When Kaiser Permanente selected Gresham Smith to design a 38,000-square-foot medical office building in the growing and diverse community of Haymarket in Northern Virginia, our designers were tasked with delivering a solution that balanced both historic and modern aesthetics. Adhering to Kaiser Permanente’s national brand, the end result is an elegant yet simple building form with contemporary aesthetics that is a “good neighbor” to the surrounding historic context.


Kaiser Permanente


Haymarket, VA

Project Type



Showcase, 2021 AIA Middle Tennessee Citation Award, 2022 AIA Tennessee Award of Merit


square feet




reduction in building energy consumption

Bridging the Gap

Our architects, interior designers, engineers and graphic designers worked in collaboration to deliver the state-of-the-art medical office building. In order to meet substantial compliance due to an existing exterior-design proffer connected to the site, the design had to walk a delicate tightrope between the historic and modern. To achieve this, we made a series of seemingly benign modifications to the design in order to arrive at an architecture that fits into the historic context of the area but is unmistakably playful and modern.

“The site required that the new building align with the community’s expectation for ‘traditional design’ but it lacked in character and quality. We were able to meet the expectations by using more conventional materials like red brick while applying contemporary details to the building form. The end result bridges the gap between the local vernacular and Kaiser Permanente’s innovative aspirations for their national brand.”

—Chris Hoal, Architect

While Haymarket provides a traditional and historic environment, Kaiser Permanente’s national brand requires a modern, unique member experience. The resulting building is crafted as an elegant and simple form with contemporary aesthetics.

Throwing Shade

Due to the site constraints, the envelope design had to accommodate a less-than-ideal north-south building pad orientation. Chris Hoal explains:

“The pad-ready site meant that we didn’t have a lot of control over the building orientation. Ideally, a building footprint is oriented east-west instead of north-south. This is because a north-south orientation poses the environmental challenges of glare and solar heat gain from low-angled sun that heats up a space and reaches far into the interior of a building.

“We met this challenge by locating the lobby on the southeast corner of the building, which brings in an abundance of natural light during the morning hours while preventing a lot of heat gain in that space. By using solar shades around the exam room windows on the upper floor we reduced the overall building energy consumption by 3%.”

Sustainability was considered throughout the planning, design and construction process and the building is on track for LEED CI certification.

Keeping It Simple

Simplicity in planning as it relates to simplicity of the user experience was a hallmark of the design. The most important planning goal was to create a clear, simple, and efficient diagram that enhances the user experience by maximizing daylight and views.

“From the visitor’s perspective we wanted the building to unfold in a very simple way in which each clinic is accessible from a public concourse and is marked with portals for wayfinding,” says senior architect Adam Smith. “We stacked the space vertically so the lobby area that connects everything is visually cohesive and is a pleasant space to enter when you’re walking into a clinic.”

On the first floor, the main entry leads to the lobby, check-in area and retail pharmacy. On the second floor are clinical waiting areas, exam rooms, and conference room.

An Active Design

To encourage physical activity among staff and visitors, a monumental stair that connects the building’s first and second floors was located between the waiting areas. Senior interior designer Ashley Wood explains:

“We wanted people to be active in this space, so we located the stairs in the middle of the building between the waiting areas so the circulation essentially runs into them—you can’t miss them! Although it’s intuitive for users, their placement wasn’t an easy thing to execute while we were developing bubble diagrams and determining where to locate them. However, it ended up being a fun exercise from a planning perspective, and the middle of the building really worked in terms of both aesthetics and promoting activity.”

The stairs are located in the middle of the building between the waiting areas so the circulation essentially runs into them.

Progressive Planning

The MOB’s clinics are arranged sequentially within the building perimeter, connected by a well-defined public spine that links the entrance, the clinics, the waiting areas and vertical circulation. The clinic design encourages communication by grouping the physicians’ offices and nurse stations into an open, collaborative hub at the back of the clinic.

Exam rooms are fully templated so staff can easily flex between departments as demand rises and ebbs. The standardized clinic design allows the building to accommodate brand-new modalities into the existing spaces without renovation. Even the walls are demountable to ensure the facility is flexible for Kaiser Permanente’s future needs.

“The integration of DIRTT demountable walls was key in supporting communication and collaboration,” says project coordinator and interior designer Deanna Kamal. “It allowed us to keep the walls in the nurse station a lot lower, providing staff with a clear line of site to one another.”

By locating the staff and materials corridor along the back of the clinics, the back-of-house flow of materials, technicians, and doctors was removed from public view.

“The onstage and offstage clinical functions are separated so that the member experience is visually decluttered,” notes Hoal. “It creates a more calming and quieter environment in which visitors aren’t exposed to unnecessary back-of-house activity, such as someone wheeling a dolly full of stethoscopes to the materials closet.”

The design encourages communication between healthcare providers by arranging offices and nurse workstations around an open, collaborative hub. 

Serving Kaiser Permanente Members Old & New

Offering a wide range of specialty clinical services, including adult primary care, family practice, behavioral health, imaging, OB-GYN and optometry, Kaiser Permanente Haymarket Crossroads Medical Center is now bringing high-quality, integrated healthcare to more than 7,000 Kaiser Permanente members in the Prince William County area while attracting new members to the system. Notable for its sustainable strategies and the use of clinic standardization practices, the medical center is on track for LEED CI certification.

Due to the success of this project as well as others for the client, Gresham Smith was selected to participate in Kaiser Permanente’s “Center of Excellence” program with the purpose of driving the AEC industry forward in developing a kit-of-parts construction process for healthcare architecture.

“Kaiser Permanente is one of our most valued longstanding healthcare clients,” concludes senior engineer John Horst. “They not only have a strong brand sense but also an uncompromising set of standards when it comes to design and sustainability. All of these things are intended to deliver the highest quality healthcare. With this project, as with our previous work for the client, our job was to create the spaces in which this can happen. For me and others on the project team, our careers at Gresham Smith have been defined by the work we’ve done for Kaiser Permanente.”

“With Gresham Smith, we were able to work collectively with the developer and seamlessly go from the developer build turnover of the core and shell to the interior buildout. At the end of the day, by working with Gresham Smith, we were able to come in well under budget for this project. ”

—Dustin Warf, Project Manager, Kaiser Permanente National Facilities Services

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Brent Hughes, AIA, EDAC, LEED AP
Brent Hughes, AIA, EDAC, LEED AP
Vice President