Vanderbilt University Hospital Lobby

Project Statement

The Vanderbilt University Hospital Lobby renovation was overdue, as the lobby, which also serves as the hospital’s main entry had not been significantly altered since being constructed in 1979. The primary objectives were to create a front door more reflective of the patient care provided, improve operational efficiency, and expand services to align with the past 40 years of growth, all of which would contribute to significantly improving the patient experience.

The lobby is the main entry to the hospital with vehicular drop-off directly in front. Without any viable alternatives for drop-off, the renovation was designed to be phased, and the main entry location maintained. Phasing required the build-out of a temporary waiting and admitting space in the shell-space of an adjacent building, and various temporary circulation paths that were reorganized as components of the new lobby were re-opened over the 15-month construction process. Phasing introduced technical complications that needed to be resolved during design, including complex mechanical coordination, that was critical to the project’s success.

The final programming and design, including the phased occupancies, was developed through a series of interdepartmental meetings with representatives of all groups related to patient experience, admitting, and discharge. The hospital also regularly organized design presentations and discussions with the Patient and Family Advisory Committee to solicit feedback, as the design evolved. Each program was addressed by department, and then again in group charettes to ensure the final design would meet the overall objectives of the hospital and the patients they serve.

The renovation modernized the atrium by enclosing a portion of the double height space, shifting surgical waiting and registration at the second floor to create a more private, personal experience for patients and visitors. A feature wall and open-stair screen the waiting areas from the main entry, eliminating the chaotic mix of functions, and create a welcoming space for those arriving to the hospital. The relocation of shops and discharge lounge, adding more direct access to elevators, and new central stairway helped improve circulation and the overall patient experience as they enter the hospital.

Framework for Design Excellence Narrative

**Design for Integration**

Prior to the start of design, medical center leadership established that the hospital lobby planning process would integrate feedback from all levels of staff, faculty, facilities management, security personnel, and the Patient and Family Advisory Council; essentially every stakeholder would be involved in the design process.

 

Early in the process, it was determined that the project would need to be constructed in phases, and maintaining the same drop-off location for visitors & patients throughout the renovation would help to reduce confusion and anxiety. Intuitive circulation and wayfinding were key factors in determining each of the construction phases. Considerations for proximity to noisy construction was also a key factor, resulting in the construction of a temporary waiting room in an adjacent building with new circulation paths terminating in the same locations pre and post-renovation. Transitioning operations as each completed construction phase was heavily coordinated with all stakeholders to best accommodate patients and their families throughout the 15-month construction process.

 

Beyond the logistics of completing the renovation in a manner that minimized impact to patients, visitors, and staff, the design team held programming & design meetings over several months to fully understand operations, and discuss potential space configurations that would improve patient experience, and hospital operations. It was imperative to all stakeholders that the new hospital entry be welcoming to all, and representative of the patient care provided at Vanderbilt University Hospital. The result was an open two-story atrium that defined a clear circulation path to each potential patient destination; patient waiting, registration, guest services, valet, and the main elevators are all visible from the main entry point.

 

**Design for Equitable Communities**

The primary objective of the VUH lobby renovation was to improve the patient experience, and better represent the quality of care provided at Vanderbilt University Hospital for all members of the community. In addition to expanding patient and family services, improving access, and updating the aesthetics of the lobby, the design integrated materials and detailing to improve ADA accessibility, and ensure patients and visitors have unburdened access to all amenities. The original 1979 interior was reinvented with appropriate finishes and program placement to foster a welcoming and bright environment.

 

New terrazzo floors and enhanced lighting create a safe and pleasant path for wheelchairs, and patients with limited mobility by removing the existing brick paver flooring, which created trip hazards and contributed to excessive noise in patient waiting areas below. The new front desk and registration positions are now in line-of-sight with greeter positions necessary for incoming patients and families.

 

**Design for Well-Being**

Being in a hospital is typically unsettling for most patients and family members; entering a dark, crowded entrance enhances that stress, and makes the patient experience more upsetting. The objective of this renovation was to develop a hospital entry that did the opposite. Existing brick flooring was replaced with a beautiful and seamless terrazzo. Brick walls were reclad with sounds absorptive materials and proper wall protection and handrails. A mix of direct and indirect lighting was introduced at the ceiling plane to improve visibility and enhance wayfinding; the central uplighting shines on a recessed acoustic fabric ceiling with hung chandeliers, reducing noise in a heavily trafficked area. Natural maple was used as an accent at the primary donor wall, and interior landscaping was incorporated throughout the space to soften the clinical environment innate to a hospital setting.

 

The existing waiting space lacked the desired visual and acoustic separation, pulling waiting out of the entry path created a fluid and welcoming transition for arriving patients to reach their destination. Families and patients now have more private and isolated waiting areas to relax and wait for news regarding their loved ones, while also providing a closer and more transparent relationship between patient and staff. The reallocation of space also allowed for less staff to maintain easier control over their areas regardless of how busy the department is at any one time.

The new two-story feature wall and open-stair helps to define circulation, screen waiting spaces, elevate the entry experience to the hospital and opened more direct access to elevators. General and Surgical waiting and registration were split between both levels, and screened from circulation to create more privacy for patients and visitors. The level two floorplate was expanded behind the feature wall, reducing the double-height space, provided additional area required for surgical waiting.