CHILDREN’S OUTPATIENT CENTER
RESULTS
ARCHITECTURE
BEYOND
ATRIUM HEALTH:
CHILDREN’S OUTPATIENT CENTER
Results Beyond Architecture 1
Our Purpose: To partner with our clients, their patients and care providers in the creation of hopeful, healing and healthy built environments.
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Atrium Health: Children’s Outpatient Clinic
Facility Master Plan
FACILITY MASTER PLAN
Results Beyond Architecture 3
THE NEED
In January of 2019, Little was charged with developing a 10-15-year Master Facility Plan to co-locate and expand the existing Levine Children’s Specialty clinics. Many existing clinics have outgrown their current physical space and need to expand in order to serve the needs of children in the Charlotte area, improve the patient/family experience and recruit staff and physicians.
In addition, the focus of medical services for children has shifted from general pediatrics to multi-specialty care pediatrics. Patients with complex illnesses require care from a care team rather than a single physician. Atrium Health’s goal is to provide a central multi-specialty pediatric center on their main campus as a “one-stopshop” for patients who currently visit a number of decentralized locations. The team evaluated emerging clinic trends and the proposed Medical Office Building condition and infrastructure to develop a solution.
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Atrium Health: Children’s Outpatient Clinic Facility Master Plan
GUIDING PRINCIPLES
CHILDREN’S SPECIALTY CLINICS
DELIVER CARE WITH A MULTIDISCIPLINARY APPROACH
PATIENT EXPERIENCE
CREATE A “ONE-STOPSHOP” FOR ALL PATIENTS
INFRASTRUCTURE
BRING IN HOUSE AND CENTRALIZE IMAGING, LAB, AND PHARMACY
IMAGE
IMPROVE ACCESS, WAYFINDING, INTERIOR DESIGN AND SPACE PLANNING
FUTURE ASPIRATIONS
ALIGN SPACE WITH A WORLD-CLASS APPROACH
Results Beyond Architecture 5
CHILDREN’S
•
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Atrium Health: Children’s Outpatient Clinic
Facility Master Plan
Clinical Neighborhoods
Age-Appropriate Themes
Family Amenities
Wayfinding
Natural Light
Mechanical
Electrical
Plumbing
Technology
Parking Deck Theming
Valet / Lobby
Public Spaces
LEVINE
HOSPITAL •
•
•
•
•
•
•
•
•
•
•
•
New Services
New Locations PATIENT EXPERIENCE CHILDREN’S SPECIALTY CLINICS INFRASTRUCTURE IMAGE FUTURE ASPIRATIONS MCP CHILDREN’S SPECIALTY MOB
•
Results Beyond Architecture 7 STACKING DIAGRAM PEDIATRIC CARDIOLOGY CARDIAC NEURO DEV RHEUM. PULMONOLOGY INFECTIOUS DISEASES SURGERY/ UROLOGY/ PLASTICS NEPHROLOGY NEUROLOGY & EPILEPSY REHAB GENETICS NICU FOLLOW UP LAB IMAGING GI NOT IN SCOPE CLERICAL NOT IN SCOPE LOBBY AUDIO PSYCH CONFERENCE CANCER AND BLOOD DISORDERS PHARM 01 M 02 03 04 05 06 LEVEL NOT IN SCOPE NOT IN SCOPE NOT IN SCOPE
PLANNING SCENARIOS
The stacking diagram below demonstrates the owner’s real estate team’s attempt at fitting all clinics into one building, and then realizing there were more program SF than space allowed. It was a significant concern for everyone working on the project.
Once we were engaged, our team conducted visioning sessions and held director interviews to determine the needs and wants for each clinic. Through the director interview process we identified three groups that felt their patients would not be well served in a centralized location. Peds Sleep, Development and Behavioral, and Endocrinology didn’t fit in with the building’s “one-stopshop” goal because their patients do not often see multiple specialists. By leaving these groups in their current off-campus locations, we were able to fit all of the appropriate programs into the building.
