Alexian Bros. Expansion

How to Shoehorn an
Addition into a Medical Center

by Steve Kaelble

It's taking a tower crane-and maybe a shoehorn-to transform the campus of Alexian Bros. Medical Center in Elk Grove Village, Ill.

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Construction of a new bed tower and outpatient "mall"-all squeezed into a courtyard surrounded by existing buildings-is under way.

The $117 million project is adding about 250,000 sq ft to the multibuilding medical complex, says Mike Doiel, senior vice president and health-care principal with HDR Architecture in Chicago. Led by Schaumburg-based general contractor Power Construction Co., the project is adding a building with four floors above grade and a basement.

The ground floor will consist of an ambulatory and diagnostic mall, with a full range of medical diagnostic services clustered conveniently, says Alan Becker, principal with Denver-based Health Futures Development Group, master planner and owner's representative for the Catholic order known as the Alexian Bros.

"You walk in the front into a beautiful lobby that feels more like a luxury hotel than a hospital," he adds. "At the front desk is a concierge, and there is a big registration area for a streamlined registration process."

The medical mall will include laboratory, radiology and cardiac diagnostic services, along with a pharmacy and coffee shop, Becker says.

"It will become the new main lobby of the hospital," he says. "At one end of the mall are two medical office buildings and a parking garage. Patients will be able to see their physician in the medical office building, then come downstairs to get their testing done."

Doiel says the medical mall will be focused "with both onstage and offstage areas," he adds. A series of back corridors that will allow private inpatient access to the services and keep the busy behind-the-scenes medical activity out of the sight of outpatient visitors.

New Bed Tower

Rising three levels above the mall will be the bed tower, which will contain 108 private rooms.

All of the rooms, except for the 36 intensive-care rooms, will include pull-out sofas for family members and desk areas with wireless Internet access in the room.

"The key in the design concept is a healing environment," Becker says. "We look at fabrics, materials and colors to try to make the environment soothing and healing. We're trying to make everything very comfortable for the patient and family."

The new bed tower will be connected on all levels to an existing bed tower that Doiel says has been called the "bow tie" because of its shape when seen from above.

"The only way to add beds and connect to the 'bow tie' was to place it in the courtyard and basically wedge it into the open area," he says.

Doing so is posing multiple challenges, the first of which involves the hospital's chapel-larger than many hospital chapels and tucked into the courtyard where the new bed tower is to go.

"We took a challenge and turned it into an opportunity," Doiel says. "As it happens, the hospital's owners are fond of their chapel and wanted to figure out how to get greater exposure to the chapel, so we are moving it to the front of the hospital."

That means creating a new structure, though elements of the old chapel are being reused, including stained-glass windows and the restored organ. The new chapel will be clad in stone on the front, with brick on the sides to match the existing hospital buildings. The chapel will be connected to the mall area.

Relocating Utilities

Removal of the old chapel brought to the forefront a significant issue: relocating existing utilities.

"The courtyard was full of utilities, and they were not well mapped out," Doiel says. After careful utility work, caissons were installed and a tower crane installed.

"We're erecting a tower crane with a long reach to get the materials over the top of the existing buildings," Doiel says. "We had to reach everything but also make sure the dragline is not going to be over occupied areas or areas that can't be managed."

Becker says connections on all floors will allow for staff to move back and forth easily between the old building and the new building.

Linking each floor of the two buildings creates another problem because the old bed tower was designed in the 1960s and does not have as great a floor-to-floor height as is typical in today's hospital construction, Doiel says. The old building measures 12 ft or less floor-to-floor, while typical steel hospital construction today would require 14 to 16 ft, he says.

"In order to meet the existing floor-to-floor height, we had to use poured-in-place concrete," Doiel says. "It's a construction premium, but you can't build the floors as narrow with steel."

The building will be clad in glass because it is lightweight and will be easier to use in the confined courtyard construction area, Doiel says. In addition, from a design perspective, it has a much less heavy appearance, and the architects felt that it was more visually appropriate for a tower dropped into the middle of existing buildings, he adds.

"We've designed the building to accommodate two more floors of beds," which can be added atop the building sometime in the future as demand requires, Doiel says. "We designed it with a mechanical floor on top, so that when you come back to add floors you're building on top of a mechanical floor rather than an occupied floor."

Designing for the possibility of two more floors affects the foundation and requires extra elevator shafts and larger pipes, Becker adds.

After the tower opens in 2009, work will continue with phased remodeling of existing facilities. The project is "the largest project the Alexian Bros. have ever built, and it's one of the few times you'll ever see a tower crane in Elk Grove Village," Doiel says.

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