A renovation of an existing unused space in the basement of University of Illinois Chicago’s Neuropsychiatric Institute, the 17,000-square-foot University of Illinois Chicago School of Medicine Surgical and Innovation Training Lab (SITL) creates a futuristic simulation space for surgical students. The project earned an Award of Merit for its creative solution to its unique location, including the introduction of skylights to bring in natural light as well as create a visible presence for the school on the exterior of the building. Inside, a hyper-flexible design allows an appropriate setting to mimic surgical space of today as well as anticipate how surgeons of the future might operate. The project was submitted to the Design Showcase by CannonDesign and Bailey Edward. Here, lead designer Carlos Amato, health market leader for Southern California offices at CannonDesign (Los Angeles), shares insight on some of the design solutions most celebrated by the jury.

Healthcare Design: This project is a renovation of a basement in an existing space—without any visible exterior. How did you deliver a presence for the school on the outside, despite these conditions?

Carlos Amato: This was a significant design challenge because the lab is entirely underground, so the program can’t have an overt physical presence to passersby on campus. One of the challenges we faced was enhancing the underground space and connecting it with daylight and nature. The skylights that are now part of the completed design were not part of the original scope of the project; however, in conversations with Dr. Pier Guilianotti, who heads up the lab, he spoke often about how important it is for staff and students to have that connection with nature when doing their work. That prompted a series of conversations with university leadership, and eventually I came up with the idea of incorporating skylights. The reason the skylights are pyramid shaped is to bring the light down into the underground space and to provide privacy so no one can look directly down like you can with a flat skylight.

When leadership said we could do the skylights, I shifted to how I could get maximum attention from a small skylight and create that presence. I thought of the pyramid of the Louvre. The Louvre is also underground, and you would never know there is a world-class museum there if not for the pyramid. So I maximized the design opportunity to make the pyramids happen. It allows those on campus a glimpse of the innovation below and those in the simulation lab a window to the outside.

What other challenges did you have to solve, given the existing site?

The basement space was initially dark, old, abandoned, and leaky. That’s the reason it was available: No one else wanted the space. One of the initial challenges was developing a creative way to manage the mechanical air distribution system and make it work in a space with a very low floor-to-ceiling height. This challenge was aggravated by the fact that the operating and procedure rooms we were trying to simulate typically have the highest ceilings in a hospital. So we had to manipulate the mechanical systems to make this possible.

Access to the basement was another challenge. The main public elevator down to the lab was not suitable to serve as an entrance to a world-class simulation center, so we upgraded and revamped that system completely.

While not a design challenge, convincing the staff and surgeons that we could turn such an unappealing space into a hub for cutting-edge research was difficult at first. We had to create excitement and the right visual imagery to help them understand this would be a remarkable space where they could execute surgeries and innovations to the field for the foreseeable future.

What did that type of setting require in terms of the space and infrastructure necessary to support equipment/technology needs?

The most difficult aspect of the design of this space was also the most inspiring and rewarding. University of Illinois Chicago (UIC) leadership asked us to design a space where the brightest minds could experiment and simulate for an unknown future reality. We were able to find success through extensive collaboration with surgeons, educators, and others who are all imagining the future frontiers of surgery and what we should be reimagining and training for now.

The project team had to replicate the surgery space as it exists in today’s world for traditional surgery and then create the other extreme where unknown future surgeries and processes could be modeled and simulated. This is why we drew inspiration from theater design. In theater, you have to set the stage for somebody to build what they are trying to recreate. It combines the world that we know and the one we don’t yet understand. That center space of the lab is where these two worlds collide, with the surrounding areas being support spaces of conference rooms, lockers, lounges, and more.

Keeping the main areas used for simulating surgeries and testing new equipment as open as possible was key. We wanted to ensure the space would allow for infinite adaptations (set changes, if we’re using the theater comparison). Just as theaters have spaces adjacent to the side and behind stage for quick scene changes, set pieces, or new costumes, the innovation lab has similar spaces that allow surgeons and students to swap out different pieces of equipment to test them out, see what might work well together, or practice a complex surgery that requires extensive equipment and personnel. The spaces are adjacent to the main surgical areas, so little to no time is lost for these transitions. The creative possibilities are seemingly boundless.

How did you answer the specific needs for the curriculum and overall program via design?

For UIC to remain a groundbreaking surgical program, this space needed to push the envelope and be capable of constant ingenuity. It is meant to pioneer the future “surgineer,” the surgeon being a clinician as well as a computer scientist and a medical technology engineer and inventor. The adaptability of the lab allows the surgical program to accommodate all kinds of learning and easily pivot its goals and priorities.
This could’ve just been another simulation center, but the unique aspect of this project is the type of collaboration that leads to innovation and requires that you integrate all the different fields, in and out of medicine, to advance innovation. The space we created is done through that lens of “surgineering.” Previously, when a surgeon was in an operating room, surgery was all they were doing. We created an environment that integrates all the fields required to advance surgery, and it’s important for students to be embedded in the process and witness and participate in the collaboration in real time.

The mission of the SITL is to advance simulation and surgical education as a space where doctors, researchers, educators, and commercial partners will imagine, experiment, and help create the surgical rooms of the future and allow students and surgeons to train with the latest in robotic and minimally invasive surgical tools. The main lab is surrounded and supported by classrooms, research spaces, imaging, 3-D printing, telesurgery, artificial intelligence interaction, and traditional surgery spaces with cutting-edge audiovisual technologies.

What inspired the interiors approach on this project?

When we started the project, Dr. Giulianotti and Dr. Leo Chen, director of the lab, wanted to create a space that conveyed a futuristic feel and not an old academic medicine feel. It had to give the sense that people were entering the future of medicine, a place where cool things are invented and the latest and greatest is always being discussed. Near the entrance of the lab, we have a large screen where the lab broadcasts and communicates what’s happening in the back of the house, sort of a branding strategy to share what’s going on in the lab. Adjacent to the skylights is a conference room that features a full green wall, something that otherwise could not exist in a basement space. A use of warm wood throughout the reception and multipurpose areas also brings a sense of nature underground and provides a contrast to the bold graphics and lighting used throughout the different lab and classroom spaces.

Jennifer Kovacs Silvis is editor-in-chief of Healthcare Design. She can be reached at jennifer.silvis@emeraldx.com.