{"id":53297,"date":"2022-03-02T10:41:07","date_gmt":"2022-03-02T15:41:07","guid":{"rendered":"https:\/\/healthcaredesignmagazine.com\/?p=53297"},"modified":"2023-04-26T16:07:05","modified_gmt":"2023-04-26T20:07:05","slug":"right-path-penn-medicine","status":"publish","type":"post","link":"https:\/\/healthcaredesignmagazine.com\/projects\/right-path-penn-medicine\/","title":{"rendered":"Penn Medicine 17-Story Pavilion Makes Impact In Philadelphia"},"content":{"rendered":"

From the beginning, Penn Medicine\u2019s new Pavilion was going to be a big deal. The $1.6 billion inpatient building on the Hospital of the University of Pennsylvania\u2019s (HUP<\/a>) campus in Philadelphia marks the largest capital project in the University of Pennsylvania\u2019s history.<\/p>\n

Furthermore, it expands the academic medical center\u2019s research, clinical care, and education offerings, including cardiology, oncology, neurology, emergency, and transplant.<\/p>\n

It’s also the latest piece of an overall vision that started nearly two decades ago to transform HUP into a connected medical campus.<\/p>\n

IPD process guides medical campus planning<\/h2>\n

That vision would call for a sizable building\u2014specifically, a 1.5 million-square-foot, 17-story facility that houses 504 patient rooms, 47 ORs, and a two-story emergency department with 61 exam rooms.<\/p>\n

Due to the massive size of the project, leaders at Penn Medicine saw an opportunity to utilize an integrated project delivery<\/a> (IPD) process for the first time. In 2015, a multidisciplinary IPD team, called PennFirst<\/a>, was formed.<\/p>\n

Comprising Penn Medicine, architecture firms HDR<\/a> and Foster + Partners<\/a>, engineering firm BR+A<\/a>, and construction managers L.F. Driscoll<\/a> and Balfour Beatty<\/a>, the team had more than 100 team members housed together in a collocation office (called \u201cthe collo\u201d) on Penn\u2019s campus throughout most of the seven-year project.<\/p>\n

\u201cIt was really kind of a learning lab that was designed to promote the collaboration and innovation that we were looking for,\u201d says Sara Gally, interior design principal at HDR (Philadelphia), which was the architect of record on the project and designer of the clinical areas. Foster + Partners, which collaborated with HDR on the overall architecture, provided the design of the exterior and public space interiors.<\/p>\n

Outlining project goals<\/h2>\n

One of the first tasks of the IPD team was outlining a set of guiding principles focused on patient experience, investing in the community, innovation, enhanced patient care, and designing for flexibility.<\/p>\n

Daryl Bodewin, director of strategic projects at HDR (Princeton, N.J.), says a \u201cpatient first\u201d mentality permeated the decision-making process from the start. As such, the team focused on providing private patient rooms equipped with the latest technology to help patients engage in their care.<\/p>\n

Another goal was to create a \u201cfuture-ready\u201d building with acuity-adaptable patient rooms capable of flexing from medical\/surgical to intensive care. Hybrid operating rooms (ORs) with intraoperative MRIs and infrastructure to support evolving technologies were also important.<\/p>\n

\u201c[Penn] wanted to make sure the building had the ability to adapt and grow as healthcare changes, so they wouldn\u2019t lose that patient experience, and that they can always maintain that level of care over the life of the building,\u201d Bodewin says.<\/p>\n

Campus vision at Penn Medicine<\/h2>\n

While the size of the building was embraced, the design team wanted to make sure it complemented the existing medical center buildings. It also had to fit in with neighboring University of Pennsylvania Museum of Archaeology and Anthropology (known as the Penn Museum), a historic facility that incorporates a variety of architectural styles, including a rotunda.<\/p>\n

\u201cAs we studied the building more and more, we felt like we shouldn\u2019t try to pretend that it\u2019s not big and break it down into lots of different pieces,\u201d says Chris West, partner and architect at Foster + Partners (New York). \u201cInstead, we decided to treat this building as a large sculptural element and not try to conceal that.\u201d<\/p>\n

