Reinventing the Community Hospital

Architects look to flip the script on healthcare design by elevating the local hospital experience.

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A welcoming courtyard at The Christ Hospital provides a place of calm and respite. Photo © Tom Rossiter

purred by a focus on patient-centered care and by competition in the marketplace, the healthcare industry has made major strides toward creating a more uplifting experience for patients. But while academic medical centers and highly specialized facilities are leading the way toward progressive design, community hospitals — the smaller facilities that are often the most accessible places for medical care in American towns and cities — leave much room for improvement. “In an industry that has come to align itself with the hospitality world, the community hospital is still the local motel of healthcare,” says associate director Scott Habjan. “It offers basic services and no-frills accommodations, and it’s close by when you need it. But in an industry dominated by large cookie-cutter facilities, the community hospital can become the boutique hotel of healthcare.”

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Gracious and sophisticated waiting areas at Mount Sinai Hess Center. Photo © Eduard Hueber

Embracing the idea of “local”

To differentiate this important type of medical facility, we should draw upon exactly what already sets it apart: the way it’s embedded in its surrounding community. “By creating a stronger connection to place, the community hospital can provide a sense of familiarity and authenticity that most large medical centers lack,” says design partner Chris Cooper. “This connection to local environment and spirit of place can humanize a place that can often be perceived as intimidating and alienating, particularly for people in a vulnerable state.”

Much more can be done to make the community hospital feel a part of its community and place. A holistic and nuanced approach begins with the scale of the building, and the way it sits in its context. It extends to the interior design — the color and material palette, furnishings, artwork, and the connection between inside and out. Although not a community hospital per se, the Mount Sinai Hess Center in New York City embodies this approach — it provides cancer patients a sophisticated, gracious, and art-filled waiting area in keeping with its Madison Avenue address. For the Cleveland Clinic campus in Weston, Florida, our team designed buildings that are consistent with the Midwestern hospital’s identity, while tailoring the architecture to South Florida’s climate and more relaxed lifestyle.

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The Weston, Florida Campus of Cleveland Clinic is tailored to local culture and climate. Photo © Tom Rossiter

Beyond its physical setting, a community hospital can embrace and embody a local ethic in the way that it operates. “The hospital can serve as a true community facility — not just a place where people go when they’re not well,” says healthcare practice leader Anthony Treu. By sourcing fresh produce from local farms, for instance, a community hospital can celebrate its connection to place, support the local economy, and further its mission of wellness. It can host fitness programs and wellness events, and vary these programs with the seasons to embed the hospital in the life of the community year-round. On a current hospital project, our healthcare design team is exploring how to implement some of these ideas — using a rooftop vegetable garden on the diagnostics and treatment base to support a “roof-to-table” cafeteria, bringing local food trucks onsite once a week at lunch time, and embedding a local fitness center into the ground floor retail zone.

“The hospital can serve as a true community facility, not just a place where people go when they’re not well.”

Lessons from farther afield

We can also draw inspiration from projects outside the healthcare industry. Our design for a public school in Staten Island, New York — the city’s first net-zero-energy school building — has established a new sustainability benchmark for community facilities. The design demonstrates a commitment to environmental stewardship and preserving resources. Among other features, it includes an onsite greenhouse and garden courtyard where children can learn to grow food, as well as a gymnasium with equipment that generates energy for the building when in use.

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The master plan for Cornell Tech incorporates a resiliency strategy that uses the island’s natural topography and reinforces a sense of place. Photo © Lucas Blair Simpson | SOM

At a larger scale, our master plan for the Cornell Tech campus has shaped a new innovation community on New York City’s Roosevelt Island, with an approach that’s unique to its setting. Community hospitals, with their need for uninterrupted services, can learn from this project’s resiliency strategy. Taking advantage of the island’s natural topography, the campus plan protects the buildings from rising sea levels and future storm surges with a network of landscaped earth berms that raise the building entrances in a seamless, integrated way. Resiliency strategies like this can prepare a local hospital to be a fully-functioning place of sanctuary when a community may need it most.

Strengthening community ties

For private-sector projects, as well, we’ve sought to reinforce connections between a company and its community. At the Brooklyn headquarters of a financial services company, the design team worked to create a “marketplace” within the building. Inspired by the food markets and creative culture of the surrounding neighborhoods, we sought to capture the spirit of the borough while also supporting local artists and small businesses. We applied a similar idea with our design for Sheikh Khalifa Medical City in Abu Dhabi, which includes a large ground floor multipurpose room available for community use. Strategies like these can both enhance and broaden the mission of local healthcare facilities.

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A financial services headquarters in Brooklyn fosters a sense of community with shared spaces and dining options. Photo © Jeff Goldberg | ESTO

Community hospitals may always find themselves in the shadow of major medical centers, but with a fresh approach, they can offer the very best of both worlds — leveraging the deep resources of affiliated academic medical centers, while responding to the unique cultures, lifestyles, rhythms, and needs of their local communities. In an industry that often makes parallels to the hospitality world, designers and operators of community hospitals can accentuate the “boutique” qualities that make these facilities unique — human scale, intimacy, personal attention, and a real connection to place.

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