Greater Issaquah-Sammamish is a fast-growing suburban community on the east side of Seattle. To meet this population’s healthcare needs—not only to get well after an illness or accident, but to stay well—Swedish Health Services opened a five-level community medical center that includes a 175-bed, 353,250-square-foot acute-care hospital with 14 interventional platforms, imaging and emergency departments, a cancer institute and support services; a comprehensive ambulatory care center; a 175,000-square-foot medical office building with a retail mini mall; and structured parking, on a 12.5-acre site in the scenic Cascade foothills.
Sustainability is a major focus in Swedish/Issaquah Medical Center’s design. Creating a noninstitutional, healing environment that is airy, brightly lit and colorful gives patients, visitors and staff a healthful, stress-relieving environment and also contributes to energy savings.
“The interconnected themes of nature, nurture and community were incorporated in the design with crisp aesthetics and material integrity to evoke a sense of warmth and familiarity,” says Phil Giuntoli, principal and healthcare practice leader at CollinsWoerman, the Seattle architecture firm that designed the campus.
One of the medical center’s unifying elements is a commons, a central public space that bridges the medical offices and the hospital. The multilevel atrium space adjoins the buildings and incorporates patient registration functions, foodservice and retail operations set in a T-shaped, suburban-style mini mall, a hospitality-style waiting room with a fireplace, and an open courtyard that allows visitors to enjoy the indoor and outdoor environments. “This is seen externally with an iconic roof form and a multistory glass façade that is visible from primary entry approaches at either end,” Giuntoli says.
The mini mall area in the commons contains storefronts offering wellness products; women’s lingerie and postsurgical wear; yoga classes; high-end gifts; baby and new mother products; and day care as well as a Starbucks unit and Café 1910, a restaurant named for the year Swedish Hospital was founded. “In Café 1910, the overall concept of nature, nurture and community was carried through from the menu to the design of the restaurant’s servery and dining room,” says Heather Nye, interior designer at CollinsWoerman. “Café 1910’s location in the corner of the building allowed designers to maximize the exterior glazing to let in as much daylight as possible, creating an open and airy space similar to that found in the atrium and retail areas. The expanse of glazing continues into the servery and gives employees behind the counter daylight as well.”
Entering Café 1910
Terrazzo from the atrium transitions to stained concrete, which continues throughout Café 1910. “The primary focus of the entry is the reclaimed teak planks cladding the wall,” Nye says. “The warm tone of the wood announces the general look and feel of the café. From there you are greeted with clean stainless steel letters announcing Café 1910.”
On the left, an image of Dr. Nils Johanson, the founding father of Swedish Hospital, greets guests, along with a brief
history of Swedish Hospital’s beginnings. Other archival pictures also sit on a custom graphic wall covering. To the right of the wall covering, an informational monitor announces upcoming events in the café and facility.
Upon entering the 1,600-square-foot servery, guests see an expanse of windows behind the culinary staff stations. “The overall intent of the material selection was to create a warm neutral backdrop, making the food the primary focus of the space,” Nye says. The servery contains multiple foodservice platforms and a warm solid surface counter with stainless steel and wood veneer. Wood veneer also appears in the soffit above. The menu boards are monitors that staff easily revise to announce the seasonal menu items. Guests entering also see the servery’s food preparation areas.
“This project was a fantastic opportunity to deliver on a very clearly stated vision,” says Kris Schroeder, administrative director of support services, Swedish Health Services. “The executives of this facility knew what they wanted in regard to the retail foodservice, and it wasn’t a hospital cafeteria. They wanted a destination eatery that would appeal to the community and just happened to be in a hospital.”
“Because Swedish-Issaquah Medical Center is a wellness center and a benefit to the community, we made a commitment to handle and prepare food with utmost care, much like the way our grandparents did,” says Eric Eisenberg, executive chef and retail operations manager for Swedish Health Services. “We purchase the best ingredients and adhere to local, sustainable practices. Nearly everything in the café and for the patient room service is made from scratch and is fresh and natural. It’s far from the stereotypical hospital food.”
“We are so proud that our staff can showcase their talents and provide not only delectable dishes, using local ingredients whenever possible, but also deliver world-class service,” Schroeder says. “For example, one of our sous chefs is known for making pies to order so that our customers can take them home. This isn’t something we put on the menu as an offering. It’s just something he did because he saw the opportunity to provide an outstanding service that was unexpected.”
The biggest design challenge was “to create a café that met the expectations of the medical center’s executives for a retail restaurant that takes advantage of local farmer’s crops, but also creates a sustainable environment that wouldn’t have to be operated in the red,” says the project’s foodservice consultant, Jean-Michel Boulot, principal, Ricca Newmark Design.
