The Future of Family-Centered Care
University Health Women’s & Children’s Hospital
Healthcare
As the first hospital in South Texas focused solely on women’s and children’s health—one of only 20 such medical centers in the United States—the new University Health (UHS) Women’s & Children’s Hospital in San Antonio marks an important moment in advancing the care of a historically underserved patient population. ZGF, in association with Texas-based Marmon Mok, approached design and programming of the 14-story tower with the highest of aspirations: to design the hospital of choice for women, children, and babies in South Texas. In the words of George Hernandez, President and CEO of University Health, “this hospital should provide a strong foundation for improving health and helping to shape the future for children.”
In addition to client aspirations and goals, stakeholder and community input provided valuable insights that informed design. Each space was seen as an opportunity to welcome and support users with empathy, compassion, and a family-centered approach to care at each step of their healthcare journey.
In partnership with the University of Texas at San Antonio Medical Center—the largest research institution in South Texas—the new Women’s & Children’s tower serves as an academic teaching hospital to ensure the standard of care is constantly evolving to incorporate the latest advances in obstetric, gynecological, and pediatric health that may then be delivered to patients.
Location
San Antonio, TX
Completion date
July 2023
Project Component
Architectural design services
Interior design services
Medical planning
The architecture of the hospital tower establishes a distinct identity for the new facility while alluding to the massing and visual language of the broader University Hospital campus.
The four-story Women’s & Children’s podium is positioned perpendicular to the existing Sky Tower, while the new 10-story tower sits slightly apart from Sky Tower and askew on its podium to maximize views of the Hill Country to the north, to strategically abate the solar heat gain and glare of Texas summers, and to distinguish the new hospital within the campus.
The building serves as a connector from the new 900-space garage that was constructed at the northern side of the Women’s and Children’s Hospital. Intuitive wayfinding and informative signage ensure the routes through the buildings are clear and destinations are easy to find.
The facility features evidence-based strategies, with care given to provide natural light, expansive views of nature, private patient rooms, and ample space for families. The interior design is characterized by a stratification of materials and finishes, including terrazzo, plaster, and textural elements, that create a visual cadence within large public spaces to humanize their scale. A consistent selection of core interior architectural finishes, comprised of regional materials such as stone and wood, and accented with dichroic glass, strengthen the continuity between public and clinical spaces.
Family activity spaces at the north end of the building feature variable, single- and double-height spaces throughout the patient tower. These spaces take advantage of views, create a pop of color, and initiate a warm, living room-like atmosphere for family to socialize, share meals, and have moments of respite.
Amenities designed to accommodate patients and their families in settings that suit any need or occasion are found throughout the hospital tower and the podium. For women, the facility features large, private delivery suites; spacious private patient rooms; a breastfeeding support center; and spacious family lounges on every floor. For children, the facility includes oversized, kid-friendly private rooms; pediatric rehabilitation gyms; a child life center with a performance area and game room to reduce stress and foster coping and resiliency. The hospital also includes an expansive dining hall, and conference center, and the SaludArte: Art of Healing Program.
Located in the podium, the dining hall is designed with upscale finishes, ample natural light, and artworks by local artists to create a vibrant, hospitality-forward setting within the hospital.
Advancing Equity, Agency, and Lifelong Care
As South Texas’ first Level IV Maternity Center, which makes the facility capable of treating cases of the highest acuity, the hospital addresses regional health outcome disparities while specializing in high-risk deliveries and pregnancy complications, with support from a Level IV Neonatal Intensive Care Unit.
While the purpose of the building is female- and family-centric, the architecture and design of the building is not about making spaces feel feminine. Instead, spaces are designed to mirror the beauty of the surrounding landscape, and impart empathy, safety, and University Health’s commitment to cutting-edge care. The facility responds to women’s needs through an understanding of the different situations and circumstances that mothers, children, and their families will experience along their healthcare journey.
Recent research shows that the presence of family can improve safety and patient comfort as well as health outcomes, such as improved baby weight gain, fewer infections, and shorter NICU stays. In response, this design actively works to encourage family participation in the health and healing process.
NICU facilities equipped with kangaroo rooms help parents more comfortably stay in proximity should their newborn require special post-natal care. Larger labor and delivery rooms encourage more family support, and mother-infant units that promote couplet care—rather than traditional postpartum units—more readily establish and strengthen the mother-infant bond. Space has been made for family members in patient and consultation rooms, as well as providing dedicated waiting lounges and other amenities for families.
