Clare Herrera - Senior Thesis Book - Volume 1

YX U M E U A E C T I M R S E V

The focus of this thesis is to study how a well-design rehabilitation center that prioritizes accessibility to nature and various mediums of art therapy can help spinal cord injury patients heal and prepare them for life after their injury.

The city of New York is an urban jungle filled with glass skyscrapers and concrete sidewalks, however, woven into the city grid are beautiful pockets of nature and parks that were designed to escape the city. A city like New York can often feel similar to a healthcare facility, cold and rigid. The goal of my rehabilitation center is to take inspiration from the parks and nature that surround my site and introduce them to the healthcare environment. Through finishes, lighting, and layout, a healthcare environment can transform into a more hospitality-based environment.

Along with access to nature, which in turn promotes quicker healing, the overall goal of the center is to teach its patients how to live with their injuries and show them that they are still able to experience the beautiful things in life before their injury.

INTRODUCTION

PROJECT OVERVIEW

Problem Statement

The spinal rehabilitation hospital is an eight-story, 60,000-square-foot building located in Brooklyn, New York. Brooklyn is one of the five boroughs of New York City. New York City is the United State’s most populous city with a current population estimated at over 8.8 million people. Brooklyn in particular is the most populous borough of New York and occupies 81 square miles. The developer has placed this rehabilitation center in the heart of Sunset Park, which over 200,000 New Yorkers call home. The appeal of Sunset Park is the accessibility to entertainment, parks, shopping, healthcare, hotels, and dining. The proposed clientele for this rehabilitation center is 14+ year-old patients with a variety of medical conditions, primarily, spinal cord injuries, brain injuries, stroke survivors, amputees, etc. The rehabilitation center will focus on physical and cognitive rehabilitation services in collaboration with a series of amenity spaces to create an environment that promotes healing and improves the overall quality of life when learning to overcome a disability.

Thesis Statement

The mission of this Spinal Rehabilitation center is to improve the overall quality of life and healing of the patients by introducing amenity spaces with access to nature, not commonly found in healthcare to improve overall healing whilst simultaneously offering physical and cognitive rehabilitation services.

The Clients

The Staff

The Patient’s Family

The Patient

GOAL: Create hospitality inspired private patient rooms

OBJECTIVE: Use various FF+E finishes to create warmth in the space not commonly found in health care spaces

GOAL: Design state-of-the-art therapy gyms

OBJECTIVE: Use the newest technology available to populate the designated therapy gym spaces

GOAL: Design training spaces that promotes the development of real-world skills

OBJECTIVE: Use specific non-ADA areas to teach patients how to maneuver in the real world

GOAL: Create amenity based therapy spaces

OBJECTIVE: Provide a variety of different therapy spaces such as music, art and gardening

GOAL: Access to nature for healing benefits

OBJECTIVE: Place patient rooms and amenity spaces next to outdoor access zones or windows

GOALS + OBJECTIVES

NEW YORK CITY

SOCIOECONOMIC + CULTURAL RESEARCH

SITE: New York City, New York

New York City is the largest and most influential metropolis in America. The city is located at the mouth of the Hudson River in the southeastern area of New York state. New York City is made up of a collection of five boroughs, Manhattan, Brooklyn, the Bronx, Queens, and Staten Island. Each borough has a unique style that differentiates it from the other four. New York is the most ethnically diverse, religiously varied, commercially driven, famously congested, and, in the eyes of many, the most attractive urban center in the country. More than half of the people and goods that enter the United States come through the ports of New York.

The Landscape of New York

New York City’s topography, like most of North America, was shaped by the last Ice Age over 2.6 million years ago. During this time, a sheet of ice formed on top of the North American continent that kept expanding and thickening over millions of years. At its maximum depth, the sheet of ice reached a depth of roughly two miles. Roughly, 18,000 years ago our planet began to warm and the sheet of ice covering North America began to melt and recess. The weight of the ice depressed the underlying bedrock of modern-day New York. Boulders became embedded in the land and were scattered across the city. Many can still be seen in the famous Central Park. The glacial recession also created terminal moraine, mounds of rubble left behind, around the 5 boroughs such as Brooklyn, Queen, and Staten Island. These mounds of rubble formed these hilly ridges of high ground that surrounded New York City. The early developers of New York ignored the areas with glacial ridges as they were inaccessible and too difficult for construction. The neglected areas of the glacial ridges in turn became a string of parks, cemeteries, golf courses, etc, that are now landmarks to some of New York’s most attractive neighborhoods. Prospect Park in Brooklyn is one of the several parks that are a part of the ridge-line.

JERSEY

BRONX MANHATTAN NEW

STATENISLAND

The Boroughs of New York

QUEENS

In the 19th century, a pattern of urban imperialism was sweeping the United States. A part of this referendum allowed for the expansion of modern-day New York City by absorbing the independent city of Brooklyn, a portion of Westchester county called the Bronx, Staten Island, and large areas of Queens county. In the early years of the 20th century, the population of New York had more than doubled. This caused concern for city administrators who noticed a major lack of communication and transportation systems to promote coherence in the metropolis. The first segment of the subway system opened in 1904, and soon all the boroughs were linked except Staten Island. In the 1930s and ’40s, the system often handled more than two billion passengers per year; the world’s most extensive subway system soon became the best way to move about the metropolis.

BROOKLYN

Brooklyn Manhattan Queens Staten Island Bronx

Brooklyn, New York

Brooklyn is the most populous borough of New York. To the east of Manhattan, Brooklyn occupies 81 square miles. Early in the 19th century, Brooklyn became the world’s first modern commuter suburb because of its adjacency to Manhattan. Brooklyn became an independent city in 1834 and adopted the grid system of its sister city across the East River. Brooklyn’s independence was largely dependent on its ability to create attractions unique to its landscape. Prospect Park was constructed in the 18070s, by Olmsted, the same landscape architect who designed Central Park. Prospect Park is considered an urban green space that represented a more mature version of Olmsted’s vision across the river. Brooklyn was even ranked among the largest cities in the country for the last four decades of the 19th century. The independence of Brooklyn was quickly doomed with the construction of the Brooklyn Bridge. John and Washington Roebling found a way to connect the two metropolises. Soon after, Brooklyn was voted into the Greater New York footprint in 1898.

NEW

YORK CITY POPULATION DEMOGRAPHICS

New York City is the United States’ most populated city and also New York State’s most populous city with an estimated population of over 8.8 million people and counting.

Population: 8.865 million as of July 1st, 2022

Population Density: 28,210 people per square kilometer

LANGUAGE

14.44% Spanish 2.61% Chinese 1.2% Russian 1.18% Italian 0.79% French Creole

Sunset Park

A prime real estate that serves as an attractive offering in the heart of Sunset Park, Brooklyn, one of the largest urban communities in New York City.

Highly sought-after location thanks to its rapid residential and population growth, multi-billion-dollar redevelopment, and insatiable market appetite for commercial real estate.

7th Floor

8th Floor

Est. NET 3,546.8 sqft Est. NET 3,214 sqft

Mission Statement

The mission of Magee Rehabilitation is to improve the quality of life of persons with disabilities by providing high quality physical and cognitive rehabilitation services.

About Them

Magee Rehabilitation Hospital offers inpatient and outpatient services. They are structured to provide lifetime rehabilitation and wellness programs for people with spinal cord injury, brain injury, stroke, amputation, orthopedic injury, joint replacement, arthritis, pulmonary disorders, multiple sclerosis, Parkinson’s disease, cancer, geriatric rehabilitation needs, neurological disorders, pain syndromes, work-related injury, and cardiac disease. Values

Care Team

The care team includes clinical and non-clinical staff who all work together the make the patients experience exceptional over the course of their stay at Magee Rehabilitation.

Studio + Patient Art Galleries

Art Therapy is part of their Clinical Outreach Program, and part of the healing process for patients. Individual patients, assisted by an art therapist, use all forms of art and the creative process of making art to improve and enhance their physical, mental and emotional well-being.

Segal Street

One of the most active places on the 6th floor rooftop is Segal Street, named after Magee’s longtime benefactor and former patient, Jerry Segal. Jerry helped create a city street scape on the roof so patients could experience real-life examples of what life after discharge would be like.

Healing Gardens + Greenhouse

In total, Magee has five different healing gardens, all growing beautiful plants and flowers, with fun water features, changing the entire look of the outdoor space on the roof. In addition to the gardens, there are multiple raised, accessible planter beds tended to by Magee Horticulture Therapist.

STEPHEN WHALEY INTERVIEW

What type of lighting is essential for a healthcare environment?

The lighting in all of the hallways on each floor is cove lighting that lines each side. Unlike most hospitals that use fluorescent panels, we wanted to soften up the space and give it a hospitality-type feeling while also being sustainable and switching to LEDs. As for the specific lighting that was used, they are circadian lighting systems. A circadian lighting system is, essentially, a system that takes its cues from natural daylight. Circadian lighting systems are set to adjust based on the time of day and what lighting we would observe at that given time of the day.

