Texas Children's Hospital, Lester and Sue Smith Legacy Tower

Bringing pediatric care to new heights

Texas Children's Legacy Tower

Texas Children's Hospital
Houston, Texas, United States
640,000 square feet

Children and families going to Texas Children's Hospital are seeking the best possible care and are in some cases up against immeasurable odds. The building is home to the hospital’s critical care, surgery and heart units, serving some of the most critically ill pediatric patients. Yet the space is warm and inviting—it uses bright colors, inventive wayfinding and comforting artwork to make this clinical space welcoming for its young patients and their families.

Our work on the tower began more than a decade ago when we designed the initial six-story podium building. Shortly after, we partnered with the hospital to design a 19-story vertical expansion to go atop the podium—making the 25-story tower the tallest children’s hospital in the world.

Texas Children's Legacy Tower
Texas Children's Legacy Tower

All in the family

Recognizing the critical role parents and family play in pediatric healthcare, we engaged a Family Advisory Group at the earliest stages of design. In-room storage wardrobes and sleeping accommodations, laundry facilities on each floor, magnetic marker boards in each room for notes to care staff, and lounges to help families rest and recharge during their child’s treatment were important and successful outcomes from their feedback.

While family members spend an extensive amount of time in the patient rooms and within the hospital itself, they also felt it was important for the staff to be taken care of. Family Advisory Group members were interested in better understanding what staff needed in order to provide the best care for their children as part of the design process, asking what the nurses needed to best care for their children.

Texas Children's Legacy Tower
Texas Children's Legacy Tower

The collaborative design process continued with staff. In addition to creating physical mockups of spaces, we ran simulated scenarios focusing on the ideal state of operations compared to the current state to account for rapidly changing technology and equipment. Post-simulation surveys showed an eight-point increase in provider confidence to respond to pediatric emergencies in the new unit, and a 10-point increase in provider confidence of minimized patient safety risks.

Top of U.S. News & World Report


children's hospital in the country


in cardiology, heart surgery and pulmonology


in neonatology


in neurology and neurosurgery

Texas Children's Legacy Tower

Legacy Tower is the home of the top-ranked Texas Children’s Heart Center, with expanded inpatient and outpatient capabilities to serve more children with critical congenital heart conditions. Atop the tower, a helistop—specially designed to screen the view of the pad—allows the most critically ill children to receive care rapidly.

This cloud-grazing expansion fulfills a crucial step in Texas Children’s Hospital’s strategic plan to bolster critical care services at its Texas Medical Center campus. Specifically, it houses five types of ICU units across seven floors, a high-acuity surgical center in addition to the Texas Children’s Heart Center.

Staying close to the heart

Texas Children's Legacy Tower
Within Legacy Tower is a one-of-its-kind Adult Congenital Heart Program. Designed to address a growing need for adult treatment spaces within pediatric hospitals as more patients with chronic health issues survive into adulthood, this new, contemporary unit provides comprehensive medical care with 16-bed acuity-adaptable inpatient beds, an outpatient clinic, a cardiac rehab gym, procedure space and more.
Texas Children's Legacy Tower
The Adult Congenital Heart Program has been a part of Texas Children’s since 2004, and this dedicated unit helps with continuity of care so patients can see the same doctors who are familiar with their disease.

Texas Children's team of expert clinicians care for the most critically-ill children with complex medical needs—children who simply would not have survived just a few years ago. This tower allows Texas Children's to continue to deliver world-class care to even more children, in an environment that can adapt to the rapidly changing pace of pediatric care.

Texas Children's Legacy Tower
Texas Children's Legacy Tower