Circulation focuses on shaping the patient journey through responding to personal experience and birthing outcomes. To avoid creating or intensifying emotional distress for all patients and their families, the design ensures that those experiencing loss or trauma move through channels that maintain their privacy, eliminating visual and auditory crossover with the buzz and bustle of those experiencing joyful outcomes.
Labor and delivery rooms were designed with space to accommodate the mother’s choice to engage the clinical team typical of a hospital birth and/or the services of a midwife. The rooms are also designed to support the choice of a vaginal birth (via traditional bed or hydrotherapy tub) or c-section, as well as the swift transition from one to the other.
While most women’s hospitalizations are for obstetrical services, women maintain a consistent hospital presence across their lifetimes, extending well beyond childbearing age. This facility meets the demand for midlife and senior women’s services, such as breast health, urogynecology, osteoporosis screening and treatment, and cardiovascular and gastrointestinal conditions.
The combination of care for women and children is also a response to the fact that women are often the primary caregiver and holder of responsibility for the health of their children. Bringing care for both groups under one roof is shown to simplify and improve health outcomes and general wellbeing of mother and child in the long term.
Waiting lounges for the women’s gynecology department provide sophisticated yet serene settings that are designed to accomodate both women and children.
Seamless Campus Integration
To facilitate continuity between the new tower, podium, existing campus thoroughfares, and the parking garage, the designers and engineers collaborated to develop a solution using versatile 90-foot wide, 15-foot-tall steel Howe trusses. These trusses connect to concrete columns on both sides of the underpass, supporting the podium's entry and the parking garage. This method transfers loads, providing unobstructed space under the truss and reducing the number of columns in the podium. The bundled steel and concrete columns form large elliptical columns within the podium's interior, adding a visually striking rhythm.
Among the first such structural applications in a healthcare project in the United States, these trusses serve multiple functions:
- They support the tower above while maintaining a column-free 30-foot space below. This preserves an important campus thoroughfare for accessing the parking garage and other amenities.
- They enable the creation of a glass-enclosed bridge that connects the parking garage to the Women’s & Children’s tower and allows access to the broader campus beyond.
- They house the necessary mechanical, electrical, and plumbing infrastructure within their interstitial spaces, encased within the podium's second floor.
Building Innovation and Pre-fabrication
The building’s massing and facade are defined by three zones: stacks of patient rooms, spacious public areas with large windows, and a vertical stack for the mechanical system. Windows and louvers ribbon vertically down the facades, adding emphasis to the overall massing. The design also subtly spotlights unique and highly functional features, embedding the tower's numerous prefabricated elements and mechanical systems into the sleek aesthetic.
The patient bathrooms, curtain wall, and MEP racks above patient rooms are one of the first examples of prefabrication at this scale for a healthcare facility in the United States. They offer unparalleled consistency across rooms, while positively impacting construction schedule and budget.
The tower’s 10 stories of patient rooms are designed in an arrangement of couplets with mirrored layouts and shared headwalls. Achieving this arrangement without losing significant square footage per level is only possible with prefabrication. The patient room headwalls and bathrooms were produced off-site in parallel with building construction and were installed collectively. The aluminum curtain wall elements were also prefabricated, with cassettes built and loaded with electrical and other infrastructural components at a separate location and later craned into place and connected.
The design capitalizes local climate's abundant sunshine, while protecting users from extreme elements. The tower's glazing is tailored to the patient rooms' layout, featuring pairs of pleats consisting of opaque spandrel glass and transparent vision glass.
The building has two distinct mechanical systems: one for the podium and another for the tower. The tower's mechanical system is positioned along the south vertical of the building. This vertical stack arrangement enables independent HVAC functionality on each floor, ensuring resilience and flexibility in times of crisis and futureproofing for responsive adjustments as healthcare delivery needs and standards evolve. The tower's facades showcase air intake and exhaust louvers, which are stacked to create ribbons parallel to the patient room glazing, enhancing the elegant vertical design of the tower.
As one of only a handful of women’s and children’s hospitals in the United States, the design of the University Health Women’s and Children’s Hospital represents a leap forward in the understanding of women and children’s unique healthcare needs and supports University Health in achieving their ambitious goal of providing a strong foundation for improving health and helping to shape the future for children.
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