What kind of equipment do I need to consider for a patient room?

Every room is equipped with an Amazon Alexa, to help the patients turn on lights, open the blinds, ask the time of day, etc. This allows for more freedom for the patients as they are not reliant on the nursing staff to do these things for them. Every room also has its on computer, whiteboard, TV, and overhead ceiling lift. Additional equipment that may be needed is instead place in the hallway in designated equipment alcoves with charging stations to help declutter the hallways and patient rooms. The overhead lift is the most important thing in health care to help getting patients in and out of bed.

What is you reasoning for the color you used in the hallways?

To help with way finding and visual cues in the space, we designed all the exterior walls of the hallway to be a different color, in this case a shade of blue. The core was then painted a different, more contrasting, color to highlight the difference from the perimeter patients rooms to the core nurses station and support rooms. We also added a pop of color on the ends of hallway runs to give another visual cue as well as an extra pop of color.

Stephen Whaley Shareholder at Charles Matsinger Associates Background: Interior Design Alma Mater: Drexel University

What trends

healthcare design today?

The trend seen in health care today is a more hospitality based approached. More visually elevated finishes and private patients rooms are very appealing to people searching for a facility to stay at. Especially for a facility such as a rehabilitation center where most patients stay for around 3 months, people want to make sure they are comfortable and can feel at home in a healthcare building like this. It is very popular now that many patients and their families “shop” for rehabilitation centers and hospitals. That was one of the reasons for Magee’s most recent renovation was creating all single private rooms to appeal to the masses and updating the shared amenity spaces.

In every patient room there is a special couch by Wieland. This couch can transform in a twin sleeping bed or larger depending on what size you use. It can also become two upholstered chairs with a table in the middle for patients to eat or work at because it is equipped with electrical outlets. This piece of furniture is great because it is simple and streamlined but also allows for a family member of the patient to sleep over, if necessary.

How do you accommodate for the family of the patient?

are you seeing in

SPINAL CORD INJURIES

What is a Spinal Cord Injury?

Damage to any part of the spinal cord or nerves at the end of the spinal canal (cauda equina) — often causes permanent changes in strength, sensation and other body functions below the site of the injury.

What are the severities of a Spinal Cord Injury?

Your ability to control your limbs after a spinal cord injury depends on two factors: where the injury occurred on your spinal cord and the severity of injury. The lowest part of your spinal cord that remains undamaged after an injury is referred to as the neurological level of your injury.

The severity of the injury is often called “the completeness” and is classified as either of the following: Complete or Incomplete

What are some of the causes of a Spinal Cord Injury?

Spinal cord injuries can result from damage to the vertebrae, ligaments or disks of the spinal column or to the spinal cord itself.

Traumatic vs Non-Traumatic Spinal Cord Injuries

A traumatic spinal cord injury can stem from a sudden, traumatic blow to your spine that fractures, dislocates, crushes or compresses one or more of your vertebrae.

What does the Spinal Cord do for the body?

The central nervous system comprises the brain and spinal cord. The spinal cord is made of soft tissue and surrounded by bones (vertebrae). It extends down from the base of your brain and contains nerve cells and groups of nerves called tracts, which go to different parts of your body. Tracts in your spinal cord carry messages between your brain and the rest of your body.

What damage does a SCI do to the body?

Whether the cause is traumatic or non-traumatic, the damage affects the nerve fibers passing through the injured area and can impair part of or all the muscles and nerves below the injury site.

What is the treatment for a SCI?

Unfortunately, there’s no way to reverse damage to the spinal cord. Spinal cord injury treatment focuses on preventing further injury and empowering people with a spinal cord injury to return to an active and productive life.

What happens are the initial SCI?

After the initial injury or condition stabilizes, doctors turn their attention to preventing secondary problems that may arise, such as deconditioning, muscle contractions, pressure ulcers, bowel and bladder issues, respiratory infections, and blood clots.

The length of your hospital stay will depend on your condition and the medical issues you face. Once you’re well enough to participate in therapies and treatment, you might transfer to a rehabilitation facility.

Why is rehabilitation such an important part of SCI?

Physical Therapist

SPINAL CORD INJURIES CONT.

What

are the common causes of a Spinal Cord Injury?

Social worker Recreation Therapist CAUSES

Who is most likely to be affected by a Spinal Cord Injury? 29 - 42

Approximately 80% of new SCI cases are men

Since 1970, the average age of injury has increased from

SPINAL CORD INJURIES STATISTICS

How many people are affected by a Spinal Cord Injury?

