Contract - The Art of Healthcare Design: Laguna Honda Hospital moves into its next century of service with a design by Stantec/Anshen+Allen

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The Art of Healthcare Design: Laguna Honda Hospital moves into its next century of service with a design by Stantec/Anshen+Allen

11 October, 2010

-By Jennifer Thiele Busch


“When I am no longer even a memory, just a name, I hope my voice may perpetuate the great work of my life.”
—From a rare recording of 70-year-old Florence Nightingale’s voice, captured on Edison Paraffin Wax Cylinder on July 30, 1890.

Florence Nightingale’s memory lived on in the generations of San Franciscans who have spent time at Laguna Honda Hospital, a skilled nursing center based on Nightingale’s nursing philosophy that was built in 1866 to care for indigent Gold Rush pioneers and was finally replaced in 2010 by a state-of-the-art, acute care and rehabilitation facility designed by Anshen+Allen. Admittedly, the 30-person “Nightingale Wards” of the original facility have given way to a contemporary healthcare model that emphasizes patient privacy over communal care, but down to the last detail the new Laguna Honda represents Nightingale’s most important legacy and the “great work” of her life: an ethos of humane, patient-focused care.

Laguna Honda’s history—and particularly its 10-year march toward modernization and rebirth—is a long and complex story. Suffice it to say that in a way, the new facility is the tobacco industry’s gift to the City of San Francisco. Dreadfully outdated by local seismic and federal patient privacy regulations, as well as the advance of time and technology, Laguna Honda had been continuously threatened with closure since 1984 and might well have been shut down had it not been for the determination of then-mayor (now California State Senator) Dianne Feinstein, who wanted Laguna Honda to remain a vital source of healthcare for the people of San Francisco, and City Attorney Louise Renne, who in 1998 allocated the Bay City’s share of California’s $20 billion tobacco industry lawsuit settlement toward fixing Laguna Honda, which by then had become a pressing public health issue.

It was a big problem that required a big design solution. In 1999 Anshen+Allen partnered with the office of Gordon Chong (now Stantec) to answer an RFP to design the new hospital. The $784-million, 750-resident, LEED Silver-certified, skilled nursing facility finally and triumphantly celebrated its grand reopening on June 30, 2010.

Lawrence Funk, associate administrator of Laguna Honda Hospital, explains that the new Laguna Honda reflects the same values of patient-focused care upon which the original hospital was built, and that the ambitious mission for the new facility is to encourage rehabilitation and independent living while setting a national and international standard for the enhancement of the quality of life. Early descriptors for the design included the words innovative, technologically advanced, efficient, flexible, humane, natural—and importantly, accessible, given Laguna Honda’s history of service to the less fortunate. Still today, a majority of residents are indigent. “Socioeconomic status did not cause us to limit our vision,” says Funk. “It is a San Francisco value that we take care of those in need.”


Adding to the designers’ challenge was the need to fulfill the goals in a way that puts each resident at the center of his or her own care by creating an environment that emphasizes independence. “All residents can choose their own path,” explains Mivic Hirose, executive director at Laguna Honda. “Laguna Honda used to be a place where people came to live the rest of their lives. Today, it is a stepping stone, a place to reinvigorate them for the next step in their lives by promoting maximum physical and cognitive independence.”

With an extensive program that includes everything from rehabilitation with hope of independent life to a continuum of care for the aged and infirm that emphasizes independence for as long as possible, the design team made “resident-focused care” its overarching goal. “We took it as a point of inspiration,” says Anshen+Allen principal Jeff Logan. “The neighborhood concept we generated was inspired by that directive.”

Floor plans, circulation paths, and amenities were all developed to approximate varying levels of domesticity and independent life, and the design solution began with the massing of the buildings nestled in the hills of the Laguna Honda site in the western part of the city. Each floor of the two, multistory residential towers (one five stories, one seven) contains distinct “households” of 15 residents each, combined in “neighborhoods” of four households (or 60 residents). At this most intimate level, residents enjoy private or semi-private rooms with shared bathrooms, household living rooms with flat-screen television, and core neighborhood centers with activity space, dining facilities, dedicated kitchens where fresh food is plated, and outdoor terraces.