BUILDING
Pros:
• Due to budget and size (USF / floorplate “fit”), leave HemOnc on 6 and LSCS on 2
• Accommodates 3 of 4 short-term priorities: Peds Surgery, Children’s Psychology, and SHVI Peds
Cons:
• Doesn’t accomplish short term priority of moving Peds G.I. or allowing them to grow
• Doesn’t accommodate adjacency of Peds Surgery, Peds Urology, and Peds Plastic Surgery
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Atrium Health: Children’s Outpatient Clinic
Facility Master Plan
188,822
BB BB BB BB BB BB BB Diet. / Heine Ped HemOnc 16,072 SHVI Peds 13,615 Peds Surg. 5,684 Peds Plast. 3,875 NICU 4,003 Ceenta, Ortho, OP Rehab 4,913 Peds Sleep 5,522 Peds End 5,542 Ped Urology 5,171 Peds GI 10,267 Peds Neuro 8,471 Dev. Bhav Peds
LSCS 26,266 Pharm 889 Ceen, Ortho, Op
Chick-fil-a Child Psych 2,585 One Day
One Day
CHR. Radio / Lab 167
01 M 02 03 04 05 06 LEVEL SF
SF
4,556
Rehab 3,357
Surg. 2,851
Surg. 32,139
19,240 23,453 23,453 33,290 36,265 15,202 37,919 1,076 SHORT 1,790 SHORT
TOTAL
During program verification and our discover phase, we identified the lack of growth space for many groups and the ability for these groups to share space.
For Example: Surgery, Urology, Plastics, and Gyn are all in the clinics less than five days per week, spending more time in the ORs. Their programs combined were initially about 12,000 SF. By collocating them and taking advantage of alternating scheduling, we reduced their space need by 5,000 SF.
LEVEL DEPARTMENT DGSF # EX ROOMS
06
Pediatric Infectious Diseases 3,942 6 Pediatric Physical Medicine & Rehab 1,694 3 Genetics 4,637 9 Pediatric Rheumatology 4,347 9 Total 14,620 27
Floor Area Available 18,283 Growth Potential 3,663
05
SHVI (Pediatric Cardiology) 16,976 24 Cardio Neuro Developmental 2,754 5 Total 19,730 29
Floor Area Available 22,912 Growth Potential 3,182
04 Pediatric Surgery 9,000 Pediatric Neurology & Epilepsy 8,000 13 NICU Follow Up Clinic 3,746 6 Total 20,746 22
Floor Area Available 22,708 Growth Potential 1,962
03 Pediatric Cancer & Blood Disorders 23,418 15 Infusion Pharmacy 2,000 0
Total 25,418 15
Floor Area Available 30,893 Growth Potential 5,475
02 Pediatric GI 8,883 15 Pediatric Nephrology 5,110 9 Lab 3,200 0 Radiology 3,000 0 Pediatric Pulmonology 6,413 12
Total 26,606 33
Floor Area Available 31,563 Growth Potential 4,957
Total for Clinics 109,253 126
Total Floor Area Available 126,904
Results Beyond Architecture 9
SCOPING & PROGRAMMING
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Atrium Health: Children’s Outpatient Clinic
Facility Master Plan
28’ 28’ 28’
28’ 28’
LINEAR EXAM ROOMS PROCEDURE TEAM STATION SUPPORT/OFFICE
CLINICAL CONNECTION
CLINIC SUPPORT
PUBLIC CONNECTION Pros: • Efficient space utilization • Single exam room door
TYPICAL NEIGHBORHOOD 3 PROVIDERS 4,700 SF 28’ COLUMN GRID
• Modular within structural grid Cons: • Limited patient and family privacy • High noise level at peak hours
•
• Simplified wayfinding
•
Results Beyond Architecture 11
OFF
28’ 28’ 28’
ON STAGE /
STAGE EXAM ROOMS PROCEDURE TEAM STATION SUPPORT/OFFICE
CLINICAL CONNECTION 28’ 28’ CLINIC SUPPORT Pros:
• Team work core is more collaborative
More privacy for patients and staff
1,566 SF / PROVIDER 9 EXAM ROOMS 1 PROCEDURE ROOM
Modular within structural grid Cons: • Two doors per exam room
PLANNING SCENARIOS SUMMARY
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05
04
03
02
CURRENT CONDITION (FINISH REFRESH ONLY) + NEW BUILDING IN PLANNING
Exam Room Count / Area 15 / 90 SF
Renovated SF 18,283 - Finish Only
Construction Duration 87 Calendar Days
Exam Room Count / Area 58 / 80 SF
Renovated SF 22,912 SF - Finish Only
Construction Duration 96 Calendar Days
Exam Room Count / Area 28 / 98 SF
Renovated SF 22,708 - Finish Only
Construction Duration 96 Calendar Days
Exam Room Count / Area 46 / 86 SF
Renovated SF 30,893 SF - Finish Only
Construction Duration 115 Calendar Days
Exam Room Count / Area 46 / 92 SF
Renovated SF 31,563 SF - Finish Only
Construction Duration 115 Calendar Days
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Atrium Health: Children’s Outpatient Clinic
Facility Master Plan A
PLANNING
PARTIAL RENOVATION + NEW BUILDING IN PLANNING
FULL RENOVATION + ADJACENT EXPANSION IN 10 YEARS
9 / 137 SF TBD / TBD SF 2,410 SF - Renovation 15,873 SF - Finish Only 18,283 SF - Renovation 154 Calendar Days 210 Calendar Days 44 / 126 SF 35-44 / 120 SF 10,350 SF - Renovation 12,562 SF - Finish Only 22,912 SF - Renovation 177 Calendar Days 248 Calendar Days 20 / 140 SF TBD / TBD SF 5,710 SF - Renovation 16,998 SF - Finish Only 22,708 SF - Renovation 177 Calendar Days 248 Calendar Days 34 / 127 SF TBD / TBD SF 7,710 SF - Renovation 23,183 SF - Finish Only 30,893 - Renovation 229 Calendar Days 294 Calendar Days 30 / 138 SF TBD / TBD 7,590 SF - Renovation 23,973 - Finish Only 31,563 SF - Renovation 229 Calendar Days 315 Calendar Days
Results Beyond Architecture 13 B
C ONLY)
TYPICAL NEIGHBORHOOD ON STAGE
STAGE
TEAM WORK CORE
EXAM ROOM
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Atrium Health: Children’s Outpatient Clinic
Facility Master Plan
/ OFF
PATIENT / FAMILY CARE TEAM CIRCULATION
TYPICAL EXAM ROOM
CLINICAL
CORRIDOR
FAMILY PATIENT
TEAM STATION
DISCUSSION ZONE
Space for physician and care team to sit or stand facing the patient. Dual computer monitors to display images and education for patient and family.
