New Patient Tower Signals Hope for Richmond Children and Families
No matter how you approach downtown Richmond, VA, your eye will catch a glimpse of something special. Standing tall among the historic structures of the city center is a shimmering building clad with glass, a bright yellow ribbon and colorful fins: the new Children’s Hospital of Richmond at VCU (CHoR) Children’s Tower.
During the last several decades, CHoR has established itself as a premiere pediatric care provider, delivering a full range of services for children experiencing common diseases, injuries and complex health conditions. But until now, the hospital’s services and facilities were “fragmented” across the VCU Medical Center Campus.
“When care is fragmented, there are gaps and inequities that get created,” said Jeniece Roane, CHoR’s Vice President of Operations.
In 2016, the outpatient Children’s Pavilion opened and marked a big step forward in CHoR’s goal to consolidate services in a centralized, state-of-the-art environment. The Children’s Tower, which opened this spring, fully accomplishes that goal with 72 critical and acute care inpatient rooms and a Level 1 pediatric trauma center.
“Now, we’ve got a world-class facility that reflects our commitment and makes it very clear for parents and guardians where the best care for children is delivered,” said Roane, who has been a registered nurse for 30 years and has worked with CHoR for 25 years.
The Children’s Tower signifies the importance of investing in children’s health care for a rapidly growing region full of young families. HKS health studio practice leader Leslie Hanson, who served as Principal in Charge of the project, said that the building’s contemporary design also symbolizes an even broader transformation taking place in Richmond.
“This project, along with the Pavilion, is making a significant difference in how people look at the city. The design beckons to the future and sets a trajectory for Richmond as being progressive and forward-thinking,” said Hanson.
An Integrated Team and Process from Day One
To create a building that would signal a hopeful look forward, the design team searched outward and inward, relying on precedent projects, community engagement, research, and innovative thinking to guide them.
HKS, CHoR and VCU Health first began developing plans for new facilities as far back as 2006, when Hanson and health system leaders toured pediatric hospitals across the United States for inspiration. Over the next several years, the project went through multiple iterations before the idea to build the Children’s Pavilion and the Children’s Tower on a combined site emerged as the best solution.
From the start, an integrated HKS team of architects, interior designers, and researchers sought to design a Children’s Tower that reflected the needs of everyone who would set foot in the building and create an oasis of healing for children. The team worked hand in hand with CHoR and VCU Health leadership, care team members, community partners, and the CHoR Family Advisory Network— which includes young adult and adolescent patients, as well as parents and guardians of younger patients — to accomplish these goals. Engagements included interviews, patient journey mapping, and a community design fair where more than 100 children and their family members gave input on design concepts and color palettes.
“The ability to partner with care team members as well as patients and families really helped ensure we were creating meaningful moments in the design,” said HKS’ Kate Renner, the architect, medical planner and researcher who led the project team. “We talked with them about their experiences in the current facilities and what opportunities we could leverage to create the ideal future state.”
Roane and Renner both said that the team responsible for creating the Children’s Tower felt like a unified group, where everyone worked toward the same goals.
“I felt very supported by the HKS team and that we’ve had a great partner,” Roane said. “They listened to the voices of our team, of our community, our caregivers, and patients and they’ve been able to translate that in a way that really reflects all the pent-up desire for this community to have a true children’s hospital.”
The design team leveraged almost every single health research tool HKS has in its toolbelt, according to Renner, including parametric analysis, intent and evidence documentation, shadowing, behavior mapping, benchmarking, rapid prototyping and FLEXX research. They gleaned insight from post-occupancy performance evaluations at the Children’s Pavilion and extensively studied interprofessional workflows. The team also built full scale mock-ups and tested them with care teams and stakeholders, making adjustments to the design based on feedback.
“We were able to address operational concerns at the same time we were designing the space,” said Renner, who has been working on CHoR projects for nearly a decade. “That level of collaboration resulted in spaces that are truly interprofessional throughout the clinical areas and different care team spaces that function better.”
Cara Timberlake, a registered nurse who works in the emergency department located on the Children’s Tower’s third floor has found that spaces such as an internal waiting room, private consultation rooms, and ample storage areas have all helped create more efficient workflows for cross-team professionals including nurses, physicians, social workers, child life staff members and security personnel.
Timberlake said that the new space fully supports the collaborative and collegial working dynamics she enjoys in her day-to-day work.
“The good relationships between everyone haven’t changed since we’ve moved into the new building and that’s something I really appreciate,” she said.
