BWBR Health Care Experience

HEALTH CARE DESIGN

On the cover | Avera McKennan Hospital, Avera Prairie Center

efficient. safe. HeaLinG.

Health care facilities have evolved from utilitarian medical practices into destinations for personalized care and wellness. Icons that tout the availability and quality of care in a region, hospitals and clinics today are essential elements to the quality of life in a city and help attract both businesses and families to an area.

As the definition of health moves beyond absence of illness, we’re adapting health care spaces to foster strong partnerships for health and well-being.

BWBR is a design solutions firm with a diverse practice in architecture, interior design, and health care master planning. Medical planning and design comprise more than 50% of our work, including tertiary, regional and critical access hospitals, behavioral health hos-pitals and clinics, and ambulatory care centers. Our diverse experience includes working with large urban health care systems, academic health centers, and community and critical access hospital organizations.

In the past six years, projects we have designed have led to more than $900 million in med-ical construction costs. From free-standing clinics and new hospitals to unit renovations, laboratories, and medical office buildings, we have worked with health care organizations across Wisconsin and the Upper Midwest to expand services, innovate care, and improve operations for medical and support staff.

BWBR is a professional, business-centered architectural practice that attracts and retains a highly qualified credentialed staff, from dedicated medical planners and board-certified ACHA architects to AAHID designers, LEED and EDAC Accredited Professionals, and nationally respected codes analysts and specifiers among our 133 employees. With strong project management and technical excellence, we offer a collaborative culture and design process built around our clients.

Rooted in the Upper Midwest with offices in Madison and Saint Paul, BWBR has thrived for more than 90 years by fostering long-lasting relationships through successful projects that enhance our clinics. For the last decade, 80 percent of our work has come from repeat clients.

BWBR incorporates the best aspects of medicine, technology, and knowledge to design solutions that meet the challenges of a changing health care environment.

MERCY MEDICAL CENTER-WEST LAKES HOSPITALWest Des Moines, Iowa

The 82-bed, 226,000 s.f. Mercy Medical Center–West Lakes brings services to where patients need them and delivers them in an environment that aligns acute care with comprehensive health and wellness services. Using evidence-based design, Mercy–West Lakes improves both patient safety and outcomes, while its focus on efficiency improves staff satisfaction and saves money.

• Iowa’s first newly constructed LEED Certified hospital.

• Evidence-based design strategies promote the safest, highest quality outcomes for patients.

• Work environment assists Mercy in attracting and retaining the highest quality professional and support staff.

HEALTHEAST CARE SYSTEM, ST. JOSEPH’S HOSPITAL, EXPANSION & RENOVATIONSaint Paul, Minnesota

This substantial expansion to Minnesota’s oldest hospital included a 180,000 s.f. patient tower with outpatient services, 89 private patient rooms, conference rooms, and a 54,000 s.f. emergency department renovation and expansion. Patient rooms are divided into zones, allowing nurses, doctors, and families to support the patient without interfering with each other’s role. The tower also centralizes distinctive patient services offered by St. Joseph’s, including the Heart Care Center with four new cardiovascular imaging labs; the nationally ranked National Brain Aneurysm Center; and the CyberKnife Center for cancer treatment.

• Three-story light-filled atrium serves as the center of the hospital community.

• Patient tower floor plans feature a race-track design with patient rooms on the outside, each with a window, and nursing stations that place staff at the core of each area near patients.

• Intensive care rooms easily can switch to regular rooms, eliminating some of the need to move patients during their recovery process.

• Emergency department renovation separates public and staff circulation, organizing activities around a core of central staff/support services creating a more efficient work flow.

MAPLE GROVE HOSPITALMaple Grove, Minnesota

The Twin Cities’ first new hospital expansion since the 1980s, the 231,000 s.f., 90-bed Maple Grove Hospital was designed as part of a medical campus that is the anchor for expansion of a commu-nity master plan. Visibility from major roadways and integration of natural site amenities ranked high, along with patient-focused care and an environment to influence health and wellness. Planning utilized Lean/Six Sigma principles to create efficiencies, such as separation of materials traffic from public and patient areas, while inpatient and outpatient areas incorporated evidence-based design strategies to create a more healing and comforting environment.

• The interior design creates a safe, healthy, warm, and intuitive space where people can enjoy an uplifting and inspiring visual experience.

• Specific design objectives aimed to reduce staff turnover, noise levels, patient falls, medical errors, infections, and waste.

• Throughout the facility, art created by local artists provides a rich visual experience and gives visitors and staff a sense of belonging to the arts and community.

