“Sumter Regional Hospital was a standalone community hospital that didn’t have adequate FEMA and insurance funding to build a new facility,” explains GS&P senior project manager Skip Yauger. “So the Americus and Sumter County Hospital Authority sought a partner, and after seeking proposals from interested parties, Phoebe Putney Health System was selected to be that partner.”
In October 2008, Phoebe Putney Health System agreed to invest in, develop and operate a new replacement facility, to be renamed Phoebe Sumter Medical Center. With the goal to build a new state-of-the-art medical center that not only met the specific needs of the community, but also attracted top-tier physicians and nurses from larger cities such as Atlanta, GS&P was selected to master plan and design its new acute-care hospital.
Built in the 1950s, the original facility was closer to the center of town, and there were a number of constraints on the 13-acre site, including a 40-foot drop in topography from one end to the other. In addition, the site was landlocked by major roads and residential areas, and it was clear that future growth would be limited without acquiring a new location.
When Phoebe Putney Health System became a partner, it purchased a new 270-acre greenfield site that would give the hospital room to grow for the next 100 years. Its location at the intersection of two major highways was ideal in terms of making the new hospital far more accessible both to city and county residents.
Engaging Staff and the Community
As the third largest employer in Americus, the loss of Sumter Regional’s facilities struck a severe economic blow. There were fears within the community that if the hospital could not be rebuilt quickly enough, the city of Americus would face further economic hardship. In addition to being a major employer, Sumter Regional was also interconnected with many of the businesses and educational institutions within the city. Additionally, without a hospital, the city would have a much more difficult time attracting new residents to the area due to the lack of emergency health services.
“The community was desperate to have a hospital again,” says Yauger. “The people of Americus had managed to rally together following such incredible devastation, and when the time came to design and build the new facility, it was important to engage the community to help begin the healing process.”
To help gain community support and also encourage staff buy-in, the team implemented an all-inclusive design process. Team meetings were held in a downtown Americus storefront building so passersby could see the team at work, or maybe even stop in.
“We met with numerous community groups and leaders, as well as medical staff, patient focus groups and other city representatives. In short, everyone involved was on board to help. Even the mayor said, ‘Just tell us what to do, and we’ll do it!’”
Right-sizing the Hospital
GS&P was initially charged with designing a 100-bed hospital. However, it soon became apparent that the community didn’t merely need to replace what was lost. They needed a new facility that was rightsized and designed to provide an efficient, flexible and patient-centric healthcare environment.
“We went through a detailed market analysis to determine the optimal number of beds for the new facility,” says Marc Sauvé, senior health strategist. “We evaluated components such as population service areas, demand for hospital service lines and demographic trends. Based on our analyses, we recommended that a 76-bed facility—with the potential to expand to up to 250 beds—was much more reasonable and financially sustainable.”
In addition, the GS&P team worked closely with hospital staff to garner a thorough understanding of their operational processes.
“We brought in staff from every department within the hospital,” says Sauvé. “We discussed their current practices and then looked for opportunities to improve those practices. The process resulted in a number of takeaways that we incorporated into the design that would improve staff efficiency and the overall patient experience.”
Reimagining the New Facility
After right-sizing the future hospital’s bed capacity, the design team worked with the owner to develop a series of site planning strategies. After evaluating multiple concepts, the decision was ultimately made to arrange the new 76-bed, 190,000-square-foot hospital (and three freestanding medical office buildings) around a central green space the team dubbed the “town square.”
“The city of Americus is rich in history and culture,” says GS&P senior designer Jim Kolb. “The town has a legacy of historic structures that they’re incredibly proud of. When we met with the owner to determine the goals and vision for the project, we established several key design drivers. These included capturing the quality of the town’s historic character, as well as creating a campus that was a destination and an economic magnet for the community.
“This led to a design response related to New Urbanism, which is a strategy for organizing buildings and public spaces that are pedestrian-friendly, and involves understanding how a building fits within the larger whole. Rather than design a single building, we decided to create a medical village that consisted of four structures organized around a public town square. This is a little unique in healthcare. Typically, you’ll see a parking lot and the building is set behind it. But we didn’t want the parking lot to be the centerpiece. We wanted the heart of the campus to serve as a stage for community events and reflect Phoebe Sumter’s commitment to Americus.”
Creating a Village
To fortify the new hospital against future natural disasters, precast concrete and brick were used in lieu of a more typical alternative such as stucco. To aesthetically complement the town’s historic core, the design team incorporated context-appropriate architecture—a key element of New Urbanism—into the new medical village. Standing seam metal roofs were used to give the hospital a traditional feel, while precast accent bands were added to punctuate the exterior’s striking brick façade. Aluminum airfoil sunshades, reminiscent of awnings found on downtown buildings, were utilized on the hospital’s south elevation. Throughout the new facility’s interiors, darker woods and a warm color palette of brown hues was used to reinforce the historic arts and crafts context.
