Approximately 80 people receive organ transplants each day in addition to the more than 1 million tissue transplants performed annually. These life-saving procedures are a result of a complex network of physicians, donors, and patients that connects recipients to vital organs and tissue from across the country. Highly time-sensitive, tissue and organ retrieval and transplants must happen quickly, within strict time frames, and often do not have the scheduling benefits of other medical procedures. Rather, donated organs may become available at any hour, with a recipient on the other coast and with only a small window of time for a viable transplant. Part of a carefully choreographed process between several parties, standalone transplant/recovery facilities are available to receive these patients, preserve and move vital and sensitive organs and tissue, and manage the administrative process, all while providing a setting that honors the gift of life and the important work a center’s staff delivers.
These standalone facilities offer several benefits, including improved efficiency and seamlessness for a national network of agencies that are responsible for the retrieval and allocation of organs and tissue, but are not without their unique challenges. From considerations of building access, security, and workflow processing, the design and operations require discretion that balances technical agility and management with sensitivity and respect for human life. Honoring the respective emotional, mental, and physical needs of the staff mix and donor families is also important.
Care and compassion
Hospitals are typically facilities designated for sustaining human life. Transplant/recovery centers also save lives, but because of the nature of their work, they’re not recognized as a hospital; instead, these are facilities and organizations that focus on recovering, retrieving, or collecting organs from donors (because the patients have been pronounced dead, they’re referred to as “donors”). While the facilities are often categorized as commercial or office spaces, these centers are sometimes where families say their final goodbyes to loved ones, so it’s important to approach the building and design with the same sensitivity and respect afforded a traditional healthcare facility.
Southwest Transplant Alliance’s (STA) new three-story, 77,000-square-foot headquarters, designed by Corgan (Dallas), serves as a case study example. The center is a mixed-use facility that consolidates administrative business functions and clinical spaces to perform organ recoveries (STA does not handle tissue donations). Completed in 2020, the facility includes operating rooms, a donor care unit (which manages all elements from donor intake), waiting rooms, and associated processing, as well as administrative floors to support the organization’s various business functions from billing and human resources to records management and the C-suite. A memorial garden for commemorative events and recognizing donors and recipient families, ambulance garage, and multilevel parking structure complete the comprehensive campus.
While the actual transplant is completed at a designated hospital at the recipient’s location, STA’s facility provides a centralized hub for the removal team to act quickly to retrieve organs, such as a heart that has only four to six hours to be saved. The facility’s partial sub-grade level houses several operating rooms for organ retrievals, a CT, donor holding and preparation spaces, and equipment to help preserve organs for transport. To improve the staff experience, large windows and volumes are used to bring light into the below-grade areas and establish a connection to the outside.
Donors are pronounced dead off-site; however, some may be transported to the facility while still being supported by machines. As such, family members may choose to accompany their loved one until the very last minute. To accommodate these arrangements, each donor bed in the donor care unit, located on the garden level, is surrounded with a curtain for safety and privacy. To further support families, there’s a parking lot and motor court adjacent to the building to ease access into the building. Inside, a family room on the first floor offers a safe, intimate space to mourn, celebrate, and remember a loved one’s life. Additionally, the exterior windows are frosted to prevent views into the facility.
While supporting a culture of compassion and care, the STA is also a highly technical facility. As such, the building is organized with clear workflows and journeys for its distinct users, including staff and families, using dedicated entrances and separate circulation paths. For example, families are welcomed through a front, public-facing entrance, while deliveries, including supplies and materials, are brought in through back-of-house elevators. An enclosed ambulance garage is located directly adjacent to the medical floor for efficient and private arrival and departure of donors.
Additional technical considerations for the facility include processing and preparation areas for before and after the retrieval operation. These areas are equipped with storage and packing materials, temperature-controlled units, and sorting that allows for direct connection to local or air travel services.
The ORs are set up with equipment, lighting, and technologies common to traditional hospitals. While these types of facilities are not licensed as hospitals, they’re designed to mirror the same best practices and codes of a surgical suite, such as accommodating specialized equipment like freezers and right-sized on-site generators for the safe completion of in-progress procedures, as well as planned with additional storage and access for oxygen tanks.
STA’s headquarters combines medical operations with the business and administrative functions that make organ donation possible, in one place. While adding efficiencies between teams and creating a more seamless workflow, the mix of more than 150 staff members across a variety of teams, from accounting and call center staff to processing and C-suite leadership, presented the challenge of supporting several job functions and needs in a single space.
The solution was a variety of work settings, including dedicated desks; pop-up collaboration spaces; and more casual, comfortable seating options to support the mix of tasks and responsibilities of staff members throughout their day. With views to the outdoors and balconies and terraces that punctuate the space, occupants maintain a connection to nature, tapping into the potential of biophilic design to support demanding workplaces and promote overall wellness. Additional on-site amenities for staff include a work café and fitness room.
Additionally, respite spaces throughout the facility, on-call rooms on the garden level, break rooms with connection to the memorial garden, and sleeping rooms help provide comfort to staff members, many of whom work unconventional and long hours without the reliability of scheduling and planned procedures. With the expectation that staff be ready at all hours, additional security and ease of access are especially important. For the STA facility, a horizontal skybridge between the parking garage to the facility’s second floor provides arriving doctors and nurses a quick connection to the facility without disrupting the sensitivity of the public-facing ground floor.
Conference rooms and training spaces support ongoing professional and team development programs. As a connection point for team collaboration as well as interdepartmental learning, these spaces respond to modern work demands and are outfitted with technologies and audio-visual equipment for information sharing and presentations. The STA project team introduced furnishings and materials to create a calm, serene setting, including earth tone colors, natural wood details, and brightly colored fabrics and patterns to add visual interest.
Empathy in action
Complex and layered in their functions, these highly technical spaces combine efficient operations and dedicated workflows with spaces that uniquely support the needs of staff, medical professionals, donors, and their families.
As healthcare spaces challenge design and the built environment to create more human-centric spaces, STA is an example of a proactively empathetic space that not only honors the patient journey but also the fullness of human life. Balancing sensitivity and compassion with practical and intuitive interventions, the ultimate design is a powerful testament to healthcare design and the impact of the built environment on our lives and those who move through it.
Carole Blythe is a project manager and senior associate in the healthcare practice at Corgan (Dallas). She can be reached at firstname.lastname@example.org.