• Walking paths along the natural areas provide places of respite and link to adjacent commercial zones.

MAYO CLINIC, DAN ABRAHAM HEALTHY LIVING CENTERRochester, Minnesota

This 110,000 s.f., four-story wellness and fitness center was created to help Mayo Clinic’s 28,000 employees and their families improve their health and fitness, reduce stress, and implement beneficial lifestyle changes. The center offers aerobic conditioning, strength training, a lap pool and a warm-water therapy pool, and a running track. Fitness facili-ties are complemented by wellness programs, including nutri-tion assessment, weight management, stress reduction, and relaxation instruction.

• Research areas, including physical assessment spaces, labs and exam rooms, enable researchers to capture and analyze data related to the fitness programs’ effectiveness.

• A healthy cafe, healthy cooking demonstration kitchen, and education and meeting facilities round out the building’s offerings.

• Flexibility for future vertical and/or horizontal expansions was incorporated into the design.

UNIVERSITY OF MINNESOTA AMPLATZ CHILDREN’S HOSPITAL,CHILD AND ADOLESCENT MENTAL HEALTH UNITMinneapolis, Minnesota

This exciting 31,000 s.f. renovation project created new inpa-tient mental health facilities specifically designed for children and adolescents. Floors within an existing building adjacent to the new Amplatz Children’s Hospital were transformed into two treatment units, one for child-adolescent behavioral health and another for adolescent chemical dependency. The project also included improvements to a therapeutic pool and creation of a secure outdoor play area.

• Behavioral health care has very unique requirements, most of which are a balance of creating a space that is both extremely safe and welcoming, healing, and friendly. A project driver was to design a forward-looking mental health facility that is more open and inviting to children and their families. This meant including natural light whenever possible, carefully placing color and design details, and developing healing spaces specific to children.

• Beyond the usual facilities and design participants, our workshops also included amazing conversations with patients, their families, and a team assembled from the National Alliance on Mental Illness (NAMI). These talks truly inspired the design team to look beyond planning issues and to create a distinctive environment.

AVERA MCKENNAN HOSPITAL, AVERA CANCER INSTITUTE-PRAIRIE CENTERSioux Falls, South Dakota

The Avera Prairie Center, housing Avera Cancer Institute, is a 260,000 s.f., five-story facility, designed to convey hope, personal choice, dignity, inspiration, and a connection to nature and new life. Infusion suites with sliding doors allow patients the option of chemotherapy treatments in private or with the support of other patients, with some second-floor suites offering balconies overlooking the indoor garden and third-floor suites overlooking a roof-top garden.

• The latest in imaging and chemotherapy treatment helps people from rural areas tied to farms and ranches reduce the time they have to spend away from their homes and livelihoods.

• Indoor air quality measures include exposure to UV light to kill airborne bacteria, and 7,500 s.f. of indoor plants, trees, grasses, ponds, and waterfalls to aid in balancing humidity and air quality.

• The garden atrium is one of the premier locations for community organizations to host events, ranging from the Sioux Falls Chamber of Commerce to the South Dakota Symphony.

PARK NICOLLET HEALTH SERVICES, FRAUENSHUH CANCER CENTERSt. Louis Park, Minnesota

The vision for the new Frauenshuh Cancer Center at Park Nicollet Health Services saw sustainability as more than guiding the construction of a facil-ity, but also as a way to treat patients’ emotional, psychological, and spiritual needs. Simple materials like wood and stone on the interiors, with organic walls growing out of the landscape, create passages and gateways that open up to places of serenity and decompression. With a low elevation site situ-ated on a flood plain, the design team turned the terrain into an asset, creat-ing a six-level parking ramp, which returned three acres of green space to the site, and opened the possibility for health and rain gardens.

• First LEED-NC Silver Certified cancer clinic in the Upper Midwest.

• Private treatment rooms offer privacy during treatment while bringing nearly all services directly to the patient (the non-moving patient).

• More than 90% of respite spaces for staff and patients offer direct views to the outdoors.

• Patient satisfaction increased to 90% from 77% after the new facility opened.

MAYO CLINIC HEALTH SYSTEM in AUSTIN, OUTPATIENT EXPANSIONAustin, Minnesota

BWBR worked with Mayo Clinic Health System to design a new 90,000 s.f., four-level outpatient clinic adjacent to Austin’s existing main campus buildings, as well as 35,000 s.f. of remodeling to existing areas that had been vacated to the expanded space. The new facility provides an efficient outpatient environment that co-locates spe-cialties and improves public access to them, as well as a sustainable, state-of-the-art patient care experience that enhances patient safety and healing through the Medical Home care model.

