Flex Plan

Facing an influx of new residents and an aging population in Charleston, the Medical University of South Carolina (MUSC), one of the country’s oldest academic medical centers, decided to rebuild and renew its medical campus.

After completing a 20-year strategic master plan, NBBJ was selected for the first phase of development, the Ashley River Tower. This facility consists of a procedural building and a bed tower, linked by an indoor atrium and conservatory garden, and establishes centers of excellence for the heart and digestive disease programs.

With rapid advances in healthcare quickly making existing methods and equipment obsolete, the tower was designed for maximum flexibility. Features include a universal patient room module, standardized operating rooms, bundled vertical conduits, separation between the procedural building and bed tower, and removable exterior panels that allow corridors to expand into future adjacent buildings.

Furthermore, as patients’ comfort with their surroundings can directly affect stress levels, recovery rates and length of stays, the building interiors borrow concepts from the hospitality industry, providing spaces for wellness and relaxation.

Within a year of opening, the Ashley River Tower scored in the 88th percentile of Press Ganey’s patient satisfaction survey — a 14% increase from MUSC’s previous scores — and the average length of patient stays dropped from 5.32 to 5.16 days.

Strategic Master Plan
Strategic Master Plan
Strategic Master Plan
Strategic Master Plan

Designed for Disaster

As a coastal city located on an active fault, Charleston faces threats from hurricanes, flooding and earthquakes. Because of this, the Ashley River Tower was designed to remain operational during a variety of natural disasters.

As the first healthcare facility to meet the 2000 International Building Code’s enhanced seismic requirements for Charleston (now on par with California’s standards), the building includes expansion joints that allow it to sway up to 16 inches during an earthquake without comprising structural integrity. Specially designed coiled wires and pipes at these joints prevent the loss of critical air and energy supplies.

At lower levels, the unitized curtain wall is designed to withstand the impacts of large projectiles that may become airborne during a hurricane; above 30 feet, the glass can withstand the force of smaller debris. A 20’ x 15’ mock-up of this curtain wall was tested with 130-mph winds to guarantee the glass would remain in place during a storm.

Furthermore, to ensure that critical services are not disrupted by flooding, the first floor and all safety equipment is elevated at least 10 feet above ground level, and elevator lobbies and storage rooms are protected by special flood gates and doors. A 90,000-gallon water tank in the basement can supply the fire protection system if city water service is temporarily interrupted.

Awards and Publications


AIA South Carolina, Honor Award


Healthcare Design, “Designing for Multiple Disasters,” June 1, 2008
Medical Construction & Design, “‘Defend in place’: Key strategies to prepare hospitals to withstand emergencies,” January/Feburary 2013