Balancing the desire to be a good neighbor while creating a new campus landmark, the project team decided to forgo a more traditional rectangular building shape and round the ends of the Pavilion.<\/p>\n

The decision was a nod to the museum\u2019s architecture that also helped to \u201csoften the building\u2019s presence,\u201d says Derek Tasch, health system architect at Penn Medicine (Philadelphia). \u201cIt also makes it a little more welcoming and fitting in the space.\u201d<\/p>\n

Pivotal project change<\/h2>\n

Inside, however, the facility was shaping up to resemble a lot of other hospitals. Specifically, patient floors would utilize a racetrack layout with two patient units divided by a single public core in the middle. Patient rooms would wrap around the perimeter, including the curved ends of the building.<\/p>\n

Because of the IPD approach, clinicians and staff had been involved throughout the design process; the team had utilized table-top models, room mock-ups, and visualization tools such as virtual reality glasses to review layout and room concepts with the staff.<\/p>\n

\u201cEveryone was seemingly happy with the direction we were going in,\u201d Tasch says.<\/p>\n

Taking it one step further, the team decided to build a 30,000-square-foot Styrofoam mock-up of part of an inpatient floor. Next, they brought in nearly 500 hospital staff, including clinical surgeons, nurses, environmental services staff, mock patients, and food service, to tour and participate in simulations and day-in-the-life scenarios to help find any friction points that might need to be addressed.<\/p>\n

\u201cIt was the most important moment in the project,\u201d Tasch says.<\/p>\n

However, instead of reassuring the team that it was on the right path, the process resulted in some unexpected feedback. Specifically they heard about walking distances, the size of the floor plate, and access to daylight.<\/p>\n

For example, West says the goal was to make all the acuity-adaptable patient rooms identical in size and layout. However, the ones that wrapped around the curved ends of the building were more irregularly shaped, which impacted clinical care.<\/p>\n

Furthermore, the configuration of the public elevators in the middle of the building meant some visitors would have to walk nearly 300 feet to their destination, West says.<\/p>\n

Rethinking hospital layouts, operations<\/h2>\n

Rather than move forward on that plan, the team decided to spend another few months rethinking and redesigning the layout.<\/p>\n

Among the changes that ultimately came out of the process were elongating the building to 650 feet to get all the patient rooms to the same square layout and size. Also, family lounges were added at the rounded ends of the floors to help bring daylight into the corridors. Another change was designing two separate sets of public elevators to reduce walking distances. Utilizing a flexible planning system, the 72-bed inpatient floors were able to be broken down into smaller units to respond to changing needs and patient demands.<\/p>\n

Once again, the team built a 30,000-square-foot mock-up of the patient floor\u2014a process that went much better the second time around and led to getting the right hospital built, Tasch says. \u201cIt was the best thing that ever could have happened to us,\u201d he says.<\/p>\n

Defining elements of The Pavilion<\/h2>\n

Opened in October 2021, the Pavilion features a variety of amenity spaces on the first two floors, including a chapel, caf\u00e9, cafeteria, and family caregiver center. The interventional and patient floors are housed on levels four to 14.<\/p>\n

Within the clinical areas, the building programming was arranged so that ICU care and inpatient units for specific service lines, such as oncology, are placed on the same floor. This allows care teams to respond quickly to changes in care level or treatment needs.<\/p>\n

Meanwhile, neuroscience research and care are brought closer together through an advanced epilepsy monitoring unit and a human neurophysiology research lab.<\/p>\n

Interior design focuses on hospitality elements<\/h2>\n

For the interiors, PennFirst focused on elements of hospitality to create a welcoming, noninstitutional setting. The overall neutral palette features natural materials in strategic locations to add a sense of warmth. They also serve as visual cues to support wayfinding, such as copper portals to frame the entrances to the elevator lobbies on the first floor.<\/p>\n

Wood is used throughout the facility, starting with bigger gestures in the public spaces\u2014such as on the ceiling in the main corridor on the first floor or on the walls of the elevator lobbies. This creates a sense of welcome within the environment.<\/p>\n

