Growing taller

BY MICHAEL SHIRLEY, AIA, LEED AP, Senior Principal, FKP Architects

Gowned surgeons, nurses and technicians surround the operating table. As the camera pans out, a mock cardiac surgery begins, revealing a child-size mannequin supine on a wooden platform amid an entire theater of plywood and foam core, complete with full-scale mock-ups of apparatus, medical equipment, and supplies. Information garnered from the simulations guides the architects partnering with the hospital in their design of room sizes and arrangements as well as the layout of technologies and workflows in the pediatric critical care center of the future.

Its growing global reach and increasing patient demand have helped Texas Children’s Hospital defy downward local economic pressures and continue the implementation of its long-term facilities master plan. The $506 million, 19-story patient tower addition is the keystone of a $575 million capital investment at the hospital’s main campus in the Texas Medical Center. The new tower, slated to open in 2018, will be built atop an existing six-story base that it will share with Texas Children’s Pavilion for Women, which opened in 2011. Its 640,000 square feet will house 130 beds for pediatric and cardiovascular intensive care and new operating rooms fitted out with the latest technology. It will also become the new home of Texas Children’s Heart Center, including an outpatient clinic, cardiovascular operating rooms, catheterization labs, and CVICU. The tower’s ability to adaptively support industryleading treatment processes is expected to serve as a powerful magnet to attract and retain top-level pediatric clinicians.

After the tower opens, the master plan calls for the renovation of the Emergency Center and other areas in the hospital’s existing West Tower. Space vacated by tenants aggregating in the new tower will be redesigned for other users. Diagnostic and therapeutic services will be expanded and distributed throughout the hospital’s multi-building campus to deliver care close to patients.

The intentional delay between the construction of the podium structure and the tower atop it four years later presented challenges. When the shared podium was built, the hospital anticipated that the future tower would house general inpatient beds. In the intervening years, however, increasing numbers of critically ill patients, rapidly evolving medical technologies, and the hospital’s desire to consolidate and elevate the reputation of its intensive care program drove fundamental programmatic changes. As a result, designers were challenged to accommodate the new programmed spaces around the physical limitations of floor plates, column grids, and elevator and stair circulation systems that were preset with the podium construction.

Digital processes facilitated the design. Digital modeling allowed designers to work closely with clinicians to collaboratively examine multiple possible solutions to optimize operational efficiencies. To streamline and speed the City permitting process, all submissions were electronic, a first for a major project in Houston. This digital communication almost wholly replaced the conventional slower process of paper documents moving from department to department for agency review and approval.

All aspects of building orientation, campus circulation, and signage will welcome and comfort children while easing way finding for their adult companions. Sited at the southwest corner of the Medical Center and visible from surrounding highways, the 25-story tower – which will become the tallest structure in the Texas Children’s campus – will serve as a signature landmark for the hospital. Once through the campus gate, drivers will clearly distinguish the path toward children’s services from routes to adult services. The new structure is angled from the city grid to allow vistas from all patient rooms. The design aesthetic for the building exterior and interiors complies with Texas Children’s standards established 30 years ago, ensuring compatibility with its neighbors. At the same time, design vocabulary and materials selections for the new tower were made current and more playful for young patients.

Unlike an adult, a child is never alone in the health care environment. As a result, the pediatric design requires special considerations. For example, correctly sizing pediatric inpatient rooms demands a delicate balance between accommodating parents and siblings and avoiding costs and inefficiencies of wasted space. Lounges, sibling distraction rooms, and resource rooms will be among family amenities for respite, privacy and reenergizing. Decentralized team communication stations will keep caregivers close to their patients, improving response times while minimizing nurse travel to retrieve medication and equipment.

The facility developments are being partially funded by the hospital’s Texas Children’s Promise Campaign, a fundraising effort that ensures the future of Texas Children’s as a leader in pediatric and women’s health. The goal of the campaign is to support critical care services at Texas Children’s Hospital’s main campus, specifically redesigning and expanding the Emergency Center, critical care, and surgical areas. The Promise Campaign also enables programmatic improvements and facility expansion projects such as Texas Children’s Hospital The Woodlands.

Growing the business and reputation of Texas Children’s hinges on this expansion project. Building patient and family satisfaction, improving patient outcomes, applying technology successfully, and empowering the best caregivers will ensure healthier communities worldwide, starting with the littlest constituents.