That views of nature, and cues from nature, can hasten a hospitalized patient's recovery is not news. How nature is brought into a hospital setting, or any other health care environment, can certainly be news if the approach is fresh and exciting.

The healing powers of nature are incorporated in both patient and visitor surroundings at the Alfred and Norma Lerner Tower/Samuel Mather pavilion, a recent addition to University Hospitals of Cleveland, which is the medical teaching facility for Case Western Reserve University. Architects and designers from the Boston, MA-based firm of Payette Associates Inc. succeeded in removing the sterile barriers that are common to a hospital and replacing them with concepts suggestive of nature. The general design concept is in accord with a master plan that merges architecture, landscape design and interior design to bring nature's healing elements indoors.

This new addition to the existing hospital campus consists of 584,000 square feet covering nine patient floors. There are 70 intensive-care rooms, 30 recovery beds, 210 acute-care, single-bed rooms and 21 operating rooms. The facility replaces one with 210 acute-care beds that was built in the 1930s and is now being renovated to provide additional space for other hospital departments.

The $103 million project was designed within the context of its surroundings-the park-like area known as University Circle of Cleveland that was originally designed by American landscape architect Frederick Law Olmsted. This is immediately evident at the main entrance to the hospital where a landscaped forecourt and fountain set the stage for the interior.

"The University Circle environment was the springboard for our design concept," says Dennis Kaiser, AIA, principal at Payette. "The color palette and organic patterning of fabrics used throughout the hospital reflect the facility's natural surroundings."

The hospital's main lobby showcases a backdrop of the outdoors. The grid pattern of the architectural partitioning in the lobby is based upon the look of a garden trellis. Partitioning was designed to divide the large lobby into manageable spaces and to provide some privacy among waiting groups of people. According to Kaiser, the lower portion of each partition, or seating screen, is blocked in to provide the most privacy at seated head height. The middle portion is rendered transparent with textured or colored glass, while the upper portion is open. Throughout the hospital, this trellis-like partitioning designates an area as public space.

The partitioning, as well as the rest of the woodwork in the lobby, is made of maple and cherry wood with a clear, natural finish. According to Kaiser, the natural grain of the wood camouflages any scuffs or scratches, and the use of wood adds a level of richness not expected in a hospital lobby.

Adjacent to the lobby entrance is a circular stair that leads to the family waiting area outside intensive care surgery on the second floor. Not only does the staircase add character to the lobby, it serves a functional purpose, as well; use of the staircase helped to significantly reduce elevator traffic between the first and second floors. Thus, the elevators are better able to serve traffic between the lobby and higher floors.

Patient Floors
On each acute-care floor, 30 patient rooms are arranged in clusters around either the central nurses' station or one of the two satellite nurses' stations. This cluster arrangement allows for direct views into at least eight patient rooms from every station, which provides a high level of patient monitoring. It also makes staffing easier during off peak hours when fewer staff members are on duty.

Although each floor includes 30 patient rooms, walking distance for the staff was minimized by the cluster concept and a diagonal staff corridor that runs between the central nurses' station and the support space behind. This support space, which includes staff work areas and lounges, is segregated by a glazed partition on the corridor with a window wall behind that allows natural light to flood the central nurses' station. The light also provides a warm backdrop to the receptionist's desk, which is located in front of the nurses' station. From the public elevators, all visitors pass this desk before proceeding to a patient's room.

The approach to the nurses' stations is a scaled down version of that in the lobby registration area. A circular ceiling soffit and floor pattern signal a concave portion of the station. Here, patients and visitors can receive information. In this way, the architects relied more on architecture for wayfinding than signage.

All patient rooms are private in order to accommodate greater flexibility and marketability. Each room is well appointed with furniture and finishes that lend a residential character to the overall environment. The window seat in each room not only adds additional seating for visitors, but also provides a clear view of the outdoors.

"The height of the window sill is below the level of the bed," explains Kaiser. "So even if patients are lying flat, they can still look down to the trees around the hospital and out over the horizon."

The window treatment is a drapery with a botanical design, so even when the window is covered the view is still of nature. Alongside the window seat are built-in shelves for family pictures, cards and books. Most of the patient rooms have linoleum flooring, which as a wood or cork-styled product, again harks back to the influence of nature on design choices.

Each floor has four VIP rooms that are larger than the standard patient rooms and include a kitchenette. These rooms feature a higher level of finish through the use of carpet, upholstery and furnishings.

A visitors' waiting area and patient day room is located just off the unit near the elevators. This room is separate in character, but is within close proximity to the central nurses' station for monitoring. According to Kaiser, the room was designed with a "back porch atmosphere" in mind. Maple wood shutters diffuse the room with sunlight. In fact, throughout the hospital, circulation is oriented toward exterior windows for sunlight and to reinforce the relationship with the hospital's front lawn, which helps to orient patients and visitors, and provides an interior environment focused on the landscape.

Related Articles » Good Design Is Good Customer Service » How Interior Design Improves Productivity » A New Experience for Home Offices » Design team creates new statement in a familiar place. » Art Deco Echo » What Does a Designer Actually Do? » Eco Design Matters: What's Green? » No More Great American Lunch Hours » Design for Disability » Understanding Disabilities