Designed and created to be a healing oasis for children and their families, Children’s Hospital of Richmond VCU expanded the healthcare facility and intrinsically ties back to the community.

Bright colors and imagery taken from local natural features, biophilia and native animals, as well as local landmarks are used throughout the facility to aid with wayfinding and create an environment that is calming and engaging. The design by architect HKS draws inspiration from the James River and other natural elements unique to the city. Sky, water and forest themes bring nature to the heart of the urban campus, and with its emphasis on connections to nature, the design reduces anxiety and promotes healing.

The Children’s Tower is a 23-story, 600,000-sq.-ft. acute care children’s hospital. The recent expansion includes a 15-story steel structure over eight stories of existing concrete, which includes 72 patient beds with shell space to expand an additional 120 beds. The facility also includes an emergency department, surgery, laboratory, pharmacy, Ronald McDonald House, kitchen/café and helipad.

All of this was achieved while navigating an incredibly tight footprint. The downtown site provided limited space for trades to work, even less for materials and equipment storage. To limit the amount of set-up and laydown space, DPR prefabricated the exterior skin and concrete panels off-site with DPR’s strategic partner Digital Building Components. Doing so not only limited workforce on-site, allowing other trades to work more efficiently, but also enhanced quality and delivery of materials created in a controlled environment.

The Digital Building panels required a ½-in. tolerance on the edge where it met the concrete—necessitating precision in execution. If the concrete were outside of that tolerance, it would cause structural issues with the installation of the exterior panels. Due to this low margin for error, the project team leveraged DPR’s field technology experts to scan and document the slab edge formwork before the concrete was placed to determine if it was within the tight tolerance. After setting 500 control points, the MEP trades were able to accurately set up the site for concrete deck pours. These same control points were used to scan the slab edge formwork, showing the edges that were outside of the 1/2-in. tolerance, and allowing for correction prior to placement, saving what could be extremely costly re-work. After the team determined that the scan was right and the slab edge needed some adjustments, the subcontractor performed the work without any delay to the slab pour. The total process from scan to results was only 24 hours.

With more than 72 identical patient rooms, the team prefabricated head walls off-site with framing, med-gas, electrical and wood blocking in a panelized wall system. The on-site self-perform work (SPW) crews then installed the head walls and connected the overhead piping to the in-wall piping. With rooms back-to-back, one prefabricated wall accommodated two patient rooms.

In tandem with the prefabrication, DPR’s SPW teams utilized the MEP coordination effort to spool sheet metal stud framing drawings to assist with layout, verification, and quality control of openings for all parts. They also worked with the door and hardware supplier to pre-install all hardware on the doors prior to delivery.

Quality was also enhanced by engaging trade partners and SPW teams early in the planning and virtual design and construction (VDC) coordination process. Work was coordinated months in advance, so when it came time to build, they could focus completely on the quality and craftsmanship. This also streamlined the schedule, allowing teams to advance the project without having to wait for another trade to finish because they had to wait for decisions, questions to be answered, or gaps in scope to be corrected.

SPW teams completed the demolition, concrete, drywall, waterproofing, floor finishing and polishing, door frames and hardware, specialties installation, seismic retrofit of the outpatient facility, infection control program, and general requirements.

“The kids love seeing all the construction, the equipment and the workers, so there were a lot of smiles woven into the active construction site,” said Elias Neujahr, president of Children's Hospital of Richmond.

The project team also worked closely, and early on, with the customer, healthcare workers on-site, and even got input from children to determine the best building and design elements that help facilitate healing and health for front-line workers and patients.

“One of the most critical elements of this project has been the intentional inclusion of our families in the planning and design process—this hospital is built by and for them,” said Neujahr.

This also included having designated nursing staff present to advise on what is and is not needed for staff and patients.

“We had to get the clinicians involved because they are the ones that have been living this. They are the ones that know what this treatment takes and what is going to work from a clinical perspective,” said DPR’s Jason Maxwell. “Everybody is engaged. Not everyone is involved in every detail, but they are at the right level of communication and decision making with the right people in the room.”

“Having everybody in the Big Room, everybody together, hearing and seeing, and sometimes feeling what’s going on is very important,” added Shirley Gibson, associate vice president of real estate at VCU Health System, and a registered nurse.

Due to the tight downtown location, DPR and Children's Hospital of Richmond had to work very closely on logistics, especially with road closures on the busy Richmond campus.

“We have a lot of patients coming from outside of our region, so to come downtown is already difficult enough, but to come downtown and not know where to go means we had to have good signage, we had to communicate, to work with our staff that made appointments so they could send notices out to patients, we updated the website, we met weekly to talk about the impacts that would happen in the next week. I cannot say enough about how much we had to communicate and coordinate,” said Gibson.

The new pedestrian bridge, which spanned diagonally over a busy intersection, required coordination on road shutdowns because that road was also an access point to the hospital emergency room. On top of that, two tower cranes were erected on top of the existing building because there was nowhere else a crane could be placed. This involved an incredible amount of planning with the structural engineer and sorting through any liabilities that could be present due to interference with the buildings surrounding it, the adjacent Interstate 95, not to mention the hospital helipad, which required coordination with the FAA.

DPR is an expert in the construction of healthcare facilities, but building a children’s hospital struck a chord with the team. The project team launched the "Greater Purpose" campaign to emphasize how the construction work would impact the lives of the children being cared for at the hospital and their families.

“Asking why is so important, and being able to explain what a certain room is and how it will function in the care of these patients brings you down to a different level. It helps you connect what you are building, and see the bigger picture,” said DPR’s Eric Rasmussen.

The leadership team maintained regular communication with the safety managers, which proved beneficial in improving the safety culture on the project. The team conducted more than 60 safety inspections a week. As a result, the project witnessed a 500% decrease in the incident rate from 2021 to the project's completion in 2023. An overall culture was cultivated where individuals prioritized their own safety and that of their colleagues, driven by the realization of the impact their work would have on the region's future.

In addition to the technical expertise displayed on planning, designing, and constructing the Children’s Tower, the hospital has become an integral part of the community, and was built with the care and consideration that should be present for a children’s hospital. Due to this, among other efforts, the Children’s Tower received Engineering News-Record’s Mid-Atlantic project of the year.

“This new Children’s Tower is a dream come true for our kids, families, team members and community. We’ve completed an entire city block—nearly 1 million square feet—dedicated to caring for kids and their families,” said Neujahr.