How Seattle Children’s Hospital Took the Lead on Healthy Transportation

Seattle Children's Hospital demonstrating how healthcare providers can be leaders in healthy transportation. Image: Seattle Children's Hospital
Seattle Children’s Hospital’s sustainable transportation goals for 2028. Image: Seattle Children’s Hospital [PDF]
It’s more than a little ironic that in many places, hospitals are some of the worst offenders when it comes to perpetrating unhealthy transportation patterns. Often surrounded by enormous parking decks, hospitals have earned a reputation as isolated institutions hermetically sealed off from surrounding neighborhoods.

But that’s beginning to change. Healthcare providers are undergoing a fundamental shift from focusing on contagious diseases to treating chronic conditions that are often related to unhealthy lifestyles, like diabetes and heart disease. Industry leaders like Kaiser Permanente are pushing reforms not only in healthcare policies and procedures, but in the physical form of hospitals and the role they plan in their communities, write Robin Guenther and Gail Vittori in their book, Sustainable Healthcare Architecture

I asked Guenther which hospitals are leading the shift to healthier transportation practices, and she singled out Seattle Children’s Hospital as the best model by a wide margin. It is indeed impressive.

In 2008, under pressure from the city of Seattle, the hospital mapped out a comprehensive transportation plan [PDF] calling for major reductions in solo car commuting. Even before that, the hospital had demonstrated leadership. Beginning in 2004, it used a combination of strategies to reduce the share of daytime commuters who drive alone to work from 50 percent to 38.5 percent.

The 2008 plan laid out a new target: to reduce the share of commuters who arrive alone by private car to 30 percent by 2028. As part of an agreement with Seattle City Hall, the hospital’s permitting to build new clinical space is tied to reductions in solo car commuting.

Parking lots make up an impressive small portion of Seattle Children's footprint. Photo: Seattle Childrens
Compared to other hospitals, parking lots make up a small share of Seattle Children’s Hospital’s footprint. Photo: Seattle Children’s Hospital

“The reduction of [single occupancy vehicle commuting] in our case is tightly tied to our ability to grow our business,” said Jamie Cheney, the hospital’s manager of transportation systems. “We have commitment at the highest level of Children’s.”

So the hospital has rolled out a multi-faceted strategy to cut down on driving, running more than a dozen programs to reach its goal.

“One way we think about reducing [single occupancy vehicle] commuting at Seattle Children’s is to think about tipping the scales,” said Cheney. “We make it more attractive to take alternatives and less attractive to drive.”

For starters, the hospital offers free transit passes to all employees. In addition, employees who pledge to bike to work two or more days a week are given free bikes. Those who don’t drive also get a bonus in their paychecks: $4 a day.

Parking policy also plays a huge role in the hospital’s efforts to reduce driving.

“Whether you’re a physician or an administrator or clinician, everybody pays to park,” says Cheney.

The rates are variable, depending on when workers arrive and how long they stay, ranging from $2.25 to $10 a day. Charges are highest for employees who arrive during prime commuting hours.

Another key aspect is the way parking payments are structured, says Cheney. The hospital charges drivers daily, rather than by week or month, to apply the strongest possible incentive.

“There are no monthly parking passes,” she said. “You pay by the day. That monthly pass is really a 30-day investment. It sends a signal to somebody to optimize that investment by getting as much parking as possible by driving.”

The hospital also requires some employees to park in an off-site lot and take a shuttle to the hospital.

Seattle Children’s Hosptial also offers one of the largest vanpool programs in the Seattle region. The program is administered by King County Metro, but the hospital provides discounted rates to its employees. Vanpool vehicles also receive free parking at the hospital. About 35 vans serve the hospital, and about 19 percent of the hospital’s 6,000 employees rely on a vanpool or carpool to get to work, said Cheney.

The hospital sweetens the deal by providing people who opt for a shared vehicle a “free ride home” from a taxi service in the event that an emergency with one driver leaves the other one stranded.

That’s crucial, because Seattle Children’s Hospital is located in a residential neighborhood that isn’t well-served by buses or trains, said Cheney. Even so, about 19 percent of employees opt for transit. One way the hospital assists is by shuttling commuters from nearby transit hubs to the hospital.

To make the campus itself more walkable, the hospital made a a special effort to attract useful business and services for employees, like restaurants and daycare centers, to the neighborhood.

Image: Seattle Children's
Image: Seattle Children’s

In part because of the hospital’s limited transit access, biking is a big part of its strategy. About 25 percent of employees live within three miles of the hospital, making for an ideal bike commute. In addition to the free bike program for bike commuters, the hospital recently opened its own, on-site bike shop, offering employees free maintenance and discounts on bike gear.

Among hospital employees, about 9 percent now bike to work, nearly double the citywide average, says Cheney. Lisa Brandenburg, the hospital’s president, is a bike commuter herself. The hospital hopes to increase its bike commute mode-share to 10 percent.

If the hospital reaches its ultimate goal of a 30 percent car commuting rate by 2028, it will avoid constructing 500 parking spaces. That will save 225,000 square feet, enough to support 56 patient beds. At a construction cost of $40,000 per structured parking space, it will save the hospital an estimated $20 million.

