HCA’s StoneSprings Hospital Center
Setting a New Standard
Hospital Corporation of America (HCA) is the nation’s leading provider of healthcare services with approximately 165 hospitals and 115 freestanding surgery centers in the United States and United Kingdom. HCA employs more than 200,000 people and provides up to 5 percent of all inpatient care in the U.S. Founded in 1968, HCA was one of the nation’s first for-profit hospital companies, as well as one of GS&P’s first clients. GS&P and HCA have since enjoyed a successful working relationship for more than 45 years.
In 2013, HCA selected GS&P to design a new 124-bed, 234,000-square-foot greenfield hospital in Dulles, Virginia, that would bring much-needed healthcare services to a rapidly growing community.
“HCA recognized a great opportunity to expand their market share in Northern Virginia,” says Ken Priest, senior vice president for GS&P’s Nashville Design Studio. “Their other facilities were too constrained for further expansion. The StoneSprings location provided a fresh start for a new facility that would demonstrate HCA’s dedication to personal, community-focused healthcare.”
Thoughtful, Efficient Planning
HCA originally tasked GS&P with taking the company’s existing model for a new hospital and adapting it to fit the specific programmatic requirements for StoneSprings. The overall scope needed to be reduced, but the design team knew the layout could also be more efficient and delved into an exhaustive study of the existing facility plans to maximize efficiency, improve departmental adjacencies, and enhance internal circulation.
“One of the first things we did was walk through another HCA facility with the client and ask questions regarding efficiencies that could be incorporated into our design,” explains Scott McQueen, senior healthcare principal. “We also clarified the circulation and imagined ways to make the hospital wayfinding more intuitive.”
“As trusted consultants, we felt it was our duty to do our homework,” notes intern architect Chris Hoal. “We didn’t want to move forward without asking all the necessary questions and finding every last possible improvement.”
What started out as a simple design exercise ultimately turned into a rigorous audit of HCA’s accepted model for a new hospital. The team outlined ways to achieve better departmental relationships, delineated zones for expansion, and improved patient, staff and material flows. The result was an efficiently engineered hospital for 124 beds, but with 70,000 fewer square feet.
“We proposed two options for improving the existing hospital layout,” adds designer Traci Myers. “One was a more efficient adaptation of their existing plan, and the other was essentially a redesigned prototype. Our design went above and beyond the client’s expectations, giving HCA another option for future opportunities.”
In executing the new model, the single biggest challenge the GS&P team faced was time, which was quickly running out given the rapidly approaching expiration of the hospital’s Certificate of Need (CON).
“The certificate is a way for local communities to regulate the construction of new healthcare facilities according to market need,” says Myers. “By the time HCA had settled on and secured this particular location, the CON had run out of extensions. We had six or seven months to complete the design, and 18 months to build it.”
“We also had to fulfill requirements related to planned urban development, including zoning, elevations, and types and amounts of materials used,” notes McQueen. “The client’s floor plan/building footprint had been pre-approved before the design process started, so we had to contend with fixed starting points, such as the location of the front door and the placement of the emergency department. In the end, that meant going with the more efficient adaptation of the existing plan.”
A Modern, Sensitive Design
GS&P’s layout resulted in reduced square footage, better-organized departments and improved flow. The design also reinforces staff and patient well-being through intuitive wayfinding throughout the hospital.
“You always know where you are in the building,” says Priest. “When you step off an elevator, you can tell what floor and department you’re in. We also better specified the delineation between staff and public areas, which is extremely helpful in a naturally stressful environment. Another design component is a connector that runs between the hospital and the medical office building in case a patient needs to go for tests or consultations. The facility is one-stop shopping and very easy to navigate.”
“A public spine connects all the places a patient might go, and beyond that, you have a spine linking staff to their relevant departments. So the back-of-the-house staff activity is separate,” adds McQueen.
“Public spaces are also linked visually,” notes Hoal. “The main lobby has a large glass front that looks down into the courtyard near the medical office building. This sets the stage for finding yourself in a certain place. As you move up the building through the elevator, you have views to help locate yourself in the space in an intuitive way.”
“The layout and design both set a tone and expectation from the outside in,” notes Priest. “Patients and visitors walk into a bright, cheery and confident environment that speaks to HCA’s competency and dedication.”
