Limited by the inefficiencies of its existing facility, Owensboro Health Regional Hospital in Owensboro, Ky., came to a conclusion about its future: Delivering a higher quality of care meant starting over and rebuilding. On June 1, Owensboro Health, along with its project team of HGA Architects and Engineers (Milwaukee); KLMK Group Inc. (Richmond, Va. ); Smith Seckman Reid Inc. (SSR) (Nashville); and Turner Construction (Nashville), unveiled a modern 780,000-square-foot hospital with a flexible and integrated plan. Its fluid design with sweeping lines and nearly floor-to-ceiling windows on each floor that open up to an outside view of the Ohio River, ponds, courtyards, and 1,000-plus trees make the hospital itself a part of the healing process.

The planning and programming stage
With an existing 359-room, 1-million-square-foot facility originally built in 1938 and new sections added on every decade since, Owensboro Health started to run out of space and options. A railroad track on one side of the campus prevented future growth to the east. So expanding across the street would be necessary, which would affect adjacencies of already-disorganized departments. This, in addition to ADA compliance issues, floor heights restricting bringing high-tech imaging into operating rooms, and a helicopter pad placed above the operating rooms (which would have to close down due to helicopter fumes), was affecting the hospital’s ability to provide top-notch care.

Renovating in place would have taken more time and money than starting over, so the facility looked to 162 acres of open land just two miles away to provide the opportunity to eliminate waste and maximize efficiency with a tailor-made layout to meet its needs.

Working with the community and hospital staff gave Owensboro Health the opportunity to rethink everything, from streamlining processes to grouping related hospital units together. The ultimate goal was to revolutionize the quality of patient care. For example, before creating the overall vision for the new hospital, the team spent six weeks brainstorming with hospital administrative staff. “Lean [design] concepts were developed through a three-month exercise to investigate Lean principles we could incorporate in the hospital with an emphasis on safety and staff efficiency,” says Merrill Bowers, a project executive at Turner Construction. Then, during the programming phase, the team sought insight through interactive workshops with community members, drawing vital information from “keystone experiences,” which illustrated the patient’s experience from the parking lot to the main lobby to the patient rooms and check-out. “We spent about five months before deciding what the ideal patient experience would be,” adds Merrill. “From there, we went into the design process.”

New efficiencies
One goal for the 477-bed facility was to answer the previous hospital’s fragmented layout, which resulted in it taking too long to get patients where they needed to be, especially during emergency situations. With a new integrated design, services in the new building are organized in a much more intuitive manner, making way for faster traffic flow and reduced patient travel time. For example, in the old facility, the emergency department and surgery were on opposite ends of the building. The new design instead offers a three-story diagnostic treatment center with an interior courtyard in the middle, with dedicated entrances for women’s health services and the ED. The heart center and 16 operating rooms with video integration for high-quality imaging were then placed on the second floor above the ED, so patients can be transferred quickly, and the women’s birthing center is located on the third floor.

The main lobby links the diagnostic treatment center to the nine-story bed tower, which functions as the primary hub to all services. While corridors in the existing building weren’t even up to code in some of its 1930s-era spaces, the new hospital allows for separate staff elevators and hallways where supplies and equipment can be stored or moved without crossing paths with patients or visitors. The hospital was also able to upgrade its HVAC and emergency power systems to enhance performance and reduce both its carbon footprint and costs. “We put advanced systems in the new building’s surgery suites to aid the surgeons and [to ensure] energy efficiency,” says Clay Seckman, SSR senior principal, healthcare program director. In the older facility, backup power was a major issue, too. “Systems designed in one era cannot always be modified or upgraded to meet expectations in the next. More and more medical equipment is desired to be on backup power, as the average acuity of the patient population is ever increasing.  More critically, many medical procedures are now expected to be able to be continued during a power outage and switch over to emergency power, instead of being interrupted.”

Owensboro’s private patient rooms grew in size from between 302 and 322 square feet to 400 square feet, to address patient comfort and wellness, as well as efficiency. The same-handed rooms also feature a sofa bed and desk table for visitors, and ample space around the patient bed for caregivers. The rooms were built with the future in mind, too, with a universal design that allows the hospital to adjust between services for more efficient day-to-day use as well as later expansions. “Whether it’s intensive care or standard care, it could flex over time with minor changes and without major renovation,” says Kurt Spiering, healthcare principal at HGA. “These are costs we’ve built into the plan for long-term use.”

Taking utilities into account was also a must in providing flexibility for the universal care rooms. “If a regular patient room is going to be repurposed to an ICU room, it impacts medical gas outlets, electrical circuiting, and air change rates,” Seckman says. “Those types of features have to be built into [the room] when you change the purpose. We could be flexible from an infrastructure standpoint, provide for future expansion, and not have to completely rebuild.”

Healing aspects of the design
Every floor in the nine-story bed tower has almost floor-to-ceiling windows, including the patient rooms, which let in natural light and views of the courtyards along the riverscape. Patients also have access to a main outdoor courtyard with a water fountain, an interior courtyard and rooftop garden within the women’s services unit, and an outdoor walking trail. “There’s something about looking at the fields, ponds, and trees, and being able to focus away from your issues, that helps the healing process,” says Greg Strahan, chief operating officer of Owensboro Health. In addition, natural materials were incorporated into the interior and exterior of the hospital to tie in with the surroundings and create a serene environment. “There’s an emphasis on drawing from natural materials, and colors and tones found in nature,” says HGA vice president Mark Bultman. “The exterior is largely clad in limestone along with some quarry stone from Wisconsin on the interior of the building. The warm wood tones are very calming for patients.”

A step ahead
With more efficient processes, easier access to services, and a health-promoting design, Owensboro Health can now offer a level of care its former facility simply w
asn’t able to accomplish. Ultimately, the hospital hopes to boost its readmission rates with a new and much-improved facility that represents its commitment to providing quality, innovative care. “It’s provided us the opportunity to push the envelope,” says Strahan. With every aspect of care fine-tuned, patients can receive even more attentive care and the new hospital’s peaceful ambience not only enhances the experience, it helps the healing process.

Margie Monin Dombrowski is a writer based in southern California. She can be reached at



Paperless progress
The team on the Owensboro Health Regional Hospital replacement project worked under an integrated project delivery (IPD) contract that set a guaranteed maximum price of $385 million, and they ended up at $5 million under budget. Going “paper light” was one way the team controlled costs.

Major construction projects such as this can involve substantial printing costs, especially when plans may be difficult to look at on a computer screen. But moving from paper to handheld devices yielded a significant savings when everyone onboard communicated via a BIM program for the iPad. The estimated savings: up to $300,000. The tool was used to create quality checklists, document issues during construction, and generate punch lists. “Being a Web-based tool, and having supervisory personnel of all our major subcontractors outfitted with iPads, the interface/input/sign-off between Turner, A/E team members, and trade contractors occurred in real-time and without paper,” says Merrill Bowers, a project executive at Turner Construction.

Everyone involved was able to receive instant notification of any issue that hadn’t yet been addressed and how to fix the problem. The only challenge? According to Tim McCurley, a principal consultant for KLMK Group, it can be too easy to enter every minute detail, which can potentially overwhelm other subcontractors. “It was a very positive experience,” says McCurley, “but on a future project, we should have some guidelines as to what is an issue versus what’s not.”


For a detailed source list, including costs, project team, and other vendors on this project, please visit: "Project Breakdown: Owensboro Health Regional Hospital."