Ratcliff expands John Muir Medical Center to deliver high-quality patient care

Ratcliff (www.ratcliffarch.com), the San Francisco Bay Area-based architecture, planning and interiors firm, announces the completion of The Tom and Billie Long Patient Care Tower, centerpiece of a $612 million expansion of John Muir Medical Center, Walnut Creek, California. The new patient tower opened to patients on April 17, and was designed to provide a patient-focused, non-institutional, sustainable environment, enabling John Muir Health to fulfill its commitment to high-quality patient care and safety and accommodate future growth and technological advances.

"The fact that this massive and complex project was completed on time and below budget to the satisfaction of the client attests to the successful long-term partnership our firm has developed with John Muir Health over the years," said Kit Ratcliff, FAIA, LEED® AP, president of Ratcliff. "Every single detail of the project - from interior design and maximizing access to the outdoors, to parking and way finding - was designed to help this highly respected hospital and their incredible medical team continue to deliver great care, while improving efficiency."

The five-story-plus-basement, 380,000 square-foot tower includes 242 patient beds, a renovated and expanded 24,000 square-foot emergency department, a rooftop helistop, a new neonatal intensive care unit, and three new state-of-the-art surgical suites. Improvements also include a 20,000 square-foot central utility plant and a 780-stall parking structure. Ratcliff developed the entire campus' master plan that guided the project, designed and built over a nine year period.

The project addresses seismic safety standards mandated by SB-1953 with a structural steel building frame with 160 buckling restrained braced frames to provide increased seismic performance and reduce the likelihood of earthquake damage. The system is known as "resilient bracing" and also reduces overall use of steel by 25 percent compared with conventional systems. The hospital will be able to withstand major seismic events and remain fully operational, which is key to John Muir Health's role as the designated trauma center for Contra Costa and parts of Solano counties.

Celebrating the hospital's location in a beautiful setting, Ratcliff took its cue for the building's architecture from John Muir Health's culture, history and stature in the community, as well as from the natural features of Contra Costa County. The stone, metal and glass that clad The Tom and Billie Long Patient Care Tower relay strength and permanence, anchoring the prominent building and reflecting the surrounding foothills and sky. The entire facility is interwoven with artworks that recall California's nature. "John Muir Health serves as an anchor for this community, and we reflect this strength and permanence in the design," said Tom Patterson, principal with Ratcliff and project manager of the design team.

Inside, the entry sequence opens into a two-story, wood and stone paneled lobby with a vast, skylight canopy. Visitors are beckoned towards a circular, glazed rotunda, open to the sky, where lush bamboo thrives alongside a refreshing pool of water. In addition to its aesthetic value, the circular, 52-foot-diameter rotunda plays an important way-finding role by providing a central point of visibility for patients and visitors.

"A new circulation system creates separate public and non public paths of travel to increase privacy and decrease the potential spread of infectious contagions," explained Patterson. "Circular design patterns in ceilings and flooring echo the rotunda and provide a sense of continuity for patients and visitors."

Sustainable Design

• Ratcliff designed six rooftop gardens that provide respite, fresh air and sunlight for patients, visitors and staff.
• Generous windows in all patient rooms, corridors and lobbies flood the interior with sunlight and exterior views, promoting healing and mitigating anxiety.
• Mindful of the wellbeing of patients of all ages, the designers used high-performance, low-VOC materials to reduce indoor air contaminants
• The new patient tower is designed to be energy efficient through the use of intelligent building controls and energy-efficient mechanical systems and lighting. The new central utility plant co-generates a portion of the campus' energy requirements.

Additional Project Highlights

• Patient Rooms: All new, private, family-centered rooms have zones for patients, family members and staff to help enhance patient and visitor comfort, increase staff efficiency, and decrease medical errors and hospital-acquired infections. All rooms have outdoor views and maximum natural light, as well as lighting and acoustical treatments to create a more healing environment. All rooms have access to electronic medical records to enable in-room charting for physicians and medical staff. Ratcliff employed the concept of decentralized nursing stations and charting alcoves to help nurses stay closer to their patients and reduce walk time during shifts.

"Ratcliff introduced hospital design concepts during our planning process such as zoning, decentralized nurse stations and acoustics control to help us create a hospital of the future," said Michael Monaldo, vice president of Facilities Development and Corporate Real Estate at John Muir Health.

• The relocated and expanded Emergency Department (ED) doubles the capacity with 44 private treatment and observation rooms that can accommodate up to 65,000 emergency and trauma visits annually. The helistop on the tower rooftop is connected to high-speed elevators that allow for rapid patient transfer to the ED or surgery. The ED includes four dedicated trauma rooms, two negative-pressure isolation treatment rooms and three satellite waiting areas for families and is immediately adjacent to the expanded imaging department.
• Three new, spacious inpatient Surgical Suites are located adjacent to the Intensive Care Unit and accommodate current and future technological advances, such as minimally invasive robotic surgery.
• The Neonatal Intensive Care Unit (NICU) is designed to promote infant-parent bonding and allows for more collaboration between nurses and families. The 35 private NICU rooms are designed to provide a more personal and comfortable setting for parents and families while providing access to the unit's roof garden. Rooms are equipped with an advanced lighting system to support infants' day/night cycles and enhanced acoustical finishes that protect infants' heightened sensitivity by reducing background noise.

• Evidence based design: The facility incorporates elements of the evidence based design, where design decisions are informed by studies that have determined a positive effect on patient wellbeing by certain techniques, for example, acoustical treatment and light control. Ratcliff worked closely with John Muir Health to identify appropriate materials quality, allowing design to carry deeply into the facility with a minimum of special care.

• Public Art: The work by Napa artist Gordon Huether and others was incorporated in support of the City of Walnut Creek's public art program. Sited in "The Sharon Garden" at the hospital entry are Huether's installation in metal and glass that echoes Mt. Diablo and his dichroic-glass "River of Light" footpath that "flows" into the hospital from a rough-hewn Sierra granite water "Headwaters" water feature designed by landscape architect Gates and Associates.