The café design features self-contained platforms with ample refrigeration and sinks located for easy access, thus increasing the staff efficiency. Nearly 1,000 square feet of preparation and storage space sits behind the platforms and includes such equipment as a char broiler, flattop, conventional oven, six-burner range and combi oven. Menu items served at the platforms vary from burgers and local fish to salads and kids’ favorites such as tacos and pizza.
At the hearth station, the oven’s versatility allows staff to bake pizza and also roast meats that are carved here. Each station, including this one, features holding wells that staff can set to either hot or cold, which gives them maximum flexibility when assembling ingredients for dishes or for guests helping themselves to prepared food.
A salad station sits adjacent to the pizza station. Next to the salad platform sits an action station/exhibition grill, known as a taqueria station throughout the Swedish Health system’s hospitals. Here staff use a three-feet-in-diameter circular grill to sauté everything from skewered meat and vegetables to quesadillas and stir-fried dishes. “Staff showcase their talent on the grill and make food the center of attention. They have access to all the ingredients they need in hot or cold wells, which helps them provide quick, efficient service,” Boulot says.
At the sandwich station, guests order made-to-order favorites or pick up freshly made sandwiches or salads in the grab-and-go built-in refrigerator in front of this area. At the adjacent home-style and soup platforms, versatile wells and heated shelving allow small-batch food displays.
Throughout the café, staff members are supported by comfortable, nonslip flooring made with quarter-inch-thick recycled vinyl that is easier than floor mats for the staff to maintain.
Intentionally absent from Café 1910 is equipment that the culinary staff feel projects a non-nutritious image: fryers and soda fountains. Replacing the popular soda fountains, a fountain with a water spigot dispenses ambient or refrigerated carbonated water. Vending equipment located near the exit area offers additional beverage choices.
After selecting food, guests transition into the dining room where a staircase leads up to the Green Room, an employee and guest gathering space on the second floor. “The stair is cladded with ceramic tile that reflects patina COR-TEN steel that alludes to the large steel grass blades found in the commons,” Nye says. “The glass is also used as a visual connection between the Green Room and café.” This area is equipped with induction warmers hidden in the counter, a microwave oven, coffee-brewing equipment, hot water dispensers and vending machines.
The 150-seat dining area is open and airy with a variety of fixed seating options and tables with movable chairs. “The ceiling was kept simple with strategically placed wood slats hanging above and small drop light fixtures leaving the opportunity for flexible furniture layouts,” Nye says. A key dining room feature is a large custom communal table created by a designer that harvests local reclaimed trees. The finish exposes the natural contrast of the grain pattern.
Though most of Café 1910’s food preparation takes place in the servery, bulk items such as soups and sauces are made in the 2,000-square-foot main kitchen, which contains an additional 500 square feet of storage and receiving space. The kitchen’s location in the basement requires staff to travel through the kitchen and up in an elevator that opens into the back of the servery. The kitchen is located in a building that requires adherence to disaster and earthquake compliance requirements, while the café is in the commons, which is not subject to such compliance. “If the café had been built in an ‘essential’ space, the facility would have had large cost overruns for complying with requirements,” Eisenberg says.
In addition to supplying bulk food for the café, the kitchen provides hotel-style room service for patients and catered functions.
In the Kitchen
After food arrives at the loading dock, staff take it to dry storage, which contains high-density shelving, or to a walk-in freezer or one of four walk-in coolers specified for prepped food, produce, meat and dairy.
In the prep area, six tables allow staff to work at stations specified for raw proteins and other items such as vegetables. “By specifying the type of preparation at each table, we avoid cross contamination,” Eisenberg says. Two tables contain utility sinks, which further assist staff in complying with sanitation standards.
Running down the middle of the kitchen, a utility distribution system (UDS) feeds power to all the foodservice equipment. The system contains emergency shutoffs for the whole system and individual pieces of equipment. “Indicator lights show on the front panel indicating what has been tripped and where,” Eisenberg says. “Staff can easily access the UDS for maintenance. We never have to break through the line and worry about connections.”
Equipment along the UDS includes a double-stacked combi, which cooks meats, fish and also baked goods, a 36-gallon steam kettle, a tilt skillet, two 10-gallon jacketed kettles, a six-burner stove with an oven below, a vegetable prep sink and table, and a blast chiller.
In the same work area staff use two 20-quart mixers for making pizza dough and grinding meat. A third 20-quart mixer serves as a backup for the other two. This area also contains a meat slicer and food processor.