Wood is also used more sparingly on the patient care floors to denote specific focal points, such as at the footwall in the patient room, Gally says.<\/p>\n

The clean aesthetic also provided a backdrop for two art installations in public areas of the hospital. For example, a vibrant mural by Philadelphia artist Odili Donald Odita starts on the first floor and stretches up to the second floor and down a corridor.<\/p>\n

The other work, a handmade glass sculpture titled \u201cDecoding the Tree of Life\u201d by artist Maya Lin, is installed in a quiet respite space near the chapel on the first floor and rises through an opening in the floor to the second level.<\/p>\n

\u201cIt goes from being a very dynamic piece at its top to a very contemplative piece at its base,\u201d Gally says.<\/p>\n

Designing to achieve LEED Gold certification<\/h2>\n

Throughout the facility, a priority was made to use materials, indoor finishes, and furniture that would contribute to healthy indoor environments, says Eileen Gohr, senior sustainability consultant at HDR (Atlanta).<\/p>\n

Specifically, the project used guidance from the Health Product Declaration Collaborative<\/a> and U.S. Green Building Council\u2019s LEED<\/a> for Healthcare guidelines. (The Pavilion is the largest project in the world to achieve certification in LEED v4 Gold Healthcare.)<\/p>\n

Along with indoor air quality, the building also was constructed with energy- and water-saving features, such as low-flow sinks and showers and low-flush toilets, which are expected to cut indoor water use by 30 percent.<\/p>\n

\u201cWe really wanted to deliver an environmentally responsible contribution to the campus,\u201d Gohr says.<\/p>\n

Prefabrication supports project goals<\/h2>\n

Additionally, during construction, about 25 percent of materials were prefabricated and manufactured off-site, which helped to minimize on-site waste and reduce site congestion.<\/p>\n

Ed Hanzel, vice president at L.F. Driscoll (Bala Cynwyd, Pa.) and the project executive representing the construction team on PennFirst, says a multidisciplinary group within the IPD team was organized early in the project to consider how prefabrication could be utilized.<\/p>\n

The bathroom pods for the facility\u2019s 504 patient rooms were a good place to start, he says, because of the repetition of elements and potential for cost and time savings. But the project team didn\u2019t stop there. It also prefabricated the headwalls; nurses\u2019 alcoves on the patient floors; and 570 mechanical, electrical, and plumbing racks.<\/p>\n

Turning to the exterior architecture, West says the PennFirst team chose a lightweight extruded aluminum panel system that\u2019s used on louvers, which conceal the mechanical systems housed on the rooftop as well as the second and third floors, and the spandrel panels of the building.<\/p>\n

\u201cIt unifies the building and kind of echoes the scale of brickwork but in modern way,\u201d West says.<\/p>\n

Inspiration for the color scheme came from the historical deep purple\/brown-colored brick that\u2019s used throughout the university\u2019s campus and in some of the existing building on the medical campus.\u00a0 \u201cIt shines and catches the light in different ways and gives a real visual complexity that\u2019s quite nice to look at,\u201d West says.<\/p>\n

Flexible healthcare design<\/h2>\n

Reflecting on the project, Tasch says many of the firsts on the project for Penn Medicine, including the IPD and prefabrication processes, are tools that he expects the healthcare organization to take forward to future projects.<\/p>\n

\u201cWe\u2019re still working on our lessons learned, but these are certainly things that we\u2019re going to revisit and continue with and improve upon,\u201d he says.<\/p>\n

Alyson Cole, associate executive director, HUP transition and occupancy, at Penn Medicine, says feedback so far has been positive on the new Pavilion. Specifically, some of the building\u2019s inherent features have supported infection control during the pandemic, such as the private patient rooms and the updated HVAC system, which provides outside air to the patient rooms.<\/p>\n

Additionally, she says staff members have commented on the access to natural light and the fluidity of the patient floors, which helped eliminate barriers between units.<\/p>\n

