UPMC Hamot Women’s Hospital Erie, Pennsylvania
by Todd Hutlock, Editor-in-Chief
Leadership at UPMC Hamot Hospital in Erie, Pennsylvania was at a crossroads. Faced with the choice of upgrading-or perhaps even removing-its women’s healthcare services, the board of directors ultimately decided not only to stay the course, but to build a beautiful new facility to house them. With the addition of an outside physician’s practice to boost census overnight, UPMC Hamot Women’s Hospital was born, designed to treat its clientele with the care and attention it so richly deserves, with picturesque views of nearby Presque Isle Bay as a bonus. HEALTHCARE DESIGNEditor-in-Chief Todd Hutlock spoke with Principal Ross Rectenwald, AIA, Project Manager Gregg Daubenspeck, and Interior Designer Dan Wallace of Rectenwald Architects, Inc., and Debbie A. Burbules, RN, BSN, MPA, president of UPMC Hamot Women’s Hospital, about the project.
A vision of change
Debbie A. Burbules, RN, BSN, MPA: UPMC relocated its women’s services into Hamot Women’s Hospital in January 2011, ahead of the original scheduled opening of April 2011. Historically, the OB and NICU departments were collocated on one very old unit in the oldest part of the main hospital. We started planning for the movement of our women’s services about five or six years ago, and our board considered everything, including getting out of the maternity business altogether. But the board finally decided that we wanted to be in women’s services and that if we were going to do it, we wanted to do it right. The decision was made to finally put energy and dollars into developing women’s services to the caliber that we needed to properly serve our community, and to bring those services up to par with our other clinical service lines. The first shovel went in the ground in August 2007.
Ross Rectenwald, AIA: Between our firm and hospital planners Gresham Smith and Partners, we embarked on a roughly six-month study on how to make this project work in the existing building footprint. In fact, when our firm was first hired, we were initially planning to turn the behavioral health building into a medical office building (MOB). Despite the fact that the behavioral building was only two stories, it had the infrastructure and supports to accommodate five stories, and so it turned out to be an ideal site for the women’s hospital. We also were able to connect this building to the adjacent main hospital and the Hamot Heart Institute. Eventually, we wound up building the MOB for UPMC Hamot about three blocks away and building the women’s hospital on this site at the same time.
Burbules: Hamot Women’s Hospital is located adjacent to the main hospital. The footprint of our behavioral health services building was used as the base of the new women’s hospital; it was a two-story building that was gutted and three additional stories were then built on top, resulting in the new five-story women’s hospital. It is connected via a covered walkway on the ground level to the main hospital.
Currently, the building houses all of our obstetrical and gynecologic surgeries, as well as our maternity unit, our nursery, and NICU. We also are in the process of moving over our women’s cosmetic surgeries and breast surgeries. The building has five ORs for women’s surgical procedures and a post-op recovery unit.
Rectenwald: Approaching the building, visitors drive into an existing parking lot in front of the heart institute. The heart institute already had a drive-thru canopy in front of the building, and we extended it around the corner to allow drop-offs at either the heart institute or the women’s hospital underneath the canopy.
Upon entering the women’s hospital, patients and visitors first encounter a two-story lobby space, with information and valet parking desks. The lobby is split level, with the entry lobby at the floor level of the heart institute and the upper lobby at the floor level of the original behavioral health facility-there is a difference of about 18 inches between them. The main feature of the lobby is a 40-foot-long waterwall-basically a glass wall that separates the secure elevator lobby and the main public lobby. This leads to a security check-in desk, which is essential in a women’s hospital. The triage area with nine exam rooms is directly behind the security desk; expectant mothers are kept here until doctors confirm they are ready to deliverat which point they are taken upstairs to the labor and delivery ward.
The building is located on a bluff overlooking Presque Isle State Park, with gorgeous views of the natural surroundings. We tried to bring all of those natural features inside the building to create a calm environment for mothers-to-be and surgery patients. Half of the patient rooms look out over the bay, and the other half look into the downtown area, so there are great views from everywhere in the building. All of the finishes we used were earth tones that helped make this connection to nature. All of the elevators in this building, at every level, empty into a public lobby that faces Presque Isle Bay, further taking advantage of the beautiful views.
Gregg Daubenspeck: In conjunction with the opening of the hospital, Hamot began ran a fundraising campaign focused on the faces of women. Today, visitors walk up a gradual incline near the café on the first floor toward a large mosiac art piece of women’s faces from around our community-a ceramic piece done by a local artist-that was the result of this program.
