Stanford Medicine Newsletter Updates For the Local Community


Nature by design

Hospital expansion adopts a California ecosystem theme

Each floor of the hospital expansion represents a specific regional landscape. The plants and animals of California’sshoreline are incorporated into the ground floor.


For nearly a year, a group of designers, architects, parents and staff held regular sessions to weigh in on some very important plants and animals. Discussions ranged from cottontail rabbits to Western dogwoods, tiger salamanders to black bears. The results of their final decisions will help refine the identity of the Lucile Packard Children’s Hospital Stanford expansion and make a lasting impression on the children, expectant mothers and families who will enter its doors when the new building opens in summer 2017.

“We wanted to create a hospital that had a real sense of place, one that could be nowhere else but in California. All of our conversations focused on the uniqueness of this area’s geography, ecology and wildlife,” said Robin Guenther, FAIA, principal at Perkins+Will and the lead designer of the hospital expansion.

The expanded facility builds on the foundation established 30 years ago by hospital founder Lucile Salter Packard, who envisioned a place for young patients and expectant mothers where the latest tools and technologies would be coupled with a warm, family-friendly environment. The addition incorporates many elements of the original hospital, which opened in 1991, while expanding on a design concept that integrates nature seamlessly into the overall patient experience.

The new building will add 521,000 square feet to the approximately 300,000-square-foot existing hospital, streamlining care and adding more private rooms. Once the expansion opens, the hospital and its satellite locations will be licensed for 397 beds.

Integrating nature

“Lucile Packard was passionate about helping kids. We wanted to honor her spirit and build a hospital that is about the people who will use it,” said Guenther. “It’s all about the patient experience and how families feel when they are in the building. From the very beginning, we knew that nature would be a guiding theme.”

The original hospital incorporates an ocean theme, using colors, sea animals and wavy patterns on the carpets to help visitors find their way around the building. Guenther and her design team expanded on that general concept to help integrate the two adjacent structures, joining together ocean and land. The addition is themed around the land-based ecoregions of California, with each floor representing a specific regional landscape that celebrates native animals and plants.

The ground floor, for example, is themed to the California rocky shoreline, populated by harbor seals, the salt marsh harvest mouse and cypress trees; the high desert theme on the third floor will showcase bighorn sheep, valley quail and saguaro cactus. Leafy patterns and accent colors reinforce the sense of the unique environment on each floor, which reflect ecosystems by elevation, from deep ocean on the lowest level to mountain on the top floors.

“The themes establish a universal language to help visitors navigate the hospital,” Guenther said, since using visual wayfinding cues makes it understandable for people regardless of their native language. “It’s intuitive to use and intrinsic to the design layout.”

Commissioned artwork and animal sculptures will serve as directional landmarks throughout the hospital and provide inviting spots for entertainment and education. “There’s a signature theme of mothers and babies that helps create a sense of warmth and healing. We want the nature theme to act as a counterpoint to all the technology that is such an essential part of a hospital,” said Diane Flynn of Menlo Park, a member of the hospital’s Public Spaces Committee, which includes parents of former patients.

Group effort

Each environment has been carefully researched to include only native species, both common and endangered. Guenther’s group met with Stanford biologists and ecologists to define the specific ecosystems and to identify the flora and fauna unique to each region. They then showed the concept and a range of options to parents and children for feedback and final selection.

“It was a very democratic process, and the designers were extremely open to our input. We want to create a place like nowhere else, one that is representative of the Bay Area and California,” said Liz Pavlov, a Woodside parent working in the hospital’s Department of Family Centered Care. “Our vision was to create a place that is uplifting and entertaining and amusing to kids without being too ebullient or sweet.”

She and members of the Family Advisory Council looked at numerous iterations to refine the themes and to develop educational aspects of the selections. Their feedback was incorporated into artist renderings, which were presented to a focus group of young patients and their siblings for their insider perspective.

“Some of the kids’ top votes were surprising to me,” Guenther said. “They didn’t always pick the ‘warm and fuzzy’ animals. I mean, who would have thought that bighorn sheep would be a winning favorite? Some are endangered species, but we thought it was reasonable to include their stories even if the ending isn’t always happy. We made no attempt to enforce a balance, so there’s a random and unique cross-section of mammals, amphibians and insects of vastly different sizes and personalities.”

A sense of place

The hospital’s depictions of owls, foxes, bears and frogs are more than just decorations. Numerous studies have shown that integrating nature into a hospital setting helps to reduce stress and anxiety, speed recovery and increase patient well-being. Florence Nightingale observed in 1860 that placing patients where they could see nature was “quite perceptible in promoting recovery.”

A sense of place pervades other aspects of the new building’s design, Guenther said. Stanford limestone cladding is used at the building entry and in the lobby. Reclaimed old-growth redwood appears throughout the interior, and access to nearly four acres of gardens and landscaping will be almost seamless from the indoors. Local artists were selected to create sculptures and paintings for the hospital’s nooks, corridors and waiting areas.

“We’ve tried to engender a sense of fun and a sense of discovery to inspire health and support healing. Being in a hospital is a stressful experience, so we are using the healing powers of nature to create distraction and comfort,” Pavlov said.

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