Looking ahead, she says Penn Medicine plans to do more in-depth review and study of the building and operational performance. It plans to look at energy- and water-saving features, patient experience, and investments in flexibility, particularly in the acuity-adaptable patient rooms.<\/p>\n

\u201cIt was designed to be flexible,\u201d she says. \u201cTime is going to tell if, in fact, we are as flexible as we think we have built to be.\u201d<\/p>\n

Project details for The Pavilion at the Hospital of the University of Pennsylvania:<\/h2>\n

Project open date: October 2021<\/p>\n

Owner: Penn Medicine<\/p>\n

Total building area: 1.5 million sq. ft.<\/p>\n

Total construction cost: $1.6 billion<\/p>\n

Cost\/sq. ft.: +\/- $1,000<\/p>\n

Architect, interior designer, general contractor, engineer, builder: PennFirst<\/p>\n

Art consultant: Ivy Press<\/p>\n

Signage\/wayfinding design: Cloud Gehshan<\/p>\n

AV equipment\/electronics\/software: Schneider Electric (low voltage integrator), JBB (A\/V design), Yorktel (A\/V install)<\/p>\n

Carpet\/flooring: Mannington, Polyflor, Duraflex, Sika,<\/p>\n

Ceiling\/wall systems: Armstrong Ceilings, MFPhD<\/p>\n

Doors\/locks\/hardware:\u00a0 Acrovyn Doors, Stanley Doors, BEST, Sargent, McKinney<\/p>\n

Fabric\/textiles: Maharam, Pallas, Designtex, Momentum, CF Stinson<\/p>\n

Furniture\u2014seating\/casegoods: Allsteel, OFS, KI, Davis, Hightower<\/p>\n

Handrails\/wall guards: IPC<\/p>\n

Headwalls\/booms: Modular Services Co. (headwalls), Stryker (booms)<\/p>\n

Lighting: Vode, Axis, Crenshaw, Fluwerx, Finelite, Focal Point, Gotham, Kenall, LF Illumination, Lucetta, Lutron, Pinnacle<\/p>\n

Signage\/wayfinding: AGS<\/p>\n

Surfaces\u2014solid\/other: Wilsonart, Corian<\/p>\n

Wallcoverings:\u00a0 IPC<\/p>\n

For an additional article on the transition and activation of Penn Medicine’s Pavilion, go here<\/a>.<\/p>\n

Anne DiNardo is executive editor of <\/em>Healthcare Design. She can be reached at <\/em>anne.dinardo@emeraldx.com<\/em><\/a>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Penn Medicine utilized an IPD design process, prefabrication, and LEED design features in constructing the 1.5 million-square-foot Pavilion on its Philadelphia campus.<\/p>\n","protected":false},"author":2812,"featured_media":53316,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[538,537],"tags":[],"acf":[],"aioseo_notices":[],"parsely":{"version":"1.1.0","meta":{"@context":"https:\/\/schema.org","@type":"NewsArticle","headline":"Penn Medicine 17-Story Pavilion Makes Impact In Philadelphia","url":"http:\/\/healthcaredesignmagazine.com\/projects\/right-path-penn-medicine\/","mainEntityOfPage":{"@type":"WebPage","@id":"http:\/\/healthcaredesignmagazine.com\/projects\/right-path-penn-medicine\/"},"thumbnailUrl":"https:\/\/healthcaredesignmagazine.com\/wp-content\/uploads\/2022\/03\/penn3-150x92.jpg","image":{"@type":"ImageObject","url":"https:\/\/healthcaredesignmagazine.com\/wp-content\/uploads\/2022\/03\/penn3.jpg"},"articleSection":"Acute Care","author":[{"@type":"Person","name":"Anne DiNardo"}],"creator":["Anne DiNardo"],"publisher":{"@type":"Organization","name":"HCD Magazine","logo":""},"keywords":[],"dateCreated":"2022-03-02T15:41:07Z","datePublished":"2022-03-02T15:41:07Z","dateModified":"2023-04-26T20:07:05Z"},"rendered":"