The Benjamin Russell Hospital for Children (BRHFC) in Birmingham, Ala., a new landmark on the city’s landscape, is the largest single healthcare project built to date in the state of Alabama. With 332 beds plus 48 bassinets, the $400 million, 760,000-square-foot hospital uses color and design to appeal to children of all ages.

Early in the process, BRHFC brought in HKS Inc. (Dallas) and Giattina Aycock Studio (Birmingham, Ala.) for planning and programming. The hospital and the design teams also met with user groups to develop guiding principles that would direct overall facility design as well as organization of its service lines. Previously, cardiovascular and other services were being performed at the university, creating a fractured system. The goal was to bring all services in-house, create a campus with comprehensive care for children, and integrate family-centered care.

Patients, parents, and staff all provided input into the interiors, with the resulting design shaped to avoid a look that was too whimsical, cutesy, or lacking in sophistication for older-age children and adults in the building. HKS’s Iris Dates, interior designer, explains that one of the driving forces for the project was centered on positive distraction. “We wanted the space to be childlike but not childish,” she says. “I would run the idea through a filter: No matter what we design, would a two year old girl as well asan 18-year-old boy like it?”

Themes were created using color and art, and are unique to specific areas and floors. Works of art from Alabama artists brighten the walls of each floor, while different-colored cubes—built into the walls along corridors—provide alcoves for privacy. A colorful, meandering path and fun visual cues help with wayfinding throughout the building. Doug Compton, principal designer, HKS, says the aim was to simplify the journey for patients and families as much as possible. An abundance of windows throughout the hospital provides views of the Birmingham cityscape and beyond. The main circulation areas are situated on the perimeter of the building so that natural light and exterior views can provide orientation for patients and families.


Perfecting the patient room
Modular headwalls, built off-site and then installed, were used in all patient rooms. And after extensive research, BRHFC decided on mirrored patient rooms with outboard toilets instead of same-handed rooms.

“A same-handed room isn’t a universal truth and doesn’t necessarily give you the best patient-safe environment every time,” says Ron Dennis, principal-in-charge, HKS. “BRHFC looked at the research and made a decision that would simplify some of the complexities of their operations while still providing quality care and safety for the patient.”

The surgical theaters and exam rooms, however, were designed as same-handed rooms to address a different flow of function as the staff in these areas delivers a particular type of service.

Future flexibility
Mike McDevitt, executive vice president of facilities and technology for BRHFC, explains that a partnership was formed with a healthcare IT consulting and design firm to establish a thorough needs assessment and planning process to create a technology platform that would support future modifications and expansion. “We knew that we needed to create a platform that would allow us to embed technology in the future and still be relevant today,” he says.

In addition, BRHFC is pursuing LEED Gold status and will be the first LEED-certified hospital in Alabama. Green roofs offer thermal protection for the building, while captured water from its air handler units is used to irrigate landscaping and feed the chiller system.

“We were looking at creative ways to reduce cost on the project, and so we seized an idea to take the $35 million central energy plant (CEP), which would supply hot and chilled water, and created a D-BOOM [design/build/own/operate/maintain] model,” McDevitt says. By working with the City of Birmingham a Government Utility Service Corporation (GUSC) was established as the utility plant owner from which the hospital now purchases its hot and chilled water.  The CEP was designed, built, and is operated by a third party contractor under the employment of the GUSC. Using this mechanism, BRHFC was able to take the cost of the CEP off balance sheet and off credit, and take advantage of tax exempt construction purchasing.

The hospital also focused on integration and created a connection between the old and new buildings as well as the Birmingham community. Glass façade footbridges link the new hospital to the existing buildings and parking structures over Birmingham’s city streets, creating a continuous link throughout the campus. With an urban park being developed a few blocks away from the hospital, BRHFC placed the front door to face one of the avenues that leads to this major green space.

The hospital created its own identity to distinguish itself from the University of Alabama’s medical campus, and defined itself as a nationally recognized facility for children as well as a significant part of the city fabric.

Shandi Matambanadzo is associate editor of Healthcare Design. She can be reached at

For a source list relating to this project, see Benjamin Russell Hospital For Children: Project Breakdown.