Scott & White University Medical Center
Round Rock, TX
The Scott & White Hospital and associated Clinic/MOB is located on a 67-acre site in Round Rock, Texas. The campus and support services were planned by Page to accommodate future expansion to a 300-bed hospital and additional MOBs, some of which has since been executed. With the design of this first phase of the University Medical Campus (UMC), Page was challenged by Scott & White Healthcare not only to design an efficient, yet welcoming patient-centered healthcare campus, but particularly to create an integrated solution that responded to three important client needs.
First, the design had to incorporate evidence-based design concepts that would promote superlative patient care, as well as attract the best doctors and staff possible. Second, the design should reinforce the architectural brand of the Scott & White Healthcare system first established several years earlier by Page at the main campus in Temple, Texas. And finally, the UMC facility needed to be designed logically for future expansion to support the rapidly growing Round Rock healthcare market.
The first goal—a state of the art, patient-centered healing environment based on evidence-based design concepts—was accomplished through several design strategies. The underlying organizational element is a wide daylit concourse that runs along the entire public entry side of the project, from the clinic at the south end to the patient tower elevators and cafeteria at the north end. The concourse functions at three levels: it allows completely transparent and user friendly way-finding, with all major departments and vertical circulation elements located directly off the concourse. Situated adjacent to two healing gardens and connected to them via large spectrally selective glass window walls, the concourse provides access to nature and daylight for all major public spaces. The linear concourse also provides a framework for the logical expansion of the facility without compromising the intuitive ability to navigate the facility. The themes of circulation clarity, nature and access to daylight are reinforced by the use of natural materials, including stone and brick on the exterior; slate floors, wood paneling and nature-inspired art glass on the interior; and spatial drama exemplified by the two-story, light-filled atrium at the hospital entrance. These same principles are then carried through to the rest of the facility, including the patient rooms where large windows introduce natural light and views, and clear user zones facilitate efficient and unobtrusive patient care.
Architectural branding and continuity were important factors for the client as they made this major move into the Austin healthcare market. The UMC hospital is the first greenfield hospital built by Scott & White since Page designed the new Center for Advanced Medicine for its flagship Temple hospital. Page redefined the Temple facility’s dated image and provided it with a strong visual identity rooted firmly in regional and sustainable concepts. At the Round Rock campus, the defining pilasters of native limestone interspersed with horizontal bands of red ledgestone have been successfully deployed not only to provide a strong identity for Scott & White but also to reinforce the warm, inviting and stress reducing character of the facility. Using an easily identifiable architectural vocabulary based on regional and sustainable materials, as well as a strong but flexible geometric scheme, gives Scott & White the ability to adapt these concepts to a variety of facilities in the future.
With the Austin area being one of the fastest growing healthcare markets in the United States, the ability to successfully expand the UMC was a prime consideration. Page addressed this by doing extensive plan and three dimensional studies of possible growth scenarios. The result was a clear yet flexible scheme organized around the central concourse/spine that allowed the hospital to later accommodate growth up to 300 beds, expansion of the clinic as well as the addition of several medical office buildings, all the while maintaining a user friendly way-finding environment.
Phase I campus development involved the construction of the hospital, a clinic/MOB, and a central plant. The four-story, 193,000-gross-square-foot hospital contains 76 private inpatient beds (48 medical / surgical beds, 12 step-down telemetry beds, six ICU beds, and 10 LDRP rooms with two C-section rooms). The surgery suite, designed to accommodate both outpatient and inpatient surgery, contains four operating rooms (expandable to eight ORs), an 11-bed PACU, 18 pre-post recovery beds, and central sterile supply. The three-story, 81,000-gross-square-foot clinic / MOB provides exam, office, and support modules for 40 physicians with expansion capacity to accommodate 25 additional practitioners. The two-story, 6,800-gross-square-foot central plant houses the chillers, boilers, emergency generators, and electrical switchgear and is designed to expand to accommodate the 300-bed / multiple MOB campus configuration. The central plant is connected to the hospital by an underground utility tunnel.
When Scott & White later expanded the surgical unit as expected to meet growing demand, Page added several key clinical areas including a vertical addition providing 4 new operating rooms and 25 new ICU patient rooms above existing occupied areas, and a horizontal addition with 8 new ER exam rooms, a new laboratory, and a new administrative office and conference suite. All clinical areas remained operational during construction, with zero impact to patient services. The team was also able to accelerate the schedule during construction and completed the ICU patient rooms two months ahead of schedule.
Two new floors were stacked vertically on top of the existing structure, housing the Surgery expansion at the second floor, and a new ICU Suite at the third floor. The surgery expansion doubled the number of operating rooms from 4 to 8, including 2 cardiovascular rooms which allowed the hospital to begin a new heart program. The surgery expansion also provided a 12 bed PACU, expanded central sterile and significantly increased surgical equipment storage. A third Endoscopy procedure room was also created, and was opened early allowing immediate use of this procedure room to respond to a spike in demand for these services. The new ICU suite is located directly above surgery, minimizing travel distances from the ORs and PACU. The 26 new patient beds increase the total bed count to 101, and were opened three months early to make the additional beds available in time for flu season. The vertical stacking brought several challenges with plumbing and medical gas risers being shared with existing spaces below, however through detailed coordination and an integrated delivery method, the phasing of construction and tie-ins to systems were coordinated with users well in advance to avoid any conflicts. This approach enabled the project to achieve the desired stacking of the program, and provided the best possible adjacencies for functional operation of these high acuity departments within the hospital.
A horizontal addition at the ground level provides additional space which includes an expanded Emergency Department, new Laboratory, new Radio-Fluoroscopy Imaging suite, an Administrative Office Suite, Conference Center, and new Loading Dock and Support Services areas. It was critical to maintain lab services throughout the project, so the phasing was sequenced to maintain the existing lab in service until the new lab was certified and operational in the new space. The Emergency Department was then able expand within the existing core of the hospital, adding 8 new exam rooms yet maintaining necessary adjacencies with the imaging department and the patient elevators up to surgery. The Conference Center and Radio-Fluoroscopy Imaging suite were not part of the original scope of the project, but were identified as high needs early in programming and were able to be incorporated into the project while remaining within the client’s budget.