Facility of the Month May/June 2009 – Listening & Learning

When it came time for Children’s Hospital of Pittsburgh of UPMC to upgrade its facilities, planners set out with one core goal in mind: improve the experience of everyone who sets foot inside.


After more than a decade of master plans, revisions and all-too-common funding snafus, the new CHP rose like a phoenix from its demolished former self and opened to the public on May 2. In the end, 30 percent of the old complex was kept intact, but much of the original building was leveled during construction of the a new $293.6 million building.


“The initiative to look into a new building design actually lead to a paradigm shift for the owner,” says Tim Powers, senior vice president of healthcare at Astorino architectural firm’s Pittsburgh, Pa. office. “The possibility of a new building created the opportunity to build a new model.”







CHILDREN HOSPITAL OF
PITTSBURGH OF UPMC


Construction Cost: $293.6 million
Building Area: 1 million square feet
Land Area: 3 acres
Patient rooms: 296 licensed beds including 41-bed emergency room and trauma center, 36-bed pediatric intensive care unit, 12-bed cardiac intensive care unit and 31-bed neonatal intensive care unit.


• Nine floors of inpatient and outpatient care areas
• Private rooms with overnight accommodations for parents
• 20,000-square-foot family resource and activity center
• 13 Operating Suites, including six equipped with leading-edge minimally invasive equipment
• Nursing workstation for every two patient rooms in addition to computer and communications equipment that enhances efficient communication within teams of caregivers
• Paperless information management system that allows physicians to place nearly all inpatient care orders electronically, eliminating handwritten and verbal orders

Once UPMC committed to building a new facility, it embarked on a plan to improve medical delivery while creating a new identity based on feedback from constituents who use the facility.


“In essence, the main problem that we had to solve was that children’s hospital was always associated with a larger, conglomerate hospital UPMC,” Powers says. “Children’s hospital didn’t have an identity.”


Shaping Identity


CHP is anything but lacking identity now. The 1 million square-foot complex spans three acres and has 296 patient rooms. Friendly, warm colors are featured inside and out, and improvements were based on in-depth research with patients, family and staff.


There’s colorful movable furniture in the waiting room, along with artwork, a fish tank, toys and games. A family town square houses a two-story movie screen where kids can watch educational and entertainment programs with loved ones. Even the cafeteria screams fun with a carnival theme.


To determine the ideal identity for the new hospital, Astorino tapped Fathom, an in-house affiliate research firm, to conduct one-on-one interviews with patients, families, nursing staff, doctors, administrators and others.


Conclusions drawn from fathom’s research led planners to look at the hospital as a community that fosters healing.


“That entire community exists for the sole purpose of helping sick people,” Powers says. “We need to care for the staff because if they become run down, dismayed or disaffected that would lead directly to the care of the patients.”


Color stood out as one of the most important factors for patients. Interviews with patients lead the fathom team toward more sophisticated colors, instead of traditional healthcare tones.








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Transformation was another overarching theme that Fathom pulled from its research, and designers worked to implement that concept in a meaningful way.


One of the hospital’s main corridors has a long mural with a dynamic array of colors representing the four seasons — symbolism for the changes children and families will go through during the healing process.


Control, connection and energy were other reoccurring themes revealed during Fathom’s research process.


In the old building, shared patient rooms made it impossible for children to control their room environment. The hospital is now composed entirely of single-patient rooms that offer several opportunities for patients to adjust the environment to suit their needs. Fold-out beds are also stored in most patient rooms to give parents a more convenient way to stay the night, if they choose to.


“From the parking lots to the spacious, private patient rooms, each and every aspect of the hospital is designed to improve the healing environment and to make patients and their families as comfortable as possible during their stay,” says Eric D. Hess, vice president and project executive of CHP. “Behind the scenes, we’ve achieved an unmatched level of digitalization including a fully-integrated electronic health record that dramatically improves patient care and safety.”


Community Connection


Perhaps the most unique aspect of the building is the patient atrium, an area on the sixth floor that leads to an outdoor healing garden that separates people from the hustle and bustle of the main lobby.


Patient rooms surround the 4,000-square-foot atrium and healing garden so even those children who can’t get outside can still see this healing space from their room.


“This sixth floor patient atrium area almost became a town square for them,” Astorino says. 


Most hospitals want the lobby to be the grand expression of who they are, Powers says, but CHP decided to scale back on that area because it thought the atrium would mean more to its patients, families and staff.


“We believe that architecture has the capacity to be an element in the healing process,” Powers says. “The building is not secondary to the healing process. It actually can promote healing if it’s done effectively.”


With that frame of mind, Astorino designed the facility with many ways to access the outdoors.


“We wanted you to have an outward look and understand that there are other people in this community who care for you,” Powers says. “The whole building was designed to foster those relationships.”


A Personal Experience


Looking back on the project, Powers says it will take a few years before he’s able to look at the building with unbiased eyes.


“Actually, being an architect ruins your experience in life,” he says. “I’ll walk into a building and see all the things that went wrong. All I do is look at all the mistakes.”







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However, Powers says when he is able to look at CHP without a critical eye, he is sure he will realize the magnitude of the 12 years of work that he put into the project.


“We did it right,” Powers says. “We’re all really proud of this thing. I think this is the proudest achievement of my life. I actually think I’m living through the highlight of my life.”


Indeed, many went down a long road to get to this point. CHP’s CEO Roger Oxendale, who guided plans for the construction of the new hospital, resigned just one month after the hospital’s opening. Oxendale’s departure was a long time coming; he determined some time ago that he would step down once the hospital opened.

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