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Shriners Hospitals for Children

Design with Child in Mind

They want to contribute to the area rather than just fit in... Every decision seemed to reflect their philosophy.

The Shriners Hospitals for Children - St. Louis provides orthopedic care at no cost to the families through the volunteer efforts of local medical staff. When facing the prospect of moving to a more visible, urban location, GS&P worked to develop a facility that would not only enhance Shriners’ presence in St. Louis and the region but also contribute to the nearby medical community and Washington University. The result is a regionally themed, welcoming environment that furthers the mission of the Shriners organization to improve the lives of children around the world.

When did the relationship between Shriners and GS&P begin?

Alba Lopez-Isa: It started about six years ago, when we were invited by a group of architects around the nation to enter a competition. GS&P was selected, and after taking a few months to make a final decision on the building site, Shriners ultimately chose the Washington University site because of its proximity to Barnes Jewish and other medical facilities.

Shriners has a unique mission of helping children around the world. What was it like to work with this organization?

David Goodspeed: From my perspective, Shriners operates completely differently than most other medical institutions because of the way they go about their business with helping children. They don’t charge anything, they don’t have to deal with insurance companies or Medicare, and they are able to make innovative decisions independently, all of which helps them keep the focus on helping children.

Angela Holcomb: Their whole mission, from the initial vision to the program, was all about the kids. They looked at how their current facility operates and how they wanted to improve upon that to make the experience for their patients even better. For our design team, understanding that and then applying those principles to the new building was the biggest driver behind the facility.

What was the give-and-take on trying to be innovative while working with a group that’s been operating hospitals around the nation for some time?

Alba: They are definitely not the typical client, and don’t want cookie-cutter hospital design. Instead, they want to establish an individual image for each campus, so every one of their facilities is very different. The goal was to provide a very visible project for a very prestigious medical campus near Washington University in St. Louis. And, since part of the building faces I-64, they wanted to establish a highly visible architectural presence in the city.

Why was the interaction with that campus so important to them?

Angela: The physicians donate their time, so having it close to the hospitals where they work makes it easier.

Alba: They also wanted to be on campus to take advantage of sharing the facility. One example is the research lab on the 6th floor, including the researchers.

David: And they want to contribute to the the area rather than just fit in. They want to be outspoken and unique, but they also want to take advantage of the interaction and uniqueness of the university setting and the innovative medical opportunities there.

What effect did moving the facility from a suburban location to an urban setting have on the hospital's design? Were there any particular challenges?

Christopher Davis: The site was actually perfect from a design point of view. It was a flat parking lot with asphalt, with pretty much no underground utilities to deal with, other than one off in the very corner of the site, and maybe a tree or two.

David: But a major challenge of the site was that it had seismic issues. Seismic issues are easier to deal with if you’re lower in height, but more difficult with a building that’s eight or nine stories tall.

Angela: A challenge for the staff was getting them to think vertically instead of spread out, which is what they were used to.

Alba: They were also used to a very high-end residential neighborhood, so it was definitely a challenge getting them used to one side of the facility facing a highway and the other facing an urban neighborhood. They were initially concerned about the changes, but they were looking forward to the new building, the new technology, and the therapy areas for the kids. They were ready to get out of their old 1950’s building regardless of any challenges with the new site.

You had to hire an acoustical engineer. Was that because the facility is so close to the highway?

David: When you have a site that’s small in footprint and you go vertical to accomplish the square footage needs, you end up stacking things logically. Acoustics become more of an issue in that scenario when you’re stacking things, as opposed to a one- or two-story building where everything’s spread out.

Angela: For instance, we had a children’s play area right above the chief of staff’s office, and surgery right below the mechanical room, so the challenge was determining how to minimize the sound of bouncing balls from transferring down to office space and the operating rooms.

Besides placement and stacking, did you have to use any special materials because of the acoustical considerations?

Christopher: The primary difference, as compared to a standard hospital design, is the flooring system. In addition to a standard floor, there is about a ten-inch floating floor on top of it in about 60 percent of the hospital as a whole.

Angela: And we had to thicken walls, readjust certain room sizes, square footage…

Christopher: It was a unique sequence of events. Normally we design the floors and the engineers design systems to fit. But the acoustical engineer couldn’t do his calculations until all the mechanical, electrical and plumbing was sized. Deck sizes got much larger, which started interfering with ceilings. It was a challenge toward the end to thicken up walls and adjust for acoustics and mechanical equipment.

