Dell Children's Medical Center

On Axis with Nature

A new children's hospital with LEED ambitions takes an organic approach to wayfinding.

It’s not often that hospital wayfinding systems are created from the ground up, but when new construction is involved, designers have a rare opportunity to integrate wayfinding cues into the architectural fabric of the building. And when that hospital is built to LEED standards, a whole new vocabulary of materials and processes is created.

The Dell Children’s Medical Center in Austin faced the challenge of meshing those two goals, and Karlsberger (Columbus, Ohio) worked to meld its architectural design with LEED criteria and a wayfinding program that takes its cues from nature.   

“Graphic design was involved from the beginning of the planning phases, working with the architectural designers, landscape architects, and interior design staff to create a vision for integrating wayfinding cues into the building organically,” says Daniel J. Clements III, Karlsberger’s vice president, director of graphic design. Started in 2003, the design was Karlsberger’s first LEED project and will likely be the first hospital to achieve LEED Platinum certification under the program designed by the U.S. Green Building Council.

In the beginning: compassion

Built on a 32-acre “brown” site at the former Robert Mueller Municipal Airport, the former Children’s Hospital of Austin had outgrown its home in downtown Austin and needed a larger facility to serve the patients it draws from 46 Central Texas counties.

With the $200 million new hospital, the Seton Healthcare Network had the opportunity to build a facility around the needs of its patients, their families, and the hospital staff, says Robert Walsh, senior director of nursing and a key member of the hospital stakeholder group that worked with Karlsberger.

Part of that opportunity was to spare patients and their families as much emotional trauma as possible. “We’re here to take care of not just the child, but the family, too,” says Walsh. “It’s important they be as comfortable as possible when they’re in our care.”

So the hospital includes built-in stress-reducing amenities including six open-air “healing courtyards” that represent the six eco-systems found in Texas. Karlsberger optimized natural light so that people in most of the building are never more than 32 ft. away from an outside wall with daylight, another important stress reliever. And public and patient transportation elevators and operational areas were segregated to reduce visitors’ exposure to sick patients.

A carefully conceived wayfinding program was also designed for visitors’ comfort. While there are various rules of thumb about how much wayfinding information people can absorb and retain, most experts agree that the stress of visiting a loved one in the hospital dramatically decreases short-term memory capacity. So Karlsberger knew it was important to integrate plenty of wayfinding cues into the hospital’s design. The project’s LEED goals of using locally sourced materials for construction resulted in a happy marriage between the two.

Follow the Red Rock Wall

The first wayfinding task was to guide visitors to the hospital from the surrounding roadways. While the four-story, 473,000-sq.-ft. building is located just off I-35, surrounding development obscures the site line from the interstate. To provide a landmark for visitors, Karlsberger designed an unoccupied, 145-ft.-tall steel-frame tower clad in glass, stone, and metal—and topped it with a white tensile fabric sculptural element that recalls the headpieces of the nuns who founded the original hospital. 

Once it draws visitors to the hospital grounds, the wayfinding program focuses on identifying key entry points and intuitively guiding people toward them, says Clements. A series of structural canopies on the exterior of the building identify the main entrance, emergency room, and outpatient functions such as imaging and rehab. Signs direct visitors toward two primary parking lots.

Inside, Karlsberger recognized that functional relationships between the spaces resulted in two distinct axes they could capitalize on and celebrate. The east/west axis includes the main lobby, the gift shop, and other entrance functions, while the north/south axis includes the emergency entrance and outpatient functions such as imaging, rehab, and other departments.

Working within LEED guidelines that encourage native materials and contextualization of local culture and resources, Karlsberger was inspired to mark the two major axes in a quite literal way. The center of the building is cleaved east and west by a 955-ft.-long wall of regionally quarried red split-face sandstone that extends outside to the main hospital entrance. The north/south axis is marked by a 385-ft.-long wall, visible on all four floors, made of a patterned laminate that simulates the look of mesquite (real mesquite wouldn’t pass local fire codes).

“The Red Rock Wall runs from the campus front entry to  the front of the building and all the way through on all floors; it acts as a major organizer,” Clements explains. “It’s an inherent navigational aid and reference point. Using either the Red Rock Wall or the Wood Wall, people can easily and intuitively get to the center of the building and therefore to the elevators.”

