The idea: What’s known today as the Hoover Pavilion originally opened in 1931 as the Palo Alto Hospital. Stanford University operated the hospital and eventually purchased it in the late 1960s, converting it to medical office space. The building served in this capacity for the following four decades, undergoing several renovations that included a seismic upgrade and a new elevator.

Flash forward to 2008, when the Stanford Hospital & Clinics was planning a renovation and expansion and looked to the aging Hoover Pavilion as a prime location for new clinic and office space. While the 85,000-square-foot building boasted Art Deco details like ziggurat massing with four-story wings and five- and six-story towers, it presented a number of challenges, too.

The facility had been built to meet Florence Nightingale principles with small wards to control the spread of infection. The structure also had low floor-to-floor heights and a double-loaded corridor on an already narrow floor plate.

How they did it: What followed was a major interior and exterior renovation that took place between 2010 and 2012. While the design by architect Tom Eliot Fisch (San Francisco) and consulting historic architect Page & Turnbull (San Francisco) had to meet the Secretary of the Interior’s Standards for the Treatment of Historic Properties, the team also had some flexibility in its approach because the interior of the building had already been gutted in prior renovations, meaning existing interior walls could be demolished and the space reconfigured to meet modern needs.

This included carving out deeper floor plates by eliminating a central corridor and placing circulation along the side of the building to bring in more daylight via triple-height windows. However, even the new floor plate was rather narrow, so the design team chose to modify the traditional sequence of medical spaces (waiting, check-in, diagnostic/treatment area, physician offices) and instead compressed the size of waiting areas, provided benches along the hallway for additional seating, and removed physicians’ offices from the clinic itself but kept them on the same floor.

The big reveal: Opened in December 2012, the space now houses clinics for family medicine, internal medicine, integrative medicine, senior care, and dermatology, as well as physicians’ offices, a health library, and pharmacy. The interior design borrows motifs from the historic building’s Art Deco exterior and showcases warm materials  to avoid an institutional feel, with “neighborhoods” created to give each space its own identity through the use of different ceiling patterns and carpet color and texture.

As for that historic exterior, the façade and windows were restored where possible and a replica of the building’s original iron finial was returned to the top of its highest tower.