Architecture: Building teamwork at Columbia Medical Center
By James S. Russell,
NEW YORK —
Lounges, balconies and terraced gathering spaces jut out of the 14-story sheer-glass facade of Columbia University Medical Center’s planned medical and graduate education building. In an architectural rendering, the structure appears to have disrobed.
That bebopping southern edge is called the Study Cascade, said Elizabeth Diller, partner in the Manhattan architecture firm Diller Scofidio + Renfro, which designed the building.
Shared meeting and study areas carved in diagonals and softly curved edges clamber up the building behind large sheets of glass. Zigzagging wood-clad stairways hook the levels together. (The northern two-thirds of the building slips behind an unassuming veil of a material yet to be finalized.)
This sun-splashed vertical canyon unites floors of classrooms and labs and throws together students, teachers, researchers, and doctors brushing up their skills.
The shared spaces “promote communal and collaborative study,” Diller explained. “No longer do students learn only with a teacher standing at the front of the class. Smaller groups meet to solve problems. They break up and come together. You can get quiet time and social space, but they kind of bleed together.”
To have human interaction shape a building is an extraordinary departure from the standard considerations that affect health-care architecture, namely technology, insurance reimbursements — even the distances between nurse stations and patient rooms.
The medical-education building focuses on collaboration and problem solving that unites many disciplines from all four medical-education programs: physicians and surgeons; nursing; dental medicine; and public health.
Teams are the future of both medical research and patient care, according to Roy Vagelos. A medical doctor and former chairman and chief executive officer of Merck, he and his wife, Diana, put $50 million into the 100,000-square-foot building’s fundraising campaign in 2010.
“An older person may come in with a condition that affects the heart and kidneys. Maybe there’s arthritis or an immune problem,” Vagelos said. “That patient should not be referred to one doctor after another. Early evaluation and a plan developed with all the relevant specialists is much more efficient. It also avoids treatments that interfere with each other.”
The building’s heart is floors five through eight, which are devoted to developing clinical skills through simulations and anatomy.
While carving up cadavers has long helped students learn their way around the human body, simulations using actors and robotic dummies are growing in importance. In these labs, teachers can observe how groups of students figure out a response to the symptoms presented.
Teaching doctors can instruct an actor to create an emergency. That avoids learning on the job.
The Study Cascade extends this collaborative, problem- solving approach to classrooms and larger meeting and teaching spaces. At the 10th floor, for example, tiny lounges in bumper- car-style balconies hang above an airy student commons in the sky.
The dynamic series of spaces, framing city and river views in ever-changing ways, will foster exploration. People from different disciplines may find themselves chatting with newly met colleagues over a cup of coffee.
The Study Cascade explodes out of the building at street level. Next to the glass-wrapped lobby, a small public lawn will replace an ugly concrete driveway. Behind the lobby, a windswept, cracked-slate courtyard between two 30-story residential towers will become a lushly planted garden opening to a spectacular view of the Hudson River and the George Washington Bridge.
The garden is the only gap in the view-snuffing wall of buildings Columbia built along a cliff above the river, and Diller’s team makes the most of it.
If appealing collaborative spaces work for medical education, think what they could do for patient care.