Function Dictates Form

Scaffolds are fashionable in the Northwest Arkansas medical community right now.

Construction crews are painting the 10 surgery suites in the new 345,000-SF Washington Regional Medical Center on Northhills Boulevard in Fayetteville. Across the county line, Northwest Medical Center of Benton County — formerly known as Bates Medical Center — broke ground last month on a new 221,000-SF Bentonville facility.

Together, the projects will cost more than $150 million. According to the project budgets, each square foot of Northwest of Benton County will cost about $285, $25 more per square foot than the new WRMC.

Specialty sections such as sterile operating rooms and lead-lined radiology suites raise the cost of construction. Linda Marzialo, president of the Nashville-headquartered Gould Turner Group Inc. and principal architect of Northwest of Benton County said the average hospital costs about $200-$300 to build per square foot.

Although they are expensive to construct, hospitals must attract quality medical staff in an increasingly strained market.

Aside from the two facilities under construction, Willow Creek Women’s Hospital opened its doors this year less than five miles from WRMC’s future home.

Mercy Health System of Northwest Arkansas has also set aside 75 acres of land along I-540 for possible expansion.

In an attempt to build the most staff-friendly facilities possible, WRMC and Northwest of Benton County administrators went to the source. Both hospitals used their medical and nonclinical staff to help design the new buildings.

Northwest of Benton County hosted round-table discussions and one-on-one interviews between interested employees and the project’s architects, interior designers, and equipment and electrical engineers.

“We asked them to put together their pie-in-the-sky attributes for their departments,” said Northwest of Benton County Chief Operating Officer Mark Bever.

“We feel so fortunate to get to build a hospital from the ground up,” Bever said. “We want to get it right from the get-go.”

He said the $63 million budgeted for the new hospital includes outfitting most of it with new equipment.

WRMC, slated to open next summer, also will spend a little more to make employees and visitors happy.

Project Manager Jack Morris said WRMC will sacrifice its monthly heating and air-conditioning bill by implementing six air changes per hour. An exhaust system will regularly flush the hospital with fresh air to help dissipate the antiseptic smell associated with hospitals.

Suggestions from the staff — such as extra phone jacks in patient rooms and dictation stations for physicians to record medical records — were implemented by the hospital designers. Northwest of Benton County will construct physician sleep areas in the surgery, emergency room and obstetrician areas. Both of the hospitals will feature adjacent medical parks.

Some of the most considerate planning involved the nurses in Northwest Arkansas.

Aging nurses and fewer nursing students have cramped Arkansas’ health care industry. To entice nurses, WRMC designers included nursing alcoves between every pair of patient rooms on a wing.

Each alcove or pod features a small charting desk, a chair and windows into each of the two patients’ rooms. Nursing pods are trendy in new hospitals because they save nurses miles of walking to and from the main station.

Northwest of Benton County will feature similar alcoves, but they will be placed between every 4-6 rooms.

Innovative Forethought

Northwest of Benton County offered architects interested in designing the new hospital a dauntingly short timeline between conceptual planning and groundbreaking. Marzialo said the schedule is one of the tightest she’s ever accepted.

Gould Turner received its first call from Northwest of Benton County in July, three months before site preparation began. Final plans for the hospital should be published in December, Marzialo said.

In contrast, HKS, a design firm in Dallas, has drawn plans for WRMC since 1997.

However, Northwest of Benton County administrators showed remarkable foresight by requiring prospective architects to not only present plans according to the hospital’s basic specs, but each firm also had to draw master plans that showed the hospital expanded to double its originally planned size.

The master plans include space for 250 beds and increased dietary, storage and departmental space to accommodate those future patients.

“They were extremely prudent in asking for that,” Marzialo said. “It will be beneficial to them down the road.” Northwest of Benton County was the first to demand such expandability.

WRMC made provisions for an eventual fifth floor addition, but Northwest of Benton County will be ready to add a second bed tower to its plans.

“The key in hospital design is that you cannot shut it down when you’re trying to expand it,” Marzialo said.

According to the U.S. Bureau of the Census, Benton County’s population increased 57 percent from 1990 to 2000. The growth is expected to continue as big business in Northwest Arkansas attracts more development.

Northwest of Benton County will be able to expand every department without interruption, Bever said.

Construction crews will stub the medical-gas tubes at the walls that are expected to expand for the master plans. When the additions are built, the tubes will be in place to deliver medical gases to the new areas.

Even individual patient rooms must be adaptable for changes in health care.

“Obviously what is state-of-the-art today won’t be state-of-the-art tomorrow,” Bever said.

Northwest of Benton County isn’t yet managed by electronic medical records, he said, but the building will be wired to accommodate them.

Hospital administrators haven’t decided whether to outfit the building with wires or remote, wireless sensors, Bever said.

Northwest of Benton County wants to have 100 percent digital imaging by its opening.

At WRMC, 80 percent of the medical records are now kept electronically, and Morris said digital images from the radiology department will be available at computers on each floor.

Team Rosters

Expansion at Northwest of Benton County has taken several turns as management changed over the years.

Quorum Health Resources of Brentwood, Tenn., owned the hospital most recently, and Bever said the project under Quorum would have been on a much smaller scale than the current plan under Triad Hospitals Inc. of Dallas.

Bever said Triad began planning to build an all-new Bates Medical Center long before the Quorum acquisition was final.

WRMC and Northwest of Benton County have had new hospitals in various stages of planning since the early ’90s.

For their current projects, each hospital chose design firms with national reputations for medical design.

Gould Turner has worked with Triad before, but Marzialo said Northwest of Benton County administrators made the decision to go with Gould Turner. Working with a staff of 45, Marzialo is usually involved in 12-15 projects of varying phases. Eight Gould Turner employees are working on the project’s structural engineering and interior design.

Gould Turner, according to the company’s Web site at www.gouldturner.com, has about $2 billion in completed and under-construction projects. Marzialo has managed more than $700 million of medical construction projects since 1978.

The firm is licensed to work in 46 states, and 68 hospitals are listed in Gould Turner’s online portfolio. South Crest Hospital in Tulsa was the closest listed project.

HKS, the firm working with WRMC, staffs 500, and Penelope Wright, a vice president at HKS, is construction administrator for the WRMC project. Wright manages quality control and communication between the work site and Dallas.

HKS had designed and constructed 7.4 million SF of health care facilities at the end of 2000. Arkansas projects pepper the firm’s portfolio. According to HKS records, St. Edward Mercy Medical Center in Fort Smith used the firm for $41 million of renovations. Little Rock, Conway and Hot Springs all feature completed HKS projects.