While the hospital’s driving reduction programs do cost money to administer, much of that is offset by revenues from parking fees, said Cheney. And the programs are viewed as perks that help retain and attract employees, she said.

Settle Children's shuttles transport employees from transit hubs to the hospital. Photo: Seattle Children's Hospital
The hospital shuttles employees from transit hubs to its campus. Photo: Seattle Children’s Hospital

“Our employees really appreciate that we subsidize transit and bicycling and walking and carpooling,” she said. “It’s essentially seen as a benefit. It’s helpful in our attraction.”

While Seattle Children’s Hospital is already more than halfway to its goal of getting from 50 percent car commuting to 30 percent, Cheney says the hardest part is yet to come.

“The low-hanging fruit is kind of gone,” she said. “It was fairly easy to move certain people out of their vehicles.”

Cheney says one of the biggest obstacles that remains to reducing driving is where people live. Seattle is an expensive city, and increasingly, she said, employees choose to live in far away areas with limited or no transit access. The next phase of the hospital’s transportation demand management planning might involve trying to steer employees toward living nearby, or at least in areas well-served by transit.

“We’re looking at how we can influence where people live,” Cheney said. “We attract people from all over the world to come work at Children’s. We’re interested in developing some resources and strategies about how to help them decide where to live.”

16 thoughts on How Seattle Children’s Hospital Took the Lead on Healthy Transportation

  1. How St Paul does it: this stretch has 5 parking garages (red) & at least 4 surface lots (blue), one of which is an entire block.

  2. Hospitals are full of paradoxes. Not only do they encourage driving, but emergency responders (including ambulance services) fight traffic calming, vending machines in hospitals tend to be full of junk, food served to patients of questionable nutrition value, patients lined up outside doors in wheelchairs smoking, essentially forcing mind-numbing television on invalid patents (billed), giving air-borne contagious diseases a free reign. Hospitals need to rethink their position with regard to promoting health on a broader level than simply cutting holes in people and sewing them shut again while bankrupting the economy (a separate matter, perhaps). Encouraging sustainable transportation is just one critical piece of this. Until then, they’re really barbaric, best avoided at all cost.

  3. Not mentioned in the article, but just as important for getting people biking (and walking!) to the hospital: their liveable streets initiative includes construction of public facilities.

    This has included a greenway that feeds into a nearby highly-utilized bike trail, a two-way protected bike lane, a direct connection between the aforementioned bike trail and the hospital, and numerous intersection improvements. As someone who used to live in the area, I can’t stress enough how fantastic it was to have these improvements made on the hospital’s dime. It would’ve taken decades for the city to find the funds to make similar improvements.

  4. Walter Reed National Naval Medical Center in Bethesda MD also achieved great results in reducing single occupancy vehicle mode share for the 2011 BRAC move of patients and workers from DC

  5. I’d love to hear more about their efforts to incentivize carpooling. Do they offer priority parking for carpoolers? …downloading the PDF now.

  6. those parking practices sound pretty good for incentivizing carpooling – everyone pays, up to $10/day for parking.

  7. Great article!

    “That will save 225,000 square feet, enough to support 56 patient beds.”

    Is that a typo – 4,000 sq ft per patient bed? I understand this may include other facilities rolled in, but that still sounds like a crazy high sq footage.

  8. Gotta be a mistake. That would be 450 square feet per parking spot. Cars have gotten bigger, but… Now if it’s 22.5k square feet, that’s 45 square feet per car, and 400 square feet per hospital bed.

  9. Nice job clipping the stadium out of this picture. For those not familiar with St Paul, the hockey stadium where the MN Wild play is directly across the red pavement intersection at the NE corner of the picture. There is a convention center attached as well. This whole area sucks with too much parking, etc, but it’s disingenuous to blame it on the hospitals.

  10. I focused on the structures used for the hospitals. The stadium, while it does use some of this parking, doesn’t have daily events. I also didn’t highlight the large parking lot in the upper left hand corner as it sits empty nearly every day (even half empty on game days).

  11. In estimating the square footage of a parking lot or garage, I typically use 300 square feet per parking space and that includes the area for getting in, out, turning around, etc.

  12. Lindsey,

    300 is a low number for a extremely efficent surface parking lot. note that many times one ends up with 400 or even 500 per space especially once one goes underground. A better number to use is 375 per space

  13. I spent the first few years of my career pigeoned holed as the go-to kid in the office who could layout difficult parking garages in LA. LMK boss would go to the big cheese ” Alex just squeezed out 4 more spaces on the fourth ( underground ) deck ! ”

    Word of advice – never be really good at a task you and everyone else dislikes. 🙂

  14. UCLA Medical Center in Santa Monica CA is recipient of a 2016 sustainability award (, but this hospital has pretty much excluded transportation from its its sustainability efforts. The Affordable Care Act will lead to lots of consolidation in the future: hospitals, but also regional practice groups etc: Interesting challenge to get these health care corporations to acknowledge the traffic they produce, and to get them to make the connection between active transportation and health, wellbeing and the diabetes epidemic, bicycles and health.

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