Laguna Honda wholeheartedly embraces its site and the designers took great care to activate the outdoor spaces—the facility opens up to a valley complete with gardens, walking paths, a greenhouse, wander garden, and basketball court. But each residential area also was given a terrace so residents “don’t have to leave their neighborhoods to go outdoors,” explains Anshen+Allen associate principal Sharon Woodworth. In addition, “we incorporated as much southern light into the design as possible,” she says, with three of the four living rooms in each neighborhood facing south and the fourth facing west. Logan notes that light and views create a real sense of place and are among the things he likes best about Laguna Honda. “Visual access to the landscape offers residents the same kind of lifestyle as anyone living in San Francisco,” he says.

The towers are connected by a four-story link building or “Pavilion” that houses inpatient and outpatient rehabilitation services, as well as a café, art studio, multimedia library, community meeting room, barber and beauty shops, a tropical bird aviary, and a cafeteria with indoor and outdoor seating. These public amenities are located along a broad indoor boulevard known as the Esplanade in a way that references the activity of a city street. On the exterior, “the design reflects these sensibilities,” notes Logan. “The architecture of the two towers has a domestic feel to it, while the Pavilion building is a more civic response.” Operationally, the link building also includes a transport floor that efficiently connects the two towers, but its far greater value is experiential; it adds much to the holistic quality of institutional life by encouraging exercise and mobility and drawing residents out of the isolation and into the social life of Laguna Honda.

“It is also one of the places where the integration of art and architecture was really important,” says Logan. Since 1969, municipal ordinance in San Francisco has dictated that 2 percent of the construction costs for public projects be dedicated to art enrichment programs, which translated into $3.9 million for Laguna Honda. “Wayfinding, passage of time, texture, personalization of space, interaction, engagement…these are all things our program contributes in conjunction with the architecture,” says Susan Pontious, public art program director for the San Francisco Arts Commission.

Each residential floor was assigned to a selected artist who in turn created an art program that helps facilitate wayfinding and differentiate between households, making it easy for residents to understand their whereabouts as they leave and return to their neighborhoods and households. In public spaces, such as the lobby and Esplanade, the art programs took on more historic or inspirational tones, as in a series of Louis DeSoto tapestries depicting the history of Laguna Honda, a mosaic mural of the Golden Gate Bridge by Owen Smith, and a 400-ft. handrail in the Esplanade by artist Cliff Garten. “The hospital handrail is ubiquitous, but here it became a piece of art,” says Woodworth. “It becomes a fanciful element that has beauty, texture, patina.”

In total, Laguna Honda currently holds 110 commissioned pieces with 87 more planned for the collection. “I can’t think of another facility that has art integrated to this degree,” say Pontious. It’s a facility of firsts in many ways, and for the design team a just reward for 10 years of diligent planning without ever losing sight of the needs of the patient. “Our goal was to do it once, and do it right,” says Funk. This was the opportunity of a lifetime for the San Francisco area, and hopefully it will serve us for the next 90 years.”

who
Project: Laguna Honda Hospital & Rehabilitation Center. Owner: City and County of San Francisco, Department of Public Health. Architect: Anshen+Allen Architects and Stantec Architecture - Laguna Honda Joint Venture Architects. Associate Architects: Powell & Partners Architects, Aviva Litman Cleper Architects, Tsang Architecture. Interior designer: Kai-Yee Woo & Associates, Fougeron Architecture. Contractor: Turner Construction Company. Construction manager: M. Lee Corporation. Low-voltage consultant: Vantage Technology Consulting Group. Telecom consultant: Teecom Design Group. Code consultant: Rolf Jensen Associates. Plumbing/Fire Protection: SJ Engineers. Cost estimator: TBD Consultants. Material management/vertical transportation: Lerch Bates Hospital Group, Inc. Hospital operations: HFS Consultants. EIR: Impact Sciences. Lighting designer: JS Nolan + Associates Lighting Design. Structural engineers: Rutherford & Chekene, Forell/Elsesser Engineers, Ansari Structural Engineers, Bello & Associates. MEP engineer:Arup & Partners California. Civil Engineer: AECOM. Electrical engineer: F. W. Associates. Geotech engineers: URS Corporation, Robert Y. Chew Geotechnical. Food Service Consultants: Cini-Little International, Inc. Landscape Architects: Office of Cheryl Barton. Wayfinding/Signage:Kate Keating Associates. Acoustician: Charles M. Salter Associates. Furniture dealer: Corner Office, Furniture by William Webb, One Workplace, Pivot Interiors, Resource & Design, Workspace Solutions. Photographer: David Wakely.

