Project category: New construction (completed May 2005)

Chief administrator: Carolyn Knaup, RN, BSN, MHA, CNOR, Vice-President Ambulatory Services, (919) 350-1420

Firm: BBH Design, PLLC, (919) 460-6700

Design team: Dan Koenigshofer, PE, MSPH, Senior Partner, MEP Engineering (I.E.S. Engineers); Robert Macia, Structural Engineering (Stewart Engineering, Inc.); Lester Lowe, Civil Engineering/Landscape Architecture (Kimley-Horn and Associates, Inc.); Dawn Gum, AIA, IIDA, Managing Partner, Interior Design (IDeA, PLLC)

Photography: JWest Productions

Total building area (sq. ft.): 20,000

Construction cost/sq. ft.: $225

Total construction cost (excluding land): $4,500,000


The architect was retained to create the first freestanding Emergency Department in the state of North Carolina. The design includes a small waiting pavilion and an interior upfit for the Emergency and Radiology departments.

The design team conceived the ED waiting space as a garden room and strategically placed the pavilion in the middle of a developing forecourt of honey locust trees. The resulting design is a curving, pre-patina copper wall with transparent ends that allows the garden space and waiting room to fuse together.

As one moves from the waiting area to the clinical spaces, the focus subtly shifts from the calming effects of nature to the soothing comfort of nurture. The patient exam rooms are organized to look through large, glass sliding doors into a reciprocal interior landscape. The landscape houses the care-givers in organically shaped nurses’ stations with floating metal-panel ceilings.

The clinical area has direct access to a separate ambulance entry and the Radiology Department, consisting of CT, R/F, and Ultrasound functions. Each of the radiology functions is clustered around a working core that promotes staff efficiency. The layout also allows for the separation of ED patient and radiology outpatient traffic.

As a whole, the design seeks to provide a healing environment by blurring the distinction between inside and outside and refocusing the patient experience from sickness to tranquility.