Whether to remodel an existing structure or build a new facility was the question for the Southwest Health Center in Platteville, Wis.

It used the design-build services of Marshall Erdman and Associates of Madison to study various options and gather input from the community, and then it made the decision to build a new facility.

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The resulting $27 million Southwest Health Center and adjacent office building currently under construction in Platteville will serve a five-county area. The center's facilities are designed to adapt to the rapidly changing needs and technologies in the health-care industry.

Construction began on the 102,000-sq.-ft., three-story facility and adjacent office building in April 2002. The center will open in early 2005 with 28 inpatient beds and the capacity to expand to 35 beds.

"We actually knew from the outset with this project that we wanted to do design-build," said Anne Klawiter, president and CEO of Southwest Health Center. She said that previous positive experiences with Marshall Erdman were a great part of that decision.
Decisions regarding the direction of the project were more involved.

Ed Anderson, project director with Marshall Erdman, said the existing hospital was tucked into a small residential neighborhood. The structure, originally constructed as a nursing home, had been renovated and added onto several times over the years.

"Each expansion was becoming more and more difficult," Anderson added. "It was a leapfrog approach. The areas in greatest need of expansion ended up being the last areas served because there was no cost-effective way to expand those services without doing something else first. They had to add space before they could move departments."

He said an important factor in the eventual decision to build a new complex was the fact that many rural hospitals, including those in southwest Wisconsin, are currently converting to critical-access hospitals.

"The health center thought it was likely that it would eventually be the only full-service hospital in the area," Anderson said. He added that a strategic analysis indicated that a new facility, constructed in an area more easily accessible than the current residential neighborhood location, would be the best long-term plan for the people in a five-county area, allowing them to receive the majority of their health care without traveling to Madison or Dubuque.

A new site was found - a green field area adjacent to a new highway expansion on the outskirts of Platteville.

But the decision to build and selection of a site did not trigger the design phase of the project. The next step was getting as much input as possible from staffers, board members and the community at large to determine how to make the hospital fit everyone's needs - in terms of image as well as function.

"The process started with a multitude of meetings with staff and board members," Klawiter said. Then others were brought in, including the chief of police, the city manager, members of the business community, clergy and others.

Calling these meetings "visioning sessions," Anderson said that at one meeting an area resident asked if the folks from Marshall Erdman had noticed the Cadillac dealership on their way into town. When they said no, he explained that was because there was no Cadillac dealership.

"He said people are much more into Buicks than Cadillacs in this area and therefore didn't want a Cadillac hospital either," Anderson said.

John Ford, designer with Marshall Erdman, called the meetings "a helpful exercise to go through. "They helped us to really hear everyone."

And Klawiter called the visioning sessions "the smartest thing we could have done."

The design of the new hospital reflects views gathered in visioning sessions, the hospital's mandate that the new facility not require the addition of any full-time employees and the results of recent studies indicating that hospital designs affect patient outcome.

"We tried to create the feeling of healing hospitality, doing anything we could to reduce patient and visitor anxiety," Ford said. "We centralized all the registration, check-in and waiting areas and created healing gardens as places patients and family members can go and have a little retreat to nature to relax."

Anderson added, "Staff, patient and public areas are separated to keep noise and commotion away from patient rooms. We brought more daylight into the room by positioning toilets near the doors. This also gives the patients more privacy because there are no patient views from hallways."

The location of bathrooms near the patient room doors means that maintenance personnel do not have to enter the room for daily bathroom cleaning, minimizing patient disruption and exposure to additional possibilities of infection.

In addition, all the patient rooms are on the second floor, so there are no headlights in the patients' windows as night.

In order to reflect the region and avoid an institutional feel, the hospital features a lot of natural wood, stone and some water features.

Although Marshall Erdman carried the ball in terms of both design and construction, there was room in the process for input from subcontractors and room for some changes.

"We worked with Marshall Erdman a little bit to make the building last longer," said Jon Banse of Seedorff Masonry Inc. of Strawberry Point, Iowa. "We adjusted a few details to make the building function a little better. We discussed and tweaked expansion joints on the exterior and some flashing details."

Details such as location of departments were taken into consideration to make the hospital functional for the future as well as the present.

"We didn't overbuild, and yet we did all of the planning with the future in mind," Klawiter said. "The departments that have the greatest potential for growth and further development are sitting along the outside of the building."

Some hospital departments, such as imaging, are likely to expand in the coming years and others, such as medical records, are likely to contract. Positioning departments likely to expand beside those likely to contract means that departments and the patients they serve will not have to go through the upheaval of moving during necessary expansions.

Klawiter added that the hospital wanted to keep as much work as possible in the Platteville area.

"Although there are definitely things that could not be done by local firms, we have had about $5 million in contracts go to Platteville or area contractors," she said.