In 2008, an exuberant crowd gathered on each degree of the multistory foyer to dedicate the brand new 181,000-square-foot DePaul Affected person Tower addition to HealthEast St. Joseph’s Hospital in downtown St. Paul, Minn. As chief of the HOK design staff for the challenge, I used to be particularly moved by the variety of Sisters of St. Joseph Carondelet, many aged or infirmed, who made the particular journey for the event.

Greater than $10 million was donated by the group towards the $52.4 million building price for the rejuvenation of St. Joseph’s Hospital, which was based by the Carondelet order in the course of the cholera outbreak of 1853, making it the primary hospital in Minnesota and the oldest establishment in St. Paul.

Quick ahead 12 years to December 2020 and a somber crowd of 100 or so St. Joseph’s employees members gathered within the chilly exterior the darkened foyer with candles and prayers to mourn the closing of their hospital. A Fb group paperwork the empty flooring of 90 acuity-adaptable specialty companies beds, catherization labs and working rooms.

The information of St. Joseph’s demise hit me onerous. I’ve been a healthcare architect for 38 years and have seen a few of my tasks renovated and re-renovated, expanded, and re-clad. However by no means has certainly one of my outstanding tasks closed in such a short while span. The affected person tower was featured on the quilt and as a characteristic article within the March 2009 subject of Healthcare Design.

The challenge was introduced at a number of conferences highlighting the way it contributed to St. Paul’s grasp plan imaginative and prescient of city revitalization and enchancment within the total high quality of life for its group. The only-handed, acuity-adaptable, outboard-toilet affected person rooms have been copied by different architects for his or her new mattress towers. Most significantly for me, our challenge staff together with the shopper, architects, program supervisor, engineers, and contractor turned good mates and even had a five-year reunion.

So what went fallacious?

In keeping with the Minneapolis Star Tribune, St. Joseph’s turned a part of Fairview, one other nonprofit  well being system, as a part of a 2017 merger with HealthEast, which hastened its losses by concentrating extra inpatient psychiatric companies there. (For extra on the story, take a look at this Star Tribune article.) This all didn’t bode nicely for St. Joseph’s, which noticed its as soon as formidable cardiology and neurology applications moved to suburban hospitals.

The group, now referred to as M Well being Fairview, has a brand new acknowledged objective to show St. Joseph’s right into a well being and wellness heart, concentrating on outpatient psychological well being as soon as the COVID-19 disaster is over. How they’ll accomplish this adaptive reuse, I have no idea.

This modification from a once-vibrant acute care hospital to a mothballed, empty constructing raises many questions in my thoughts. Was the preliminary strategic plan flawed? Because the structure agency on the challenge, we created a really custom-made answer to a novel program and difficult web site, assuming it will be the frontispiece to a phased redevelopment plan.  That plan was nicely thought-about by the well being system however by no means moved ahead. These have been heady pre-Nice Recession instances when even the stair rails could possibly be customized patterned, and our design mirrored the historical past of St. Paul as we assumed this constructing could be a landmark hospital for years to come back. No what ifs.

This business now is aware of that speedy change is not only a chance however inevitable in healthcare and the buildings that home it. Adjustments in market circumstances, know-how, medical apply, operations, and even sudden pandemics will have an effect on how tasks will probably be utilized sooner or later. As healthcare designers, we want not solely handle the present program but in addition the adaptability or flexibility of our buildings for the unforeseeable.

Relaxation in peace, St. Joseph’s Hospital. I hope no matter you grow to be sooner or later serves to enhance the well being of the group in methods we can’t start to ponder.

Sheila Cahnman, FAIA, FACHA, LEED AP, is president, JumpGarden Consulting LLC. She might be reached at

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