Swedish Medical Center’s Issaquah Campus opened its doors in 2011 in the Seattle suburb of Issaquah, Wash. And during the 2017 Healthcare design Expo & Conference, held Nov. 11-14 in Orlando, Fla., members of the project team opened up about the facility’s performance during its first five years in operation.

Construction on the 18-acre campus began in 2009 and wrapped up two years later with a 324,000-square-foot hospital and an attached 224,000-square-foot medical office building (MOB). The two buildings are connected by an enclosed atrium, which houses retail services and public spaces as well a central elevator core and shared waiting areas on the upper floors.

Speakers Lori Epler Hout, healthcare market leader at CollinsWoerman, Jeremy McClanathan, senior energy engineer, Mazzetti + GBA, and Beata Canby, senior project manager, stewardship and strategic development, Swedish Medical Center, gave an overview of the project’s goals, which included a commitment to sustainability, supporting the community, providing efficiency and flexibility, and targeting clinical excellence, before diving into some specific lessons they learned on the project:

• Energy efficiency: McClanathan explained that the facility utilizes variable air volume (VAV) and heat recovery systems and set an initial energy use intensity (EUI) goal of 150 EUI. It achieved that within the first year and marked 104 EUI in 2017, with the two systems accounting for 90 percent of total energy savings. However, the systems haven’t been without their challenges. While Swedish hired two in-house controls engineers to take ownership of the building system after the project engineers were gone and accounted for a learning curve to get the systems up and running, McClanathan says it still took longer to educate everyone. The staff also had to learn that a tweak to one element, such as the heating or cooling levels, would set off a chain reaction on other mechanical systems. “We had to learn to treat the system as a whole,” he says.

• Community engagement: The organization was intentional about putting diverse services into the mall-like common area to create a destination as well as provide amenities for staff, patients, and families. “It’s a hospital that’s not supposed to look like a hospital,” Canby says. While the facility originally housed a Starbucks, Lululemon athletics clothing store, gift store, lingerie retailer (which provided prosthesis fittings), pharmacy, and baby store, only a few remain, including the gift store and Starbucks, which are regularly drawing in customers from the community who don’t have appointments within the medical facility. Other public spaces are being well used, including a meeting room on the second floor, which has hosted PTO meetings and regular knitting group. The activity in these areas combined with the shared waiting rooms is having a positive impact on the overall environment and is helping to reduce patient and visitor anxiety. “It makes it all seem less scary,” she says.

• Built-in flexible design features: The design team was mindful to plan for future growth, creating a roadmap for how the system would grow over the years and using a universal patient room design and identical floor layouts. These features have allowed the hospital to more easily expand during its first few years. For example, nearly two years ago the facility was building out some additional patient rooms, which was going to impact an ICU unit on the floor below. Swedish Medical Center initially considered doing a phased closing of ICU rooms, which would drag out the project and take rooms out of use, but instead utilized its universal design to temporarily relocate the entire ICU floor to another area of the hospital during the construction project. The nurses didn’t have to adjust to delivering care in an unfamiliar environment, and, more importantly, “We didn’t lose one ICU day,” Canby says.

But that doesn’t mean the project team got everything right with the layout. Hout says the hospital’s two bed towers branch out from the main elevator core and waiting areas, which end-loads the unit and created travel distances of nearly 400 feet from elevator to the end of the unit. Additionally, Hout says 36 beds is too big for a unit size and, in hindsight, she says they should be half that size or a third bed tower should have been used to create smaller units with shorter corridors. For now, the facility is going back and reconfiguring a back-of-house elevator to be used by families to more easily access the back units on each floor.


While the organization did some qualitative research on the project, they didn’t conduct a full post-occupancy evaluation to provide measurable data on performance outcomes. Still, the speakers say the community has embraced its new facility and that the owner is happy with the care that can be provided at its Issaquah campus and is using some of the lessons to impact future and existing facilities. “Overall, Swedish feels they did a good job,” Canby says.