On the exterior, it was imperative that GS&P appropriately embed the facility in a county that’s defined by its history and horse farms.
“StoneSprings is located along a corridor that transitions from the Colonial developments of eastern Loudoun County to the ‘horse country’ farms, Civil War trails, and historic sites of western Loudoun County,” explains senior interior designer Julia Boren. “We explored a more neutral palette than what HCA was typically accustomed to and created a more contemporary hospital that pulled in the wood and stone detail of an adjacent horse pasture.”
Through the composition of both traditional materials and modern forms, StoneSprings Hospital Center embraces Virginia’s historical context as well as its future.
A Sustainable, Cost-Effective Facility
GS&P embraces best practices in sustainable design for both good environmental stewardship and economic efficiency. The new state-of-the-art medical center fully embodies this mandate.
“The first tenet of being a good steward of the environment is to ‘reduce,’” says McQueen. “The exterior design simplified the form and cut out the fluctuations of surfaces from HCA’s previously accepted design. The modern look and feel is much leaner with fewer parts and pieces.”
StoneSprings’ reduced interior layout and choices for décor also resulted in substantial energy and cost savings to the client.
“The hospital layout retained its effectiveness for patient care and circulation, but with 70,000 fewer square feet,” says Priest. “Beyond savings in construction costs, the new design will naturally lower energy usage and operating costs that would have come with all that extra space.”
“One of the questions we faced was: How do you take the budget you have and create something that lives up to high expectations? You simply have to build more economically while also producing a high-end look,” says Boren. “To achieve that, we used paint instead of vinyl wall coverings, and in place of terrazzo tile we used porcelain arranged in a way that was still elegant.”
To increase energy efficiency and combat noise from the nearby Dulles airport, the design team upgraded the windows to an ultra-thermal system, used ample brick for sound and thermal insulation, and chose thicker exterior insulation finish systems.
A Boon to the Community
In addition to providing high-quality healthcare to Loudoun County, StoneSprings Hospital Center will provide 500 new jobs and generate $2.1 million in local tax revenues for community services.
“HCA’s decision to plant a flag in this community will generate a lot of new business in that market,” notes Priest. “Hospital employees and office tenants will eat, shop, and fill their gas tanks at local businesses.”
“Physicians and other medical professionals are very interested in moving to this new facility,” adds McQueen.
“The medical office building filled up so fast we had to add two more floors. The hospital prototype that we designed will make it easy for HCA to expand StoneSprings from the back and add another 124 beds once future demand requires it.”
Slated to open at the end of 2015, the new hospital is projected to receive more than 3,200 admissions and nearly 20,000 emergency room visits in its first year.
Designed and equipped to provide the Loudoun County area with comprehensive inpatient, outpatient, surgical and diagnostic medical care, the new StoneSprings Hospital Center comprises 124 beds, including 104 medical and surgical beds, 10 intensive care unit beds, and 10 labor, delivery and postpartum recovery beds. The 234,000-square-foot facility also accommodates 15 emergency room bays (incorporating trauma), a cardiac cath lab/OR, and five diagnostic imaging rooms including MRI, CT and nuclear medicine. In addition, the 51-acre site encompasses a 100,000-square-foot medical office building.
Through an intimate understanding of the client’s goals, GS&P successfully integrated the new hospital into a historic Virginia community while effectively balancing an aggressive schedule, the constraints of pre-approved site designs, and HCA’s desire for improving the hospital’s efficiency and patient appeal.
“I’m proud of how well we worked under those specific pressures,” says Myers. “We were behind schedule from day one, but we pulled it off successfully in half the normal time with half our usual people. We truly gave HCA something more than they expected—something quite different from your typical hospital.”
“I am very pleased with GS&P’s design,” notes W. Mark Rader, CEO of StoneSprings Hospital Center. “The exterior of the building is modern, yet ties in the history of Northern Virginia through the use of stone, reminiscent of the stone walls still found in the surrounding countryside that pre-date the American Civil War. The interior layout is patient- and visitor-friendly, with ample space for guests to wait comfortably while a loved one is being cared for. I am very happy with the completed project and look forward to our community benefiting from this facility for many years to come.”