Pavilion blends beauty and history Wilmer re-engineers eye care in an oasis of calm and color

Critique

November 01, 1996|By Edward Gunts | Edward Gunts,ARCHITECTURE CRITIC

Beauty is in the eye of the beholder. But if the beholder has trouble seeing, can there still be beauty?

The answer is an emphatic yes, as shown by a remarkable combination of art and medical architecture at the Wilmer Eye Institute of the Johns Hopkins Medical Institutions.

A new patient treatment area on the third floor of the historic Wilmer Building on the East Baltimore medical campus is literally a sight for sore eyes.

Called the Wilmer Eye Care Pavilion, it will be dedicated today as the latest addition to the Wilmer institute, home of the No. 1 ophthalmology program in the country as ranked in a nationwide poll of eye doctors.

The $2.7 million pavilion reflects an effort to rethink eye care services at Wilmer.

What makes it so impressive from an architectural standpoint is a series of design touches that may not have been essential for treating patients but make the place visually richer and more meaningful.

The touches range from the introduction of a color scheme inspired by the palette of Claude Monet, the French impressionist who kept painting into his 80s despite failing eyesight, to a museum-caliber gallery that honors eye-care pioneer William Holland Wilmer.

By far the most dramatic feature is the way the institute revealed the underside of the dome atop the Wilmer building, an area that had never been exposed.

"This is meant to be an oasis of calm and beauty for patients," said Dr. Morton F. Goldberg, director of the Wilmer Eye Institute and the William Holland Wilmer Professor of Ophthalmology. "But it's beauty with a history."

Constructed in the 1880s, the Wilmer Building is one of the oldest on the Hopkins campus. Along with the Marburg Building, a twin, it frames the main Billings administration building at 501 N. Broadway.

The eye-care pavilion is one of the first major re-engineering projects to be completed at Hopkins since administrators launched plans in November 1994 to rethink the way health care is delivered.

In the "bad old days," Goldberg said, the average stay in an eye hospital was "one week per eye." Eye patients lay in bed with sandbags on each side of the head so they would stay still. Some were in the hospital for months.

But with laser surgery and other recent eye-care advances, most patients now can be in and out of the hospital in less than 24 hours. In fact, 90 percent of all ophthalmology surgery is done on a same-day basis. And the number of outpatient visitors at Wilmer has increased dramatically -- to more than 80,000 in the past year.

Those advances have caused more than a few juggling problems for the hospital. Until two years ago, Wilmer had 120 beds reserved for overnight patients, when it needed only one-tenth that many. But it didn't have enough room for same-day patients.

In addition, Wilmer had separate nursing units for emergency eye care, same-day care and in-patient care that required an overnight stay. The three were in different places and were monitored by different nursing staffs. As the number of overnight stays dropped, nurses assigned to the in-patient unit had less to do. Yet the same-day nurses were busier than ever.

Catching up

The pavilion being dedicated today is the culmination of a two-step re-engineering process.

Reacting to the dramatic changes in the way eye care is delivered, administrators first combined the three nursing units.

But even after the staff reorganization, the institute had problems with traffic bottlenecks and diminished patient privacy, because the treatment areas hadn't been redesigned.

So the institute launched a second phase: construction of a patient treatment area to accommodate the new nursing unit.

Goldberg and his associates also asked the architect, the DeWolff Partnership of Rochester, N.Y., to upgrade the work setting.

The patients already get "world-class care," he said. "We wanted the facilities to be commensurate with the kind of care that goes on around here."

Many of DeWolff's decisions simply amount to intelligent space planning. Working with an L-shaped floor plan, the designers separated overnight patients from same-day surgery patients and emergency patients.

The overnight patients were put on one leg of the L, where they would have more privacy. The same-day and emergency patients were put on the other leg of the L, separated by a central registration area. At the elbow of the L, designers located the nurses so they would be close to all types of patients.

Visual appeal

While tailoring the layout to accommodate the new work patterns, the designers created spaces that were visually pleasing.

Lighting levels were increased to create an open, airy atmosphere. Rooms were equipped with upgraded furniture, including upholstered sleep sofas for overnight visitors.

The color scheme includes vivid shades of blue, green, purple and pink -- the same colors found in Monet's paintings. Goldberg said he specified the Monet palette because his colors are "timeless" and patients find them "pleasing and comforting."

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