Hospital Meets Hospitality

MEDCO, RTKL Help Bring New Shape, Functionality to Heart Hospital

By Lesley Hensell

The stereotypes that often define health-care construction are familiar to most anyone who has set foot inside a hospital. Boxy design, sterile finish-out and a generic look and feel dominate most of these structures, which tend to have an institutional aura.

But every phase of development at Texas Heart Hospital of the Southwest, from conception to design and construction, has defied the stereotypical formulae. Built adjacent to Baylor Regional Medical Center at Plano, the specialty cardiovascular hospital will span 180,000 sq. ft. over four floors and offer 68 beds. The $106 million venture is scheduled for completion in October, when it will offer cardiovascular outpatient, interventional and surgical services.

Perhaps most striking upon first glance is the facility's bow-tie shape and strong hospitality industry environment.

"The design is very sculptural in feel - definitely not boxy like typical hospital buildings," said John Castorina, principal for RTKL, the architect on the project. "Baylor tends to be conservative, and rightly so. So the design kind of freaked them out at the beginning."

But RTKL's design was unusual for more than just aesthetic reasons. The bow-tie shape helps traffic flow smoothly through the building, while also keeping hospital staff members close to every patient, Castorina said. This is key in a hospital where the larger-than-average patient rooms incorporate a junior suite design, enabling most care to be provided at the patient's bedside.

Unlike a typical hospital, where patients are wheeled from room to room for testing and procedures, the heart hospital offers universal beds.

"Patients will be admitted and recovered and discharged out of the same place, and each room has ICU capabilities," Castorina said. "They also have a guest area with a sofa that pulls into a bed, a 32-inch flat screen television and a desk with Internet access. For guests, it will be like a hotel environment."

The design also provides for public and private hallways so that patients prodded to exercise soon after surgery can walk in their own zone, away from the rush of hospital corridors.

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"We've made every part of the hospital patient-friendly, while looking at every angle to provide high-intensity care," said Mark Valentine, president of the hospital. "The internal corridor is so important, giving patients their own area in which to walk. The bow-tie design ensures that patients are never far from the services they need."

The bow-tie shape is created by radius curtain walls, as well as canted walls built at angles, said Jim McSweeney, senior project manager for MEDCO Construction, the general contractor on the project for owner Baylor Health Care System. These features pushed the project's structural engineers to perform at their highest levels, McSweeney said.

"The building is very different from what we've constructed in the past," he said. "It is complex, with odd angles and radius shapes. It really taxed our engineering abilities. It's been a challenge simply to get it laid out just right, with the various shapes and forms required by the drawings."

The unusual shapes also have created waterproofing issues, prompting MEDCO to bring in a consultant who specializes in waterproofing curtain-wall systems.

"It was an immense help to us to have a consultant look at both the original drawings, as well as the shop drawings prepared by the various trades," McSweeney said. "It will take a lot of tweaking on the design and attention to detail to keep the building watertight."

Water challenges also plagued the launch of the project. Construction began after MEDCO relocated a parking lot that sat on the building's footprint. When MEDCO began excavating for the foundation, the company found unstable ground - a surprise since the adjacent medical center had been placed directly on bedrock with no foundation challenges.

"Even though we are on the same parcel, the nature of the earth below is different," McSweeney said. "We found there was considerable water beneath us, and the ground was sandy. We had to case all of our foundation piers, which put a kink in some of our scheduling."

Next to the hospital stands a 300-vehicle parking garage. The structure features a hybrid design that incorporates precast columns, spandrel beams and wall panels, but has cast-in-place six-in. concrete elevated slabs rather than precast Ts.

"Precast is cost-efficient, yet precast garages tend to have a bad reputation," McSweeney said. "They have too many joints, so water gets into the connections, rusts the steel and causes leaking. A better and more durable garage over the long haul is cast-in-place, but that can get costly.

"The hybrid design is a mixture of both, with the emphasis on cast-in-place horizontal slabs for longevity," he added. "You pay a bit of a premium. But in the long run, it will be worth it."

Also at a premium are the building's finishes, which center around natural products. Eldorado stone and Texas limestone offer a feel of elegance and comfort, while terrazzo flooring helps visitors find their way throughout the building.

"When you walk in, you will fell like you are entering a hotel," Valentine said. "We'll have five-star amenities, including valet parking, concierge services and a Starbucks with Internet service. We want every patient to feel like they are being treated as a guest. And that all starts with the way the building appears to them at first glance."