Once food is prepared, staff take it to either the café or patient room service area. “The kitchen was designed near the elevators and with a continuous flow that would not be interrupted by any other functions,” Boulot says. “All equipment and condiment containers were integrated into the line so attendants can find all they need without leaving the counter.” At the end of the line, a walk-in cooler contains sliding doors that flush with the counter so staff can refill the shelf from the back with items prepared in-house.
The room service operation started up when the hospital opened in Phase II. “This room service program is modeled after our signature A la Carte dining room service program developed for Swedish Health Services hospitals that we are so well known for,” Schroeder says. “New features with state of the art technology installed here in Issaquah will be installed in all our facilities over the next year or so. In many ways the new Issaquah facility sets the bar for what we will achieve in all of our facilities.”
One new feature is state-of-the-art menu selection via televisions in the patients’ rooms. This begins the tracking of the meal tray from the time the meal is ordered all the way through delivery. This system also accepts credit card payments from visitors who wish to order additional in-room meals. Meals are beautifully presented on china settings that are anything but institutional.
The room service line moves in a single direction from beginning to end. “There is no floating equipment so attendants can slide trays down the line and build the trays without lifting them up and moving them somewhere else,” Boulot says. Staff lift trays only when placing them on delivery carts. In addition, the line minimizes wasted steps and is ergonomically designed to accommodate the reach of staff members regardless of height.
Storage runs beneath the assembly line, allowing staff to refill their stations easily.
The line in the patient services kitchen contains pass-through windows and ample shelving with a prep table under each window. “We built in dipper wells into the counters to hold tongs and other serving tools, which helps us keep these utensils sanitary,” Eisenberg says. Staff place filled plates on a European-style restaurant pass thru with hanging heat lamps above.
The tray line assembly begins with the cold garde manger area, which is backed up with refrigeration holding salads, sandwiches and fruit plates and cups, and a small freezer holding hard and soft-serve ice cream. Following the garde manger area is a hot prep area with a flattop griddle, a prep table, a char broiler with refrigerated drawers beneath, a six-burner range and oven beneath, and a combi oven at the end. “We formed a hybrid line because we only want one cook to work the entire line if needed,” Eisenberg says.
Before trays are placed in delivery carts, a staff member inspects them for accuracy and compliance with quality standards. To provide a higher level of service and to complement the culinary talent, room service offers food served on china; both plates and domes are used rather than traditional heat-holding bases and lids.
At the end of the line, staff access cold beverages and condiments through a slide-fed cooler. “The cooler is stocked from inside, helping assure efficient stock rotation,” Eisenberg says. “Hot beverages are at the end of the line also, so staff can place these on an assembled tray and only lift it once to the delivery cart.” Once carts are loaded, staff roll them out an exit door to an elevator that serves all floors of the hospital.
Staff bring soiled trays down to the kitchen and take them in through a separate door to the warewashing area and place them back into circulation on the line. Throughout all kitchens, the staff use an automated handwashing system that records the frequency of usage by each unit’s employees.
As Swedish/Issaquah Hospital and Medical Center grows and becomes part of the community, it will undoubtedly help redefine the role of a health center and the integral role dining services and equipment play in contributing to the well-being of a community and its citizens.
Swedish Medical Center opened a five-level community health center that includes a 175-bed, 353,250-square-foot acute-care hospital with 14 interventional platforms, imaging and emergency departments, a cancer institute and support services; an ambulatory care center; a 175,000-square-foot medical office building; and structured parking, all on a scenic 12.5-acre site in the Cascade foothills. For Phase I, the medical office building, outpatient center and food and retail services opened in July 2011. For Phase II, the 175-bed Issaquah Hospital opened in November 2011. The foodservice project includes the main kitchen, café and coffee shop. The 2,000-square-foot main kitchen and 500-square-foot storage/receiving area, located on the lower level, prepares bulk menu items, such as soup and sauces, for the ground-level café. The kitchen also provides hotel-style room service for patients and catered functions. The 150-seat café with 40 seats on an outdoor patio includes a 2,600-square-foot open kitchen with a serving area; a 500-square-foot dishwashing area, a 600-square-foot greenroom serving/pantry area on the level above the cafe, and a 300-square-foot coffee shop. Together the kitchen and café occupy 6,700 square feet. The café is open for breakfast and lunch from 6 a.m. to 2:30 p.m. with plans to open for dinner hours. The average check in the café is $10; the average coffee shop check is $5. Anticipated first-year sales for breakfast and lunch are $500,000. The total 12.5-acre Issaquah project budget totaled $400 million. The cost to build out and equip Café 1910 and the ground-level kitchen was $2.2 million, including $1.55 million for equipment. Staffing includes nine persons in the café per shift during peak times (includes cashiers and sanitation) and six in patient services, including two cooks and two expediter/delivery positions.