A café terrace and colorful lobbies are obvious giveaways that Seattle Children's Bellevue Clinic and Surgery Center in Bellevue, Washington, is special among the cluster of medical buildings adjacent to the I-405 freeway. A prototype for a series of ambulatory surgical care centers planned around the region, this clinic is a welcoming presence amidst the more institutional-appearing neighbors for young patients. The American Institute of Architects (AIA) agrees, having awarded the center a 2011 AIA Healthcare Design Award.

The team behind the innovative clinic hails from the Seattle office of NBBJ, a firm that's been honored for numerous healthcare projects through the years. For this facility, NBBJ embraced the client's commitment to Continuous Performance Improvement (CPI), a practice of reducing waste and increasing efficiency through continuous small adjustments. The result is a lean design that is still rich in human experience for patients and staff.

Thoughtful programming

Even before entering the building, approaching families spot welcoming qualities from a steel-framed, mesh-screened zone running the length of the clinic's glazed facade. This outdoor space houses a café as well as a healing garden, with views out over a green roof. Inside, a bright orange wall draws attention to the patient check-in area of the light-filled lobby. Farther in, different hues are used for each exam-room corridor to facilitate wayfinding.

There's more to navigating the center besides color cues. A key CPI concept identified early in the design process was separation of patient circulation from staff and equipment. Most facilities use the same halls and room doors for both patient and caregiver, creating bottlenecks. NBBJ double-loaded the exam rooms with patients entering from a dedicated corridor and staff entering from a common teaming area that's sandwiched between the rooms. Separate circulation systems imply increased footprints, but the 80,000-square-foot building is almost 30 percent smaller than originally planned, thanks to minimized circulation and increasing efficiencies. For example, doctors collaborate with staff at rolling workstations with equipment close at hand in the teaming areas, and that efficiency leads to shorter wait times which, in turn, allow for smaller lobbies―now 1,650 square feet compared to the programmed 5,000 square feet.

NBBJ challenged conventional ideas about room size requirements by researching via full-scale mockups of exam rooms, surgical suites, and waiting areas built within a vacant office building. Doctors, staff, and patients role-played different scenarios to test operational flows and room layouts with the results fed back into the design. For instance, stretcher storage is traditionally outside operating rooms, but the mock-up experiment enabled NBBJ to configure rooms that incorporate the stretchers within, leading to a reduction in room size from 635 to 550 square feet. "The use of prototyping and departmental mock-ups dramatically improved healthcare flow," says Cindy Evans, vice president, ambulatory and regional services for the hospital.

One of the most significant outcomes of CPI was the decision to connect induction rooms to operating rooms. "When we recreated the path of gurneys we realized that every turn reduces efficiency, so we designed straight shots between induction and surgery," explains project architect Reeve Elliott. It also increases patient safety since they don't move through an unsanitary corridor to surgery. Pairing two induction rooms with one surgery allows quicker breakdown and turnaround time. More importantly for families, parents can stay with a child during sedation.

NBBJ also used Integrative Project Delivery (IPD) to foster collaboration between team members. Early on, the architects met with the local electric company to identify incentives and ways to lower energy costs using turbo-chillers, lighting control, and shading. Sustainability was not necessarily a client goal at the start of the project, but the architects tracked LEED points as decisions were made and the efficient building has achieved Gold certification. Natural materials and textiles were selected, including perforated wood for ceiling sections and rubber cork flooring, and green roofs were incorporated on top of the entry canopy, vestibule, parking, and sports medicine gym.

While sophisticated in appearance, the facility also boasts family-friendly design. Vibrant color on the first floor is just a start. The second level's surgery check-in area offers cushiony, colorful seating and windows looking into a playroom. A glazed corridor brings in light and assuages any ideas of medical centers as dungeons. Outside doors leading to surgery is a cheery mural depicting local flora and fauna. And as patients undergo sedation, they literally see stars—in the good sense—thanks to a backlit ceiling that mimics a nighttime sky.

National recognition

Significantly, this was the only completed, built project to win a 2011 AIA Healthcare Design Award. According to the AIA, this award is intended for projects that "exhibit conceptual strength to solve aesthetic, civic, urban, and social concerns as well as the requisite functional and sustainability concerns of a hospital."

Seattle Children's Bellevue Clinic and Surgery Center. Architect NBBJ. Where Bellevue, Washington. What 80,000 total square feet on two floors. Cost/sf $337

SOURCES

ARCHITECTURE PROJECT TEAM

Jay Halleran, partner-in-charge; Brian Zeallear, project manager; Brian Uyesugi, lead designer; Reeve Elliott, designer; Hao Duong, lead medical planner; Dick Lee, medical planner; Jim Hobbs, architect; Scott Johnson, architect; Jane Loura, healthcare operations; Gary Mo, BIM lead; Chris Dixon, specifications; Duane Jonlin, code expert

INTERIOR DESIGN PROJECT TEAM

Diane Lindberg-Nigh, interior designer; Marcy Naismith, interior designer; Stacy White, interior designer

CONTRACTOR

Sellen Construction

LIGHTING CONSULTANT

Cierra Lighting Group

ENGINEERING

PCS Structural Solutions - structural; Affiliated Engineers, Inc. - mechanical, electrical

KITCHEN

Starbucks

LANDSCAPE

Site Workshop

GRAPHICS

NBBJ

ACOUSTICIAN

Sparling

WALLCOVERINGS

Carnegie, Forbo

PAINT

Benjamin Moore, Kelly-Moore, ICI, Sherwin Williams

LAMINATE

Formica, Arpa, Abet Laminati

DRY WALL

Type X, Quiet Rock

FLOORING

Dal Tile, Nora Rubber, Expanko, Zandur, Pental

CARPET/CARPET TILE

Shaw Contract Group, Bentley Prince Street, InterfaceFLOR

CEILING

Armstrong

LIGHTING

Spectrum, Halo, PDS, Rambusch, Fiberstars, Portfolio, Focal Point, Metalux, Coreline, Failsafe, Sharper, Eureka, SPI, Resolute, Lumark, Rebelle, Prisma, Winona, Bartco, Prudential, Bruck, Everbrite, Bronzelite

DOORS

Goldfinch Bros.

GLASS

PPG Solarban; Goldfinch Bros. - installation

WINDOW TREATMENTS

Naysan Shading Systems Ltd.; Spring Window Fashions

FURNITURE

Herman Miller - workstations, tables; Harter - tables; Softcare - tables; Community Playthings - tables; Landscape Forms - tables; Nurture - tables; Vecta - tables; Izzy - files; TU - files; Meridian - files; Custom Interiors - shelving

SEATING

Herman Miller - workstation seating; Keilhauer - lounge; Hag - lounge; Brayton - other; Coriander - lobby; Brayton - other; Knoll - other; Segis - other; KI - other; Landscape Forms - other; Cabot Wren - other; Legacy - other; Intensa - other; Sittris - other

UPHOLSTERY

KnollTextiles; Designtex; Architex

ARCHITECTURAL WOODWORKING

Custom Interiors

ACCESSORIES

Site Workshop

SIGNAGE

Graffix Inc.

PLUMBING FIXTURES

Zurn; Kohler; Elkay