R.I.S.E. DEPARTMENT Resilient In Surge : Emergency Department

R.I.S.E. DEPARTMENT Resilient In Surge : Emergency Department

Danielle Wilder

Neha Rampuria

Joseph Ali

Uran Sokoli

daniellessmith@tamu.edu

neha_rampuria@tamu.edu

anjoe2@tamu.edu

uransokoli@tamu.edu

Emergency and Urgent Care

Flexibility

Adaptability R.I.S.E. The RISE Department responds to both normal circumstances that demand an efficient, patient-centered Emergency Department, as well as the ideal location for Surge capacity emergency services during viral outbreaks.

8,106

92,473

Total Tests

74

92,473

Deaths

Total Hospital Bed Occupancy

85.45

Total ICU Bed Occupancy (%)

Total Hospital Bed Occupancy (%)

90+

70-79 80-89

50-59

10-19

40-49

60-69

Proportion of all positive test results delivered out of all tests collected in the Bryan-College Station area. Tests (including students, faculty and staff) are processed by Texas A&M University Student Health Services.

30-39

BRAZOS VALLEY COVID CASES BY NUMBER

9 OR LESS

20-29

Total Cases

73.08

22.6

22.6

22.6

Male

Female

92k

85,000

7,235

22.6

54,111

56,671 20 - 25 Year

Male Students COLLEGE STATION DEMOGRAPHICS Average age of a College Station resident is 23 years old Over 7,000 residents are over the age of 60

Female Students

PROJECTED FACILITY

PROJECTED SERVICE

24/7

SITE PROJECTED USER

60k

SITE CONTEXT Connected to primary and secondary roads Very visible and accessible location Close proximity to residential areas and student dorms

1 2 3

Student & Resident

USER ACCESSIBILITY

Recreation & Sport WORKERS

Educational

SITE

SITE ACCESSIBILITY Pedestrian access from North dorms and South residential zone Ambulance access directly from George Bush Car access from Bizzell coming North from student dorms and South from George Bush Blvd TAMU Bus Stop proposal located near the site on Bizzell Street

TRAFFIC ACCESS

PROXIMITY Name Ambulance Distance Service Size Type

SIGNATURE CARE EC No 2.6 Miles Open 24 hours

STUDENT HEALTH SERVICES Yes 5.8 Miles Mon - Fri 8am - 6Pm

Emergency

Emergency & Urgent

SITE

SITE CONDITION Using large overhangs and tree canopies to help shade the south-facing glass helps prevent the building from overheating in the summer. Overhangs are sized to let light inside in the winter.

1 2 3

24 EUI - 2020 Goal

Daylight

Building Performance

SITE CONDITIONS Connected to primary and secondary roads Very visible and accessible location Close proximity to residential areas and student dorms

SITE PLAN

SITE ACCESSIBILITY Pedestrian access from North dorms and South residential zone Site circulation Ambulance access directly from George Bush Car access from Bizzell coming North from student dorms and South from George Bush Blvd TAMU Bus Stop proposal near the site onEXPANSION Bizzell Street SURGE ADDITION & located PROPOSED FUTURE

SITE PLAN PLANPLANPLAN Site circulation

SITE ACCESSIBILITY

This ED needed to rapidly transform to deal with the risk of COVID-19. Having limited floor space, a phased, dynamic response allowed the ED to adapt multiple times as the epidemiology of the pandemic evolved. Guiding ED operations with data, enhancing infection control practices, and being prepared to transform areas of the ED to care for different groups of patients are key points.

Main strategies that could be utilized to make safer healthcare strategies, parallel to CDC’s original recommendations

Distancing/Separation Patient, staff and supply flow Materials and surfaces Smart technology Surge Design

https://onlinelibrary.wiley.com/doi/epdf/10.1002/emp2.12 264

LITERATURE REVIEW

https://facilityexecutive.com/2020/06/healthcare-facilities-design-after-covid-19/

Staff Entrance Staff access to outdoors

Ambulance access

Exit

Exit

Exit

Exit

Patient Entrance

Simple Geometry CONCEPT DEVELOPMENT Carving out circulation spines in the structure and branching out corridors and spaces to enhance staff efficiency and patient’s satisfaction.

Separating ED patient types Patient’s arrival flow Capability to expand the facility

Separate Circulation (Normal Condition)

Separate Circulation (Surge Condition)

GAMING WITH TUCKER BELL RN - DIRECTOR OF COVID NAVAL MEDICAL CENTER, SAN DIEGO

SCALED LAYOUT

DEPARTMENTAL

NORMAL CONDITION FLOOR PLAN

SURGE CONDITION FLOOR PLAN

COLLEGE BOY BROKEN FOOT

MOTHER + CHILD COVID19

NURSE COVID PATIENTS

COLLEGE BOY BROKEN FOOT

MOTHER + CHILD COVID19

NURSE COVID PATIENTS

1. CIRCULATION/ WAYFINDING

4. CONNECTION

2. CUBISM

3. DIFFUSED DAYLIGHT/ SHADE

5. FUNCTION

6. VIEW

White Natural Thin Stone Veneer

Corrugated Metal sheet

Color Palette

Materials Zachry Engineering Building Texas Limestone Storefront/Curtain Wall Glass “Dark Grey Metal Cladding�

Neutral Color Palette

All Faiths Chapel Texas Limestone Roof: Dark Brown Corrugated Metal sheet Neutral Color Palette

Wood

ENHANCING PERSONAL EXPERIENCE A key goal of the RISE Department is rooted in patient and staff experience.

Bringing daylight into interior spaces where staff, patient and families are circulating has proven to increase overall satisfaction and improve physical, mental and emotional health for those within the space.

Additionally, windows facing exterior green spaces introduce pleasing views that may provide calm sensation no matter the interior chaos.

UPDATE NEW VIEW

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AERIAL VIEW

AXONOMETRIC VIEW

MAIN ENTRY

VIEW FROM GEORGE BUSH DRIVE

VIEW FROM NORTH-SIDE PARKING

VIEW FROM BIZZELL Street

STAFF LOUNGE VIEW / STAFF ACCESS

THANK YOU