You know you've hit the bull's-eye of healthcare design when hospital patients returning for a second stay phone ahead to request a specific room because of the view. That's exactly what's been happening at Intermountain Health Care's McKay-Dee Hospital Center in Ogden, UT, about one hour north of Salt Lake City. Operating from an outdated facility nearby, Intermountain chose a 60-acre horse farm at the base of the Wasatch Mountains for the site of its new hospital center. The five-story, 690,000-square-foot center is surrounded by natural beauty—the mountains, a valley, gardens and a lake—all of which strongly influenced the design choices of the team from HKS, Inc., Dallas, TX. Needless to say, however, patients return to a hospital for more than just the view. To this end, McKay-Dee has set a new benchmark for medical facilities.McKay-Dee Hospital center is essentially a building in three parts. First, a half-circle structure at the southeast corner of the building maximizes views of the mountains, valley and lake. Here, the cafeteria, dining room and Behavioral Health Patient Care Unit are all on the first floor, while in-patient rooms are grouped into clusters on floors two through five. The interior side of the half-circle features a saw tooth formation, thereby allowing the hospital to have more rooms facing the mountains—some 48 to 60 beds per floor. Each cluster of in-patient rooms has a family room that also offers a mountain view and plenty of daylight. Furthermore, according to the center's master plan, when the time comes for expansion, a mirror image of this half-circle structure can be built at the southwest corner of the complex. Beyond the half-circle is the main rectangular portion of the hospital center, which is divided lengthwise by a four-story, sky-lit atrium. Diagnostic and treatment areas run along the west side of the atrium, and physicians' offices are to the east. Bridges criss-cross the atrium connecting one side to the other. Here, too, there is room for expansion: to the north along the doctors' side of the atrium and to the north and west on the diagnostic and treatment side. According to Jeffrey Stouffer, AIA, senior vice president, HKS, McKay-Dee Hospital Center is organized by service lines. Thus, physicians' offices are integrated into the facility near their area of specialty within the hospital. For example, a cardiologist would have an office near the Heart Institute and Cardiac Rehabilitation Center; pediatricians as well as OB/GYNs have offices on the fourth floor of the center where women and children's health services are located. This "horizontal integration" of the hospital center improves wayfinding and provides greater efficiency for doctors and patients. In addition to the proximity between doctors' offices and their specialties, the fact that the facility is organized around an atrium creates a large, recognizable landmark for navigation. In fact, doctors' waiting rooms are open to the walkways that run alongside the atrium on each floor. Although each waiting area is distinct, the walkways provide additional seating space and the "positive distraction" of natural light. In preparation for its newest facility, Intermountain Health Care undertook a nine-month study that involved 13 different task forces. One was the healing environment task force. This committee came up with six guiding principles that not only set a course for McKay-Dee, but for the design team at HKS, too. In summary, the principles called for a comfortable and nurturing environment; a building sensitive to the spiritual and natural beauty of Utah; a facility that engages patients, families and staff in a participatory environment; and a hospital that supports patients' choice and control of their environment, including what television channels they watch, lighting in patient rooms and air conditioning controls. With these principles to guide them, HKS set about specifying the exterior and interior of the hospital center.The exterior of the building progresses from natural materials through to those that are machine made. The base is Utah red sandstone. A pre-cast concrete matched to the color of Utah sandstone covers the mid-portion of the hospital, and aluminum panels are located at the top."This facility is located in a seismic zone four, so the architectural requirements are stringent in order to ensure the building's ability to withstand a major earthquake," says Stouffer. "One of the requirements limits the weight of the building for its size. Therefore, we chose concrete and aluminum for the upper portions because both are lighter weight than sandstone." Circling around the building are walking paths that connect to an outdoor dining area, as well as to an exercise trail running along the perimeter of the campus. Outdoor dining overlooks the center's lake and gardens and is accessible through the cafeteria. The main entrance to the hospital is a voluminous space that soars four stories. A sweep of arched steel trusses frame the interior of the entry, which is entirely glass fronted. Walls of cherry, maple and granite accents complement the natural beauty and pattern of the terrazzo floor. The soothing sounds of piano music fill the lobby; the music is not only entertaining, but is yet another wayfinding technique—follow the music and find the lobby. From the front entrance, the hospital's main elevators are directly ahead. These elevators, as well as both of the other elevator banks, allow visitors to step off and look back from where they came."This was another important aspect of our wayfinding goal," says Stouffer. "When you can look back and see where you came from, finding the place where you need to go is easier."The ambiance of the main lobby extends down the terrazzo walkways of the atrium along the first floor. Carpet was used for flooring in the seating areas that make up the doctors' waiting rooms along these walkways. All of the fabrics and finishes specified throughout the hospital are a reflection of Utah's natural environment."In making our choices, we always kept in mind the terrain and colors of the outdoors," says Laurie Waggener, IIDA, vice president, HKS and a registered respiratory therapist (RRT). "The color scheme includes terra cotta, sage green and neutrals. Our choices were also a reflection of the interior and exterior architecture. So, for example, we used a sandstone color taken from the exterior around the fireplace in the cafeteria. We chose fabrics that may be somewhat abstract, but are mostly warm and contemporary."The fireplace in the cafeteria enhances the already warm atmosphere of what can be a sterile and noisy environment. Centrally located within the dining room, the fireplace is open to both sides. A light blue ceiling mimics the Utah sky, and wood veneer and natural cherry accents combine with the maple wood seating and tables for a space that is almost as natural indoors as the outdoor seating directly adjacent.This emphasis on nature is maintained on patient floors and in patient rooms. Every patient room has a view, and window treatments were chosen to keep that view visible even when the shades are drawn."We purposely chose a mesh shade that would block the sun's glare without covering up the view," says Waggener. "The public spaces, like family rooms that are at the end of each hallway, also have beautiful views and the same shades."In addition to minding cues from the natural environment, the designers carefully selected fabrics and finishes according to durability and maintenance. Waggener says hiding soil and stains is crucial in hospital design because housekeeping simply cannot be everywhere all the time. "Chairs, carpet, all those kinds of things need to look good until housekeeping gets there," she says. "For example, the carpet has white flecks in the weave to help hide white dirt, or lint, until it is vacuumed."