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Seattle Children’s Hospital Transforms Big Box to Community Clinic

May 2017


Seattle Children’s Hospital Transforms Big Box to Community Clinic

By Kate Freels, AIA LEED GA, CREW Seattle and Sound

As modern healthcare places a greater focus on the delivery of whole-person care, healthcare facility development is changing in response. Many hospital systems today adopt a decentralized facility planning strategy to bring outpatient care into once-underserved suburban communities—closer to patients—with the intention of easing the demand for acute care.

The new suburban clinics that result are often located in highly-visible areas—retail strips and power centers—with easy access to public and private transportation. As a result, they have the potential to revitalize suburban retail development by leveraging proximity: clinics offer premier care near patients’ homes and workplaces, and the additional convenience of being adjacent to established retail destinations. The clinics’ new context also nudges healthcare design to respond to tenets of retail design, and provides healthcare systems with an alternative to leasing a medical office building or developing a building ground-up.

From the healthcare provider’s perspective, locating ambulatory care and its accompanying parking to a location with lower leasing rates benefits patients while reducing operational costs. Choosing a site for such a clinic is contingent upon proximity to acute-care resources while avoiding redundancies by not building within other clinics’ service areas.

When Seattle Children’s Hospital sought to expand its service to new communities south of Seattle (Washington, U.S.) in Federal Way, the opportunity to adapt a vacant big box retail store—a former Circuit City—emerged. Located in a shopping center near a major freeway and arterials, the Circuit City site offered many immediate, ready-made benefits to both the surrounding communities and Seattle Children’s. The site’s shopping center context provides visibility, access, and ample existing opportunities for parking, signage, entrance, and egress. Although Federal Way is a full 30 miles from Seattle Children’s acute care facility, the big box’s sheer amount of usable, flexible space would facilitate incorporating laboratories, general X-ray, ultrasound, pharmacy and rehab therapy that would then resolve the issue of distance between this location and acute care resources.

The motif of circles on Seattle Children’s South Clinic’s envelope overlaps the ground plane and is picked up again in the landscaping, blurring between these two planes for visual interest. Stippled metal and large windows for daylighting create a playful environment and fun yet sophisticated architectural presence for this world class provider of children’s healthcare.

It was determined that inherent elements of the 37,000 sq. ft former store—one level, wide spans between structural columns—would advance clinic goals around patient experience and efficient delivery of care. The store’s footprint facilitated a clinic floor plan designed to centralize services within an open, flexible system of workspaces and modules that incorporate principles of lean design. The space today includes three identical clinical modules, each consisting of 10 exam rooms and a team room work area. Those clinical spaces and others, including the on-site lab and rehab gym, remain unencumbered by the structural columns common to other types of existing buildings. Key lean design decisions reduced patient and staff travel distances, decreased storage space, and decreased the total number of specialty treatment rooms from 20 to 5. The existing building’s single-floor, monument-free design supported those lean initiatives.

The adaptive reuse of a Circuit City leverages the retail center’s existing parking lot and proximity to retail destinations for patient convenience and community economic development. The building façade’s relative flatness and use of graphic punch creates a powerful and impactful visual statement from the scale and perspective of nearby roadways as patients and their families drive to the facility.

Once inside, graphics, the furniture, and lighting evoke both the Seattle Children’s brand and the aesthetic inspiration of nearby Dash Point Park. Wood slats, evocative of trees, define the lobby from the more private patient modules beyond.

Yet, despite these positive attributes, challenges did arise in adapting a retail space into a state-of-the-art healthcare facility. Significant infrastructure upgrades were required. However, the building’s flexibility and accessible location—and the opportunity to bring equity in care to the community—led Seattle Children’s to proceed to convert the empty big box.

Construction began in June 2014, and, as expected, upgrading infrastructure proved to be among the project’s biggest tasks. A retail store is not equipped with the extensive electrical and mechanical systems necessary for exam rooms or labs; those utilities would need to be added or overhauled. Facilitating these upgrades in a space with a 25-foot floor-to-ceiling height included the creation of an internal structural frame to support mechanical and electrical improvements and provide the basis for a lowered, 10-foot ceiling plane for experiential comfort. This internal frame also works in concert with a seismic upgrade, which facilitated the punching of much greater fenestration into the building envelope. Construction was staged so interior tenant improvements occurred with site abatement. Seattle Children’s worked with the Federal Way Police Department and the development’s property manager to ensure a safe environment and a supportive relationship with nearby retailers.

Exam rooms are assigned colors that ascribe to the module in which they are located. Casework treatment evokes the pattern and colors of a forest.

A basketball court aids in sports therapy. Transparency between the court and the adjacent lobby assists in wayfinding and fosters a more comprehensive understanding of Lean-driven building flows.

Seattle Children’s South Clinic opened in August 2015, on-schedule and under-budget by 2.5% of construction cost estimates. It provides outpatient services to families in two of Washington’s most populous counties. Staff members report that duplicate medical record collections have been eliminated and return-visit scheduling communication has improved, attributing both to the clinic’s design. The success of the project allows the main Seattle Children’s campus to focus on acute care as planned, and Seattle Children’s has since designated this design as the prototype for ensuing clinics. Seattle Children’s South Clinic sets a precedent for retail-to-healthcare conversion nationwide, and presents adaptive reuse as a viable option for producing stellar decentralized facilities, all in support of advancing the direction toward greater preventive care

Katherine FreelsKate Freels, AIA LEED GA, is an Associate Partner at ZGF Architects LLP, and specializes in design and design project management for commercial, institutional, and healthcare industry clients. Freels is a member of CREW Seattle and Sound.