1. EXPANSION & RENOVATION PROJECT IN COLORADO
2. IMPROVING WOMEN’S BIRTHING EXPERIENCE IN HOSPITAL THROUGH QUALITATIVE STUDY
3. PLANNING PROJECTS
4. HAVEN IN THE MEADOWS
5. SANFORD PEDIATRIC CLINIC
3. E- NTEGRAL : ECOLOGICAL.
ESPOUSAL.ECONOMICAL MIXED USED / INTERGENERATION
SENIOR LIVING COMMUNITY
“Design is nothing but a humble understanding of materials, a natural instinct for solutions and respect for nature.”
- B.V. Doshi, Pritzker Price Winner
1. Expansion & Renovation Project in CO
Professional Work Team Project
The main goal of this project the capacity for multiple services at the UCHealth Memorial North Hospital campus in order to serve the rapidly growing community in the adjacent neighborhoods to this campus. After the Covid Pandemic, the community already had a shortage of beds, ORs, primary care and specialty care to serve the community. With a rapidly growing community due to an influx of people moving to Colorado Springs, the shortage in healthcare services has only seen continued stress. This project will add a new 6-Story Patient bed tower with a total of 85 new inpatient beds in phase 1 and a future shelled capacity of 95 beds. The surgical department will grow by 4 ORs in phase 1, with a shelled capacity for a future 4 ORs. The Emergency department will grow by 14 bays and a shelled capacity for 10 CDU bays in the future. The imaging department, supporting departments, parking and infrastructure will also increase to serve the growing modalities listed above. This project will reshape the landscape for this campus and nearly doubling the square footage..
Key Factors
Project Goals and Guiding Principals:
- Project Budget and Schedule
- Maintain views of Pikes Peak/Patient Room Views (bend in building placement)
- Energy Requirements
- Reduce travel distances
- Improved Staff Experience
- Future expansion considerations
- Intuitive wayfinding for new entrances - Site (and parking solutions)
- Universal patient beds
CONCEPT
The design concept is a translation from the existing into a more modern application, using the same materials that have been previously implemented on campus. With Tripartite & Banding, there are Beacons at either end of the new patient tower through the use of glazed stairs and the brick material is modular and rhythmic. The curves that you can find in the existing patient tower are subtly applied to the language on the new bed tower for continuity.
2. Improving Women’s Birthing Experience in Hospital Through Qualitative Study
Professional Work
Responsibilities- Fellowship Research Project
In the United States, the maternal mortality rate is 23.8 per 100,000 pregnancies representing 861 maternal deaths in 2020 (Hoyert, 2022). Hospitals have made pregnancy a medical condition rather than a life event. It lacks patient-centeredness and empathy. To resolve the issue of maternal mortality and solve the physical challenges evolving during care, the need for reimagining the birthing model is evident. This research aims to study the needs of birthing women, focusing on enhancing the delivery of care and developing a new obstetrics program supporting patient-centeredness. A narrative literature review of the clinical needs of labor and delivery care is described to understand the importance of spatial conditions. The study will involve a descriptive evaluation of current facility standards and workflow of the obstetrics program in existing hospitals. The discussion from the interviews will be used as a base to outline design guidelines and goals for the study. The research findings are concluded in the form of design checklist that fulfils all the design goals or a better patient experience in birthing models
Keywords:
Women’s Health, Childbirth, labor & delivery, patient-centered care
The research highlighted the challenges and needs for improving the patient experience in hospital; the design checklist and goals are first step to achieve better patient experience and improve the health outcomes
But women’s health is major public health component, it needs tangible and intangible efforts to make it better. For future growth and trends for marketing, women’s programs need to look beyond obstetrics, prioritizing gynecology, behavioral health and fertility services depending on local patient demand. Women’s health program should integrate tele health to increase the access of care and provide continuum of care. Design might solve the tangible issues but it takes a community effort to create the intangible change. As healthcare designers we need to look beyond design problem.
Design should not stop here to check a box and complete the checklist. It calls upon working with our clients, users, and those caring for maternal health to really understand how design should, so that design can. It is easy to agree that yes, design should do all these things however, it is up to architects and designers to creatively implement strategies based on the additional factors operational processes, social and regulatory factors.
The research for the incubator was conducted concurrent with E Todd Wheeler Health Fellowship Project. The research was three part process which included background knowledge, literature review on factors influencing the maternal health outcomes, expert interviews, case study and identification design goals. The scope of incubator was to summarize this research and develop a design toolkit with in-depth utilization.
The primary goal of the environment is to influence the pattern and progress of labor, affecting both the number of vaginal births without major interventions and the rate of emergency caesarean sections. During labor, women’s bodies need to soften and open to let the baby be born. They need to feel safe and secure, be protected from disturbances and adverse stimulation, and be able to relax in order to let their body work most effectively. Hence their sequence of patient journey informs the strategies needed for planning strategies.
A typical patient journey for pregnant women starts at triage, where they are evaluated for dilation and active labor. Depending upon the clinical condition, they are either discharged or moved to an antepartum room. After the observation, women with active labor are transferred to the labor and delivery unit for vaginal delivery and where vaginal delivery cannot be instrumented. They are taken to C-section for delivery. Mothers are then transferred to postpartum to recover for a few days and then discharged.
As per FGI guidelines, LDR rooms should have a minimum 325 sq. ft clear floor with a minimum wall head of 13 ft. The clear floor area includes infant stabilization and resuscitation space of 40 sq.ft. Each patient room should have direct access to private toilet room with shower or tub. A typical patient journey for pregnant women starts at triage, where they are evaluated for dilation and active labor. Depending upon the clinical condition, they are either discharged or moved to an antepartum room. After the observation, women with active labor are transferred to the labor and delivery unit for vaginal delivery and where vaginal delivery cannot be instrumented. They are taken to C-section for delivery. Mothers are then transferred to postpartum to recover for a few days and then discharged
The aim is to understand that design should do these things and there are many different strategies and ways to achieve them. What was initially examined were specific strategies more directly influencing or achieving these design goals. What was found and how we move orward is understanding the multiple causes and influences in achieving these goals. It is easy to agree that yes, design should do all of these things however, it is up to architects and esigners to creatively implement strategies based on the additional factors of patient population, operational processes, social and regulatory factors. Design should not stop here in an effort to check box. It calls upon working with our clients, users, and those caring for this patient population to really understand how design should, so that design can.
These design goals are not intended to be applied in isolation. Many work with each other and strategies can complement each other. Implementing design strategies that reduce stress and anxity can aid in reducing pain , thus supporting patient experience.
The design checklist is a tool that can be used in pre-design space to evaluate the programming and planning of any new or renovation of women’s project. The checklist has three categories- environmental, social and operational factors. Each of the design strategy complies with one or more design goal.
3. Planning Projects
The main goal of this project the capacity for multiple services at the UCHealth Memorial North Hospital campus in order to serve the rapidly growing community in the adjacent neighborhoods to this campus. After the Covid Pandemic, the community already had a shortage of beds, ORs, primary care and specialty care to serve the community. With a rapidly growing community due to an influx of people moving to Colorado Springs, the shortage in healthcare services has only seen continued stress. This project will add a new 6-Story Patient bed tower with a total of 85 new inpatient beds in phase 1 and a future shelled capacity of 95 beds. The surgical department will grow by 4 ORs in phase 1, with a shelled capacity for a future 4 ORs. The Emergency department will grow by 14 bays and a shelled capacity for 10 CDU bays in the future. The imaging department, supporting departments, parking and infrastructure will also increase to serve the growing modalities listed above. This project will reshape the landscape for this campus and nearly doubling the square footage..
Professional Work Team Project
Bed Tower Expansion Project in Savannah, GA : Concept Planning
This project involved site study to add new tower and add new patient towers above the dining expansion on first floor. The new patient beds including ICU, med surg program. This project was the first planning project experience to understand how existing medical center evaluate their campus and look for growth opportunities. There were lot of minor renovation components too which supported the new construction program on the campus. The project taught a lot about FGI requirements for different patient units and how to implement those guidelines in planning.