FAMILY ZONE
Area for caregivers and family to participate in exam and discussion.
EXAM ZONE
Exam table and casework with space for multiple care team members.
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Atrium Health: Children’s Outpatient Clinic
Facility Master Plan
LINE OF SIGHT
Dual monitors on articulating arms allow patient and family to view information and provider at the same time.
Provider is able to address the patient and family at the same time.
Results Beyond Architecture 17
Atrium Health: Children’s Outpatient Clinic 18 Facility Master Plan ATRIUM HEALTH | PRESENTATION 5: GRAPHICS FOR PEDIATRIC MOB | 07.28.2020 | Elements for Level 5: Sky THEMING BY LEVEL ATRIUM HEALTH PRESENTATION 5: GRAPHICS FOR PEDIATRIC MOB 07.28.2020 | PAGE 3 Elements for Level 2: Coast HEALTH | PRESENTATION 5: GRAPHICS FOR PEDIATRIC MOB | 07.28.2020 Elements for Level 3: City LEVEL 3 CITY (1) PRESENTATION 5: GRAPHICS FOR PEDIATRIC MOB | 07.28.2020 | PAGE 7 Elements for Level 6: Space 06 : Space 03 : City 05 : Sky 02 : Coast
04 : Mountain
Elements for Level 4: Mountain
A themed master plan was developed to distinguish individual floors. A palette of elements inspired by Eric Carle* was developed for each floor and used in large-scale printed wall covering and signage.
* Eric Carle is acclaimed and beloved as the creator of brilliantly illustrated and innovatively designed picture books for very young children. His best-known work, The Very Hungry Caterpillar, has eaten its way into the hearts of literally millions of children all over the world.
Results Beyond Architecture 19 PAGE 6 LEVEL SKY (3) LEVEL 2 COAST (1) ATRIUM HEALTH | PRESENTATION 5: GRAPHICS FOR PEDIATRIC MOB | 07.28.2020 | PAGE 5 MOUNTAIN (2)
Atrium
20 Level 05
Health: Children’s Outpatient Clinic
LEVEL 05 PROJECT TEAM OWNER: Atrium Health ARCHITECT: Little Diversified Architectural Consulting GENERAL CONTRACTOR: JE Dunn Construction MEP ENGINEER: WSP INTERIOR DESIGNER: Little Diversified Architectural Consulting STRUCTURAL ENGINEER: Little Diversified Architectural Consulting GRAPHIC DESIGN: Little Diversified Architectural Consulting Results Beyond Architecture 21
The Pediatric Cardiac Center sets the new standard for multidisciplinary outpatient care at Atrium Health. The project features The HEARTest Yard Congenital Heart Center, made possible by Greg Olsen, former Tight End for the Carolina Panthers, through Receptions of Research: The Greg Olsen Foundation.
With central goals to enhance patient experience, increase staff efficiency and improve multidisciplinary sub-specialty care, the team developed an internal on stage / off stage concept, with emphasis on positive distraction, wayfinding, and natural light. The clinic expands from the existing 10 exam rooms to 25 exam rooms housed in three neighborhood clinic modules.