• To provide a streamlined and integrated patient experi-ence, there is a single clinic entrance and a centralized check-in desk on each floor.

• The clinic is designed with simple, clear wayfinding, allowing the facility to consider self-rooming of the patient and allowing nursing staff to reduce steps and spend more time caring for patients.

• Exam room layout improves the physician-to-patient encounter, including consult seating with closer prox-imity that encourages eye contact without seeming confrontational, and seamless integration of technol-ogy/electronic medical records interface to facilitate health conversations.

• An open nurse station design with touchdown space for physicians and consult/family care conference rooms throughout the clinic allow for better collabora-tion among caregivers.

WEST LAKES WELLNESS CAMPUSClive, Iowa

This multi-phased campus development currently includes four buildings, co-locating medical services with health and fitness facil-ities, connecting wellness and prevention to treatment and health.

• A 64,000 s.f. Wellness Center includes lap, exercise and ther-apy pools, exercise studios, fitness machines, an interior jogging track, indoor and outdoor kids’ play areas, and support space including lockers, administrative offices, and conference rooms.

• A 60,000 s.f. Ambulatory Care Center houses imaging, cardiol-ogy, and same-day surgery facilities.

• The Sleep Center offers 37,000 s.f. of general treatment rooms, specialized sleep rooms, and staff work areas.

• A 34,000 s.f. Cancer Center, operated by Mercy Medical Center, offers exam areas, two linear accelerators, a CT suite, patient resource center, and administrative offices.

• A 55,000 s.f. Women’s Center and an 18,000 s.f. Medical Office Building are part of the longer-term campus master plan.

GILLETTE CHILDREN’S SPECIALTY HEALTHCARE, CAMPUS EXPANSIONSaint Paul, Minnesota

A new freestanding, 55,000 s.f. medical building gives one of the nation’s premier pediatric orthopedic care centers a new front door. Previously located within a major hospital complex, Gillette Children’s Specialty Healthcare’s campus expansion provides a prominent and distinct identity separate from the neighboring Regions Hospital for the first time. The design team created a phasing plan to succeed the completion of the medical build-ing, including demolition and renovation of the vacated existing areas and provisions for future vertical expansion.

• Connected by skyway to their main hospital campus, the new building houses Gillette’s most heavily used services.

• The James R. Gage Center for Gait and Motion Analysis features state-of-the-art technology and heated floors for added patient comfort.

• Rehabilitation Therapies features a large therapy kitchen where patients who use wheelchairs or adaptive equipment can learn cooking skills.

• Concurrent with the medical building construction, renova-tions to Gillette’s space within the main hospital provides a technologically-advanced 10-bed Pediatric Intensive Care Unit with private patient rooms and space for parents to stay overnight.

LAKEVIEW MEDICAL CENTERRice Lake, Wisconsin

Located in the northwoods of Wisconsin in the heart of the Red Cedar River Valley, Lakeview Medical Center’s new three-level, 140,000 s.f. facility uses elements that celebrate the heritage of the region’s lakes and landscape while bringing efficiencies befitting a modern, 40-bed hospital. Wood, stone, and textured wallcoverings create a lush, rich ambiance and warmth that comforts patients and visitors upon entering, while the glass architecture creates a striking visual appeal along a major highway into the organiza-tion’s hometown, Rice Lake. Enhancing a less stressful environment are patient-centered design strategies that improve care access and delivery.

• In-room nurse supply cabinets and wireless electronic technol-ogy allow nurses to spend more time at the patient bedside.

• The laboratory is shared between the clinic and hospital for increased efficiencies and services while CT scanning and radiography were located with the emergency department for quick responsiveness and patient convenience.

• Mock patient rooms allowed staff to experience proposed room layouts for med-surg, LDRP, ICU, trauma, and emergency department.

• The building design utilizes the sloping topography to create another level and provide natural light to the dining area.

HEALTHPARTNERS, RIVERWAY CLINICS-ANOKAAnoka, Minnesota

This new 60,000 s.f. medical office building includes primary and specialty care clinics, a digestive center, lab and radiology services, and space for a retail pharmacy. The design uses Lean and evidence-based design principles, and is specifically programmed to support the Medical Home care model.

• The clinic is divided into five neighborhoods, each of which has a core staff work/ collaboration zone where nursing staff work in partnership with physicians, literally sitting side-by-side. Exam and procedure rooms surround the core.

