At first mention, the words “concrete” and “affordable elegance” don’t sound like a natural fit for a healthcare setting. But they were put to the test when The Everett Clinic (TEC; Everett, Wash.) embarked on its first Lean project, building the Smokey Point Medical Center in Smokey Point, Wash.

“The client wanted to maximize its ability to deliver care in the community,” says Dan Simpson, design principal, ZGF Architects (Seattle).

Jurors for Healthcare Design’s Architectural and Interior Design Showcase appreciated the construction method and interior finishes used on the project as well as its design delivery method, which together earned the facility a Citation of Merit. “Thoughtful, and done scientifically with Lean design elements deployed,” commented one judge.

One way the design team looked to optimize value for TEC was in the building shell. The search for alternative, cost-effective construction techniques led designers to tilt-up concrete, which would serve not only as the building skin but also as the vertical structure for the perimeter that holds up the floors and roof. It also saved $160,000 in construction and material costs.

“We took on the challenge of trying to transform what is often an industrial or mundane building material into one that has life and quality of authenticity that would support the clinic’s mission,” Simpson says.

Because the material serves as the building skin, that meant revealing—rather than covering up—the concrete material throughout the two-story building. Simpson says the design team complemented the raw aesthetic with a glass curtain wall and natural materials, including local western red cedar for wood accents, structural timbers, and decking for a drop-off canopy.

For added architectural interest, designers also cast reveals into several of the 49 sections of concrete that were then positioned in intervals around the perimeter.

To break up the massing, roofline angles were varied and certain program elements—such as the lobby, conference room, eye center, and urgent care—are housed in a family of forms at the front of the building. “The idea was to create a reference of a campus or collection of buildings that keep each other company,” Simpson says.

Inside, the affordable elegance mantra is fulfilled with off-the-shelf materials that are used in unusual ways, such as tile flooring installed in a staggered pattern in the main entry and stairway. “We tried to use simple materials in playful ways,” says Anita Rossen, senior designer, ZGF Architects.

Among Lean design approaches applauded by jurors is the design team’s approach to waiting spaces. In lieu of traditional-sized waiting areas, the 60,000-square-foot center houses simplified and space-efficient “pause” areas outside each pod of exam rooms. Patients check in and head to their assigned pod (each is color coded and numbered for identification). If an assistant isn’t already there to greet them and take them back to a room, a built-in bench with cushions is available for seating.

The goal is to help achieve low to no wait times, and Rossen says how quiet the facility is when she visits is a good indicator that the approach is working. “There aren’t a lot of people sitting there,” she says. “They’re getting in and out.”

For more on the 2013 Healthcare Design Architectural and Interior Design Showcase Citation of Merit winners and other Showcase coverage, see: