[KAART] creating symbiotic spaces
2
[CONTENTS] Introduction A Kentucky in Need Our Mission What is KAART? Hazard, Kentucky Demographics The Center for Excellence in Rural Health Workshop Outcomes Next Steps Site Analysis Article Summaries Precedent Studies Creating Symbiotic Relationships Core Values Form, Materials, and Sketches Matrices and Square Footage Table Bubble Diagrams Floor Plan Prototypes
4 6 8 10 12 14 16 18 20 22 24 26 34 36 38 40 42 44 46 48
[INTRODUCTION] R U R A L H E A LT H C A R E S T U D I O The Rural Healthcare Studio collected research and created programming that identified specific design issues and client goals for a complex healthcare interior design project. This project employed a human-centered design methodology that engaged members of the Hazard, Kentucky community in a p a r t i c i p a t o r y d e s i g n p r o c e s s f o r t h e f u t u r e h o m e o f K A A RT. W H O I S I N V O LV E D ? U N I V E R S I T Y O F K E N T U C K Y C O L L E G E O F H E A LT H S C I E N C E S The mission of the University of Kentucky College of Health Sciences is to help the people of the Commonwealth of Kentucky and beyond to attain the highest quality of health possible. The College of Health Sciences fulfills their mission through creative leadership and productivity in education, research, and service. UNIVERSITY OF KENTUCKY COLLEGE OF DESIGN A 16-student fourth-year studio comprised of four-person g r o u p s f r o m w i t h i n t h e S c h o o l o f I n t e r i o r s : P l a n n i n g , S t a t e g y, and Design worked in the rural healthcare studio in partnership with The Center for Excellence in Rural Health. 4
[A KENTUCKY IN NEED] The needs that drive the shared passion to create a center are reflected in the data from the state of Kentucky.
6 year post-treatment fatigue Kentucky has the higest cancer incidence rate in the nation. Cancer related fatigue up to 6 years post treatment is associated with high levels of disability.
30,000 Kentuckians survive a traumatic brain injury.
24,000 Kentuckians will suffer from a stroke and more than 200 will survive a spinal cord injury. 6
29.2 % 1.28 million residents of
Kentucky suffer from a disability
[OUR MISSION] Students designed a center that contains a reception area, rehabilitation gym, flexible multipurpose educational space, treatment rooms, administrative office spaces, researcher and therapist workspaces, and an assistive technology makerspace based on a humancentered design methodology. The overall proposed project focused on three of the power priorities: workforce development, economic growth, and fostering of entrepreneurial activities.
8
The proposed design outcome will bring new, innovative, and upgraded services to the Hazard community, setting new standards for medical care and educational opportunities. The overall proposed project focuses on three power priorities: workforce development, economic growth, and fostering of entrepreneurial activities. To achieve this, a facility was designed that ďŹ ts the Appalachian region and culture. The design incorporates a branded experience to enliven the building and to help communicate the priorities and mission of the KAART Center through both low-tech and high-tech solutions.
[ W H AT I S K A A R T ? ] The Kentucky Appalachian Assistive and Rehabilitation Technology Center will be a cohesive and integrated workforce development, assistive technology development/adaptation, service delivery, education, and research center focused on ensuring the highest quality of specialized support that can be delivered to citizens of rural Appalachian Kentucky. It will serve those with disabilities, in order to maximize function and physical activity needed to improve workforce readiness, longterm health and quality of life.
10
Physical Therapy students from the University of Kentucky College of Health Sciences and local community colleges will be able to continue their education in the lab, pursuing research and degrees. KAART will also support workforce training to mitigate the loss of coal industry jobs in the region. Trainees will learn how to repair and refurbish assistive technologies such as wheelchairs. Physical Therapy students from the University of Kentucky College of Health Sciences and local community colleges will be able to continue their education in the lab, pursuing research and degrees.
12
[HAZARD, KENTUCKY] NEEDS In 2013, coal production fell 19% nationally while coal-related employment for the region fell 62%. Out of the 11,223 Kentucky jobs lost from 2009 to 2017, eastern Kentucky lost 10,056. This translates to a 71% decrease in total employment of the region from 2009 to 2017. The supply of primary care physicians is 26% lower regionally than the national average. C O M PA R E D T O N AT I O N A L AV E R A G E S
Physically health is -47% Mental unwellness is +25% Diabetes diagnoses is +3.5% Obesity is +25.4% D e p re s s i o n i s + 3 % Physical inactivity is +9.7%
[DEMOGRAPHICS] The city of Hazard, Kentucky is located in
P e r r y C o u n t y. It was estimated by the U.S. Census that in 2010 there were
5,300 people living in Hazard. In 2010, the median income for a household in the city was $20,690, and the median income for a family was $27,226. Median household income is:
40% less than the national median.
26.7% The national average is 1 5 . 6 % The household poverty rate is
regionally
A l t h o u g h t h e r e h a s b e e n a s t e a d y d e c l i n e i n H a z a r d ’s population since the 1950s, there have been numerous c o m m e r c i a l a n d r e s i d e n t i a l d e v e l o p m e n t s w i t h i n t h e c i t y. T h e city is also actively working on a downtown renaissance plan to rejuvenate its business district. 14
40%
27%
90%
Median household income is 40% less than the national median
26.7% of the population falls below the poverty line
90.26% of the population white
[ C E N T E R F O R E X C E L L E N C E I N R U R A L H E A LT Situated in Hazard, Kentucky, The University of Kentucky Center of Excellence in Rural Health was established in 1990 in order to mediate a chronic shortage of health professionals in rural Kentucky which regionally struggles with poor health status. Their mission is to improve the health and wellbeing of rural Kentuckians while envisioning a healthier Kentucky. The Center provides health professional education, health policy research, healthcare services, and engages the community, while serving as the federally designated Kentucky OfďŹ ce of Rural Health, which links small, rural communities with local, state, and federal resources while striving to implement long-term solutions to rural health issues.
16
TH]
[WORKSHOP] S TA K E H O L D E R S The Rural Healthcare Studio visited the Center for Excellence for Rural Health and met with a group of stakeholders in order to hold a series of focus groups to b e t t e r u n d e r s t a n d h o w t o d e s i g n t h e K A A RT C e n t e r.
OUR GOALS UNIVERSITY OF KENTUCKY COLLEGE OF DESIGN Our particular studio group wanted to focus on the spatial needs and wants of the future users of the K A A RT C e n t e r. W e d e v i s e d a w o r k s h e e t f o r t h e participants of a focus group to identify themselves as a type of stakeholder (patient/future patient, physical therapist, occupational therapist, administration, c a r e g i v e r / f a m i l y, f a c u l t y, s t u d e n t , o r o t h e r ) a n d t o record a written response to four questions. We then held a discussion over the four questions in order to really understand where the participants were coming from. During the discussion portion of the focus group, we wrote down the needs, concerns, and desires of the participants on posters in the front of the room so that t h e p a r t i c i p a n t s c o u l d g u i d e u s a c c o r d i n g l y. 18
20
[OUTCOMES] I D E N T I F I E D WA N T S A N D N E E D S
Makerspace · internet access · clean Rehabilitation Gym · clean · handicap-accessible doors · door activation buttons · changing rooms · balance of social and private · easy access · ramps · child-friendly · locomat · high-low tables · vector-track system · high-traction floors · rubber mats · mirrors · exercise areas · locker/coat storage · aroma therapy · music therapy
Clinical Areas · privacy · clean · cognitive training · counciling · gaming/bits systems · massage therapy · water and snacks · comfortable · tables · storage space · mirrors Educational Space · light · clean · internet access · ramps · accessible and friendly to all ability levels · tables and desks · locker/coat storage
[NEXT STEPS] F U T U R E D E S I G N C O N S I D E R AT I O N S HUMAN CENTERED DESIGN After visiting The Center for Excellence in Rural Health in Hazard, Kentucky and meeting with the focus group, our studio group better understood how important it is to see the problems firsthand. It is necessary to experience the challenges with the stakeholders to have a more personal understanding. By also having an in-person conversation with our focus group we were able to better empathize with the users which will allow for us to design better s o l u t i o n s i n t h e K A A RT C e n t e r. By beginning our design with the concerns, needs, wants and hopes of the users, we are able to create a human-centered design that will best s e r v e t h e u s e r s o f t h e K A A RT C e n t e r.
22
The site will be situated in the Hazard Village Shopping Center in Hazard, K e n t u c k y. T h e p r o p o s e d K A A RT C e n t e r will be in the vacant 9,000 sqft space immediately adjacent to the United Grocery Outlet. The main entrance will be located in the front of the building and front façade fenestrations are to be specified. The space includes no existing windows, and four non-movable round steel columns situated approximately 30-feet apart line the center of the s p a c e a n d r e a c h t o e x p o s e d H VA C and structural ceiling. The mechanical room is situated in the rear of the space and is to remain as is. T h e K A A RT C e n t e r w i l l b e d e s i g n e d t o contain a reception area, rehabilitation gym, flexible multipurpose educational space, treatment rooms, administrative office spaces, researcher and therapist workspaces, and an assistive technology makerspace.
Center for Exce
Site Location
24
[SITE ANALYSIS]
ellence
Proposed Storefront
[Designing for the Patient Experience in Community Clinics] Roxanne Squires, Nancy Doyle Healthcare Construction and Operations spoke with Nancy Doyle, director of programming and medical planning at HGA, to find out more about designing community clinics. Q: What are the specific patient-centric design elements and strategies used in community clinics? How do they help improve the patient experience? Doyle: Generally clinics are a symbol of well-being and a highly-visible part of a community. It’s important to make intentional gestures such as posting signage in multiple languages to improve patient experiences. Q: How does designing for patient experience in community clinics differ from larger hospitals? Doyle: It is important to understand the need your facility serves. We participated in a community engagement night where we let the public leave post-it notes on mock-up rooms in a clinic and used their input to address community concerns. 26
Q: What are the challenges in designing for the patient experience in community clinics? Doyle: It can be a challenge to balance budget and patient experiences for smaller clinics. It’s important to develop a right-sized program at the beginning of a project so that any resources saved go towards patient needs. We collect data on waiting rooms by the hour and we shadow clinicians to understand how they collaborate and move so that we can increase utilization and decrease building area. It can also be challenging to ensure privacy when, in small clinics, people know each other. This can be helped by having smaller groupings of chairs and giving people the option of where to sit in waiting areas. Giving people the ability to make choices such as watching tv or working on their laptop makes a difference. Q: What technological or electronic systems are integrated into community clinics and how are they geared toward the patient experience?
Key Points • Pay attention to who your clients are going to be and how you can intentionally be welcoming and accommodating Doyle: Technology can help maintain privacy and move patients through the system quickly, such as checking in on a kiosk which allows less information to be shared at the desk, or RFID badges that can help assistants find patients easily in a waiting room without announcing their name to the entire room.
• Ensure privacy as much as possible • Give clients the option to choose • Be flexible
Self-rooming is a concept that should be designed to be incorporated in the future. Q: What sustainable strategies are implemented when designing for community clinics and how are they beneficial? Smaller clinics can be more vulnerable to patient volume fluctuations and provider changes which means that clinic environments need to be flexible and adaptable to remain viable. This may mean shared workspaces and clinic modules that are flexible.
“Giving people the ability to make choices such as watching tv or working on their laptop makes a difference.”
