New York City, New York
NewYork-Presbyterian Hospital’s dense web of mostly older buildings at its 20-acre campus in Upper Manhattan is not unusual for medical complexes constructed over many decades. Administrators and trustees balk at demolishing old facilities, and so with a nip here and a tuck there structures survive long past their original life expectancies, even as new space is desperately needed. The conundrum motivates these clients and their architects to scour the environs for sites they previously would never have considered.
Program
Milstein Hospital is NewYork-Presbyterian’s main inpatient facility. When it opened in 1988, its operating rooms were state-of-the-art, and over the years they have become some of the busiest in the U.S. More than 100 operations may be performed in its 26-room surgical suite in the course of a day.
Surgery and patient care have evolved at light speed since the building opened, thanks in part to new techniques developed in this hospital. Diagnostics machines and complex surgical procedures that would have been considered science fiction when the building opened are common today and continue to advance rapidly.
But to keep leading the way, Milstein needed new kinds of spaces — for example, hybrid operating rooms that could quickly change from noninvasive to invasive surgery if a patient had problems in the midst of a seemingly routine procedure. But where could it expand?
Solution
The site of the new Vivian and Seymour Milstein Family Heart Center was carved out of a schist outcropping so large it was considered unusable until the real estate became too valuable to ignore. The addition fills a void between Milstein Hospital and the Herbert Irving Pavilion, an early 1960s vintage medical office building.
Patients and visitors can gain access to the Heart Center via its entrance on a side street, which is somewhat private and gives the center its own identity, or they can enter by way of Milstein Hospital’s more public main lobby (considered the addition’s first level) and through a compact but beautifully daylit four-story atrium. It is spanned by bridges on three levels, connecting Irving to Milstein.
The new facility packs a tremendous amount into a small space. A conference center with prefunction space, an auditorium and four meeting rooms, is located on the first level. Labs and radiology occupy the level below the conference center, and a cath lab is located on level two. Eight new operating rooms have been added on the third level, and diagnostics, such as echocardiograms, are performed on level four. On level five, 20 ICU rooms have been added. Functions on all these floors have been seamlessly integrated into the existing hospital, while its circulation was improved.
Commentary
On the whole, hospital additions are more difficult to extract pleasing moments from than most building types. Obstacles range from woeful existing conditions to clients who resist spending money on frills like waiting rooms. The architects in charge of this project, Ian Bader, FAIA, of Pei Cobb Freed & Partners, and Chip Calcagni, AIA, of daSILVA Architects, were privileged to have generous donors and an enlightened client in NewYork-Presbyterian’s senior vice president, Andria Castellanos. And they are to be commended for what they’ve made of it. The addition has earned a LEED Gold rating, and its exterior stands out like a jewel between two beige monoliths that were depressing at best. Innovations such as the cable-truss, double-walled facade that frames the south elevation bless the waiting rooms and conference center with spectacular views of the Hudson River. The glass bridges over the atrium are also more than eye candy. They reconcile the differences in floor heights between Irving and Milstein and can cut critical minutes of travel time between the buildings when a quick response to an emergency is required.
One of the huge challenges for these architects was anticipating how rooms not yet built could accommodate equipment not yet invented. Although their solutions are not visible to the eye, the firms devoted much attention to ensuring that the structural system as well as utility and data lines are adaptable enough to support what may be science fiction today, but commonplace in the near future.
Completion Date: January 2010
Owner: NewYork-Presbyterian Hospital
Total construction cost: $140 million
Gross square footage: 165,000 sq.ft. (new construction), 40,000 sq.ft. (renovation)
Architect:
Pei Cobb Freed & Partners Architects LLP
88 Pine Street
New York, NY 10005
Tel: 212-751-3122
Fax: 212-872-5443