• Every room has one door facing a dedicated patient corridor along the neighborhood’s perimeter, and another door granting access from the staff core. This creates a calming environment for patients who don’t have to walk through a busy work area, and a more effective staff space that minimizes patient interruptions and improves confidentiality.

• Blood draws are done within the exam room, and each neighbor-hood has a dedicated specimen room, reducing patient steps by an estimated 50%. All bloodwork and specimens are sent to the lab via pneumatic tube, saving staff time and steps as well.

REGIONS HOSPITAL, INPATIENT MENTAL HEALTH CENTERSaint Paul, Minnesota

Regions Hospital made a bold statement to relocate their exist-ing adult inpatient mental health unit to a new 100-bed, 115,000 s.f. freestanding facility. Their desire was to create the next gen-eration of behavioral health care — single patient rooms, large open group rooms, and private areas for counseling and staff. The eight-story tower with a residential feel offers an innovative and flexible floor plan that supports a healthy community atmosphere, enhances patient dignity, and provides a safe environment.

• The exterior design fits in with the existing Regions campus aesthetic while still achieving its own identity.

• The building configuration allows natural light to penetrate deep into core dining and dayroom areas.

• Break-out spaces provide more privacy for patients to meet with family, while still allowing staff to maintain supervision.

• Findings from a five-year post-occupancy study performed on Avera Behavioral Health Center influenced low-cost changes to this facility even as construction was underway. For example, desks in patient rooms were reoriented so the door is visible from the sitting position, as many patients feel uneasy with their back to a door. The floor pattern was also changed to reinforce the transitional zone between sleeping rooms and the dayroom, allowing patients to slowly ease from the safety of their private space into a more social area.

UNIVERSITY OF MINNESOTA, SCHOOL OF NURSING BENTSON HEALTHY COMMUNITIES INNOVATION CENTERMinneapolis, Minnesota

Located at the oldest continuously-operated, university-based School of Nursing, the 12,000 s.f. Bentson Healthy Communities Innovation Center re-imagines what nursing education looks like. A complete demolition and renovation of the space, the Innovation Center brings nursing students into simulated environments that enables them to see their work through the experiences of patients. Nursing students also work with other health care professionals in the center to simulate the team-centered approach during large-scale, complex situations.

• Simulated environments include a home with a kitchen and family room that includes a digital screen to practice telehealth; a working, glass-walled bathroom for learning how to help patients use facilities safely; and rooms integrated with electronic health records and supportive technologies.

• Audio and video recording equipment throughout the center record students’ work in the simulated environments so nurses can see their performance — body language, skills, verbal cues — and spot areas for improvement.

• Components include rooms simulating intensive care, hospital, nursing home, clinic, and home care environments; medication-dispensing technology room; 38 remotely controlled video cameras; and interactive video conferencing.

The 5,600 s.f. Park Nicollet Clinic features a unique staff core planning model to support the Medical Home care model. A large, open nurse station supports a collaborative care team and allows visual connections to the exam rooms. Another unique feature explored on this project is the use of a demountable wall system. More than just a desired aesthetic, the wall system offers flexibility with future reconfigurations or possible clinic relocation due to growth.

• An emphasis on reducing waiting time was achieved through a more efficient patient flow.

• Several amenities are offered for patients, including a community room for education and discussion groups and a computer counter to provide internet access.

PARK NICOLLET HEALTH SERVICES, PARK NICOLLET CLINIC-LAKEVILLELakeville, Minnesota

To accommodate a 135% increase in surgeries in recent years, Gillette Children’s Specialty Healthcare expanded its services to add five new operating rooms, 10 pre- and post-op beds, PACU, observation deck, and associated support area. Utilizing ele-ments of evidence-based design strategies, positive distraction elements are prominent throughout the 10,500 s.f. expansion, including large digital graphic wall coverings and backlit ceiling panels.

• Operating rooms are connected with an integrated system for seamless coordination of cameras, music, and PACS images.

• One simulation operating room is outfitted with mock gases but the same booms as a typical Gillette operating room and has a mannequin for simulation purposes.

