Medical Facilities With a Soft Touch : Building: A humanism lacking in most medical buildings can be found in two new facilities.

No one wants to spend significant amounts of time in hospitals and other medical facilities. For those who have to, though, two new buildings in San Diego County point the way toward a humanism lacking in most medical buildings.

With its slanting, residential roof lines, exposed exterior beam ends and simulated wood-shingle roof, the $18-million, 171,000-square-foot San Diego Hospice in Hillcrest looks more like a Craftsman-era mansion than a medical institution. The building, designed by Delawie/Bretton/Wilkes of San Diego, opened in July and offers short-term acute care to terminal patients.

A few miles across town on the UC San Diego campus, the $6-million, 34,473-square-foot Shiley Eye Center, designed by Anshen + Allen of Los Angeles, pays homage to architect Louis Kahn while softening the austere modern approach of Kahn’s era, the 1950s and ‘60s.

The San Diego Hospice was built through the generosity of San Diego philanthropist Joan Kroc, widow of McDonald’s millionaire Ray Kroc. She felt indebted to a Minnesota hospice that cared for her dying father, so she footed the entire cost of this building, according to a Hospice spokesman.

Management at the San Diego Hospice selected Delawie/Bretton/Wilkes because of the firm’s solid reputation, but also because the architects have limited experience with medical buildings, according to Hospice President Holly Lorentson.

“Our goal was to build a hospital that didn’t look like a hospital, yet met all codes and requirements,” she said. “We didn’t want someone so used to hospital design that they couldn’t see alternatives.”

Resting on the south rim of Mission Valley, the 24-bed Hospice is intended as a place where terminal patients of all ages come for short-term, acute care--treatments ranging from five to seven days. Actually, the majority of care provided by the San Diego Hospice occurs in the patient’s home; last year, the 150-person staff served more than 1,000 patients at home.

State legislation approved in 1989 created a four-year pilot project which allowed the Hospice--which serves a more specialized group of patients than a conventional hospital--to be constructed without surgery and anesthesiology centers. To date, the Hospice is the only project in the state completed under this legislation.

Setting out with the idea that the Hospice should look more like a comfortable house than a hospital, the architects considered several possibilities.

“We looked at different styles, including traditional Mediterranean and modern,” said Michael Wilkes, one of the architects. “After looking at all of them, the consensus was that a Craftsman/Greene and Greene style was prevalent in Hillcrest-North Park-Mission Hills, and has the immediate image of being homelike.”

Charles and Henry Greene were the most famous architects of the Craftsman movement early this century. Their rustic wood homes, detailed like fine pieces of furniture, were built primarily in Los Angeles.

The Hospice consists of two buildings: a smaller administrative building and the main complex, which is closest to Mission Valley. The main building consists of a central lobby flanked by two 12-bed patient wings.

From a distance, the building does, indeed, cut a Craftsman-like profile, with its overhanging, slanting roofs and trellis-covered exterior walkways. As you approach the building on a circular drive of stamped concrete, though, you can see shortcomings caused by budget and building code limitations: exterior walls of gray stucco are somewhat cold, and the commercial-grade aluminum windows don’t capture any of the romance of Craftsman-era wood windows.

To enhance the serene environment, the architects designed an underground service tunnel--when a patient dies at the Hospice, the body can be wheeled through the tunnel to an ambulance or hearse in a concealed lot. The park-like setting, with a landscape by Wimmer Yamada Associates of San Diego, includes simple, solid wooden outdoor furniture and a wooden play structure for children.

Inside, the Hospice often succeeds in creating a more inviting atmosphere than is typical of hospitals. Nearly all hallways and common areas are covered with carpeting instead of shiny, harsh vinyl flooring. Interior designer Marshall Brown of San Diego selected wall coverings, carpeting and paint in gentle pastels to create a soothing environment. Sometimes, though, the designer look undercuts the building’s modest, rustic pretensions.

The inviting lobby has a floor of aggregate stone tiles and one wall of artificial rock, which water trickles down. Patient rooms are arranged around open, circular common areas instead of strung along narrow hallways. Skylights flood various common areas with natural light, a substantial improvement over the usual fluorescent glare.

In patient rooms, medical equipment such as blood pressure gauges and oxygen outlets are concealed in a wooden wall unit. Televisions are tucked away in armoires. Rooms have hardwood floors and include small family areas with fold-out couches where relatives can spend the night.

Several rooms have pocket decks or patios with striking views of Mission Valley. According to a Hospice spokesman, some residents see the bustling freeway traffic below along Interstate 8 as a hopeful sign of life.

The Shiley Eye Center, a branch of UCSD’s School of Ophthalmology, was funded, in part, with a $1 million grant from Donald P. and Darlene V. Shiley. Although it doesn’t offer in-patient care, it does create an extremely inviting atmosphere for doctors, researchers and patients who visit its eye clinic.

Situated just east of Interstate 5, near Scripps Hospital, the concrete-framed, stucco-paneled building is divided into two primary sections: In front is a barrel-vaulted two-story structure, containing the first-level lobby and library/conference room and second-level offices. Behind is a three-story structure including first-level examination rooms, second-level labs and a third-floor outpatient surgery center scheduled to open in February.

A slanting skylight runs along the seam between the two sections of the building, admitting soft natural light into the lobby below. Large panels of tinted glass import additional, gentle natural light and views of the surrounding landscape. Exposed concrete columns, maple paneling and finish materials in gentle, off-white tones add to the serene atmosphere.

Eye center administrators made sure that the building would be comfortable for its patients.

“Architects have their own views on things, and we do too,” says Dr. Stuart Brown, chairman of the Department of Ophthalmology at UCSD. “Bright lights can reduce the sight or make people with various eye conditions uncomfortable. Our goal was to make (the architects) aware of what a building for people worried about their eyes, should be.”

Anshen + Allen principal David Rinehart worked for Louis Kahn in the early 1960s, and he is one of the designers at Anshen + Allen responsible for the proposed, controversial addition to Kahn’s Salk Institute in La Jolla.

The Shiley Eye Center doesn’t directly resemble any of Kahn’s buildings, but it is organized with a Kahn-like efficiency. Each of the Shiley Eye Center’s primary functions--lobby, examination rooms, labs, offices, surgery center--has its own discrete space within the building, yet is easy to reach due to the logical layout of hallways, stairwells and elevators.

Such hospitable medical buildings as the San Diego Hospice and the Shiley Eye Center serve as role models for future such buildings, but user-friendly design isn’t necessarily the norm in the 1990s.

Other medical buildings by young, cutting edge California architects, such as a dental office in Kensington by Tom Grondona and a cancer clinic in Los Angeles by the L.A. firm, Morphosis, take an opposite, aggressive design approach that may provoke, rather than placate, patients. But there is much to be said for the restraint and maturity of these two new San Diego buildings.

“We wanted to keep things as comfortable and as easy to understand as possible,” Wilkes said. “We had no illusions of deconstructivism (a fragmented, contemporary style). Things are symmetrical, and the circulation is quite clear. So during a time that is stressful to people, we’re not creating more stress.”