[ T h e H o m e S t re t c h : D e s i g n i n g Rehab Centers] Sharon Schnall Today’s rehabilitation spaces are designed to contribute to and promote accomplishment and inspiration. The outcome is facilities that are therapeutic and achieve results, while working towards a goal. Everything is about preparing to leave and go home and have enhanced opportunities there. There is a trend in directing outpatient care to off-site centers which are highly visible. These “transactional” experiences are more akin to retail where patients buy a service. The designs of these spaces, considerations for the functional goals of the building and fulfilling the emotional needs of the patient and family while operating efficiently, have topped of the list of concerns. There are all kinds of checklists regarding therapy spaces and care, and the care comes first, but in the last decade we have seem more of a preference in patients and their families for a calming place to recover as opposed to a machine to deliver care. It’s important that 28
people see patients engaged in therapy. The clinic can become a metaphor for hope and strength. Patient preferences for extended stay rehabilitation are often directed towards environments designed to promote community while allowing privacy, ample therapeutic space, and multiple common spaces. Design must create an environment that makes patients and families feel good about that rehab choice. There will never be a one-size-fits-all facility. A facility needs a variety of waiting, respite, and clinical areas that will provide for each patient’s disability and preferences. Similarly, staff also wish for respite areas and spaces that overlook therapy areas for observation and provide for collaborative care that might integrate as many as eight professionals. To best support care, environments must prevent
Key Points isolation of patients. By deliberately designing without formal definition allows for patients to interpret how common spaces are meant to be used. To meet patient needs, flexibility and patient control of the environment are key. This also means that open gym areas must also provide, preferably, three-sided curtained areas for one-on-one therapy and private conversations regarding progress and next steps. In an increasingly technological world, rehabilitation gyms needs to leave high ceilings and plenum spaces clear to provide for metal supports for new equipment like zero-gravity machines. Simulation areas and interactive systems that charts patient’s progress in real-time are being integrated and help provide variety in therapy. Facilities are also installing moveable cabinetry to adjust to wheelchair heights so that therapists can work with patients at the appropriate therapeutic height. It’s important that rehabilitation environments be like a home away from home and convey less of an institutional atmosphere. The spaces need to be comfortable to the patient, especially in live-in facilities where patient spaces need to feel more residential.
• Focus on fulfilling emotional needs of patients and family • Design for comfort and a “home away from home” feeling • Promote community while providing privacy • Create variety and give choices • Prepare for further technological additions
“It’s important that rehabilitation environments be like a home away from home and convey less of an institutional atmosphere.”
[The New Exam Room Experience] Steelcase
Exam rooms must be designed by considering doctor-patient interactions and allow for clinicians to partner with patients and families and for families and patients to be active participants.
participation. Doctors want to partner with their patients by activating a patient-centered approach so that they can feel more involved and hands-on. This is an indicator of high-quality care.
Exam rooms have hardly changed since the 1950s, save for the addition of computers and digitized records. More and more, patients meet with clinicians to discuss lifestyle and behavior changes to prevent chronic conditions. These conversations require empathy which isn’t facilitated by today’s exam rooms. The raised exam table makes eye-to-eye conversation difficult, physicians have a hard time sharing information with patients, and family members in the chair in the corner of the room often feel left out.
In some spaces, physicians still need to maintain control over the patient in interactions such as delivering medications, positioning a patient for a scan, or administering chemotherapy. However, in other spaces and interactions patients are seen as people with whom agency is shared and where the doctor helps the patient help themselves. The patient-centered care movement has put an emphasis on addressing the healthcare needs, preferences, and values of patients in order to effectively deliver care.
Physicians are faced with pressure to deliver efficient care while satisfying patients and be in and out quickly. They often experience burnout because of this and feel as if they are on auto-pilot.
Steelcase Health researchers define mutual participation in three dimensions: interpersonal sensitivity, egalitarian presence, and shared decision-making. Each of these principles is essential for transforming the exam room into a space that fosters patient-centered care.
