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St. Bernard Parish Hospital

On August 29, 2005, Hurricane Katrina struck New Orleans, Louisiana, producing sustained winds estimated at 125 miles per hour. Bordering the city’s Lower 9th Ward, St. Bernard Parish was all but destroyed when a massive storm surge (triggered by Katrina’s driving rains), breached the parish levees. At the heart of the tight-knit community, Chalmette Medical Center had managed to weather the Category 3 storm’s violent winds, but succumbed to the subsequent flooding that occurred the following day.

 

 

Helicopters evacuated 300 patients and hospital employees from the roof of the medical center as it was overcome by the rising waters. When the waters receded, primary medical services for the parish were provided in a temporary clinic that was set up in a vacant Wal-Mart parking lot. In time, healthcare was delivered in a 22,000-square-foot mobile unit.

Damaged beyond repair, Chalmette Medical Center was ultimately demolished. Over time, the people of the parish slowly started to rebuild and the population began to rebound. However, officials feared that growth within the community would not continue without a hospital.

After several years, St. Bernard Parish secured both the funding and community support needed to build a new hospital. Ready to bring healthcare back to its residents, the St. Bernard Parish Hospital Service District charged GS&P with designing a three-story, 40-bed replacement facility that would not only withstand future disasters, but also reflect the community’s history.

“The project quickly became the centerpiece of the parish’s rebuilding efforts,” says Scott McQueen, GS&P principal-in-charge on the project, “and it didn’t take long for the design team to feel a deep sense of responsibility for the people of Chalmette. We knew that this hospital was the next step to getting the community back on its feet.

“At first, we didn’t know where the new site was going to be located. Eventually, the Meraux Foundation—which put a lot of money into rebuilding the entire parish—donated a parcel of land to the Hospital Service District.”

The new site, however, also had a high risk of flooding. Yet the prohibitive cost of finding and purchasing an alternative property had the potential to end the long-awaited project before it even began. Aware of the importance of the project’s financial success, the design team moved forward with the new location.

A complete site evaluation was performed in an effort to understand the contextual structures, utilities, possible parking areas and access points throughout the available and adjacent properties. Major design implications included aspect and prospect views to the site, wind patterns, sun angles and other environmental factors.

“The site was 3 feet below sea level and 4 feet below Katrina’s high water marks,” explains McQueen. “To bring the site above the floodplain, we added 75,000 cubic yards of sand fill to the site, which consisted of incredibly soft organic soil. A geotechnical report confirmed that if we tried to place the building on top of the existing soil, it would have settled anywhere from 19 to 23 inches over a period of time. We let the sand fill sit for several months so it would reduce any future settling. The final grading ultimately raised the existing grade of the site by 4 feet, which put it 1 foot above sea level.”

Adding sand fill to the site also helped protect the Gulf South Pipeline, which was buried approximately 12 inches below grade. Additionally, by berming the entire site by 4 feet, the dangers of annual flood intrusion were mitigated.


Preventing Future Storm Damage

To prevent history from repeating itself, one of the Hospital Service District’s key goals was to design the hospital so flooding couldn’t cripple the facility. To achieve this, the team carefully programmed the three-story building to withstand the devastating effects of a hurricane.

“Our team explored many different options to raise the hospital to an elevation where floodwaters couldn’t intrude,” says McQueen. “However, because cost prevented us from fully protecting the entire structure, we worked with the hospital to come up with a solution that protected essential services and equipment within the project budget. We placed all of the engineering items—from air handlers to switchgear to the hospital’s fuel tank—16 feet above the base flood elevation, on the second level of the building. That way, if water infiltrated the facility, only items not essential for critical operations would sustain damage.”

Although the parish would require the hospital to close under extreme flooding conditions, the GS&P team designed the new facility so it could be up and running as soon as the waters receded. Each department was analyzed for its programmatic flexibility and degree of public access, the cost and mobility of its related equipment, and the types of wall and floor finishes required. Of primary importance were the OR and patient rooms, which were placed on the second and third floors respectively.

One department that had to remain on the building’s first level due to access concerns was the emergency department. However, the team’s design concept of raising surgery to the second floor would allow the associated prep and PACU bays to serve as a makeshift ED should the building’s first level become unusable. In addition to custom space planning to maximize the building’s safety and efficiency, the entire facility was designed to be impact resistant.

“One of our major goals was to build a stronger hospital for the community, and just about everything had to be impact resistant,” says GS&P senior architect and project team member Rob Hamby. “For instance, glass had to be laminated, and we specifically designed for potential wind loads. In addition to raising the facility, 80-foot piles were driven down into the ground just to support the columns and the edge of the building. We knew the community couldn’t emotionally or financially afford to go through the same thing again, and it was our job to design a hospital that was built to last.”


Re-establishing the Parish’s Identity

Though the people of St. Bernard Parish certainly live with the memory of the catastrophic flooding, the community still sees water as something to celebrate. For this reason, the team developed the unique design concept of a river that passes through the main form of the building and provides circulation between departments.

