Children’s Hospital of Richmond at VCU’s New Tower: Space to Grow
This story first appeared in the 2023 July/August Edition of Medical Construction & Design. It is reprinted here with their permission.
Situated at the gateway to VCU Medical Center’s campus, Children’s Hospital of Richmond at VCU’s new Children’s Tower is a landmark 16-story, 565,000-square-foot hospital. The building expands the existing Children’s Pavilion, creating a consolidated location for pediatric healthcare — an entire city block dedicated to serving the children of Richmond, the Commonwealth of Virginia and the region.
Adjacent to some of Richmond’s most important and historic civic structures, the design establishes a bold, signature identity. A yellow ribbon articulated along the façade visually stitches the tower and pavilion together, while colorful fins along the building’s exterior highlight the tower’s identity as a children’s hospital. It includes 72 critical and acute care inpatient beds, a Level 01 pediatric trauma center with a rooftop helistop, surgical and imaging suites, and a full range of support services, including a Ronald McDonald House, multi-faith chapel and child-friendly cafeteria.
Designed by children, for children
Early in the project, designers and researchers interviewed members of the CHoR Family Advisory Network to understand and map their care journeys in the current hospital.
CHoR FAN members also participated in design workshops, physical and virtual mock-ups and operational planning alongside care team members. Touchpoints and priorities identified through those engagements formed the basis of design, with each key moment being crafted to define the optimal future state. A community design fair enabled over 100 children and family members to directly engage in the design process, voting on concepts, themes and color palettes.
The tower’s colorful interior architecture and design draw inspiration from local nature and the James River, intrinsically connecting the building with its location and creating an environment that can be both calming and engaging. Animal mascots selected by children and families provide unique themes for each level. An interactive shadow play zone, faceted discovery niches and colorful hanging sculptural elements engage patients and visitors along their journey through the hospital. Panoramic views, access to natural light and artwork in patient care areas and care team spaces have a calming, restorative effect to reduce anxiety and stress, and ultimately, promote healing.
Beacon for well-being
The tower creates an environment intended to provide normalcy and support the developmental needs of children and adolescent patients.
Each patient room is private and provides opportunities for personalization with color-changing lights and dedicated family zones with comfortable accommodations for overnight stays.
Teen lounges provide space for adolescent young adults to interact with one another, read, do homework and play video games; playrooms with colorful activity niches and age-appropriate toys provide play space for younger children. Custom art panels featuring animals and educational facts create ‘seek and find’ opportunities for children and provide a sightly cover to cabinets with personal protective equipment for providers.
Other areas that serve children’s growth needs include an area for hospital teachers to help patients continue learning during their stay and a developmental gym with physical therapy space. An indoor garden and elevated garden overlook offer diverse spaces for respite and activities; a performance room provides event space with live streaming capabilities so children who are not able to attend in person can watch performances from their rooms.
Evidence-based, research-informed
The team incorporated an evidence-based approach throughout the tower’s planning process, aligning design strategies with intended outcomes. Post-occupancy performance evaluations provided insights into design and operational strategies, as well as opportunities to further enhance key elements for continuous improvement. The team also conducted a literature review in collaboration with the University of Virginia to identify a range of drivers transforming pediatric healthcare.
Plan analytics and rapid prototyping helped optimize adjacencies to reduce travel distances for care team members, while maximizing visibility to patient rooms and among peers. Scenario testing in physical and virtual mock-ups enabled methodical testing of details within key spaces. The design team created a full reference guide to use during operational planning and activation that ensured care team members had a grasp of the design intent, strategies and supporting evidence.
Interprofessional care team model
Team spaces are designed to support the interprofessional care model and enhance opportunities for connection and collaboration. Open workstations, quieter team rooms and small team stations offer flexibility for focused or collaborative work. Charting alcoves between patient rooms provide workspace directly adjacent to the point of care for easy monitoring, and bedside computer stations provide immediate access to records within the patient room. Standardized clinical support cores provide adjacency between key spaces to maximize workflow efficiency and minimize distances to patient rooms.
An off-stage care team zone provides additional space for collaboration and adequate space for respite, as do interprofessional team lounges where care team members can enjoy daylight and views. Dedicated relaxation rooms with dimmable lighting, windows, biophilic art and a reclining massage chair on each unit and in the emergency department are available for care team members to step away as needed during their shifts.
Designing for optimization and the ever-changing present
Built on a tight urban site, the tower maximizes the available footprint to provide appropriately sized patient care spaces. To further increase the footprint of the upper levels, the tower is cantilevered 15 feet out from the lower levels, providing adequate space for the 24-bed units. The pediatric trauma center is located on the seventh floor to also take advantage of the larger footprint. It has a trauma bay with two care stations and flexibility to surge to four if needed, as well as 22 universal exam rooms with exceptional views. A 275-foot-long bridge elevated three stories above the ground connects the tower to the medical center, ensuring safe and convenient access to services for care team members and patients.
The tower is designed to support future growth. Patient rooms are all universally designed, enabling future conversion to critical care beds if needed. Shell space within the tower and pavilion will enable the addition of 48 more inpatient beds for a total of 120 beds, as well as the future addition of diagnostic and treatment spaces, research and administrative spaces, and amenity spaces based on future growth needs.
An additional two floors of vertical expansion capacity are included in the structural design of the space above the pavilion, providing even more vertical growth potential.
A true team effort
CHoR and VCU Health leadership, the Richmond community and patients and families served by the Children’s Hospital of Richmond demonstrated exemplary, thoughtful collaboration with the design and construction teams to realize the Children’s Tower. Working hand in hand, this unified team brought its vision of an oasis for healing to life, creating a world-class hospital where generations of children and adolescents will come to heal and grow.
Kate Renner, AIA, EDAC, LSSBG, LEED AP, WELL AP, is a senior medical planner, vice president and health studio practice leader at HKS, located in the firm’s Washington, D.C. office.
Project team
• Architect: HKS Inc.
• Program manager: JLL
• Contractor: DPR
• MEP engineer: BR+A
• Structural engineer: Dunbar
• Structural engineer, parking consultant: WSP
• Low voltage, technology, medical equipment: Introba
• Civil engineer: TRC Companies
• Landscape architect: Reichbauer Studio PLC.
• Lighting design: The Lighting Practice
• Logistics, vertical transportation: St. Onge
• Helideck design: FEC Heliports
• Acoustic engineering: Convergent Technology Design Group
• Wind engineering: RWDI
• Wayfinding, signage: Exit
• Graphic illustrations: Liz Taylor Creative
• Operational, transition planning: HTS, ClarkRN