Sharing is caring, or so the saying goes, but how well can sharing work when there aren’t enough resources—in particular, space—to go around? This was the dilemma faced by two existing Tacoma, Wash.-based hospitals that shared the MultiCare Medical Center campus. Mary Bridge Children’s Hospital and Tacoma General Hospital both had grown to a point where their emergency departments were handling double their anticipated service capacity, and something had to change.
GBJ Architecture’s design team was commissioned to design a solution for the pair of healthcare providers that would create an easily identifiable “front door” for the emergency complex, with bright and spacious interiors, but one that still could properly separate the children and adult sections of the hospital. The new facility would need direct connections to related hospital functions—such as imaging, surgery, and public circulation—to enhance circulation, as well as spacious and flexible patient care areas to better accommodate visiting families, equipment, and staff.
According to Kim Ritter, associate designer for GBJ Architecture, finding a solution that merged both hospitals’ identities was a challenge. “The project site is tightly constrained by topography, existing campus buildings, and infrastructure. The project needed to connect disparate parts into a revitalized whole across three stories of grade differential and create a positive and recognizable identity for the hospital.”
The final design was realized in a two-prong pavilion structure: a second level plaza at the south end of the site and a two-story emergency department that borders with the existing structure. As such, the new Emergency and Express Care Center at the Milgard Pavilion expanded the existing ambulance drive and offered a new patient entry, complete with waiting space and improved patient/public access. “This reordering of connection and flow extends through the new project with a coherent, carefully crafted sequence of spaces, and transforms the patients’ experience of the hospital,” Ritter says.
The Pavilion features 77 exam and treatment rooms on two floors. The children’s and adult wings run parallel in design, separated by waiting, exam, and treatment rooms along the main circulation spine that also houses a shared triage center and support spaces. To help eliminate crowding and long wait times, separate entries were created to separate walk-in patients from those arriving via ambulance; this also serves to help staff more efficiently sort patient care by level of priority, those needing immediate care from those suffering from a cold and sore throat. Additionally, an ecumenical chapel was incorporated to provide relief to those seeking a more spiritual healing experience.
From the time patients arrive at the Pavilion, Multicare Medical Center beams with a welcoming vibe. The exterior boasts a patterned red brick, metal, and glass façade, with street-level artistic reliefs featuring some of Tacoma’s historically prominent citizens. Inside, wood accents play into the region’s stylistic flavor. Etched-glass features maintain a sense of openness while serving to visually separate adult and pediatric waiting areas. In an act of whimsy, nature-inspired decals, like starfish and bubbles on the tiled floors, add a sense of hominess to the space and aim to represent Tacoma’s natural history.
Throughout, a patient-centered approach to lighting was employed to limit glare and discomfort. The indirect lighting strategy helped to shape the design of many other elements, including the ceilings, internal coves, and the colors and reflective qualities of surface materials chosen.
“An ED requires robust, nearly bulletproof materials and finishes that can be readily and thoroughly cleaned using hospital-grade products and methods. It was very important to develop a palette of materials that would not, as a result, create a clinical or harsh environment,” says Ritter. “The design provides a calming environment, balancing adult and pediatric patient’s needs.”
GBJ Architecture maintains that the true measure of a design’s success comes from its client’s feedback. “Our new Emergency Department provides a healthy, healing environment that will allow our staff to provide high quality care to our community,” says Crystal Billings, nurse manager of the Tacoma General Emergency Department. “The calming, spacious, private rooms and high-tech equipment will allow us to meet the needs of our customers in a way that we have previously been unable to do. Our staff will be able to apply their skill and training in a whole new way to really create a world-class experience for our patients and their families.”