Today’s exam room are not built for mutual 30
Interpersonal sensitivity addresses the doctor’s approach towards patient holistically. And it works both ways—the patient needs to recognize that doctors are people too and that both parties bring their values and experiences to the interaction. While interpersonal sensitivity positions doctors and patients as multifaceted individuals, egalitarian presence addresses the dynamic between them. There is a growing trend of patients wanting to share in decision-making with doctors. Doctors, patients and their families need to be able to engage in shared decision-making to the extent they desire and are able. Regardless of their preferences, the design of the exam room should not be a barrier to this interaction. To support interpersonal sensitivity, egalitarian presence and shared decision-making the exam room must contribute new ways to share information, examine patients and interact with both family members and technology. The Diamond design paradigm supports the key behaviors of mutual participation because the orientation of the participants allows eye-to-eye contact and shoulder-to-shoulder interaction, and includes the presence of information in the dynamic. In some exam rooms, the traditional exam table can easily be replaced with a lower exam chair, so patient, physician and family members are all at the same level. Instead of being intrusive, technology is sensitively integrated into the experience to support conversation by displaying information for shared decision making.
Key Points • Exam rooms must encourage interactions and equally include all parties while focusing on interpersonal sensitivity • Incorporating The Diamond into space planning aids empathy and clinical efficiency, and allows for shared decision making
“The patient-centered care movement has put an emphasis on addressing the healthcare needs, preferences, and values of patients in order to effectively deliver care.”
[ B e t t e r Wa i t i n g R o o m s S i m p l y C a n ’t Wa i t ] Steelcase
Waiting rooms tend to be the same around the country, with rows of chairs making it hard for conversation and eye contact. Patients are often left without privacy, information, storage space, or technology. Steelcase Health has found that positive waiting experiences are linked with positive perception of care which is key. They can decrease stress and promote active engagement. Supportive transition spaces provide spatial separation and information for patients and their families. By creating spaces that accommodate a range of activity preferences, integrate technology and information sharing, and create a supportive environment, designers can transform waiting spaces into productive time and make experiences more positive. As designers rethink transition spaces, they should consider balancing sightlines, rethinking density, and creating areas of separation and togetherness. While natural light and views are important, Steelcase 32
Health observed people orienting themselves towards information sources. Seating needs to be arranged with sightlines to clinicians and monitors, but also with natural views in mind. Seating density also calls for small group seating with storage instead of rows of chairs because there is a need for fewer chairs when they are arranged more preferentially. Giving patients and families more physical space also gives them more emotional space. It is important that different groupings of individual or groups of seating also accommodate for auditory and visual privacy as medical issues can be very personal. Interpersonal sensitivity addresses the doctor’s approach towards patient holistically. And it works both ways—the patient needs to recognize that doctors are people too and that both parties bring their values and experiences to the interaction. While interpersonal sensitivity positions doctors and patients as multifaceted individuals, egalitarian presence addresses the dynamic between them.
Key Points • Create waiting room spaces that accommodate a range of preferences There is a growing trend of patients wanting to share in decision-making with doctors. Doctors, patients and their families need to be able to engage in shared decision-making to the extent they desire and are able. Regardless of their preferences, the design of the exam room should not be a barrier to this interaction. To support interpersonal sensitivity, egalitarian presence and shared decision-making the exam room must contribute new ways to share information, examine patients and interact with both family members and technology. The Diamond design paradigm supports the key behaviors of mutual participation because the orientation of the participants allows eye-to-eye contact and shoulder-to-shoulder interaction, and includes the presence of information in the dynamic. In some exam rooms, the traditional exam table can easily be replaced with a lower exam chair, so patient, physician and family members are all at the same level. Instead of being intrusive, technology is sensitively integrated into the experience to support conversation by displaying information for shared decision making.
• Design for privacy (auditory and visual), information, storage, and technology • Consider sightlines to both outdoors and information (monitor or clinician) • Consider seating densities
“Steelcase Health has found that positive waiting experiences are linked with positive perception of care.”
