inc. Ceiling: ArmstrongWorld Industries Inc., Decoustics and USGCorp. Curtainwall framing: Walters & WolfInc. Door hardware: Assa Abloy, Door Controls International Inc., Overhead DoorCorp.’s Horton Automatics div. and YaleSecurity Inc. Doors: VT Industries Inc.Flooring: Altro Floors, American TerrazzoCo., Concept Surfaces, Forbo Flooring Sys-tems, Mondo, nora systems Inc., SolnhofenStone Group and Tarkett Glass: GlasPro,Pulp Studio Inc. and Skyline Design Light-ing: Acuity Brands Inc., Arch Lighting GroupInc.’s Architectural Lighting Systems, BelferGroup, Birchwood Lighting Inc., Boyd Light-ing, Cooper Industries Inc., Delray LightingInc., Eurolight, Focal Point, Kirlin Co., Leucos and Philips Group Paint: BenjaminMoore & Co., Dunn-Edwards Corp., ImperialChemical Industries and Kelly-Moore PaintCo. Plumbing accessories: BobrickPlumbing fixtures: Danfoss, Delfield Co.and Zurn Industries Resin panels: 3formInc. Signage: Hackley Architectural Signage Tile: Apavisa Porcelanico, CaesarCeramics USA Inc., Casa dolce casa,Ceramica Cisa, Crossville Inc., Daltile, Emilceramica and Impronta Italgraniti USAInc. Wall coverings: Carnegie, SteelcaseInc.’s Designtex, JM Lynne, Knoll Inc., MDCWallcoverings, Maharam, Maya RomanoffCorp., Omnova Solutions Inc., RJF Inter -national Corp. and Wolf-Gordon Windowtreatments: MechoShade Systems Inc.PRINCIPAL FURNISHINGS Cafeteria seating:Design Within Reach Cafeteria tables:West Coast Industries Inc. Casework:Mid Canada Millwork and Mission Bell Mfg.Conference tables: Bretford Inc., Coalesse,Herman Miller Inc. and Nevins Criticalcare patient beds: Stryker Files and shelving: Bretford Inc. and Herman MillerInc. Lounge seating: Coalesse, Cumber-land Furniture, Geiger International Inc.,Krug, Martin Brattrud and Patrician Officedesks: Geiger International Inc. and Her-man Miller Inc. Office seating: AllsteelInc., Herman Miller Inc. and HumanscalePatient beds: Hill-Rom Patient over-bedtables: Nurture by Steelcase Patient roomseating: Brandrud, JSJ Furniture Corp. andWieland Patient room message boards(custom): Peter Pepper Products Inc.Woodworking: Mission Bell Mfg. MAJORMEDICAL EQUIPMENT Magnetic resonanceimaging, computed tomography andpositron emission tomography-computedtomography scanners: Siemens Corp.Nurse call: Rauland-Borg interfaced withVocera Communications Inc. Operatingroom booms: Getinge Group and StrykerPatient lifts: Getinge Group INFRASTRUCTUREAir-handling units: Huntair Building manage -ment system, fire safety and security:Siemens Corp. Chillers: Ingersoll RandElectrical equipment: Schneider ElectricElevators: Otis Elevator Co. Generator:Caterpillar Kitchen equipment: GarlandGroup, Gaylord Industries, Hobart, VictoryRefrigeration and Wells Bloomfield Palmscanners: Fujitsu

Information provided by El Camino Hospital andKMD Architects

itself in the first 10 years ofreplacement equipment proj-ects. “Having that flexibility inthe building makes it lessexpensive … to do the reno -vations and remodels that youare inevitably doing becauseof technology and obsoles-cence,” he says.To make updates even easi-

er, the hospital’s operatingrooms and special procedurerooms are designed as “plug-and-play” environments thatcan be taken off the hospitalgrid for renovation. “Thegasses, the power, the air systems, the communicationsystems — everything in theroom can be shut down with-out impacting the room nextto it or any other room,” says

Matthew, who credits the MEPengineering work of MazzettiNash Lipsey Burch (M+NLB),San Francisco, and the com-mitment of hospital leaders.

Efficiency and flexibilityThe hospital also wasdesigned with a number ofoperational efficiencies toleverage the capital invest-ment in the new building.Inpatient and outpatient

radiology are consolidated,with separate entries and cir-culation routes for emergency,inpatient and outpatient care.This design saves on theduplication of space, equip-ment and highly-trained staff.The patient units are bridged

by a number of patient rooms

that can be served from nursestations in either of the connect-ed units, allowing the size of aunit to flex. Distributed supportspaces reduce walking distancesfor nurses. Walking distancesalso were reduced by placingthe patient bathrooms along theoutboard wall of the units. “Youdon’t have that vestibule to walkpast, six or seven feet or so eachtime, coming and going,”Matthew explains. This layout also improves

visibility into the patientrooms from the decentralizednurse stations. These are

located across the corridorfrom the patient rooms tokeep patient information frombeing visible over nurses’shoulders and to enable nurses to face the corridor asthey work, rather than turntheir backs to it. “There’s aninnate level of anxiety whenstrangers are behind yourback,” says Matthew.Even the public spaces of the

hospital are designed for flexi-ble use. A labyrinth is workedinto the lobby floor pattern tobe used for walking meditationin the evening or at night. The

demonstration kitchen adjacentto the hospital dining area canbe closed off to create a privatedining room.

Significant accomplishmentKing calls the new facility ElCamino Hospital’s “most sig-nificant accomplishment sincethe original opening in 1961.”The forward-thinking design ismade to serve the communityfor years to come, whateverthe years may bring. HFM

Amy Eagle is a freelance writer

based in Homewood, Ill., who spe-

cializes in health care-

related topics. She is

a regular contributor

to Health Facilities

Management.

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CRITICAL COMFORT

The seriousness ofthe hospital’s criti-cal care patientrooms do not

detract from theirhomelike touches

and attractive views.

FINDING THE WAY

The first floor mainconcourse features

a labyrinth-patterned marblefloor and infor -mation desks.

ABOVE A ground-level garden court-yard and respitearea brings visi-tors in touch withnatural elements.

BELOW A third-floorgreeter desk in the corridor to thecritical care unitprovides a view of the courtyard.