Amazon Web Services · Slide 3 Ambulatory Everything: The Hospital ICONs Slide: 3 “ The Great Migration” H&HN 3/14 • 33% Growth in Ambulatory Care (2004-12) • 50 million new

Slide 1

Slide 2

Ambulatory Everything:

The Hospital ICONs Program

Cleveland Clinic,

The Crile Building

WakeMed, Freestanding ED’s

Virginia Mason, Specialty Clinic

Slide 3

Ambulatory Everything: The Hospital ICONs

Slide:

3

“ The Great Migration” H&HN 3/14

• 33% Growth in Ambulatory Care

(2004-12)

• 50 million new OP visits (2008-12)

Slide 4


Slide:

4

Scripps Health in 2000:

• 6 Hospitals

• 6 Ambulatory Care Sites

Slide 5


Slide:

5

Scripps Health Today:

• 5 Hospitals

• 26 Ambulatory Care Sites

Slide 6


ICONs Goal: • Share groundbreaking healthcare facilities

• Show what is new, innovative and

what risks were taken

• Provide: Key Lessons Learned

Slide 7


Slide:

7

ICONs Process

• Literature Review & Data Collection

• Onsite Visits to projects

• Architectural Photography

• Interviews with Client and Staff

• Interviews with Architect

ICON reporters did not consult on their

case study projects.

Slide 8

The Crile Building The Cleveland Clinic, Cleveland Ohio

Slide 9

The Cleveland Clinic: Crile Building

Cleveland Clinic: Founded 1921

3 Physicians founded Cleveland Clinic Foundation

Dr. George W. Crile Original Cleveland Clinic

Slide 10


Cleveland Clinic Today

• 26 Medical Institutes

• 9 Regional Hospitals, 4600 beds in system

• CCF sees 1.5 million patient visits annually

Slide 11

Crile Building, Project Goals

1. Create Ambulatory Care Center as part of CCF

Campus Master Plan (Century Plan)

2. Provide space for varied medical specialties

3. Create flexible modular building concept


Slide 12

Architects: Cesar Pelli and Peter Van Dijk, 1983


Pelli Today Van Dijk Today

Slide 13

Early Design Concepts:

• New Ambulatory Care Center, Away from Hospital

• Welcoming, less institutional environments


Slide 14

Final Design


Slide 15

Final Design • 12 Stories, 200’ high

• Varied floor plates creates

“ziggurat” profile

• Multi-storied lobbies

• Mall, Central green space

• Skyway connector system


Slide 16

Project Statistics Owner: The Cleveland Clinic Foundation

Location: Cleveland, Ohio

Architects: Cesar Pelli & Associates and

Van Dijk, Johnson & Partners

Project Size: 620,000 GSF

1985 Construction Cost: $ 72 Million

Services: Ambulatory Specialty Care

Patients seen per Day: 2,500

Awards Won: AIA Honor Award, 1986


Slide 17

Building Tour: Site Plan


Mall Crile Hospital

Skyway Bridge

Slide 18

Building Tour: Exterior


Horizontal Banded Windows

Skyway Bridge

Granite Paneled Skin

Slide 19



Skyway Bridge

Crile Building at Night

Slide 20

“Father Crile”


Lessons Learned: Building = “Brand”

Slide 21

“Father Crile”


Lessons Learned: Building = “Brand”

“Baby Criles”

Slide 22



Back Entry: Parking Access

Skyway Bridge

Front Entry: Facing Mall

Slide 23

Building Tour: Main Lobby


Skyway Bridge

1985 Photo

Slide 24



Skyway Bridge

2015 Photos

Slide 25



Skyway Bridge

2015 Photos

Slide 26


Cesar Pelli, FAIA, RIBA, JIA

Project Architect

Architect’s Message

“I designed the Crile Building to

make the patients feel better as

soon as they enter the building.

The lobby is a soaring, uplifting

space.”

Cesar Pelli

Slide 27

First Floor Plan


Main Lobby

Elev

Slide 28

First & Second Floors


Au Bon Pan Cafe

Patient Services:

• Reception

• 2 Cafes

• Labs

• Imaging

• Pharmacy

• Skyway at 2nd

Slide 29


Joseph Strauss, ACHA

Director, Planning & Design

Cleveland Clinic

Clients Message

“Simplicity and standardization are

hallmarks of the Crile Building. As a

result , adaptation comes easily.

From a humanistic viewpoint, the

building delights its occupants.”

