Luther Hospital and the Midelfort Clinic operated as independent health care facilities in Eau Claire, WI, until their consolidation into a regional medical center by the Mayo Medical Foundation. The clinic, consisting of a main office and 14 satellite facilities, was merged onto a single site elsewhere in the city, where it continues to offer primary care. Its specialists were relocated onto the hospital site, enabling them to combine forces with the hospital to offer inpatient, outpatient and emergency services at a single location while avoiding unnecessary and expensive duplication of equipment and staff.

Marshall Erdman & Associates contracted with Midelfort Clinic to design and construct a new building that would integrate these specialists into the existing 500,000-square-foot hospital facility. The first phase of the 20-year plan consists of 160,000 square feet of space on five floors.

Several factors played a part in the development of the project concept, according to Steve Mason, architect for Marshall Erdman, a design/build architectural firm in Madison, WI, specializing in ambulatory health care facilities. The idea first presented itself when he discovered that the city of Eau Claire was considering building a bridge over the nearby Chippewa River. Then, he says, he began seeing the Mayo Health System as another bridge, bringing together two previously autonomous entities. "There were three pieces to the puzzle," he said. "There was Luther, there was Midelfort, and there was Mayo, acting as the bridge between the two."

The bridge concept is first presented at the main entrance to the clinic. The curvilinear canopy is supported by two columns, representing the original clinic and hospital facilities. The decorative grillwork centered between them represents the health system that brought them together. The design of the grillwork itself, Mason said, is "a way of doing in the vertical what a plan does in the horizontal."

Mason also chose forms and materials to forge a relationship between the building, both interior and exterior, and its surroundings. The cylindrical shape and terra cotta cladding of the columns is meant to evoke images of the region's past, according to Mason. "The economic history of this community was influenced a lot by the lumber barons and the logging industry," he explained. This theme is continued on the building's exterior through the color and texture of the brick and the finish color of the canopy trusses.

Interior finish details originated with the architect's overall concept, according to Margo Komplin, senior designer at Marshall Erdman. For instance, the grillwork motif from the canopy is carried into the lobby, where it is used in an interior window within the double-height space. It is repeated elsewhere in the space as a featured detail of the reception desk on each floor. The distinctive columns also reappear, here and elsewhere throughout the interior.

Gently curving lines, a reflection of the bridge concept, are another recurring motif. A curved window-wall in the waiting room takes full advantage of a view of nearby Half Moon Lake and its surrounding city park, and in addition, said Mason, presents a means of expressing the curve on the building's exterior. Walls step down toward the window, echoing the window grid and blurring the line between wall and ceiling. "It's a bucolic, serene atmosphere," described Mason. Reception desks also take on an arched form, seeming to float above the floor on a base of polished stainless steel.

Flooring details also tie into the main design concept. For instance, each reception desk is fronted by a circular "pond" of carpet in a soft, teal color. "Think of the reception counter as another bridge," Komplin said. "You can see the pond and the stream of water (coming from it) going under the bridge."

The ponds are connected by sidewalks defined by pale gray carpet and crossed by stepping stones in a terra cotta color reminiscent of the column cladding. A similar motif is created in tile in the main lobby. In addition to carrying out the design theme, the flooring patterns serve as a subtle wayfinding device. "The patterns cross where there's a decision to be made as to where you're going," said Komplin. "You take the stepping stones in the direction you choose."

The ceiling in waiting areas and corridors is detailed with recessed areas emphasized by cove lighting, meant to create a feeling of sunlight breaking through clouds. This effect is especially evident in the area of the reception desks, said Mason, where it once again helps direct circulation. "We used it as a way of emphasizing that there's a larger import to this area in terms of traffic," he said.

Practical considerations took precedence in decisions regarding the layout of the new facility. Physicians' practice areas were aligned on the same floor as the appropriate nursing unit in the existing hospital tower, according to Mason. "It's something we used as an organizing tool to decide which practices went on what floor," he said. Technical and treatment areas were equipped with techline cabinetry, a product designed and manufactured by Erdman & Associates.

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