[PRECEDENT STUDIES]
The Clinic - Hannah Churchill, China, 2015 The ďŹ rst of its kind in Shanghai, The Clinic is a wellness and rehabilitation center focused on users’ individual needs. The design aims to create an aesthetically pleasing interior that comforts the users. Raw materials such as concrete, rustic wood, textured glass, and industrial lighting have been used to create an intimate boutique style in the common spaces and treatment rooms.
MFitness - Smertnik Kraut, Austria, 2015 With a space concept that includes areas for communication, wellness, seating, and terraces, the gym offers its users spaces for both interaction and privacy. On the side of the training hall there are rooms set for special training, like spinning, gymnastic rooms, a side room, and a power plate room.
- St. Smertnik Johns Kraut, RehabAustria, - Canada, 20152011 This project illustrates the potential for hospitals to be more than just clinical settings. St. John’s sets an example for a more holistic idea about health: one that includes comfort, well being and inspiration, one that is closely affiliated with the ravine system which provides such a precious natural ecosystem for the healthy city.
PUMP Gyms - NOZ Arquitectura, Portugal, 2013 The PUMP Gyms’ identity is strengthened by the intuitive, functional and simple way of organizing the space layout. The element of connection–the stairs–becomes the main actor of this space, revealing the young and daring identity and the dynamics of the activity of a gym.
[ C R E AT I N G S Y M B I O T I C S PA C E S ] Symbiotic relationships are a unique, and often times beneficial, interaction among species. The conceptual foundation for the future Kentucky Appalachian Assistive and Rehabilitation Technology (KAART) Center implemented a design focused on symbiotic spaces and the relationships they can nurture. Inspired by the way that trees are capable of communicating via root systems and responding to the needs of others through the transfer of nutrients, a design was proposed that paid particular attention to the relationships among the users of the Center, the people of Hazard, and the surrounding communities. Research indicates that through community support, individuals report higher levels of well-being.1 Thus, this design proposal aims to create spaces that foster supportive communities. Specifically, integrated telepractice technology can be used to foster interconnected systems of communication, which are necessary to build new foundations and sustain growth from a variety of geographical locations. This inspires the question: How many people in the surrounding communities can the users of the KAART Center then impact through their own growth and enrichment? This idea is further explored within the interior environment through the inclusion of flexible spaces and equipment, thus allowing the KAART Center to be host to many different activities and group sizes. In order to foster strong foundations for personal growth, community growth, and workforce growth, it is necessary to connect users of the KAART Center to one another so that there is ample support available for all users. This is achieved through the creation of open, transparent interior environments that allow for easy and intuitive interaction among the occupants. By interconnecting users in various relationships within the Center, the fabric of the community is reinforced. The KAART Center will serve those with disabilities, in order to maximize function and physical activity needed to improve workforce readiness, long-term health, and quality of life. It is important that every user have the opportunity to achieve unique personal goals and objectives in a manner that best suits their ability level and personal needs. Equipment can be modified to best meet users at their physical ability level within the gym or treatment rooms, while the makerspace is capable of customizing and refurbishing assistive technologies to the users’ needs. ‘The goal of the KAART Center is to help every patient achieve lasting growth in ability levels, whether it be communication, mobility, or independence, an increase in wellness, and a higher percentage of workforce readiness. Through growth built on a strong foundation and supported by strong community relationships, users are able to lead more enriched lives.
