Methodist Stone Oak Hospital

HOK and its clients took advantage of a rare opportunity to improve patient care - building a new hospital on a Greenfield site.

By Charles Linn, FAIA

When a taxi driver said of Methodist Stone Oak Hospital, “It’s a very Modernist building, reminds me of some things Mies did at the Bauhaus” (particularly when he did not have a clue as to the occupation of his passenger), it was obvious HOK had succeeded in giving the new hospital curb appeal. But facades are easy. It was far more difficult to transform what goes on behind its glass, random ashlar stone, and brick surface.

Program

The architecture of hospitals must acknowledge and accommodate user demographics, the latest trends in the way that care is given, and staff recruitment and retention. HOK won this project when the Healthcare Corporation of America and the Methodist Healthcare System of San Antonio held a competition for “the hospital of the future.” The firm’s entry was based on several key ideas. One was that in a region where patients have many health-care facilities to choose from, and salaries for skilled nurses and health-care workers are very competitive, spending the money to provide a work and treatment facility that is distinctly pleasant compared to other hospitals, and also conveniently located, would yield a competitive edge well worth the investment. From a financial and operational perspective, the building would offer patients more treatment options than most hospitals, lease doctors office space, and be extremely compact and efficient to run.

Solution

According to Stone Oak C.E.O. Dean Alexander, “People want their health care to be in more intimate settings and close to where they live.” Stone Oak’s site, several miles north of central San Antonio, was chosen because it is a growth area, and ideally located near the intersection of a highway leading out of downtown and a loop road circling the city.

At 132 beds, this steel-framed hospital is of a modest size for the region (another nearby is being expanded to 700). Yet it is a complete acute-care facility with cardiology, general surgery and neurosurgery, oncology, obstetrics and gynecology, and a large emergency department.

The layout of the building is straightforward. A canopy at the main entrance — where valets await should you wish to have your car parked — covers two entries. One leads to a medical office wing. This convenience was added to attract top physicians who are the gatekeepers for many of the hospital’s patients. The second entry leads to the patient-care wing, where admissions take place for those who have come for procedures that will require at least an overnight stay, or for less-invasive procedures, which take a day or less. This kind of ambulatory treatment is quite profitable, yet over time most hospitals have stopped offering it; Stone Oak endeavors to reverse the trend. The emergency department has its own entrance at the rear of the building. This location is not to diminish the importance of the ER: Approximately two thirds of the patients who are admitted to the hospital come in through there, but placing it at the back separates ambulance access from pedestrian and parking-lot traffic.

Patients who come into the main entrance to be admitted or for ambulatory care find themselves in a two-story, glass-enclosed concourse that runs the length of the patient-care wing. Each medical department has its own check-in area, and wood-trimmed, small-scale waiting rooms avoid the airport-terminal feel common to mega-hospitals. The ambulatory care, surgical, and ER suites are clustered beyond these public spaces, allowing such things as imaging equipment to be shared. This organization also reduces the time patients and staff spend moving between departments.

Obstetrics is located on the second floor, accessed via a dedicated elevator. Its waiting area occupies a balcony that overlooks the concourse, allowing it to be spacious and daylit while remaining private. Extremely compact patient rooms are located on the floors above. Their unusual, canted-headwall design allows patients to easily see outdoors and to make eye contact with staff walking the single-loaded corridors. The small distance between the bed and bath minimizes the risk of falls; charting and hand-washing are isolated from the patient bed. All of the patient rooms at Stone Oak are private.

Commentary

One of the first things one notices here is that the flooring is not inlaid with color-coded directional arrows, a sign at other hospitals that there are probably lost patients wandering around — possibly doctors, too. The designers of most other medical buildings, while attempting to elicit comfort by borrowing from the hotel industry, have erred toward the mauve plastic laminate of Days Inns as opposed to the textiles of the Plaza. That is not the case here. Stone Oak’s warmth and clear layout help to banish anxiety, every hospital visitor’s constant companion, and that is one good measure of its success.

Gross square footage:
400,000  sq. ft.

Total construction cost:
$110,000,000

Location:
1139 E Sonterra Blvd, San Antonio, TX 78258, USA

Owner: Methodist Healthcare System of San Antonio and Hospital Corporation of America

Architect:
HOK (Hellmuth, Obata + Kassabaum)
620 Avenue of the Americas
New York, NY  10011
212-741-1200 phone
212-633-1163 fax

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