A Machine for Healing

When confronted with creating “the hospital of the future,” the design consultant and construction teams looked back to 1954, when the original Parkland Hospital was built, to try and anticipate the next 50–75 years. There was very little technology truly integrated into the architecture back then, as X-ray machines and penicillin were the most advanced tools available to doctors. The planning of a massive, 21st-century healing environment required side-by-side teamwork from start to finish to ensure total coordination.

The hospital was to become an all-digital facility, but that meant there would need to be a robust, wire-based backbone. Joseph Longo, VP of Information Technology at Parkland, shared his experience achieving operational effectiveness, safety, and efficiency within such a technically advanced project. Given rapidly-changing technology, it would be too easy to specify infrastructure that would quickly become outmoded. For instance, Longo explains, when the project was initiated around eight years ago, “the market leader for mobile communication devices was Blackberry.” The team wanted new media and new devices, but these were always chosen based on their capabilities — there was no chasing of the trendiest products: Technology has been integrated in a purposeful way throughout, not specifically showcased. 

A key goal was to have information at the clinicians’ fingertips. “And that started with infrastructure, or what the IT industry would call the harmonization of systems,” says Longo. The goal was to allow for necessary updates or replacement of only certain components, as needed. All of the unseen technology has a meaningful impact on the physical architecture and the patient, visitor, and staff experience. “It was never a case of the technology imposing on the architecture,” says Tina Larsen, AIA, project manager with the Corgan team; “rather, the technicians said, ‘tell us what you want to do and we will make it work’.” 

From a planning perspective, the building is very systematized and modular. The physical needs of the infrastructure were accommodated by diligent spacing and placement of the electrical and IT closets. Rack storage for the equipment was also specified in taller-than-normal heights to conserve space while accommodating more technology. Prefabricated and accessible plenums carry the technology laterally above the corridors, and a robust antennae system provides continuous coverage to cellular and life-safety paging devices. All of this behind-the-scenes work allows a heightened level of care. As minor as it may seem, a tap-in, tap-out system allows staff seamless access to information as they move from one computer to another. Not only does this eliminate the need to log in and out, but the “virtual desktop” moves with them.

Many specialty program spaces benefitted from the ubiquitous technology. The neonatal intensive care unit (NICU) of the old Parkland building was cramped and uncomfortable, but was easy for staff to

oversee. The new NICU is a more comfortable fit and is not restricted to what the eyes can see. Families will also find the welcome addition of all-private patient rooms. This causes the support systems, including nurses and supplies, to be more distributed, but technology solves this problem: RFID tagging allows for easy locating and distributing of equipment from a separate, centralized “equipment garage.” Patients have more freedom with integrated biomedical devices and more access to entertainment, including video, audio, and educational programming.

One major difference between the new Parkland and what we think of as traditional hospitals is that Parkland doesn’t look or feel like an institution. Healthcare facilities must be efficient, secure, and spotless — and this often makes for sterile environments that can be alienating. The exact opposite is required for patients who are healing, of course, and for their concerned family and friends who may spend many days or weeks at the hospital looking after their loved ones. Although many surveillance cameras are at work at Parkland – more than 2,000, in fact — the cameras, sophisticated door controls, and sensors capable of tracking supplies as well as people allow security personnel to be sequestered in a single, centralized monitoring room, where they remain largely invisible. Surveillance will always be a matter of some dispute, but at Parkland it has been made unobtrusive.

In addition, the auditory experience throughout the facility is much improved; Parkland is a noticeably quiet environment. The television version of a hospital, with lights flashing and alarms ringing, has been dramatically mitigated, if not eliminated. In an effort to lower the noise level, alarms and what used to be paging via intercom can now be sent directly to individuals’ personal communication devices. The experience is now as pleasant and peaceful as a trip to the hospital can be.

Corporate and education facilities are continually designed around a “work and learn anywhere” concept of technology integration and physical environment, but Parkland may just have left them in the dust. At Parkland, one of the most complex building types has gone all-digital and improved the overall experience of visitors and performance of systems. Storage of data and physical inventory form a productive relationship. The intention was not to design a “futuristic” building; rather, with an eye to the future, this project shows a path where technology is not a distraction or a way to pass time, but an elevation in the quality of our built environment.

Ron Stelmarski, AIA, is design director for Texas practice at Perkins+Will. 

Originally published in the January/February 2016 issue of Texas Architect.