“We expressly designed the hospital’s front entrance to look like the lobby of the downtown Americus Windsor Hotel, which was built in 1892,” says Kolb. “Everybody in the community recognizes that space, and it’s a correlation that gives the building such a strong sense of place for the community.”
In keeping with the historic theme, the medical village’s three outpatient buildings—wellness and education; surgery and oncology; and women’s and family health—were also designed to contribute to the campus’s unique appeal.
“Each building entrance has a different experience, creating a unique sense of arrival within the larger medical campus,” says GS&P senior designer Elisa Worden-Kirouac. “The designs drew from a similar kit of parts, so as a collection of buildings, they harmonize well together, yet are unique enough to create visual interest and diversity.”
“And each building has its own personality,” adds Kolb. “The wellness and education building was modeled after a gymnasium or field house. Its exposed metal trusses in the roof are what you might see in an old college campus. The women’s and family health building has a lighter feel with its soft colors and white interior woodwork, while the surgery and oncology building strikes a more embracing and nurturing feel with its darker wood tones and arts and crafts details. All three buildings are different, yet they tie in perfectly with the overall historic concept.”
To augment the medical village’s historic look and feel, the design team closely collaborated to develop a library of authentic details that could be used in different combinations throughout the campus.
“We incorporated simple ideas like adding wood trim above the doors, which really changes the character of a space,” says GS&P interior designer Carolyn Blake. “And we thought a lot about the patient experience—from the lobby to the clinical areas to the patient rooms. Every place a patient or visitor might go conveys a message of welcome and reassurance.”
Clear patterns for expansion were established both for the hospital and the medical office buildings, ensuring future growth that’s complementary to the master plan. Additionally, outparcels on the site were designated for future development with medically related retail, restaurants and physician offices to increase density and minimize sprawl.
“At the end of the day, we wanted to pay homage to the town’s historic character, and at the same time communicate that the new hospital campus is a cutting-edge medical facility,” adds Yauger, “and I believe we struck the perfect balance.”
Evidence-Based Design And Sustainable Strategies
Along with reflecting the town’s architectural character, the use of evidence-based design and environmentally sustainable design strategies were key drivers for the project.
“The new facility remembers a past technology of cutting light wells into a building,” says Kolb. “If you look at a contemporary hospital, the clinical base is typically a large mass that’s not punctuated with any daylight or windows. But we were able to carve out light wells in the emergency room and radiology. As a result, the ER nurse station has a good view both of the patient rooms and the garden. Usually, a person working in a nurse’s station never knows what time of day it is in terms of lighting. Studies show that there’s diminished alertness when you’re removed from environmental factors, which can lead to increased errors. The incorporation of natural light in this instance will help improve those factors. We also aligned the behavioral health room with a garden light well. This is an area where patients often suffer the most from sensory deprivation, and we’ve provided a superior environment for that population.”
Incorporating evidence-based design strategies into patient rooms—such as family zones and bedside control of the environment—was also a major focus during the design process. Detailed mockups were built for LDRP, med/surg and CCU rooms and were made available to the public in the downtown Americus storefront. Each detail of the rooms, from door hardware to the location of medical gases, was tested to ensure they functioned as intended. Rooms were standardized to decrease the chance of medical errors and improve the overall patient experience.
To provide patients with a pleasant view and add to the facility’s overall sustainability, a roof garden was situated on top of the hospital’s main building. The 24,000-square-foot green roof—one of the largest in the Southeast—reduces glare into patient rooms while diminishing the heat island effect.
“We didn’t like the thought of two patient floors looking out onto a dull gray roof,” says GS&P project architect Brian Schulz. “So we pushed for a vegetative roof that would not only reduce heat coming off the rooftop, but also create a much better view from a patient’s window. We used drought-resistant, indigenous plants that are specially cultivated to live in that type of environment. The native plants are also self-propagating, so they’ll continue to spread over the rooftop and thicken over time.”
In addition to the rooftop garden, another key sustainable strategy was the design of four 20,000-gallon cisterns for rainwater harvesting. Located beneath the medical village’s town square, the large reservoirs were designed to reduce the hospital’s dependence on city water for irrigation of the site. Use of indigenous plants and high-efficiency irrigation equipment also help to conserve water. Other eco-friendly components include low-VOC products, lighting sensors, low-flow plumbing fixtures and the use of local materials with recycled content.
With the distinction of being the first LEED Silver certified medical campus in the southeastern United States, Phoebe Sumter Medical Center stands as an iconic symbol of hope and represents a new beginning for the city of Americus. Completed three million dollars under budget and ahead of schedule, the replacement facility not only provides first-class healthcare services while honoring the town’s history, but it also brings back a sense of permanence and pride to a once devastated community.
“We wanted to give Americus a new healthcare destination they could be incredibly proud of, one that would attract new medical staff, be an economic engine for the community and provide state-of-the-science medical care for every family,” says Yauger. “The project has exceeded everyone’s expectations by achieving all of these goals. And it is beautiful too.”