Loma Linda, California is located in one of the most earthquake-prone areas in the United States. Loma Linda University Medical Center At the intersection of two relatively small faults. However, just a few miles to the north, is probably the most famous fault system in the world-San Andreas. For most of the past half-century, the medical center was based on a 371-bed hospital, known as the “Shamrock” because of its adjoining circular tower. The building was opened in 1967 and was equipped with the most advanced seismic technology at the time: a series of vertical support beams were integrated into its frame to prevent it from shaking in an earthquake.
In 1995, the state promulgated stricter earthquake safety standards, requiring hospitals not only to withstand major earthquakes, but also to continue to provide hospital services after the earthquake. This helped start a project to replace Clover with the $1.5 billion Twin Tower Dennis and Carol Troche Medical Park, which was completed in August. (The facility is named after a couple of philanthropists who provided a major gift of $100 million for its creation.)
The project not only provides an opportunity to meet modern seismic requirements, but also develops the campus to provide a more patient-centric and operationally efficient care environment.
First address the urgent needs of new standards, architecture and design companies NBBJ (Los Angeles) Joining forces with engineers Arup (London) and Stanteck (Edmonton, Alberta, Canada) and builders McCarthy Construction Company (St. Louis). The team installed a system of 126 basic isolators in the basement of the new building. The working principle of this type of device is similar to a car’s suspension system, which uses shock absorbers to drive on rugged ground without the passengers in the car directly feeling the bumps. NBBJ partner Richard Dallam said: “Basically, the basic isolator system helps to separate the structure from the vibrations of the earth.” “During an earthquake, the basic isolator will move the building 47 inches in any horizontal direction without being affected. Any major damage.”
In addition to the reinforced concrete floor, the superstructure of the complex also includes a 25,000-ton steel frame to further strengthen the structure, making it the heaviest building in North America. The result is an “elegant Sherman tank” facility, said Krieheinrich, CEO of Loma Linda University Health Hospital, which is an affiliate of the Seventh-day Adventist Church.
At the same time, another transformation is taking place. Loma Linda Medical Center also has an existing children’s hospital that meets current seismic standards. However, as the planning of the project began about ten years ago, hospital officials also decided to investigate whether adding a child component to the new tower would create synergies and improve the nursing experience. Verdict: Yes. “By being close to adult and children’s hospital services, such as maternal and child obstetric and pediatric care, resource sharing is very important to our community,” Heinrich said. “If your children’s hospital does not have immediate access to adult services, and vice versa, care may be adversely affected.”
Draw the design diagram
The resulting 992,000-square-foot Dennis and Carol Troche Medical Park consists of a five-story pedestal with separate emergency rooms for children and adults; a 16-story adult hospital with 320 tickets Licensed beds; there is also a nine-story children’s tower with 84 beds. (About 280 beds in the existing children’s tower will continue to operate.)
In the design meeting on the layout and appearance of the project, the NBBJ team delved into the relationship between the medical center and its long-term affiliation with the Seventh-day Adventist Church. A central story about the establishment of the hospital occurred in the early 20th century, when Ellen White, the co-founder of the church, arrived at the site of Loma Linda, looking for another nursing home between San Bernardino by the river and the church’s existing nursing home. Redlands, California. When she saw an abandoned resort/nursery in Loma Linda, she reportedly declared that “this is the place” and imagined the patient resting outdoors under the shade canopy.
Inspired by this story, NBBJ tried to evoke the tranquil scene of the project, installing a metal trellis on both sides of the new main entrance. “These provide an element of tranquility and calmness for those entering the hospital that Ellen White would appreciate,” Durham said. “This area also has a functional aspect: in the event of a major disaster or medical emergency, the space under the scaffold can also be used as a classification area.”
Beyond the entrance, the project team created various contrasting exterior surfaces for the tower to prevent the volume of the structure from overwhelming patients and visitors, and to help distinguish them. The front of the children’s tower adopts dichroic architectural glass slats, which present different colors according to the time of day and perspective, and multi-faceted precast concrete, which produces different shadows over time. The street-facing facade of the Adult Tower uses flat glass to allow plenty of natural light to enter the building. NBBJ partner and practice/design lead Jose Sama said: “These are cost-effective features that can bring visual diversity to the overall appearance and make it more interesting and less intimidating.”
Internally, specific medical service upgrades of the hospital’s podium include threefold expansion of its heart department from the front space of Clover, which includes updated equipment for heart-related diagnosis and procedures; expansion of cancer treatment, including intraoperative MRI, CT, and fluoroscopy imaging Systematic hybrid operating room; the entire floor is dedicated to the San Manuel Band of Mission Indians Maternity Pavilion, with 44 licensed obstetric beds, 11 delivery rooms, 3 caesarean sections and 9 triage rooms. (This floor was built with a donation of $25 million from the San Manuel Band of Mission Indians, another group with a long history of the hospital in the area.)
The wards are arranged along the walls of the floor and are equipped with floor-to-ceiling windows to bring in as much natural light as possible, while sliding glass doors allow sunlight to pass through the interior corridors, where there are double nurse tables outside each adjacent room. NBBJ’s Dallam said: “This can provide more personalized attention and care.”
In addition, the private ward is designed with enough space and furniture to make the family live comfortably. Since the medical complex is also a teaching hospital, the larger rooms provide enough space for medical students to accompany doctors.
Look to the future
In general, Heinrich said that the new medical center provides an improved and updated nursing experience. “Patients and their families like single rooms, where there is plenty of natural light and the beautiful views of the surrounding mountains,” Heinrich said. “The staff love it because the floor layout allows such easy flow between their workstation and the patient.”
In addition, NBBJ’s Dallam stated that due to its robust steel frame and base isolation system, safety features are expected to make the project’s life expectancy of at least 75 years. “We believe that strengthening the infrastructure of a building to enable it to function properly in an earthquake or other type of disaster is a long-term investment that will pay off,” he said.
Project Name: Dennis and Carol Troesh Medical Campus of Loma Linda University Medical Center
Project completion date: August 2021
Client: Loma Linda University Medical Center
Total floor area: 992,000 square feet
Total construction cost: confidential
Cost/Sq. ft.: Confidential
Interior designer: NBBJ
General Contractor: McCarthy
Carpet/floor: Shaw, Daltile, Mannington, Stone Source
Ceiling/Wall System: Martin (Design and Build)
Door/lock/hardware: Assa Abloy
Fabrics/textiles: Carnegie, Maharam, Momentum, Luum, Designtex, Architex, Bernhardt, Stinson
Furniture-seats/bags: National Office Furniture, Herman Miller, RFM, Humanscale, Krug, Spec, Allseating, Andreu World, Davis, Coalesse, Arcadia, Bernhardt, Martin Brattrud, Gressco, Weiland, OFS Brands
Handrails/Wall panels: C/S Acrovyn, Altro
Headwalls/Prosperity: Hill Rom/Trumpf
Surface-solid/other: Corian, Caesarite, Cambria, Pointier, Lamin-Art
Wallpaper: Carnegie, Maharam
Indoor glass/resin: 3 Form, McGrory Glass, Forms & Surfaces, Lumicor
Matthew Hall is a freelance writer/editor based in Cincinnati.He can be in [email protected].