Magazine

Aging Facilities Challenge Institutions To Plan For Growth

By Vince Ellwood

Good Samaritan Hospital (GSH), a large healthcare and teaching facility in the Cincinnati-based TriHealth Inc. system, is typical of many hospital campuses across the country. Originally built in the early 1920s, GSH expanded over time, its administrators readjusting their long-term physical growth plan every step of the way.
The hospital, however, was landlocked. Without innovative solutions to this immediate problem, and updated plans for its future, GSH's long-term viability seemed threatened.

The Situation
GSH's original facility was small and simple, located in the midst of a growing single-family residential area. Some time after GSH established itself, a private academic institution was built immediately south of the hospital. Over the years, as both facilities grew, GSH became constrained by its property size and oddly shaped configuration. Additionally, there was more than 75 feet of elevation change across the campus, typical of the natural terrain of this river city.
Therefore, GSH's building expansions became increasingly vertical and compact. This development pattern also forced GSH to create multiple building entrances around the site and at differing elevations. Parking presented an additional problem; the facility had to squeeze in spaces wherever possible. Part of its strategy was to build three large parking structures. However, a study of existing conditions tallied approximately 2,100 parking spaces but no "extras." In fact, several employees and students were forced to park on nearby streets.
Meanwhile, Cincinnati had matured. Development all but filled in the land surrounding GSH, further constraining its growth options. The academic institution restricted any more expansion to the south. A four-lane north-south roadway and a park restricted eastward expansion. And a serpentine two-lane avenue and the adjacent older, declining residential area presented obstacles to expansion north and west.
These factors made GSH's growth plans seem almost impossible; continuing the same development pattern in too small of a site would have meant negative impacts on both parking and building circulation patterns.

The Challenge
GSH had changed over time to keep pace with care delivery. However, as with most hospitals, it could not tear down outdated buildings without replacing them first. The challenge, then, was to continue operating the facility while undergoing a major expansion and upgrade. Additionally, GSH had to find a way to provide enough parking for current operations and still allow new construction - including selective demolition - to take place.

The Solution
After careful analysis, the only viable expansion option was to allow GSH to expand toward the north and west. However, the plan would require relocation of the serpentine roadway. It would be a bold move, but it would best ensure GSH's current and future service delivery.
The roadway relocation would add several benefits. First, parking expansion would be able to follow the facility's expansion to the north. Second, the road itself would be realigned, making it much safer for vehicles and pedestrians.
In 2001, planning began for a phase-by-phase construction, demolition and redesign of much of GSH's campus. The challenge in the plan was to allow for additional parking spaces due to facility expansion, yet not drop below the existing total count of spaces.
Four years later, GSH purchased much of the land on the north side of the serpentine roadway. Its officials worked with the city to develop a plan for relocating that street, razing the few existing residential properties.
The additional land also allowed GSH's contractor to set aside parking for construction workers. When construction is complete, the land will allow premium surface parking near the facility's updated main entrance.
Another unique solution was to swap visitor and employee parking designations in two existing garages. This allows visitors to access the hospital's main entrance more safely during construction. GSH's long-term master plan calls for parking garage expansion, as well as more surface parking. These additions will allow Good Samaritan Hospital to fulfill its 20-year expansion plan.

Conclusion
Older healthcare facilities present challenges today. They may not meet modern building codes, and sometimes are inefficient models in which to provide modern healthcare services. Many of these campuses have grown so rapidly, that their owners have not been able to view their needs -- including those for parking -- in the long term.
As in GSH's case, a significant expansion project may be the only way to alter a campus configuration enough to solve parking problems. However, without a good master parking plan, these facilities may fail entirely. Safe, convenient parking is a major key to ensuring patient, visitor and employee satisfaction and loyalty. Planning for tomorrow's needs today will save money and time.
Vince Ellwood is a Senior Vice President and Site Designer with HDR Inc. He can be reached at vince.ellwood@hdrinc.com.

Article Abstract from January, 2006




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