Rectenwald: The second floor contains the 24-bed NICU. The NICU is a wide-open space-there are no private NICU rooms-and basically is set up in pods, with 14 acute care beds and 10 intermediate beds, two of which are isolation rooms. We created an “outdoor” area in the space-each pod consists of four beds around a central shaft, which we turned into a “tree” with drywall soffits around them creating leaves and limbs. The flooring has a laser-cut “creek” that runs throughout the floor, as well, and one wall has a mural made to look like a meadow. The ceiling has a bunch of “clouds” around the perimeter of the space, which also helps provide the correct type of lighting. A NICU should not have any direct light, so we placed lighting above the clouds and trees, allowing us to reflect the light off the upper ceiling, creating the preferred indirect light.
Parents who have children in the NICU are basically here 24/7, and it is very stressful. We wanted to design the space to help calm them, so there are lounge areas for those times when they need to get away. There is a “quiet” lounge and a “noisy” lounge, as well as a kids’ play room so other children can be occupied while the parents are there.
While the NICU takes up the majority of the second floor, there also are two Care by Parent rooms. These are like hotel rooms that are used by parents the last night before taking their new babies home after a NICU stay. It’s really a place for the parents to become comfortable caring for their babies on their own, but with proper medical backup on hand if necessary.
The second floor also includes on-call rooms for physicians, as well as the offices of the building’s administrative staff.
Delivery and patient rooms
Rectenwald: The third floor is home to 10 labor and delivery rooms, each with a private bathroom, shower, and a whirlpool tub used for hydrotherapy and massage. We were charged with making these spaces look like a high-end hotel or a spa, not clinical. There are also five identically designed ORs to be used for any type of procedure that might need to be done, from a C-section to any kind of GYN surgery.
The core area of this floor is two prep and PACU areas. One side is for the OB procedures, with two prep rooms and three PACU beds, and the other side for GYN surgery with three prep areas and four PACU beds.
The fourth and fifth floors are identical. The fourth floor is used as a postpartum floor, with 24 patient rooms with private baths, and shelled space for six additional beds. One difference between the fourth and fifth floors is the small holding nursery on the fourth floor. The hospital’s concept is to keep the babies in the rooms with the mothers, but there are times that new babies simply won’t sleep and the mother needs rest. In those cases, the baby can be taken to the holding nursery to give mom a break for a few hours.
The fifth floor has 16 beds for GYN surgery patients, and 8 beds for antepartum patients, which are high-risk pregnancy moms. There is a simulation lab on the fifth floor, as well, for training staff for procedures.
Daubenspeck: The patient rooms are all similar in size and are same-handed to aid nursing staff efficiency. The LDR rooms are approximately 475 square feet, including the inboard toilet room, and the postpartum and antepartum patient rooms are approximately 375 square feet, also including the toilet room.
Interior design details
Dan Wallace: We designed these rooms with a spa or high-end hotel room in mind. There are four different color schemes used on the fourth and fifth floor patient rooms, varying from blues to golds to reds and terracotta. The rooms all have quiet wood-look linoleum flooring under the beds.
In the labor and delivery rooms, we kept everything the same. We used a teal blue color as an accent, and a stone-type ceramic tile with glass-tile accents to provide that high-end look we were going for around the soaking tub and in the toilet rooms.
We used a lot of the same natural colored, maple-like wood laminate throughout the building, so the entire building is coordinated that way. We used it in all the casework, armoires, and the like. The rooms have a homey look to them, as well, and we included sleeper sofas and ambient lighting to lend to that homelike sense of comfort.
Rectenwald: The headwall cabinetry in the LDRs is all the same natural wood color used throughout the hospital, as Dan mentioned. This cabinetry helps to hide all the medical outlets, adding to the hotel-like feel.
Wallace: At the beginning of this project, we created a master color palette for the building. On every floor, we tweaked the color scheme so each floor has its own personality to help visitors recognize their surroundings. All of the waiting areas that are off of the elevators are very similar in size and shape, but we changed the colors to keep them easily identifiable visually. We also used printed translucent resin panels with inner layers of organic material to give each floor its own personality, so one floor may have green grasses while another has flowers. These same themes are incorporated into signage and nurses’ stations. We also designed architectural elements into the ceilings of the corridors that mark entrances and doorways.
After we finished this building, the main hospital caught the bug, so to speak, and so now we are slowly transferring these design elements to the main hospital creating a unified look.
Burbules: Given the tough economic times since we started this project, I fully expected to hear some community members complain that we were building a women’s-only facility, but there has been overwhelming positive feedback from women and men alike. The common theme of their comments is that they can’t believe we would invest so much time and money into a women’s hospital, but they are so thrilled and excited that we did.
At the end of the day, hospital leadership wanted to usher in a new era in the delivery of women’s healthcare in the region, and wanted a facility that was going to deliver that. We wanted a facility that was going to draw in the beauty of the community, as well as be a very soothing, calming, aesthetically pleasing, and not overly institutional-looking building, and I think we were able to accomplish that. An atmosphere of calm, quiet serenity pervades the entire building. HCD