Medical Center Campus Study in Grapevine,TX: Master planning, Client Meeting Exposure
This project involved masterplanning workshops with key stakeholders to address the ED exam room shortage and the long term need for universal bed in new patient tower. The planning also involved moving existing department for emergency and procedural suites like cath lab and endo lab. The project also helped in creating future scope for heart hospital and women’s services expansion.
Re-Zoning Project in CA : Concept Planning
This project is replacement for the existing hospital, which is no longer compliant to California’s seismic requirements. The project involved phasing of new tower to accommadate existing program with some addition to the program for their future needs. This project gave first hand experience of understanding different departmental planning for an upcoming planner.
Medical Center Campus Study in Waco, TX : Master planning, Client Meeting Exposure
The masterplanning aim of the project was to find opportunities to grow their emergency department and surgery department. The growth of diagnostic facilities will synthesize the growth for future acute care beds, hence options to expand vertically or horizontally were evaluated. The project also involved opportunites for MOB expansion in future for their ambulatory surgery program.
4. HAVEN IN THE MEADOWS
Fall 2020- Final Study Project Individual Project
Softwares used- Revit, AutoCad, Illustrator and Lumion
Haven in the meadows is a behavioral health facility for substance use and mental health patients. A regional health facility which is like a hub for Larimer County ensure seamless care coordination and fill in critical gaps in the continuum of care for those experiencing crisis and substance use disorder issues. A place where education, health& wellness and early identification and intervention is encouraged. Facilitate connections between community-based services with services/providers in a centralized facility providing a stronger care coordination system and building transition bridges across providers and services in and outside of the facility (Distributive and In-Facility Services). The county has received a grant from the Colorado Office of Behavioral Health to help fund a new co- responder program for the ongoing case management which helps to ensure individuals receive the follow-up services they need to reduce any further over-use of the wrong, costly systems. This 64 bed facility has 16 bed division of housing units with also a service of outpatient detox spaces for substance use patients. The facility has three courtyards each having different functions - horticulture therapy and group therapy. This facility is set in good location with great views towards the west of the side.
Purpose & aim Site Analysis
The purpose of the project is to examine how architecture and design can improve the mental state of patients or aid the process of healing. The focus will be on how spatial planning and certain design features can be used to improve the state of well being.
To justify the aim and purpose of the project, the project location needed to be investigated where the demographic study showed the need for behavioral health services. Hence, Larimer County was chosen for the site location due to its demographic need.
Facility as a hub for eunoia The
The state of mental wellness just doesn’t come with the temporary care it needs different levels of care at different stages of mental and behavioral state. Hence to fulfil all these stages a continuum of care needs to be established. This project will cater to all those needs by providing a complete care from inpatient care to residential supportive treatment along with social interactive activities.
A regional health facility which is like a hub for Larimer County ensure seamless care coordination and fill in critical gaps in the continu um of care for those experiencing crisis and substance use disorder issues. A place where education, health& wellness and early identifi cation and intervention is encouraged.
One in five Americans have mental health issue, depression is the leading cause of this disability.
Research Goals:
Supporting Recovery:
The provision of private rooms offer more autonomy, freedom and control. Engaging patients in self healing through supportive staff and connection to nature to foster healthy behaviors.
Levels of care
Reducing Stigma
Attractive exterior and homelike interior to provide positive image to the residents, community, family and other visitors. To create positive images of collaborative healing
Safety and Security
Allowing patients and staff to feel secure and free from the harm or injury, enabling rapid response and preventing elopement.
Continuum of Care
Enhance community – based services to shift from an acute care model to a recovery based model of care. Promote emotional health and well being by access to nature and welcoming environment
Design Strategies
Design Concepts
An open voluminous lobby to break the deinstitutional feeling.
Clear Wayfindinding graphics for navigation to all the services.
A place for family and social support to decrease stress and anxiety.
Access to nature and play area to reduce the fear and creating playful environment.
Postive Distractions in waiting areas through access to nature and daylight.
Dedicated touchdown spaces for staff between the exam rooms for better efficiency.
Exam rooms with a playful furniture and colors. and space for family.
Staff lounge and respite areas with access to nature and daylight.
