Separating Services

Laguna Honda Design Keeps Patients Away From Plumbers

By Thomas York

The replacement program for the 78-year-old Laguna Honda Hospital includes about 727,000 sq. ft. of new and renovation construction (photo by Thomas York).

Architects for the $311 million reconstruction of the 78-year-old Laguna Honda Hospital in San Francisco said the new facility's most important design elements are single-floor access for patients and separating patient circulation from service circulation.

"The entire complex will possess unusual features not often seen in other hospital or nursing facility complexes," said Jim Kautz, project manager for Anshen+Allen Architects, San Francisco-co-designer with San Francisco-based Chong Partners Architecture.

Kautz said the replacement program features about 727,000 sq. ft. of new and renovation construction.

The project includes the construction of five new residence buildings and renovation of an existing hospital building into administrative offices.
In addition, an existing residence building will be razed to make way for one of the five new structures, along with the construction of several utility buildings on the 62-acre site.

The ambitious replacement program will run through 2011.

Patient access a priority
Kautz said that the new and renovated structures would be reachable via a single floor, allowing caregivers, residents and visitors to access all parts of the complex without the need for elevators or stairs.

Putting most of the hospital's services on one floor is important since 80 percent of the residents rely on wheelchairs, he added.

In addition, the three new patient and renovated office buildings will be linked by a common second floor, which will be used by service providers such as maintenance staff and delivery personnel. "We didn't want various services to go along the public concourse," Kautz said.

Later this spring, Turner Construction Co., the construction manager at risk, will solicit bids for the contracts to pour foundations and erect steel frames, a process that will begin in the fall, said Bob Dias, the project executive for the Oakland office of Turner Construction.

Demolition nearly done
ProVen Management Inc. of San Francisco got the project rolling in November 2002 with a $10 million mixed bag of demolition work, utility transfers, grading and construction of a central plant. ProVen will finish its work in July, said Charles Schrembri, the firm's vice president.

The actual construction work will be done in three phases.

When the $311 million project is completed in seven years, the new Laguna Honda Hospital will have increased its bed capacity to 1,200 from 1,062 (rendering courtesy of Anshen + Allen Architects and Chong Partners Architecture).

The first phase includes renovation of an existing residence building into administrative offices as well as the construction of the three new residence buildings. This phase is scheduled for completion in October 2007.

In the second phase, crews will demolish Clarendon Hall, another existing building, and replace it with the fourth new residence hall. That facility is scheduled for completion in late 2009.

Then, crews will begin construction on a fifth patient building, an assisted-living facility, slated for completion in 2011.

When all of the work is completed, the new Laguna Honda Hospital will have increased its bed capacity to 1,200 from 1,062.

Anshen+Allen's Kautz said private and semiprivate rooms will replace the open wards that now sleep up to 30 patients in the existing hospital building. Kautz said his design team has clustered the new patient rooms around community areas, such as dining and living rooms.

The focus on private rooms required intensive negotiations with officials in Sacramento responsible for new hospital construction.

"We wanted a residential model, and that set up some concern with the state," said Michael Lane, program manager for the Laguna Honda Hospital Replacement Program. "The hospital model tends to be rigid and we wanted to be more flexible than that. We're moving toward a model with as much privacy as possible."

Kautz noted that the hospital did have to cut back on some aspects of the project, which required even more negotiating with Sacramento.

"Three bedrooms will share a single toilet, a feature not permitted under current state hospital construction guidelines, so we had to obtain a waver to do this," said Kautz.
He explained that Laguna Honda hospital officials wanted to provide separate toilets to each resident, but couldn't afford to do so due to the construction costs involved in terms of plumbing and other code requirements.

"Having shared bathrooms is unique in California skilled-nursing homes, and it required a lot of negotiating with the state," he said.