Slide 30

Building Tour: Skyway System


Skyway Bridge

Slide 31

Building Tour: Skyway System


Skyway Bridge

Skyway Consults & Communications

Slide 32


James Stoller, MD, MS

CCF Educational Chair

Client’s Message on the Skyway

“As a horizontal space, the Skyway

serves the important function of driving

people of various disciplines into a

common space, thereby promoting the

likelihood of casual meetings. Such

horizontal spaces should be explicit

design features in multidisciplinary

environments (like hospitals) where

teamwork matters a lot.”

Slide 33

Typical Clinic Floor


Elev

Recpt

Waiting

Clinic

Suites

Office

Suites

Slide 34

Typical Clinic Floor


Reception Areas:

• Many Reception Desks Replaced

• Clinics merged Reception & Seating

• 2-story lobby cut-away

• TV corrals

Slide 35

Exam Rooms


Original Exam Rooms:

• 9’ x 14, (126 sf)

• Patient Faces Windows

• Outboard Staff Station

• Changing area

• Private Offices for MD’s

Desk &

Storage

Window Wall

Changing

Sink

Exam

Room (1985)

Slide 36

Exam Rooms


2015 Exam Rooms:

• 9’ x 14, (120 sf)

• Patient back to window

• Inboard Staff Station

• Sub-station in hall

Desk

Window Wall

Sto

rag

e

Sink

Exam

Room (2015)

Hall Station

Slide 37

Compare Exam Plans


Desk

Changing

Sink

2015 Exam Room

Hall Station

Desk

1985 Exam Room

CCF Standard: 10’ x 12’

Current CCF Exams

Desk

Sink S

tora

ge

Slide 38


Randy Geise

Sr. Healthcare Facility Planner

The Cleveland Clinic

Clients Message

“I’ve developed plans for over a hundred

projects in the Crile Building over 18 years at

Cleveland Clinic. It’s my favorite building on

our main campus. The logical zoning

and standard room sizes have been

able to afford us flexibility to

accommodate many changes in our

ever-growing clinical system”.

Slide 39


What Surprised Me:

An Entire Interstitial

Mechanical Floor

• Located between 1st & 2nd

• Plus Large Mechanical

Penthouse

• Interstitial supports HVAC

updates

Slide 40


What Surprised Me:

Viewboxes in Ortho Clinics

• Film for Ortho, Surgical

Templates

• Hallway Consult Spaces:

“ Electronic Watering Holes”

(Dr. Stoller)

Slide 41


What Surprised Me:

Artwork at Crile Building

• Hospital has major art pieces

• Crile has space for sculpture

• Space for better wall art

Hospital Lobby Art

Slide 42


What Surprised Me:

Inpatients transported to Clinics

• Hospital patients seen in Crile

• Clinic has special resources

• Skyway stretcher transports

Slide 43


Lessons Learned:

The physical impact of Electronic Medical Records

• Massive amounts equipment & space give-backs

• Anyone want some shelving and filing equipment?

Slide 44


Lessons Learned:

30 years later, the “modular, flexible-thing”, still works

• Exam & office modules convert to new clinic plans

• Interstitial Floors, keeps Crile “forever young”.

Slide 45

Lessons Learned: Multi-story Lobbies


Skyway Bridge

Slide 46


Lessons Learned:

Lobby Concepts works well with minimal updates

• New furnishings and good maintenance

• Pelli’s concept: soaring space & outdoor views, works today

Slide 47


Architect’s Message

“Not only does the architecture set

out to enhance life, but also all the

activity in this building.

Whenever the purpose of a building

is the same as the architecture, both

gain enormously.”

Cesar Pelli on The Crile Building

Slide 48


Case Study Credits:

Cleveland Clinic Interviews Dr. James Stoller, Educational Chair

Mary Ianonne, Clinic Administrator

Joseph Strauss, Director, Planning & Design

Randy Geise, Senior Health Facility Planner

Malcolm Cutting, Former Director of Facilities

Project Architect Interviews Cesar Pelli: Pelli Clarke Pelli Architects

Peter Van Dijk: Formerly of Van Dijk, Johnson &

Partners

Project Photos: Cleveland Clinic & Pelli Clarke Pelli

Slide 49

The Crile Building The Cleveland Clinic, Cleveland Ohio

Questions and Discussion

Documents

Amazon Web Services · Slide 3 Ambulatory Everything: The Hospital ICONs Slide: 3 “ The Great Migration” H&HN 3/14 • 33% Growth in Ambulatory Care (2004-12) • 50 million new