what
Wallcoverings: Daltile, Ann Sacks. Paint: ICI, Scuffmaster, Tnemec, Kawneer. Laminate: Abet Laminati, Formica, Nevamar, Wilsonart. Dry wall: Georgia Pacific. Flooring: Armstrong, Expanko, Forbo, Mats Inc., Mannington, Tarkett, Terra Green Cermaics, American Terazzo. Carpet/carpet tile: Mohawk Group, Shaw Contract Group. Carpet fiber: 6.6 DuPont Antron Lumena Solution Nylon Solution Dyed DuraLoc MG, DuPont Antron Lumena Solution with Ultraloc MP. Ceiling: Armstrong, Hunter Douglas, USG Interiors, 9Wood. Lighting: Challenger Lighting, Focal Point, Lightolier, Cooper Lighting, Lithonia, Linear Lighting, Corelite, Kurt Versen, Peerless, Luxo,Prisma, Finelite, Kirlin, Steris. Doors: Eggers Industries, Marshfield, Anemostat, Cookson, Stanley Access Technologies, Horton Automatics, Schweiss. Glass: Wausau, Fusion Glass Design, Plaskolite Inc., National Glass, Major Industries, Viracon. Window treatments: Nysan, SAFTI First, Kawneer. Workstations/seating, files: Herman Miller. Lounge seating: David Edward. Cafeteria, dining, auditorium seating: WCI, Steelcase, Herman Miller, Gunlocke. Other seating: Nurture by Steelcase, Herman Miller, KI.Upholstery: Wolf-Gordon, ArcCom, Architex, Design Tex, Momentum, Maharam, Patty Madden, Carnegie, Interspec, KnollTextiles. Conference table: Herman Miller, Steelcase, and Coalesse. Cafeteria, dining, training tables: WCI, Bastasole, Space Tables. Other tables: David Edward, Steelcase. Shelving: Herman Miller, Nurture by Steelcase. Architectural woodworking: NWD. Planters, accessories: Wausau. Signage: Corporate Sign Systems, Neimans & Co., Peterson Products. Plumbing fixtures:Toto, Delta, Kohler, Haws, Lawler, Just Manufacturing, BJ Industries.

where
Location: San Francisco, CA. Total floor area: 508,414 sq. ft. No. of floors: 17. Average floor size: 508,414 sq. ft. Cost/sq. ft.: $726.




The Art of Healthcare Design: Laguna Honda Hospital moves into its next century of service with a design by Stantec/Anshen+Allen

11 October, 2010


David Wakely

“When I am no longer even a memory, just a name, I hope my voice may perpetuate the great work of my life.”
—From a rare recording of 70-year-old Florence Nightingale’s voice, captured on Edison Paraffin Wax Cylinder on July 30, 1890.

Florence Nightingale’s memory lived on in the generations of San Franciscans who have spent time at Laguna Honda Hospital, a skilled nursing center based on Nightingale’s nursing philosophy that was built in 1866 to care for indigent Gold Rush pioneers and was finally replaced in 2010 by a state-of-the-art, acute care and rehabilitation facility designed by Anshen+Allen. Admittedly, the 30-person “Nightingale Wards” of the original facility have given way to a contemporary healthcare model that emphasizes patient privacy over communal care, but down to the last detail the new Laguna Honda represents Nightingale’s most important legacy and the “great work” of her life: an ethos of humane, patient-focused care.

Laguna Honda’s history—and particularly its 10-year march toward modernization and rebirth—is a long and complex story. Suffice it to say that in a way, the new facility is the tobacco industry’s gift to the City of San Francisco. Dreadfully outdated by local seismic and federal patient privacy regulations, as well as the advance of time and technology, Laguna Honda had been continuously threatened with closure since 1984 and might well have been shut down had it not been for the determination of then-mayor (now California State Senator) Dianne Feinstein, who wanted Laguna Honda to remain a vital source of healthcare for the people of San Francisco, and City Attorney Louise Renne, who in 1998 allocated the Bay City’s share of California’s $20 billion tobacco industry lawsuit settlement toward fixing Laguna Honda, which by then had become a pressing public health issue.

It was a big problem that required a big design solution. In 1999 Anshen+Allen partnered with the office of Gordon Chong (now Stantec) to answer an RFP to design the new hospital. The $784-million, 750-resident, LEED Silver-certified, skilled nursing facility finally and triumphantly celebrated its grand reopening on June 30, 2010.

