Healing architecture

Health care facilities have long been a part of van Dijk Pace Westlake Architects, but no one knew quite how deeply the specialty was ingrained in the firm’s history until someone uncovered some long lost materials.

“When we were moving our offices from the Warehouse District to this building, we found a book of specifications for University Hospital that was dated 1908,” says Paul E. Westlake, a principal of the firm. “Specifications are one of the last acts of documentation — after you’ve designed the building and performed your construction drawings — so that project probably was commissioned in 1906 or 1907.”

Since the firm was founded in 1905 by Abraham Garfield, son of U.S. President James Garfield, one could argue that the firm’s experience with health care started with its founding.

Van Dijk designs all types of buildings, but health care and cultural facilities are its specialty. It has partnerships with major Cleveland health care institutions such as the Cleveland Clinic Foundation, University Hospitals and Metro Health Medical Center.

Says Westlake, “As long as we have been practicing and those institutions have been in existence, we’ve been working with them. They have developed architecture that’s unique to their research or protocols.”

That experience has vaulted van Dijk to the forefront of health care architecture, and to a number of firsts: The firm designed the first cardiac catheterization suite, as well as the first kidney dialysis facility.

It’s also learned the importance of planning. With the high cost of health care — the equipment that fills a room can cost more than the building that surrounds it — both clients and the firm must keep finances in mind.

It’s a delicate balancing act, says Westlake, keeping costs down while providing the utmost in patient care.

“We find our health care clients to be extremely cost conscious from a standpoint of efficiency of operations,” he says. “But at the same time, they try to maintain a fairly high quality of environment.

“A lot of our focus in planning and programming may have to do with finding a system of organization that maximizes the use of a piece of equipment, or that minimizes duplication of an expensive piece of equipment. It’s clearly a very specialized project.”

While money is always a significant factor, Westlake says health care facilities are more interested in patient care. And they’ve been paying more attention to the surroundings and their influence on patients.

“That has to do with comfort and convenience, and a kind of visually satisfying and psychologically satisfying environment in which to receive those services,” Westlake says. “The bar has been raised significantly for design. And I think design is a marketing tool now for medical facilities, as it is for retail and hospitality environments.

“The new facilities are designed to provide a lot of dignity for the patient. It’s a different paradigm. You go to the retail paradigm because it’s decidedly noninstitutional. It’s designed to allure and attract, and make you feel comfortable. The retail spaces are often favorite spaces in the community. And hospitals are looking to that as models. They want spaces that people enjoy, that feel welcoming and are very pleasant and delightful.”

The lessons they have learned translate into other areas of architecture as well.

“One of the problems is that many architects act more like druggists than they do doctors,” he says. “They tend to fill the prescription of needs that are dictated by their clients, rather than analyzing what’s wrong with the patient and coming up with a solution.”

Westlake says some architecture firms simply do whatever the clients asks without considering the full ramifications. If a hospital increases the size of its emergency room, for example, what effect will that have on the cardiology unit or radiology? What effect will it have on maintenance or food service?

“You need to understand the effect of any change in one department on the whole system,” he says. “Our approach is more to try and make a diagnosis by testing a number of things and making hypotheses and try to prove those out. And then at that point prescribing a solution.”

The ability to “treat” the whole facility while doing a project is one of the things that separates van Dijk from other architectural firms, Westlake says.

“One of the things that our firm does that is highly differentiating and unusual for architectural firms is that we do have in-house programming capability,” he says. “We’re in a position to perform those needs assessments on behalf of our clients. You have to understand the organism is entirely dynamic. You see a change, you provide for that change physically by arranging space.

“That’s never the end game. It’s just part of the continuum of the development or change of an institution.” How to reach: van Dijk Pace Westlake Architects, (216) 522-1357, or www.vpwa.com

Daniel G. Jacobs ([email protected]) is senior editor at SBN.