Healthcare Design: Natural Progression For Lucile Packard Children’s Hospital

When Lucile Packard Children’s Hospital Stanford opened in 1991 in Palo Alto, California, the 250,000-square-foot building housed some progressive design features for that time: a rooftop deck, 26 outdoor terraces, a central interior courtyard, and child-friendly artwork for wayfinding. Those features, as well as the overall environment created, were highly valued by patients, families, and the community, even as the functionality of the building struggled to meet the needs of contemporary clinical care.

The building evolved into an academic medical center, part of Stanford University, and had to accommodate a larger patient population. “When the original hospital opened, a lot of our surgery and imaging was at Stanford Hospital,” says Jill Sullivan, vice president of hospital transformation and vice president of strategic planning and general services at Lucile Packard Children’s Hospital Stanford. “Over time, we took over any space we could, and we built out surgery and imaging and as many beds as possible. But then we ran out of places to go.”

The nonprofit children’s hospital, part of Stanford Children’s Health, provides primary care as well as rare and complex specialty care for pediatric and obstetric patients, with leading programs for treatment in cardiovascular, transplant, cancer, pregnancy, and newborn care.

Lacking space and seeking to update the facility’s semi-private patient rooms and small nursing units, the organization began working with design firm Perkins+Will in conjunction with executive architects HGA and engineering firm Mazzetti+GBA on a 150-bed expansion. The goal was to create a facility that’s inspired by the legacy of the existing structure but designed for 21st-century medicine, with flexibility to adapt to future changes in care delivery, patient needs, and technology advancements.

Staying Flexible
The Wolf, an interactive artwork made of boulders, anchors Dunlevie Garden.

Planning and design on the expansion began in 2006, with the original approach calling for the expansion to be sited on a corner near the existing hospital, with two new bed towers parallel to each other—one for ICU and the other med/surg. “That wasn’t considered positive from a family point of view,” Sullivan says, because the view from some of the patient rooms would be into the other tower. Additionally, Lucile Packard planned to operate the new and existing buildings together, including linking the surgery and imaging departments in both buildings. “When sited at the corner, although connected, the new building didn’t really relate to the existing hospital,” she says.

A year into the project, the design team decided to revise the plans, shifting the building massing away from the corner and closer to the original hospital (renamed the West Building), and changing the layout of the new hospital (called the Main Building) to a “Z” shape so the two towers would be staggered. This modification not only ensured that each room had a view of nature, but also created space for three gardens, including a public-oriented setting at the corner, a staff garden next to the hospital, and a more private setting between the West and Main buildings.

To deliver flexibility for future care needs or equipment upgrades, the inpatient floors in both the med/surg tower and the ICU tower were designed to support a transition in room type with minimal construction, says Amy Douma, healthcare designer at HGA (Minneapolis) and a medical planner for the project. “There’s adaptability in both room layouts and room size, and that will serve them long term should their needs change.” Another feature supporting flexibility is the location of the building’s major hard infrastructure elements, including IT and electrical components, in a spine that runs between the two bed towers and is positioned so those elements can be expanded without disturbing the patient care areas.

Read the complete Cover Story in Healthcare Design Magazine.

They wanted us to push this facility to be innovative and provide proper care while being very sustainable and a little bit of a laboratory.

Dan Rectenwald

Chief Operating Officer, HGA