During my nearly 30 years at Stanford, the buildings and grounds have had a profound influence on my daily habits — their changing form guides where I see my clinic patients, or even where I park my car, pick up a cup of coffee, or schedule a lunch break so I can get back to work quickly.

While sometimes the construction sign goes up simply to provide more beds for more patients or to move a tree that fell near a favorite parking space, much of the shifting landscape — as radical as this idea might seem — has been undertaken to help us practice better medicine.

As a visionary architect, Louis Sullivan, put it, “That form ever follows function. This is the law.” Consequently, Stanford Hospital, Packard Children’s Hospital and our Medical School are now retooling to meet an array of needs.

For example, we have in recent years been planning and creating larger patient rooms to accommodate the latest patient care equipment and information technology. And we are committed to making these rooms private to offer expected amenities for today’s patients who are typically sicker than in earlier years but staying with us fewer days.

Outpatient surgeries and other invasive procedures that no longer require an overnight “hotel” stay are also redefining treatment areas and flow. And on the education side, labs were originally designed to accommodate microscopes and slides, not the network of fiberoptic cables that now must link our research, documentation and illustrations to the world.

The Advanced Medicine Center (aka the Cancer Center and now also including the Ambulatory Surgery Center), completed in 2003, demonstrates how function can dictate exceptional design. We’ll soon see another demonstration of innovative clinic space when construction is completed at Stanford University Medicine Outpatient Center, Redwood City.

In February, Dean Philip Pizzo outlined a vision for the Medical School that will bring us a new Learning and Knowledge Center (LKC). The LKC will be located on the site of venerable Fairchild Auditorium, which is scheduled for demolition this fall and is emblematic of the need for change. Anyone who has ever attended a lecture or one of the many Medical Staff meetings we’ve held at Fairchild remembers how this cavernous structure has fallen behind the times. Many of us remember those long waits as embarrassed technicians valiantly struggled to make sound, Power Point and visual displays work properly in an environment designed for nothing more technological than a single speaker standing at a podium in an echoing chamber seemingly designed to emote gravity, not clarity.

Medical School home

The LKC will literally be the new face for the Medical School, allowing visitors, students and staff to drive up to its clearly delineated “front door.” But more substantively, the 120,000-square-foot, four-story LKC will represent a new world of classrooms, a media-connected lecture hall, and a state-of-the art immersive learning center with simulation facilities. The center will offer a fitness center (heal yourself, doc) and patio on the top floor, where the dean’s suite of offices will also be moved. Construction of the LKC building is targeted to begin in about a year and is expected to be finished in 2010. Two or three years later an adjacent 85,000-square-foot digital library and Office of Student Affairs is to be built.

The dean also notes that the future master plan calls for providing space for those who will work in newly created institutes, which will regroup our efforts around such broad interdisciplinary themes as neuroscience, cardiovascular medicine, immunity/transplant/infection, cancer, and regenerative/stem cell. Three Foundations in Medicine buildings (FIM 1, 2 & 3) will replace the Grant, Edwards, Lane and Alway buildings. Again, the function of our new specialties requires new forms, and these should benefit all of us who practice in the SHC community.

Overall, the LKC will be designed with a network of walkways that will integrate the Medical Center more cohesively with the rest of the Stanford campus, further enhancing interdisciplinary ties with a wider community.

Stanford Hospital and Clinics

We have already discussed in this publication and elsewhere how Stanford Hospital and Clinics is faced with meeting government-mandated seismic requirements by 2013. The Hospital Modernization Project of the 1980s produced farsighted inpatient space that will meet the new seismic requirements. However, older parts of the hospital, the B, C, G and H wings, won’t meet these standards and must be replaced. Clinics, as well as medical and administrative offices, will be housed in a new 1.1 million square foot hospital. I suppose we could view the seismic requirements as an onerous mandate, but I think there is a consensus that the changes, while costly, are in fact an opportunity to bring essential technological improvements and amenities for patients and even ourselves as caregivers.

The new hospital will provide approximately 600 beds, house new surgical diagnostic and treatment suites, while providing support services on site. Plans are beginning to take shape for this replacement hospital on a site between the Blake Wilbur outpatient clinic and the intersection of Welch Road and Pasteur Drive. The current patient parking garage will need to be removed and replaced, most likely by a 700-car underground facility.

This SHC replacement plan calls for the relocation of medical offices currently in the 1101 Welch Road complex. Office space at the Hoover Pavilion will be provided to these physicians from the private community as well as some faculty members.

On the amenity side, the plan will meet a goal of our administration and a modern hospital standard that all patient rooms be private. The rooms will be surrounded by glass that will allow staff to monitor patients from a central location, while offering patients privacy behind drawn curtains whenever safe and appropriate.

The new hospital structure is likely to be six or seven floors above and one floor below ground level. To meet planning objectives, the hospital would be approximately as tall as the press box of the Stanford football stadium. Details will be flushed out by an architect as Stanford begins work with the city of Palo Alto to ensure coherent planning.

Packard Hospital

New operating rooms are currently being built at LPCH, the first concrete step of a long-range expansion calling for some 425,000 square feet of new facilities to be built on the site of the current 703 Welch Road building. This site would add up to 104 patient beds to Packard’s current 257-bed total. The building would also include surgical, diagnostic and treatment rooms, as well as nursing and support offices. Some parking spaces will also be added for LPCH.

The future holds considerable change for all of us at Stanford University Medical Center. Most significantly, these changes will accommodate how we expect to live our work lives and practice medicine. I’d be happy to discuss these significant upgrades (lshuer@stanford.edu) with any of my colleagues, as would Mark Tortorich, SHC vice president for facilities, design and construction (Mtortorich@stanfordmed.org). The mandate set for Mark and his colleagues is to accommodate our practice and to serve our patients so our institution will survive and thrive. But to do that Mark and his group, working closely with us, must carry on Louis Sullivan’s precept to trump form with function. And, by the way, Sullivan built some of the most beautiful buildings in the world.

High tech, high touch: these rooms are designed for high standards in patient amenities and the constant evolution of technology.