Cannon's hospitable space for special surgery patients.

Phase One of Hospital for Special Surgery's major expansion program, is testimony to the very successful, long-term partnership between the internationally renowned Hospital for Special Surgery and the international architectural, engineering and planning firm, Cannon Design.

Hospital for Special Surgery is one of only two institutions in the country designated by the National Institutes of Health as a Core Center for Musculoskeletal Integrity and recognized among the leading orthopedic and rheumatology hospitals worldwide.

This 10+-year relationship--which began with the successful installation of an MRI suite in the hospital's lower level--has flourished with a continuous succession of projects that include the expansion of the MRI suite, a Hand Center, outpatient services, clinical and research labs, ambulatory care and inpatient surgery, a new central sterile supply unit supporting surgical services, and a 30 inpatient bed expansion that accommodates increased surgical volume. The entrance or "front door" image of the Hospital was greatly enhanced by an in-fill program that added 8,000 sf of valuable real estate. The project improved vehicle and pedestrian circulation, as well as site lighting, and created new opportunities to express the institutional identity and presence.

Mutual trust and client satisfaction remain the building blocks of this ongoing partnership which continues to exceed its goals for future development.

Most recently, the Hospital completed Phase One of its major expansion project, a $185 million growth and renovation program with unique planning and logistical challenges. Located in mid-town Manhattan between 70th and 71st Streets, overlooking the East River, the Hospital's east wing spans FDR Drive. Program components include a 95,000 sf renovation of the hospital's main building and two vertical expansions to the structure, totaling an additional 110,000 sf.

Designed with patient needs at the forefront, Hospital for Special Surgery recently occupied a state-of-them 30-bed medical/surgical inpatient unit with many unique features. In each room, windows stretch from floor to ceiling, maximizing views of the East River. To enhance the quality of the patient experience, a strategic business decision sacrificed additional bed capacity. Two patient or "semiprivate" rooms have been organized to create separate zones for each patient, placing them to either side of a common circulation path.

Typically, in most institutions, semi-private accommodations are arranged with side-by-side patient beds and an inboard bathroom. As a result, the patient bed is positioned away from the window---offering little privacy and often only a view of your companion's cubicle curtain. In the HSS model, each bed has its own unobstructed view of the river, even if the other patient has closed the cubicle curtain. Rooms abound with natural lighting. The finishes are warm and inviting, with natural wood accents. Lighting levels can be adjusted by either staff or patients, offering flexibility for either care or comfort. Each patient room has ample space for family members to gather and neither occupant need trespass the other's space to reach the restroom. (HSS staff has observed a positive correlation between access to the benefits of exposure to the natural environment, with its river view and daylighting, and improved recovery time.)

Staff amenities have also been carefully considered and include cheerful locker rooms and a spacious staff lounge overlooking the East River. Nurses' stations are positioned to maximize patient observation sightlines and are richly appointed with wood, stainless steel and stone finishes.

A substantial expansion of the central sterile supply department supports a new ambulatory surgery suite on the 9th floor as well as an inpatient surgical suite on the 4th floor. In the outpatient surgical center, a spacious sun-bathed waiting room with sweeping views of the East River and the city beyond, greets the patient.

Given the density and urban character of the existing site, orienting the building to capture impressive views of the East River was no easy task.

Formidable obstacles included the location of the addition above FDR Drive and construction progress without interference to traffic moving 24/7 beneath the building.

Granite-faced concrete panels of substantial size were hoisted from ground-level and conveyed horizontally along the East River to their final location, using a monorail installed on the building's roof. To increase passenger elevator capacity, a shaft was carved through the existing building while surrounded by ongoing operations.

The delivery of new construction materials and the removal of demolition debris, another project challenge, was addressed by installing a temporary lift at the 71st Street building facade.

The success of this program demonstrates that partnership--the active participation of Hospital for Special Surgery's administration and staff, and the creative energy of Cannon Design's healthcare planners, designers and engineers--creates a framework for collaborative decision-making, establishes a joint sense of ownership, and reinforces the commitment to project teamwork that can overcome virtually all challenges.

By Stephen A. Kaunelis, Senior Associate, Cannon Design