“We didn’t want to ignore the fact that the flood happened, so that’s essentially where the idea came from,” explains GS&P project coordinator Anna Barnes. “We used the river as a concept because one of the main elements of the Creole culture is water. The people have always lived on the water and have always embraced its challenges, so it’s not something they’re just going to turn their backs on. The overall design concept uses the river as a divider, but it can also be seen tying the structure back together, integrating its various parts and pieces.”

The glass curtain wall, which forms the exterior of the river, provides patient rooms and public spaces with ample sunlight and sweeping views. The distinctive architectural concept also enhances wayfinding, helping visitors circulate through the hospital to major departments and patient rooms. The bend of the river—as it passes through the building mass—cradles most of the facility’s public and social areas.

To understand the hospital’s desired image for the exterior of the new building, a visioning session was conducted between the owner and the design team. This process helped to develop a baseline for discussions and resulted in a cohesive design with buy-in from all parties.

“We went through several options on the brick color,” says McQueen. “The one thing the owner didn’t want was for the brick color to resemble mud. Everything was covered with mud after Katrina, and they were understandably very sensitive to that type of shade. We eventually settled on a neutral brick color, which gave the exterior a modern feel that was in keeping with new construction that was beginning to dot the landscape. The entire area was starting to take on a more upscale, contemporary flavor, which we wanted the hospital to follow.”

Tasked with reflecting the community while celebrating the history and culture of the parish, the design team used images of the regional landscape and local historic figures throughout the hospital’s interiors.

“Although the appearance of the parish was in a state of flux, the interior design encourages community pride,” says McQueen. “No matter what direction people move in, they will be reminded of their home, its past and its present value in their lives.

“The color and form of the interiors were also rooted in the natural environment of the region,” adds Barnes. “We used wood in the ceilings and main lobby spaces, which was in keeping with the conceptual relationship of the bayou. In addition, we incorporated a huge, two-story wall graphic of the parish that shows Lake Borgne and the bayous that surround it.

“We also tried to bring in as much natural light as possible and maximize the surrounding vistas,” stresses McQueen. “We placed large windows at the ends of the corridors and used a lot of glass in the patient rooms. From the building’s third floor, you can clearly see Lake Borgne and the river on the other side. It’s a wonderful view.”


Rebuilding the Population

With much of the parish’s buildings, amenities and local infrastructure destroyed by the flooding, the new hospital became an icon for residents to rally around. A symbol of progress and recovery, the community’s new medical center needed to bolster a recovering economy, and give evacuees a reason to move back home. To do this, St. Bernard Parish Hospital would have to deliver exceptional and progressive medical care.

In an effort to create an advanced medical facility that could attract world-class health professionals, the GS&P team utilized best practices in their design work. With no current staff available from whom to draw opinions, the design team decided to start with a blank slate. That way, no matter who staffed the future hospital (or what their individual practice styles were), the medical environment would be easy to navigate.

“Because the hospital had zero staff and had yet to hire new administrative staff, nurses and physicians, we had an opportunity to utilize all the best practices we knew that highlighted patient safety and staff efficiency,” says Barnes. “Starting with a blank canvas enabled us to focus on what we knew worked best from a planning standpoint.”

“And we tried to keep things standardized as much as possible,” adds McQueen. “We placed particular emphasis on providing same-handed work spaces to the hospital staff and clinicians. That familiarity between patient rooms can greatly reduce medical errors, as opposed to mirroring the room layouts. We located the sink beside the bed in each patient room so staff can wash their hands, and patients can see them wash their hands, which is important. We also designed the rooms to have large windows that let in plenty of natural light and provide a connection to nature, which reduces stress and promotes healing.

“This new hospital is the catalyst for bringing people back to the parish because they’re not going to return to a place where there’s no quality healthcare. The community now has a cutting-edge medical facility that will undoubtedly bring back former residents and attract top-tier medical staff.”

Featuring emergency, surgery, diagnostic imaging, pharmacy, laboratory and support services, St. Bernard Parish Hospital opened its doors seven years after a colossal storm surge destroyed the previous facility. The 109,000-square-foot hospital’s ability to withstand extreme weather and water conditions was soon tested when Hurricane Isaac barreled into Louisiana’s Gulf Coast.

“The new facility remained fully functional during major power outages, high winds and flooding, and it sustained no significant damage,” says McQueen. “The emergency generators we put on the mechanical platform on the second floor worked beautifully, so the hospital was able to keep power throughout the hurricane. One of our primary goals was to create a robust building and a safe environment for the people of St. Bernard Parish. Surviving the storm in such a big way proves we did just that.”

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Project Info

  • Client: St. Bernard Parish Hospital District
  • Location: Chalmette, LA, USA
  • Market: Healthcare Design, Rural and Critical Access Hospitals, Rural and Critical Access Hospitals
  • Services: Architecture, Engineering
  • Team:
    • C. Scott McQueen, NCARB, LEED AP Principal-in-charge, Project Designer, Project manager
    • S. Robert Hamby, AIA, NCARB, EDAC, LEED AP Project Architect, Project Designer
    • Anna L. Ward Barnes, LEED AP Project Designer, Project Coordinator
    • James D. Graham
    • Dennis L. Meikrantz
    • Ryan Sweeney, P.E.
    • Tom Taylor
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