Describe the concept for the interiors.

Angela: Early on, the nurses said they did not want the kids to hide out in their rooms. They wanted them to get out, walk around the floor, and interact with other kids. That’s why we placed kiosks and different design elements throughout the hospital to help reinforce the idea of interaction. There are gaming consoles mounted in the central core and exterior gardens so the kids can play outside.

Penny Houchens: They really wanted to create an atmosphere geared toward interaction for the children and stimulation in a positive environment.

Angela: The overall interior design concept with the wetlands and prairies was a theme Jim Kolb came up with so that it would be familiar to the kids in that area. They saw his vision and they believed in it.

Did you have to keep a lot of the themes understated because of the varying ages?

Penny: Yes, and we did a pretty good job keeping the interiors child-friendly without being geared toward a toddler. We tried to keep it innovative and interesting. For instance, the educational kiosks on each floor are based on the theme of that floor. On the first floor, it is a composite. On the second floor it is rivers, streams, and fish. A child staying at the hospital can go to each floor and interact with different themes.

Angela: The main patient floor comes to mind because that’s where they’ll have the widest age ranges. We created a teen play area, an infant zone, and the main dining/play area. The infant area is smaller, more quiet and remote. The children’s area provides enough space for the children to play on the floor. And the teens have a separate area with features like game consoles.

Shriners wanted the building to be unique with a distinct image. What were some of the design aspects of the exterior?

Christopher: They definitely wanted an architecturally iconic building. One of Jim’s concepts was a fin at the top of the building. The concept was that as you’re coming down the highway, the sun angle would actually shine through that building onto the passersby and project an image into the visitors’ area. We chose very long-lasting materials, thickened with pre-cast to help match all the other buildings in the area. We also kept everything regional, from a sustainability and energy point of view.

Alba: A Washington University agency, Cortex, is in charge of making sure certain aesthetic requirements are met. They were very concerned about the look of the building, the materials, plans, exterior lighting, signage, and vehicular and pedestrian circulation.

Angela: Sticking with the language of the neighborhood by using some of the same materials and colors helped out a lot.

Christopher: And in addition, because we had a concept of adding highly visible graphics on the building, we were required to define “art” vs. “signage”. The question would come up, “Is that considered signage?” and if the answer was “yes,” we knew that permits were required, or we had to change the design.

Alba: We also met with the city of St. Louis, and they gave us great guidance on what we could do to keep the graphics and revise the signs. It was certainly a different process than what we are used to.

Bruce M. Pitre: And because the art is proposed to mount on the garage, and the garage faces the interstate, the artistic image has potential to be the main visual impact of the facility and the site. It is such a presence on the interstate and an important part of the design. Jim was aiming for a number of different ways to do this, and in the end, they’re very happy with it.

What particular aspects of this project make you the most proud?

David: I’m a nuts-and-bolts kind of guy. I’m at the end of the project, putting things together and making sure they fit and trying to find some uniformity to the details. There were detail changes at every turn, and it was very complicated to find uniformity in the detail and keep the cost relative. It was a big challenge early on, but we all worked together as a team and I feel good about the effort we all put in.

Christopher: I’m most proud of our good team effort. Everyone played nice, and we all worked well together. We overcame most of the challenges in one form or another. Aside from the fact that the project’s 1,200 miles from where our office is, we were able to accommodate that pretty well. The set of drawings and actual construction documents are some of the best that I’ve seen out of this office in my five years here. And the pricing that came in from the construction manager reflected that compared to their initial pricing.

Bruce: Even though I was working from a remote location, we still worked as a team. We did a good job of communicating, and everyone fought hard to maintain the quality.

Angela: The whole team really embraced Shriners’ mission and took it to heart, and every decision seemed to reflect their philosophy. A lot of the project coordinators that helped on the project were less experienced with healthcare and hospital design, and I’m proud of the great job they did. It was also a learning experience for me to work with a team this big, and the personal growth was very rewarding. Hopefully, when it’s completed and built, it will be a great facility for the kids and for the staff. I look forward to visiting.


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Project Info

  • Client: Shriners Hospitals for Children
  • Location: St. Louis, MO, USA
  • Market: Healthcare Design
  • Services: Architecture, Engineering, Interior Design, Planning, Building Information Modeling (BIM), Master Planning
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