Cognitive mapping

Recognizing that visitors’ experiences in an unfamiliar environment are sequential, Clements’ team planned for what visitors would experience and what would draw them to the next point in their journey. From the information desk in the main lobby (and the emergency reception desk after hours), a human being usually directs visitors to the elevator that will take them to their destination. “But if there is no human help, they should be able to find what they need when they need it,” explains Clements. “Cognitive mapping meets those expectations.”

Guideposts include directionals that cluster visitors to primary reception points. “So it doesn’t matter if you’re having an x-ray or blood drawn. You have to first go to the primary reception point—outpatient—then get your next direction from there,” Clements explains.

The next set of guideposts includes playful floor-number graphics outside each elevator, ceiling-hung blade signs, and wall-mounted room and office identifiers. Looking down long corridors, visitors can spot major destinations by colorful ceiling elements and patterns on the linoleum floors.  

“Rather than relying solely on signs, we used the idea of architectural elements and floor patterning to landmark destinations with something distinguishable from pretty far away,” says Clements. “People aren’t always looking up for signs, so floor patterning can be especially helpful.”

Signs: all this and green, too 

ASI-Modulex’s Infinity modular sign system satisfied the projects’ aesthetic, functional, and green requirements for interior signs. While sign materials don’t typically contribute substantially to a project’s LEED goals, in the spirit of the program all wall-mounted signs were mechanically fastened to avoid using adhesives. The Infinity system’s perforated-aluminum chassis is powdercoated, a low-VOC process. Modulex’s polyester- and water-based paint system is also low VOC. And modularity also means less manufacturing waste and flexibility in making changes over the life of the system, says Jim Bishop, the company’s owner.

To make ordering and changing the signs more efficient, cost effective,  and easier for the client, Karlsberger organized them by modules according to the fabrication techniques required: photopolymer overlays for permanent Braille and tactile elements, silkscreened acrylic for other permanent elements, and paper-insert modules for those signs that would change frequently.

“We used all standard system components, but customized them for the hospital’s needs,” says Clements. That created a challenge for ASI-Modulex, says Bishop. “From a fabrication and installation standpoint it was rather difficult because we didn’t actually have sign types, just components,” he explains. “So we had to sort the message schedule by components using an Excel spreadsheet.” Karlsberger specified a wide range of colors to provide flexibility in signing various departments, but chose Futura Condensed as the universal typeface to provide visual consistency among all signage and donor acknowledgement elements.

Reality sets in

Walsh says patients, visitors, and especially the hospital staff are thrilled with the new facility, but they’ve found the need to supplement the original organic wayfinding system with a few additional signs. “I think we underestimated the amount of stress visitors are under and how much self-navigation they can do.”

Focus groups identified the need to supplement the floor graphic identifiers outside the elevators with mini directories that will tell visitors which functions and departments are on that floor. The hospital may also add a sign at the main reception desk directing people to elevators (in case the human receptionist is not there), as well as room-number ranges on the circular department identifiers.

For all that signs can do, Walsh says visitors are often so stressed that they need a human hand outstretched to help. “We want that human contact to be the first thing they encounter. We set the expectation with hospital staff that if they see someone lost, it’s their responsibility to help them. That’s what we do here.”

--By Pat Matson Knapp, segdDESIGN magazine No. 19, 2008



Location: Austin

Client: Seton Healthcare Network

Architecture and Environmental Graphic Design: Karlsberger

Design Team: Thomas Snearey, AIA, LEED AP (senior vice president, project manager, and principal-in-charge), Joseph Kuspan, AIA, senior vice president, director of architectural design), Amy Mays, LEED AP (senior interior designer), Daniel Clements III, SEGD (vice president of graphic design), Nicolas Banks, SEGD (lead graphic designer)

Consultants: Center for Maximum Potential Building Systems (LEED Consultant); TBG Partners (landscape architects); White Construction (construction manager); Bury & Partners (civil engineers); ccrd Partners (mechanical engineers); Datum Engineers (structural engineers)

Signage Fabrication: ASI-Modulex (interior signage); Austin Architectural Graphics (exterior signage)

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