In the United States the current Spinal Cord Injury prevalence (persons living with a SCI) is estimated to be between

and

Approximately per year are affected by a SCI in the According to the World Health Organization (WHO), there are between

Manhattan, New York Central Park

Designer: Frederick

and Calvert

Vaux

Law Olmsted

HEALING POWER OF NATURE

What are the physical benefits of time outdoors?

Research has shown that immersing oneself in nature influences the body. Nature is the purest pathway to inner peace, and it recharges one’s energy and renovates the personality. Even a small amount of time spent outdoors can physically, mentally, and spiritually impact health positively.

Lowers cortisol

Reduce heart rate if aiming to enjoy nature casually

Stimulate the immune system through being around trees which emit chemicals called phytocidescasually

Improves mood

Boost natural killer cells in the body that are important for fighting infection and cancer

What are the mental and healing advantages of nature?

If physical reasons are delaying your ability to get outside, just sitting by a window and looking out at any type of nature can make an impact. One study showed that patients who had a room looking out on nature got out of the hospital after surgery a full day earlier than those that looked at a brick wall.

What are the mental benefits of time outdoors?

Nature helps us deal with the over-activity of the mind and relaxes us by the creation of a soothing environment. We can release stress and inhale the breaths that calm down our chaotic thoughts. A research study showed that when participants were exposed to nature scenes, their brain parts linked with empathy and love lit up.

How does nature affect the body?

When you are exposed to nature, you heal emotionally and feel pleasant. Nature is a tonic for physical well-being. One study suggested that the nature view helps patients tolerate pain more, overcome adverse effects, and have less stay at the hospital

Magee Rehabilitation Center on November 22nd, 2022

GLOSSARY

Cauda Equina: the roots of the lumbar and sacral spinal nerves, which form a bundle within the lowest part of the spinal column.

Complete: If all feeling (sensory) and all ability to control movement (motor function) are lost below the spinal cord injury, your injury is called complete.

Incomplete: If you have some motor or sensory function below the affected area, your injury is called incomplete. There are varying degrees of incomplete injury.

Tetraplegia: Also known as quadriplegia, this means that your arms, hands, trunk, legs and pelvic organs are all affected by your spinal cord injury.

Paraplegia: This paralysis affects all or part of the trunk, legs and pelvic organs.

Physical Therapist: a person qualified to treat disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery

Occupational Therapist: a form of therapy for those recuperating from physical or mental illness that encourages rehabilitation through the performance of activities required in daily life.

Horticultural Therapist : a person who is specially educated and trained members of rehabilitation teams (with doctors, psychiatrists, psychologists, occupational therapists and others) who involve the client in all phases of gardening, from propagation to selling products, as a means of bringing about improvement in their life.

SOURCES

Broad, William J. “How the Ice Age Shaped New York.” The New York Times, The New York Times, 5 June 2018, https://www.nytimes.com/2018/06/05/science/how-the-ice-age-shaped-new-york.ht ml#:~:text=Staten%20Island%20and%20Brooklyn%20were%20once%20connected%20 by,tip%20of%20Staten%20Island%2C%20in%20Conference%20House%20Park.

“Brooklyn of New York City.” Encyclopædia Britannica, Encyclopædia Britannica, Inc., https://www.britannica.com/place/New-York-City/Brooklyn

Bureau, US Census. Census.gov, 2 Nov. 2022, https://www.census.gov/ “FAQs: Icahn School of Medicine.” Icahn School of Medicine at Mount Sinai, https://icahn.mssm.edu/research/spinal-cord-injury/resources/faqs

“Magee Rehabilitation Hospital.” Jefferson Health, https://www.jeffersonhealth.org/locations/magee-rehabilitation-hospital

“New York City Population 2022.” Population USA, https://www.usapopulation.org/new-york-city-population/

“Spinal Cord Injury.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 2 Oct. 2021, https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/ syc-20377890

Jonas, Wayne. “The Healing Power of Nature.” Psychology Today, Sussex Publishers, https://www.psychologytoday.com/us/blog/how-healing-works/202103/the-healing -power-nature.

Richard-Hamilton, Franchell. “The Healing Power of Nature.” Psychology Today, Sussex Publishers,https://www.psychologytoday.com/us/blog/the-roots-health/202111/the -healing-power-nature.

“Spinal Cord Injury Facts and Statistics.” SCI Progress, 18 Mar. 2019, https://sciprogress.com/spinal-cord-injury-statistics/.

“Spinal Cord Injury.” World Health Organization, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury.

H K T A N Y O ! U