But many things have changed for care team members like Timberlake, who said the Children’s Tower’s staff amenity and support areas are a huge improvement over cramped facilities they used before. Separate locker and break rooms, as well as dedicated recharge and respite spaces called “Watson Rooms,” are conveniently located within each unit.
“I’m right down the hall from my patients and I don’t have to travel far or take travel time to get to there. Because of the location of the Watson Room, I’m able to close my eyes and truly relax a little bit more.” Timberlake said. “It’s a serenity space.”
Design that Promotes Well-being and Discovery
To promote holistic well-being of everyone at CHoR — from care team members to patients and their families — the Children’s Tower’s design includes abundant natural light and biophilic elements.
Many interior architecture and design details throughout the hospital are inspired by the James River, which winds its way through Richmond. The river itself influenced circulation patterns and colorful mascots representing animals native to river habitats bring a unique character identity to each floor.
“When you can have design features that are relatable to the community that they’re in, it softens the experience and makes it more approachable, more like home,” said HKS’ Corrine Kipp, the project’s lead interior designer who attended VCU and lives in Richmond.
The team also made design decisions influenced by the more abstract concept of “shadow play,” which is realized though unique shapes, fun colors, sculptural elements, and niches that offer exciting moments of wonder and interaction for children.
“These elements are more whimsical,” Kipp said. “They are inspired by things children really gravitate towards that adults don’t always necessarily find the beauty in.”
Kipp and Renner said that along with the stimulating shadow play features, elements of choice throughout the building play an important role in the design. Inside their rooms, for example, patients can control color-changing lights and TVs that offer variety of entertainment options when they need rest or treatment.
“Allowing a child to feel like they have some choice or some small amount of control, you can see stress melt away,” said Kipp, noting that being the mother of a young child helped her make informed decisions throughout the design process. “They feel trusted to do things they think are right for them, and that makes them feel safer and more at ease.”
Elements of choice also help support children’s long-term holistic development across the full duration of what can be lengthy hospital stays, Renner said. Outside of their rooms, patients have easy access to areas where they can be themselves including multiple play spaces, a teen lounge, a developmental gym, and a performance room — all of which contribute to developmental growth and provide a sense of normalcy during difficult times.
Because trying to feel “normal” can be just as hard for family members as it is for children in a hospital setting, the Children’s Tower also has numerous spaces that suit the day-to-day needs of parents and guardians. The family gym, cafeteria, Ronald McDonald House Charities support spaces and services, and personal quiet rooms where adults can take a phone call, close their eyes, or get some work done, all aid their ability to focus on taking care of their kids while not neglecting their own needs.
Further fostering a cohesive and comfortable experience, the team also created connections between the exterior and interior designs. The colorful fins on the glass façade, inspired by CHoR’s brand, take the form of playful hanging sculptures inside and influenced art and furniture selections. And the yellow ribbon that visually unifies the Pavilion and Children’s Tower outside extends indoors where the color and motif indicate touchpoints and vertical transportation, making the hospital easier to navigate.
Privacy and Comfort for Patients, a Bright Future for Richmond
Perhaps the most impactful decision the CHoR and HKS teams made when planning the Children’s Tower was making every patient room private. The hospital’s prior facilities included semi-private rooms where multiple families would have to navigate care and stressful circumstances while cohabitating — a challenge for patients, families and care teams alike.
“When care team members have to start out their care giving experience apologizing for the room and the fact that you have a roommate, it taints the experience,” said Roane, who oversees the people and teams responsible for providing care to patients.
Private rooms at the Children’s Tower include a single patient bed, large windows overlooking Richmond and the James River, and flexible furniture arrangements for families to comfortably socialize, eat and spend the night as needed. Timberlake, Renner, Roane and Kipp all said that the private rooms and amenities within them offer a completely different, much more positive hospital experience for patients and care team members as well as guardians, parents, and siblings.
“Private rooms help families still feel like families. They don’t have to worry about what the patients and families next to them are doing — they can be their own family unit within a space that feels safe and a little bit more familiar,” Kipp said.
Incorporating private rooms is just one of many design choices that has a hand in helping CHoR deliver on its vision to be a nationally leading children’s health care provider and education and research institution.
On a larger scale, the Children’s Tower and the Children’s Pavilion that came before it both reflect how partnerships like the one between HKS and VCU Health can positively impact peoples’ lives. Roane said the collaborative process of designing, building, and opening the Children’s Tower has galvanized CHoR’s commitment to attract and retain team members that can provide the best care for young people so Richmond will have the brightest future possible.
“I’ve been careful to make sure we don’t rest on our laurels,” Roane said. “Yes, we have the building, and now we have even more responsibility to deliver on our brand promise for children and families.”