Atrium Health: Children’s Outpatient Clinic 22 Level 05
EXAM EXAM EXAM EXAM EXAM EXAM EXAM EXAM EXAM EXAM EXAM EXAM EXAM EXAM EXAM TESTING CONF STRESS ECHO ECHO READING ROOM THERAPY TLT OFFICE ADMIN OFFICE ADMIN OFFICE TEAM STATION TEAM STATION ADMIN OFFICE ADMIN OFFICE WAITING BUSINESS OFFICE WAITING ACHD WAITING CORRIDOR EXAM EXAM EXAM EXAM EXAM EXAM TLT EXAM EXAM TLT EXAM IT OFFICE VIRTUAL CARE OFFICE OFFICE CONSULT CLEAN OFFICE STAFF LOUNGE TEAM STATION CONSULT OFFICE ECHO OFFICE KITCHEN OFFICE SUB WAIT OFFICE OFFICE OFFICE OFFICE OFFICE OFFICE ADULT ECHO OFFICE OFFICE ADMIN OFFICE REGISTRATION OFFICE EXAM SOIL S TLT ECHO ECHO TLT ECHO
ECHO SUITE SUB SPECIALTY CARDIAC NEURODEVELOPMENTAL TLT
GENERAL PEDS CARDIOLOGY ADULT CONGENITAL HEART DISEASE EP / TRANSPLANT
ADULT CONGENITAL HEART DISEASE
CHECK IN AND WAITING GENERAL CARDIOLOGY ACHD TRANSPLANT / EP ECHO SUITE SUB SPECIALTY NEURO DEVELOPMENTAL SHARED SUPPORT AREAS
Results Beyond Architecture 23
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05
Atrium Health: Children’s Outpatient Clinic
Level
LEVEL 05: ENTRY
Results Beyond Architecture 25
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05 BEFORE LEVEL 05: ELEVATOR LOBBY
Atrium Health: Children’s Outpatient Clinic
Level
Results Beyond Architecture 27
BEFORE CORRIDOR
Atrium Health: Children’s Outpatient Clinic
28 Level 05 BEFORE LEVEL 05: WAITING ROOM
Results Beyond Architecture 29
89% of clinicians found it easy to navigate the clinic 70% of clinicians were satisfied or very satisfied with overall design of the space 80% of clinicians were satisfied or very satisfied with their ability to hear and communicate with patients and other staff 70% of clinicians agreed or strongly agreed that rooms were easy to find
LEVEL 05: MEASUREMENTS
Results received from Clinician surveys: OFFICE & ADMINISTRATIVE STAFF 21.28% NURSING 14.89% PHYSICIAN 12.77% CLINICAL STAFF 34.04 TECHNICIAN (SONOGRAPHER/ECHO/ PSYCHOMETRICIAN) 17.02%
our
Atrium Health: Children’s Outpatient Clinic 30 Level 05
Role within the Pediatric Cardiac Center: Loving the windows and the quote on the wall outside
office! Primary workspace location: TEAM STATION 17.02% NURSE’S OFFICE 10.64% PRIVATE OFFICE 14.89% SHARED OFFICE 46.81% LAB 10.64%
Respondent description: Spaces used during visit: We love the team here, and the updates to the 5th floor. Beautiful, bright and inviting design! 70% of patients and family members found
easy to navigate the clinic 90% of patients and family members were very satisfied with overall design of the space 80% of patients and
members were very satisfied
overall level of lighting within the space 90% of patients and family members were very satisfied with amount of daylight within the space Results received from Patient surveys: UNDER-18 PATIENT PATIENT ADVOCATE 10% FAMILY MEMBER/CARETAKER OF UNDER-18 PATIENT ADULT PATIENT 10% 10% 80% 10% MEMBER OF FAMILY ADVISORY COUNCIL 0% 0 10 20 30 40 50 60 70 80 90 100 70% 0% 70% 100% 0% 0 10 20 30 40 50 60 70 80 90 100 0% 10% 0% 30% EXAM ROOM STRESS TESTING ROOM ECHOCARDIOGRAM ROOM WAITING AREA OTHER TESTING ROOM PHYSICIAN’S OFFICE CONSULTATION ROOM OTHER RESTROOM Results Beyond Architecture 31
it
family
with
LEVEL 05: RECOGNITIONS
IIDA AWARD CORE AWARD FINALIST HFSE CONFERENCE
THE BEFORE AND AFTER IS NOTHING SHORT OF AMAZING. THE SPACE HAS A GREAT VIBE AND WILL BE A BLESSING FOR OUR COMMUNITY. THANK YOU FOR A JOB WELL DONE AND FOR YOUR SUPPORT OF OUR MISSION.
DentonWilson Vice President Planning, Design & Construction, MCP 5
For more information, visit: littleonline.com/work/project/the-heartest-yard-childrens-cardiology-center/
Atrium Health: Children’s Outpatient Clinic 32 Level 05
www.littleonline.com