GILLETTE CHILDREN’S SPECIALTY HEALTHCARE, SURGERY DEPARTMENTSaint Paul, Minnesota

Allina Health | Abbott Northwestern Hospital, Cambridge Medical Center, Mercy Hospital, New Ulm Medical Center, United Hospital, Unity Hospital, WestHealth Medical Center

Amery Regional Medical Center

Avera Health | Avera St. Luke’s, Avera McKennan Hospital, Avera Queen of Peace Hospital, Avera Sacred Heart Hospital, Avera Gregory Hospital, Avera Marshall Regional Medical Center, Avera Dells Area Hospital, Avera Flandreau Hospital, Floyd Valley Hospital, Avera Milbank Area Hospital, Sioux Center Community Hospital, Avera Weskota Memorial Medical Center

Box Butte General Hospital

Broadlawns Medical Center

Burnett Medical Center

Catholic Health Initiatives | Mercy Medical Center-Des Moines, St. Elizabeth Regional Medical Center, St. Francis Health Care Campus, St. Joseph Medical Center, St. Mary’s Healthcare Center

Centegra Health System | Memorial Medical Center, Northern Illinois Medical Center

CentraCare Health System | CentraCare Health System-Long Prairie, St. Cloud Hospital

Children’s Hospitals and Clinics of Minnesota | Saint Paul, Minneapolis, West Clinic

Chippewa County-Montevideo Hospital

District One Hospital

Essentia Health | Clearwater Valley Hospital, St. Mary’s Innovis Health

Fairview Health Services | University of Minnesota Medical Center, Southdale Hospital, Ridges Hospital, Northland Clinics

Gillette Children’s Specialty Healthcare | Saint Paul Hospital Campus, Burnsville Clinic, Technology Center & Lifetime Specialty Care Clinic, West Clinic, Maple Grove Clinic

Glacial Ridge Health System | Glacial Ridge Hospital

Glencoe Regional Health Services

Gundersen Lutheran Health System | Gundersen Lutheran Hospital

Hayward Area Memorial Hospital

Hazelden Foundation

HealthEast Care System | Midway Hospital, St. Joseph’s Hospital, Woodwinds Health Campus

HealthPartners | Regions Hospital, Medical and Dental Centers, Westfields Hospital, Hudson Hospitals and Clinics, Lakeview Hospital (Stillwater)

selected health care clientsAs so much of BWBR’s practice is medical design, we have worked with numerous facilities throughout the Upper Midwest. We understand the challenges faced by facilities in different loca-tions and demographic settings.

Hennepin County Medical Center

High Pointe Medical Campus

Jamestown Regional Medical Center

Lake View Hospital (Two Harbors)

Lakeview Medical Center (Rice Lake)

Lakewood Health System | Pillager Clinic, Browerville Clinic, New Hospital and Clinic

Mayo Clinic | Downtown Rochester Campus, Mayo Family Clinic Northeast, Rochester Methodist Hospital, Saint Marys Hospital, Mall of America

Mayo Clinic Health System | Austin, Faribault, Cannon Falls, Albert Lea

Meeker Memorial Hospital

Ministry Health Care | Howard Young Medical Center, Flambeau Hospital

New River Medical Center | Hospital, Monticello Medical Office Building, Monticello Clinic

North Memorial Health Care | North Memorial Medical Center

Park Nicollet Health Services | Methodist Hospital, Park Nicollet Clinics

Prairie du Chien Memorial Hospital

Provena Health | Provena St. Mary’s

Regina Medical Center

Rice Memorial Hospital

Ridgeview Medical Center | Two Twelve Medical Center, Ridgeview Medical Center

Sanford Health | Medical Center-Fargo, Detroit Lakes Clinic, Bemidji Campus, Northwest Medical Center Thief River Falls, Wheaton Medical Center

Spooner Health System

Tomah Memorial Hospital

United Hospital District

United States Department of Veterans Affairs | Minneapolis VA Medical Center, St. Cloud VA Health Care System, VISN 23 VA Clinics

University of Iowa Hospitals and Clinics

University of Wisconsin Health | Eau Claire Family Medical Center

Vernon Memorial Healthcare | Vernon Memorial Hospital

Wayside House | Wayside Residential Treatment Center

References

Joe LeValleySenior VP, Planning System

and DevelopmentCatholic Health Initiative/

Mercy Health Network111 Sixth Avenue

Des Moines, IA 50314515.247.3042

(from master planning to clinic and hospital design, relationship ongoing since

2000)

Brian KnappVice President, Operations

Fairview Ridges Hospital201 East Nicollet Boulevard

Burnsville, MN 55337952.892.2107

(sole architect serving hospital and clinic campus

for almost 20 years)

Bill SextonCEO

Prairie du Chien Memorial Hospital

705 East Taylor StreetPrairie du Chien, WI 53821

608.357.2236(current designer for replacement hospital

serving southwest Wisconsin and northeast

Iowa)

saint pauL | madison

02.14

1241 John Q. Hammons Dr., Ste. 503Madison, WI 53717

608.829.3701bwbr.com