Palo Alto Medical Foundation San Carlos Center

A glass-walled corridor with a perforated aluminum canopy, cleft-cut sandstone walls that extend from indoors out, and end-grain wood flooring connects the main lobby with a waiting area for individual clinics. Photography by Bruce Damonte

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“Bringing the outside in” is not typically a concept associated with healthcare design. That may change with the arrival of more medical facilities such as the Sutter Health/Palo Alto Medical Foundation (PAMF) clinic in the San Francisco Bay Area. Designed by global firm NBBJ, the 198,000-square-foot San Carlos Center emphasizes the beauty of the natural world, providing a sense of well-being right from the entrance. It’s likely the only medical center in the world to have a 45-foot-long, live-edge bench—a single continuous slice from the trunk of a native Claro walnut tree.

“We were trying to create an environment that exudes healing for people,” says Josie Briggs, a senior associate at NBBJ. “The design celebrates natural light and honest materials.”

PAMF needed a new facility to serve a rapidly growing population along the San Francisco Peninsula, and it commissioned NBBJ to design a medical complex that would accommodate 100 physicians. The facility occupies a prominent 18-acre property that separates downtown San Carlos from the area’s main freeway. PAMF asked the designers to find an architectural style for the four-level clinic that would speak to the local community. The result is contemporary yet warm and non-institutional, thanks to influences that include California Mission style, evident in the center’s tan Santa Barbara stucco finish, and mountain lodges, recalled by the redwood-lined overhangs and cleft-cut sandstone walls.

“First and foremost, we wanted to give patients the feeling that they’d come to the right place. We wanted to make it comfortable and not threatening,” says David Jury, PAMF’s vice president of support services and facilities development.



Transparency and natural touches

The building emphasizes transparency throughout, with significant natural light that also aids in wayfinding. The parking garage has a lofty, glassed-in staircase that encourages patients to use the stairs and allows them to easily determine where they need to go. The expansive 3,570-square-foot reception area and adjoining 1,130-car garage were designed to also serve a hospital building, postponed to a later phase of construction. The lobby’s back wall is covered in massive, end-block reclaimed Douglas fir, allowing the space to feel more like a hospitality interior. Around the corner, the wood paneling changes to the timbers’ long sides, creating the illusion of a giant stack of lumber. Here, as well as in the waiting areas for each clinic, cozy Martin Brattrud Reveal banquettes—customized with a slightly higher seat and back to make it easier to get in and out of them—provide a comforting sense of privacy for patients.

To get to the individual clinics, which range from allergy to urology, patients pass through a glass-walled corridor with gardens on either side. This showpiece architectural element creates the illusion of being outdoors. An aluminum canopy, CNC-turret-punched with an abstract pattern of leaves, filters dappled light into the space. Briggs points out that implementing Integrated Project Delivery (IDP), which brings all the subcontractors together at the start, allowed these details to be designed collaboratively. The live-edge bench, a custom piece designed in-house, runs along one side of the corridor.

The clinic waiting areas, plentiful with natural light, are far cries from the fluorescent-lit rooms of yesteryear. On the interior walls, photography of the nearby rolling hills and oak woodlands, printed on plywood panels, runs along a horizontal niche. “We really wanted to avoid having art that had nothing to do with anything around it,” Jury says. Translucent dividers, printed with botanical illustrations of the native plants in the gardens outside, serve as gentle markers for different waiting areas.

It’s not just the patients that are enjoying a new environment. Unusual for healthcare, the physicians and medical assistants have transitioned to an open-plan office. Pods of four people facilitate the workflow of team-based care, a collaborative approach designed to improve patient outcomes while reducing healthcare costs.

“We get compliments from patients daily about our new facility and how pleasant it is to get medical care here,” says Dr. Alireza Shafaie, who practices internal medicine at the center and was the project’s medical sponsor. “Physicians and staff have also responded very positively to the new design and have found that it works well in improving communication among the teams.”



Palo Alto Medical Foundation San Carlos Center

Architect: NBBJ

Client: Sutter Health & Palo Alto Medical Foundation

Where: San Carlos, California

What: 192,000 total square feet on four floors

Cost/sf: Withheld at client’s request