Lawrence Funk, associate administrator of Laguna Honda Hospital, explains that the new Laguna Honda reflects the same values of patient-focused care upon which the original hospital was built, and that the ambitious mission for the new facility is to encourage rehabilitation and independent living while setting a national and international standard for the enhancement of the quality of life. Early descriptors for the design included the words innovative, technologically advanced, efficient, flexible, humane, natural—and importantly, accessible, given Laguna Honda’s history of service to the less fortunate. Still today, a majority of residents are indigent. “Socioeconomic status did not cause us to limit our vision,” says Funk. “It is a San Francisco value that we take care of those in need.”


Adding to the designers’ challenge was the need to fulfill the goals in a way that puts each resident at the center of his or her own care by creating an environment that emphasizes independence. “All residents can choose their own path,” explains Mivic Hirose, executive director at Laguna Honda. “Laguna Honda used to be a place where people came to live the rest of their lives. Today, it is a stepping stone, a place to reinvigorate them for the next step in their lives by promoting maximum physical and cognitive independence.”

With an extensive program that includes everything from rehabilitation with hope of independent life to a continuum of care for the aged and infirm that emphasizes independence for as long as possible, the design team made “resident-focused care” its overarching goal. “We took it as a point of inspiration,” says Anshen+Allen principal Jeff Logan. “The neighborhood concept we generated was inspired by that directive.”

Floor plans, circulation paths, and amenities were all developed to approximate varying levels of domesticity and independent life, and the design solution began with the massing of the buildings nestled in the hills of the Laguna Honda site in the western part of the city. Each floor of the two, multistory residential towers (one five stories, one seven) contains distinct “households” of 15 residents each, combined in “neighborhoods” of four households (or 60 residents). At this most intimate level, residents enjoy private or semi-private rooms with shared bathrooms, household living rooms with flat-screen television, and core neighborhood centers with activity space, dining facilities, dedicated kitchens where fresh food is plated, and outdoor terraces.

Laguna Honda wholeheartedly embraces its site and the designers took great care to activate the outdoor spaces—the facility opens up to a valley complete with gardens, walking paths, a greenhouse, wander garden, and basketball court. But each residential area also was given a terrace so residents “don’t have to leave their neighborhoods to go outdoors,” explains Anshen+Allen associate principal Sharon Woodworth. In addition, “we incorporated as much southern light into the design as possible,” she says, with three of the four living rooms in each neighborhood facing south and the fourth facing west. Logan notes that light and views create a real sense of place and are among the things he likes best about Laguna Honda. “Visual access to the landscape offers residents the same kind of lifestyle as anyone living in San Francisco,” he says.

The towers are connected by a four-story link building or “Pavilion” that houses inpatient and outpatient rehabilitation services, as well as a café, art studio, multimedia library, community meeting room, barber and beauty shops, a tropical bird aviary, and a cafeteria with indoor and outdoor seating. These public amenities are located along a broad indoor boulevard known as the Esplanade in a way that references the activity of a city street. On the exterior, “the design reflects these sensibilities,” notes Logan. “The architecture of the two towers has a domestic feel to it, while the Pavilion building is a more civic response.” Operationally, the link building also includes a transport floor that efficiently connects the two towers, but its far greater value is experiential; it adds much to the holistic quality of institutional life by encouraging exercise and mobility and drawing residents out of the isolation and into the social life of Laguna Honda.

“It is also one of the places where the integration of art and architecture was really important,” says Logan. Since 1969, municipal ordinance in San Francisco has dictated that 2 percent of the construction costs for public projects be dedicated to art enrichment programs, which translated into $3.9 million for Laguna Honda. “Wayfinding, passage of time, texture, personalization of space, interaction, engagement…these are all things our program contributes in conjunction with the architecture,” says Susan Pontious, public art program director for the San Francisco Arts Commission.

Each residential floor was assigned to a selected artist who in turn created an art program that helps facilitate wayfinding and differentiate between households, making it easy for residents to understand their whereabouts as they leave and return to their neighborhoods and households. In public spaces, such as the lobby and Esplanade, the art programs took on more historic or inspirational tones, as in a series of Louis DeSoto tapestries depicting the history of Laguna Honda, a mosaic mural of the Golden Gate Bridge by Owen Smith, and a 400-ft. handrail in the Esplanade by artist Cliff Garten. “The hospital handrail is ubiquitous, but here it became a piece of art,” says Woodworth. “It becomes a fanciful element that has beauty, texture, patina.”

