Scripps Hospital Encinitas culls its design from the sea: Perkins + Will aims for cutting-edge facility with neighborhood feel.

Since the 1950s, the architectural firm of Perkins + Will has completed 500 hospital design projects in the United States and overseas, including work for Baylor University Medical Center, Ronald Reagan UCLA Medical Center, and Mayo Clinic.

With offices in North America, Africa, Asia, Europe and the Middle East, the 74-year-old firm's areas of practice are aviation and transit, corporate and commercial, education, science and technology, as well as health care. Its local office is staffed with six employees.

As a community-based medical center, Scripps Memorial Hospital Encinitas presented a different sort of challenge for the firm, which is working on the hospital's $350 million expansion plan.

"The question for us was, 'How do you keep that neighborhood feel and family focus and still be cutting edge, larger and more complex?' " said Scripps Encinitas chief executive Carl Etter.

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Scripps Encinitas serves a population that favors surfing, sailing and swimming.

"The lifestyle of people who work Nick Selerup in this facility and will be patients in this facility centers around the sea," said Nick Seierup, a principal and design director for the Los Angeles office of Perkins + Will. "Rooting the building into the specifics of that location and that population was part of the architectural expression."

In designing the planned Scripps Encinitas critical care building, Perkins + Will paired sustainable design elements with nautical references. Curved wall elements on the west facade of the building mimic sails and provide shade for windows on the floor below. Natural beige and rose-toned materials, such as block and exposed concrete, evoke the colors and textures of North County's sandy beaches. Hard woods suggest the teak of sailing ships, while glass tiles call to mind the sea itself.

The complex has a series of gardens that separate the new building from the existing hospital. One row of patient rooms overlooks a visually pleasing green roof, which will save energy use. Scripps Encinitas will install a green grid system that can retain 99 percent of a 1-inch rainfall, allowing the roof runoff water to slowly percolate through plants, shrubs and flowers.

"Making hospitals green, sustainable users of the Earth's resources and utilizing gardens as healing spaces is part of the overall design strategy," said Seierup.

On questions involving site selection, functionality, flexibility and patient care, the Perkins + Will team consulted with two categories of users: clinicians and caregivers; and administrative leaders of the hospital, including the chief nursing officer.

Staying Flexible

"Staying as flexible as possible is a growing trend, because the needs change and the buildings are more costly to adjust in the future," said Jean Mah, a principal and health care planner in Perkins + Will's Health Design Group.

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Most of the rooms are standardized, with the exception of a few larger, ocean-facing VIP rooms. All of the patient rooms will have garden or sea vistas.

The project is adding 20 intensive care unit beds and 30 medical surgery beds to the facility, which currently has 132 beds.

The nursing unit on the critical care building's second floor is designed to handle the changing staffing patterns of nursing ratios and the changing levels of care needed, without necessarily moving patients to another room.

"All of the rooms can accommodate the continuum from an acute care patient to a patient with physiological monitoring and possibly in the future to an intensive care unit patient," said Mah.

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Seismic Standards

The Scripps Encinitas project will be compliant with seismic standards in accordance with Senate Bill 1953, which the state Legislature passed in 1994 following the Northridge earthquake. The law requires that by 2030, all at-risk hospital buildings meet standards that would ensure continued operation in the event of a major earthquake.

According to the California HealthCare Foundation, a surge in approved hospital construction projects suggests that a growing number of hospitals are beginning to address SB 1953. After an average of $2 billion in new construction projects annually for several years, the number grew to $8 billion in fiscal year 2009.

In addition to the Scripps Memorial Hospital Encinitas project, Perkins + Will has been involved in the Scripps Clinic Carlsbad tenant improvement project, San Diego Miramar College master plan, UC San Diego Mayer Hall addition and renovation, UCSD Geisel Library renovation, and the UCSD School of Medicine neighborhood planning study.

Sylvia Tiersten is a freelance writer for the Business Journal.