The idea: Washington, D.C.'s Children’s National Medical Center opened its East Inpatient Tower in 2007, vacating patient units in its existing building, which created shelled space to be used later.

However, thanks to the hospital’s successful growth of the program, the tower’s 14-bed cardiac intensive care was soon consistently at capacity. While the old space wasn’t intended to be used again for patient care, need soon pushed the hospital to explore what could be done (see "before" photo in image gallery).

And the resulting idea to renovate the unit to create a 33,000-square-foot cardiac ICU answered a number of identified needs, including those for more beds, larger patient rooms, better flow, wider corridors, enhanced storage, and improved family accommodations.

How they did it: Faced with an aggressive project schedule from the hospital, which was shooting for completion within one year, the design team at Wilmot Sanz Inc. (Gaithersburg, Md.) got to work on finding solutions for the particularly challenging existing space, which required replacing its metal interstitial deck with a concrete deck for much-needed structural support.

The team also had to create what it’s dubbed an “interior exterior” wall around the perimeter of the project area. The integrity of the original 1970s curtainwall was questionable and the budget couldn’t support replacement, so the solution was to create a new exterior-grade wall on the interior of the building to protect the space.

However, the truly defining feature of the space, the team says, is the unit’s 12-foot-wide corridors with storage alcoves to replace the existing 8-foot-wide halls that previously were overcrowded with equipment and overflow storage.

The big reveal: In the end, the project took just under 18 months to complete. The resulting unit is divided into two pods, with patient rooms arranged around an open nurses’ station. To meet physicians’ requests to maintain visibility across the unit while still having private work areas, the workspaces are enclosed with glass.

The hospital’s existing interior master plan for theme and color selections was incorporated, with a floor pattern and color scheme designed to match hospital wayfinding standards.

The space successfully increased capacity—nearly doubling the number of existing beds to 26—and provides family accommodations in patient rooms and in waiting areas, including in-room toilets, recliners and sleep sofas, a family lounge, and consultation rooms; a media room; and the ability to perform emergency procedures in patient rooms, eliminating the need for transfers.

For project team details and a source list, please see "Cardiac ICU Renovation, Children's National: Project Breakdown."

Do you have a space that's been transformed? Send before and after photos, and a brief project description, to Jennifer Kovacs Silvis at