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Post-Occupancy: Yawkey Center for Outpatient Care | Children’s Hospital, Ambulatory Care Building | Naval Hospital More Health Care Projects Naval Hospital
NBBJ evokes the form of a nautical quarterdeck for an atrium that connects a new family-care wing with an existing hospital.
Originally published in the Building Types Study section of Architectural Record – October 2004
As it is in the civilian world, health care in the military is a growing enterprise that requires facility expansion to keep pace with demand. The armed services clientele doesn’t differ much from the larger population, since spouses, children, and retirees are provided with care. Similarly, military facilities are incorporating the amenities and consumer values found in the larger universe of American health care. NBBJ’s addition to the Bremerton Naval Hospital, in Washington, one of about 20 U.S. Navy hospitals around the world, embodies these values and is a model for future planning. It consists of a new family-care outpatient clinic attached to an older, more traditionally conceived hospital. Located in a nearly rural zone on the western fringe of metropolitan Seattle, the hospital serves 60,000 military families in Washington and Oregon.
Pictured: Naval Hospital 
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Program
The 63,200-square-foot addition expands a 250,000-square-foot naval hospital built in 1980, which occupies a gently sloping wooded site on Washington’s Kitsap peninsula, overlooking Puget Sound’s Ostrich Bay. The new building contains family-care clinics comprising 66 exam rooms, seven procedure rooms, and 32 medical offices; a pharmacy; three large waiting areas; and a new entry joining the old and new buildings. Support functions include medical-records storage, a wellness center, staff lounges, and an allergy/immunization clinic. NBBJ also partially renovated the older hospital. Among the project’s goals were creating a patient-focused healing environment, a pleasant work space, clarity of circulation, integration with the natural context, expression of naval motifs and traditions, and sustainability within a tight budget of $200 per square foot.
Solution
Early in the design process, NBBJ persuaded the Navy to modify its existing campus master plan to enable expansion parallel to the shoreline, rather than in an inland direction, to preserve a wooded hillside and afford the new building views of the bay. Helping to preserve the site further, a multilevel underground garage provides protection from the elements in the rainy climate and can also serve as an emergency shelter.
The key visual motif of the complex is a glass-walled atrium, dubbed the “quarterdeck”—a Navy term for the main entry area of a ship or a command, usually decorated with flags and serving ceremonial as well as circulatory functions. Here, the quarterdeck acts as a “knuckle” joining the old hospital with the new clinic by means of freestanding, intricately detailed steel stairs and second- and third-story bridges that float within a spacious three-story volume.
“Externally, this concept grew out of the form of an aircraft-carrier control tower—‘the island’, in Navy parlance,” says NBBJ project designer Jerry Yin. “Internally, the bridges and stairs are like a ship’s catwalks.”
The clinic wing is organized on a 30-foot-by-30-foot planning module and displays an impressive clarity, considering the more than 200 cubicles and functional subdivisions required by the program. The linear waiting areas, extending the full length of each floor, have generous northeast-facing window walls yielding natural light and sweeping water views, and form spines to which five cross-corridors connect on each upper floor. The latter are glazed at each end, providing orientation cues as well as visual relief and a link to the outdoors.
Commentary
Relating the addition to the existing seven-story concrete monolithic hospital was a challenge, given its heavy expression and a volume four times as large as the new wing. The new quarterdeck provides a welcome light touch at the center of the complex, and buffers the clinic building from its bulky sibling. Its bright, airy main-circulation and waiting-room spine is a big improvement over the original building’s darker internal corridors. NBBJ’s expansion is humane and enlightened, bringing natural light and inspiring water views to everyone.
At a time when scandalous conditions in the nation’s military hospitals are making headlines, it is encouraging to see a carefully designed facility that provides a comforting, even exciting, environment where naval families may receive outpatient care—and a building that, to boot, invigorates an entire hospital complex.
Architect John Pangrazio, FAIA, of NBBJ, is proud of the light-filled, three-story lobby that is connected to the rather forbidding existing hospital by bridges on two levels. “We like the fact that the entrance to the entire hospital was replaced and improved,” he says. “The entry drive and garage are now in front of the main entry. The original design had a front entrance that was never used because parking was nowhere nearby. We transformed the site by having the drop-off area and garage next to the front entry and by tying the clinic and hospital entries to the ‘quarterdeck’—the military term that refers to the first place where passengers arrive on a ship.”
The architects must have succeeded in suggesting the maritime analogy. Naval personnel have since added flags that make the space look even more like a ship’s quarterdeck. “The design is in a nautical vernacular, which resonates with the Navy.” Asked what people who use the hospital like best, Pangrazio says that “everyone comments on the bright light in the lobby and waiting rooms. The public spaces relate to the outdoors and provide a wonderful orientation to the trees and the water beyond the lush landscaping.”
Dora Herman, the Family Medicine Leading Chief Petty Officer, agrees: “The windows really add to the building. You can see the beautiful scenery in rain or shine.”
Lieutenant commander Brian Smoley of Naval Hospital Bremerton Family Medicine concurs, adding that he likes “the windows and amount of light that they allow in.” Smoley says that if he were to design the hospital today, he would insert “two more stairways to connect office spaces on the different floors along the back (west) hallway of the building.”
The architects did plan for change, though, by making the exam rooms and offices the same size so they could be interchanged. “Treatment rooms are one-and-a-half times the size of the office/exam modules,” Pangrazio explains. “To facilitate change, each office/exam space is ‘plumbed.’ Sink units hang on the wall, and there is a recessed box in the wall for quick plumbing connections, so an exam room can be converted to an office or an office can be converted to an exam room overnight.”
The only problem with that set up, Herman says, is that “some of the treatment rooms are too small.” If she were to design the hospital today, based on her experiences there, she would create “bigger treatment rooms and smaller office spaces—or adjoining office/treatment rooms.” Herman adds that, since the hospital opened, some restrooms that were underused have been converted to supply closets because there was not enough storage space. And her comments are not unusual. Almost every user at every kind of facility in every building type, when asked what he or she would like to change, mentions more room for storage.
That said, the layout of spaces in the hospital draws praise from both staff and patients, Pangrazio says: “It’s easy to understand and easy to navigate.” And he’s especially happy with the way the hospital’s energy-saving features work—some of which, like maximizing daylight exposure, were a result of carefully orienting the building on its site. “Natural light saves electricity, and a naturally ventilated garage means mechanical ventilation is not required.” He also found that recessing the garage in the hill, with the driveway above it and a direct connection to the front entry, makes for an ideal layout—so much so that he is using it at another project he is designing now.
- A spacious, light-filled lobby enhances the entire hospital visit.
- A nine-meter span structural system allows for easy reconfiguration of offices, exam, and procedure rooms.
- In rainy climates, covered parking spaces are desirable for patients unloading wheelchairs or strollers.
- Bathroom equipment should be designed for the specific population that will use a facility.
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