The Chickasaw Nation Medical Center transforms an often-demeaned building type into a highly valued and socially significant center of community life. It uses a very critical issue in Native American culture, health and physical well-being as a tool for creating solidarity and meaning and for a disadvantaged culture.
Twenty-one months after its August 2010 completion, an independent, third-party evaluation of the Chickasaw Nation Medical Center reported, The result of the architects work is a community healthcare centre inextricably bound to its site, region and local culture. It eschews the common practice of assembling anonymous machines for healthcare in favour of place-making all in a built environment that boosts the local community and exudes humanity and cultural meaning.
One can't help but ponder how the current state of health in America might be improved if more healthcare facilities had such ennobled qualities as this one, nestled in the low hills of a small Oklahoma community. The evaluation observes, The CNMC is, in effect, a compelling affirmation of the Chickasaw Nation's commitment to universal healthcare and the well-being of its people. It finds that the functional layout is a significant improvement over typical hospital design, noting in particular that, The core of the complex is a lively and light-filled public space referred to as the Town Center which serves as a working core of the hospital as well as for the community. It and the adjacent cafeteria/dining room are almost daily gathering places where many non-patient local residents eat, socialize, and gather information about health resources as well as being an increasingly popular venue for small local events.
The evaluation focuses on the extraordinary connection to nature and, in particular, natural light at CNMC. It notes, All this attention to sunlight and nature views is more than mere aesthetic effect. It is a response to a deeply held Native American belief that nature requires our abiding respect and appreciation, and in return gives potent healing and nurturing. The study also commends the many sustainability features in the building and, again, admires the way in which they have been tied to longstanding Chickasaw values and beliefs. It notes, ‘An extension of the Chickasaw belief system is the contention that we humans should take from nature only what is needed and no more.' The report outlines how integration of day lighting and orientation has produced significant improvements in energy efficiency and conservation of non-renewable resources.
The evaluation concludes built of modern materials by modern people yet with forms, colours, and patterns that embody the coded meanings of an ancient culture the Chickasaw Nation Medical Center has given the people of the local Chickasaw tribe a place for healing, communing, and celebrating their culture.
One of the primary design goals was to create more than just a healthcare facility for the Chickasaw Nation; it was conceived as a civic venue for the Chickasaw people and other American Indians in Oklahoma. The facility was designed to provoke a sense of ownership and pride among the Chickasaw people for the design motifs were derived directly from Chickasaw culture, history and future aspirations. The facility was envisioned to be a monumental statement regarding universal healthcare for the Chickasaw and other Native Americans as well as a testimony to the significance the leadership of the tribe has attached to health and well-being.
Dr. Judy Parker, Chief of Medicine at CNMC, states, ‘Hospitals are typically confusing and impersonal places for visitors and patients alike. This hospital is very clear and very beautiful. If you walk straight through the Town Center to the Healing Garden beyond, you will find staff, patients, and visitors intermixing, eating and enjoying nature. It is really a wonderful place.'
The third party study reports, For Native Americans, caring for the ill is a community function. Patient rooms include larger seating areas and fold-out beds to accommodate long visitor stays; gracious community rooms are provided on all patient floors; and multiple large public spaces provide for the larger communities participation in the care of loved ones. Trails snaking through the lush surrounding landscape as well as picnic areas are aimed at facilitating and encouraging caregivers to spend long periods of time at the medical center.
Numerous design and planning ideas were influenced by research findings in addition to fundamentally sound architectural best-practices. From the very beginning, the design team spent considerable time ensuring that daylight would be introduced into as many interior spaces as possible via courtyards, raised ceilings, corridors terminating with floor to ceiling windows and the location of public waiting areas on the perimeter of buildings. Patient room windows are large and placed to ensure patients within the bed can have unobstructed views to the pristine site.
Dr. Parker, Chief of Medicine, confirms the impact of daylight with scientific fact: ‘Clinical studies have proven that when patients have more views to nature, their need for medications decreases. In addition to having great views from the rooms to the landscape, access to the out-of-doors was provided in numerous locations for patients, visitors and staff.' The design also includes like-handed patient rooms, strategic placement of hand washing sinks and utilization of solid surface materials at all wet locations.
New businesses that support the medical centre have begun to emerge in Ada, a small town (population 16,810) where modest increments can make a big economic difference. A local blood bank has opened a new branch directly across the street from the CNMC. Since the commencement of the construction of the hospital, two new hotels have opened in the city of Ada, acknowledging the high number of visitors to patients among this community.
In a generally slow economic climate, Ada has experienced population growth and a spike in new businesses. The value of construction permits grew 91% from 2009 to 2010. Even more amazing given the current state of economic recession in America, jobs in Ada have increased by 3.03 % in the last twelve months. Such is the robust impact of the CNMC on the region of Ada, Oklahoma; a city that has experienced growth even in hard times and a city that projects continued growth into the next decade.
The siting of the hospital was driven by the need to preserve a half-dozen 100-year-old pecan trees. The building footprint assumed an angular configuration in order to accommodate these trees. Care was taken to limit parking to only one side of the facility-thus maximizing green space and providing views to the nearby creek and prairieland. Careful restoration of the native prairieland as well as the use of native plants throughout the project greatly reduced the need for irrigation.
The building makes strategic use of glass in order to promote day-lighting in patient areas while at the same time orienting the bed tower north-south to minimize solar heat gain. Regionally quarried stone forms piers that project to the south and west, providing passive shading and glare control for most of the public spaces. The building skin employs rain screen technology to increase thermal efficiency and lower energy consumption while greatly reducing the risk of developing mould within the building envelope.
Dr Judy Goforth, Chief of Medicine reports, Reactions from patients and staff to the Chickasaw Nation Medical Center are nothing short of effusive. ‘‘Just the other day, I was talking to a staff member, and totally unsolicited she proceeded to tell me how much she loves working here. She said: ‘I love coming to work each day. It is so beautiful and light-filled.'' It's not an isolated comment. The architects have received numerous comments from senior hospital administrators that patients report, better quality of care is being provided in the new facility. Potential causes of increased satisfaction include the overall improvement of environment for patients, a more pleasant working environment for staff, a significant increase of daylight into the facility and the ability for patients and visitors to have direct access to the beautiful 230 acre site.