[ C O R E VA L U E S ] FLEXIBILITY It is necessary for the KAART Center to be adaptable to each individual’s unique needs and ability levels in order to fully meet every need. By having flexible spaces and equipment, the KAART Center will be able to host many different activities and group sizes. It is important that every user have the opportunity to do tasks in whatever way best suits their ability level and personal needs. GROWTH The purpose of the KAART Center is to help every patient achieve lasting growth in ability levels, whether it be communication, mobility, or independence, an increase in wellness, and a higher percentage of workforce readiness. INTERCONNECTION To begin building strong foundations for personal growth, community growth, and workforce growth, it is necessary to connect users of the KAART Center so that there is ample support available for all users. By interconnecting users in various relationships, the fabric of the community is reinforced. ENRICHMENT Through engagement, the KAART Center will be able to enrich the lives of its users by improving quality of life in facets such as physical ability levels and community involvement.
FLEXIBILITY
GROWTH
ENRICHMENT
INTERCONNECTION
[ F O R M , M AT E R I A L , S K E T C H E S ]
40
[ M AT R I C E S A N D S Q U A R E F O O TA G E TA B L E ]
Reception Rehabilitation Gym Assistive Technology Maker Space Administrative Offices Multipurpose Educational Space Treatment Rooms Public Restroom Employee Restroom Storage Researcher and Therapist Workspaces Wellness Center Locker Room MAIN CIRCULATION Mechanical Room Exit Corridor TOTAL SQUARE FOOTAGE
S Q U A R E F O O TA G E TA B L E 42
Net Square Footage 628 SF 1,853 SF 585 SF 202 SF 1,093 SF 213 SF 125 SF 90 SF 126 SF 653 SF 776 SF 166 SF
Quantity 1 1 1 2 1 2 1 1 2 1 1 1
Gross Square Footage 628 SF 1,853 SF 585 SF 404 SF 1,093 SF 426 SF 125 SF 90 SF 252 SF 653 SF 776 SF 166 SF
1,325 SF
1
1,325 SF
--SF --SF
1 1
--SF --SF 8,376 SF
wellness center
researcher and therapist workspace
storage
bathrooms
treatment rooms
multipurpose educational space
administrative offices
assistive technology makerspace
rehabilitation gym
main circulation
reception reception main circulation rehabilitation gym assistive technology makerspace administrative offices
Immediately Adjacent
multipurpose educational space
Near Adjacent
treatment rooms
Non Adjacent
bathrooms storage
A D J A C E N C Y M AT R I X
researcher and therapist workspace
culture
privacy
community
versatility
education
storage
technology
collaboration
natural light
acoustics
growth
flexibility
enrichment
inter-connection
wellness center
reception main circulation rehabilitation gym assistive technology makerspace administrative offices multipurpose educational space treatment rooms bathrooms storage researcher and therapist workspace wellness center
High Priority Mid Priority Low Adjacent
C R I T E R I A M AT R I X
[BUBBLE DIAGRAMS] Administration OfďŹ ces
Public Restroom
Employee Restroom
Rehabilitation Gym
Reception
Wellness Center
Makerspace
Treatment Rooms
Patient Spaces
Researcher and Therapist Workspaces
Administration Spaces Education Spaces Makerspace
Directly Adjacent 44
Near Adjacent
Storage
Educational Space
engagement activated
Wellness Center
Education Researcher workspace
multi-purpose supportive
Gym
self-sustaining accessible
Makerspace
collaborative
Reception
Na
tu
ig lL ra
ht
[FLOOR PLAN]
Blocking Diagram 1
125
46
5 + 90 sqft
Restrooms
794 sqft
Reception
585 sqft
Makerspace
1,853 sqft 126 + 126 sqft 1,093 sqft
Rehabilitation Gym Storage Education
[ R E S E A R C H W O R K S PA C E ]
48
[RECEPTION]
[ T R E AT M E N T R O O M ]
50
[[ G ME] P T I O N ] R EYC
[CITATIONS] 1. Carolyn E Schwartz, Rabbi Meir Sendor, Helping others helps oneself: response shift effects in peer support, Social Science & Medicine, Volume 48, Issue 11, 1999, Pages 1563-1575, ISSN 0277-9536, https://doi.org/10.1016/S0277-9536(99)00049-0.
52