HOK’s Hugh Campbell on the Evolution of Hospital Design and Maternal-Fetal Care Centers
HOK designed the Harlem Hospital Center’s Mural Pavilion to welcome the community it serves.
Hugh Campbell has spent more than 35 years as an architect focusing on hospitals and how they relate to communities.
Hugh Campbell grew up in New York City, where one of his first jobs was working as a courier in Manhattan. Decades later, he still finds himself reminiscing about those days in which he “visited nearly every building in the borough” and fell in love with architecture. Several years after earning a bachelor of architecture degree from Notre Dame, Campbell’s interest in the built environment and its evolution led him to pursue a master’s degree in urban history from NYU.
Campbell began his career in his hometown (one of his early jobs was with HOK’s New York office) but eventually found his way to the Pacific Northwest. After a 20-year hiatus from HOK, he recently returned as senior medical planner in the firm’s Seattle office. Here he discusses his fascination with the ever-evolving field of healthcare design.
The histories of hospitals and cities are intertwined. Hospitals traditionally made huge civic statements. Every city would start out with a city hall before building a courthouse and then a hospital. In the 1800s, the first urban hospitals looked like churches, and there was a religious aspect to them. Then they started resembling public buildings. As medicine became more scientific, hospitals began looking like labs and then factories. In the 1960s and ‘70s, they started mimicking hotels. Then we went through a period where they felt like residences. Today we’re once again deciding what hospitals are and how they should function. Hospitals are constantly evolving, which is what makes them so fascinating.
New York Hospital, circa 1811. (Courtesy New York Public Library Digital Collections)
Designing hospitals is like working a gigantic puzzle where you have to fit together all the pieces in a three-dimensional space. When you chart a hospital’s flow diagram, you realize how amazing they are. All these people and things are moving through the space. We call it the “Seven Flows of Healthcare:” medical staff, patients, families, medication, equipment, supplies and information. They all have to work together.
What I like about children’s hospitals is that they still exhibit the civic pride that you don’t always find with adult hospitals. They’re quite a bit different, too. Children aren’t just little adults. Caring for them requires an entirely different kind of hospital.
Vibrant colors and materials alleviate the anxieties of pediatric patients at Stanford Children’s Health Specialty Services Center.
Maternal-fetal care centers represent one of the greatest recent advancements—and challenges—for children’s hospitals. Over the past 15 years, pediatric surgery has made incredible leaps. Physicians can operate on a baby in utero or while still attached to the mother’s placenta. As pediatric and fetal surgery has advanced, it makes more sense to perform these operations in children’s hospitals equipped with the staff and equipment to handle potential complications. Yet moving mothers with high-risk pregnancies from adult hospitals to a children’s hospital creates its own complications. The mother will have different medical, lab and pharmacy needs than the baby.
Solving the maternal-fetal care puzzle requires understanding four key components: the patient room for the mother, the birthing room, the procedure room for the child (if not done immediately in the birthing room) and the neonatal intensive care unit (NICU). These four components have to respond to one another quickly and efficiently. Sometimes, though, the design team often doesn’t have the luxury of arranging the puzzle pieces so closely together. In those cases, it’s our job as architects and designers to help build consensus among all four parties.
In tomorrow’s hospitals I expect to see more community connections. At some point many urban hospitals began shutting themselves off from their surroundings. They erected fences and set up security stations. There was a sense that community members were not welcome. But I’ve been involved in several recent projects where the design team has worked to open up these hospitals. That’s a positive trend.
HOK’s design of the Eskenazi Health Sidney & Lois Eskenazi Hospital in Indianapolis includes a rooftop fruit and vegetable garden to encourage healthy eating and wellness habits while giving patients and employees opportunities to enjoy nature.
The notion of wellness is beginning to dramatically impact hospital design. No longer are hospitals there solely to take care of you when you’re sick. Now they’re trying to prevent you from being sick in the first place. So hospitals begin to shift from treatment centers to treatment and education centers. Once again, the evolution of the hospital continues.