In total, Laguna Honda currently holds 110 commissioned pieces with 87 more planned for the collection. “I can’t think of another facility that has art integrated to this degree,” say Pontious. It’s a facility of firsts in many ways, and for the design team a just reward for 10 years of diligent planning without ever losing sight of the needs of the patient. “Our goal was to do it once, and do it right,” says Funk. This was the opportunity of a lifetime for the San Francisco area, and hopefully it will serve us for the next 90 years.”

who
Project: Laguna Honda Hospital & Rehabilitation Center. Owner: City and County of San Francisco, Department of Public Health. Architect: Anshen+Allen Architects and Stantec Architecture - Laguna Honda Joint Venture Architects. Associate Architects: Powell & Partners Architects, Aviva Litman Cleper Architects, Tsang Architecture. Interior designer: Kai-Yee Woo & Associates, Fougeron Architecture. Contractor: Turner Construction Company. Construction manager: M. Lee Corporation. Low-voltage consultant: Vantage Technology Consulting Group. Telecom consultant: Teecom Design Group. Code consultant: Rolf Jensen Associates. Plumbing/Fire Protection: SJ Engineers. Cost estimator: TBD Consultants. Material management/vertical transportation: Lerch Bates Hospital Group, Inc. Hospital operations: HFS Consultants. EIR: Impact Sciences. Lighting designer: JS Nolan + Associates Lighting Design. Structural engineers: Rutherford & Chekene, Forell/Elsesser Engineers, Ansari Structural Engineers, Bello & Associates. MEP engineer:Arup & Partners California. Civil Engineer: AECOM. Electrical engineer: F. W. Associates. Geotech engineers: URS Corporation, Robert Y. Chew Geotechnical. Food Service Consultants: Cini-Little International, Inc. Landscape Architects: Office of Cheryl Barton. Wayfinding/Signage:Kate Keating Associates. Acoustician: Charles M. Salter Associates. Furniture dealer: Corner Office, Furniture by William Webb, One Workplace, Pivot Interiors, Resource & Design, Workspace Solutions. Photographer: David Wakely.

what
Wallcoverings: Daltile, Ann Sacks. Paint: ICI, Scuffmaster, Tnemec, Kawneer. Laminate: Abet Laminati, Formica, Nevamar, Wilsonart. Dry wall: Georgia Pacific. Flooring: Armstrong, Expanko, Forbo, Mats Inc., Mannington, Tarkett, Terra Green Cermaics, American Terazzo. Carpet/carpet tile: Mohawk Group, Shaw Contract Group. Carpet fiber: 6.6 DuPont Antron Lumena Solution Nylon Solution Dyed DuraLoc MG, DuPont Antron Lumena Solution with Ultraloc MP. Ceiling: Armstrong, Hunter Douglas, USG Interiors, 9Wood. Lighting: Challenger Lighting, Focal Point, Lightolier, Cooper Lighting, Lithonia, Linear Lighting, Corelite, Kurt Versen, Peerless, Luxo,Prisma, Finelite, Kirlin, Steris. Doors: Eggers Industries, Marshfield, Anemostat, Cookson, Stanley Access Technologies, Horton Automatics, Schweiss. Glass: Wausau, Fusion Glass Design, Plaskolite Inc., National Glass, Major Industries, Viracon. Window treatments: Nysan, SAFTI First, Kawneer. Workstations/seating, files: Herman Miller. Lounge seating: David Edward. Cafeteria, dining, auditorium seating: WCI, Steelcase, Herman Miller, Gunlocke. Other seating: Nurture by Steelcase, Herman Miller, KI.Upholstery: Wolf-Gordon, ArcCom, Architex, Design Tex, Momentum, Maharam, Patty Madden, Carnegie, Interspec, KnollTextiles. Conference table: Herman Miller, Steelcase, and Coalesse. Cafeteria, dining, training tables: WCI, Bastasole, Space Tables. Other tables: David Edward, Steelcase. Shelving: Herman Miller, Nurture by Steelcase. Architectural woodworking: NWD. Planters, accessories: Wausau. Signage: Corporate Sign Systems, Neimans & Co., Peterson Products. Plumbing fixtures:Toto, Delta, Kohler, Haws, Lawler, Just Manufacturing, BJ Industries.

where
Location: San Francisco, CA. Total floor area: 508,414 sq. ft. No. of floors: 17. Average floor size: 508,414 sq. ft. Cost/sq. ft.: $726.

 


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