Portfolio Supplement: Health and Wellness 2016-17 (Work in Progress)

Portfolio Supplement 2016-17

HEALTH AND WELLNESS Melanie D’Souza

Contents A supplement that covers my deep engagement in the well-organised Health and Wellness Architecture program at the University of Kansas through various components of research and design as a final-year specialisation, and work in progress (2016-17) 609 COMPREHENSIVE HEALTH AND WELLNESS STUDIO

Spring 2016 p4-p9

807 HEALTHCARE DESIGN INTERNSHIP WITH HKS INC.

Summer + Fall 2016 YEAR 5

Melanie Philomena D’Souza M. Arch; Graduate Certificate in Health + Wellness | 2017 melanieedu@gmail.com meldsouza@ku.edu (Skype for Business) https://www.linkedin.com/pub/melanie-d-souza/b2/671/65 USA: + 1 (785).979.2079 OMAN: + (968).96736808

YEAR 4

700 HEALTHCARE DESIGN WORKSHOP AT GEORGIA TECH

700 HKS + KU SENIOR LIVING RESEARCH THESIS

Fall 2016 p10-p13

Fall 2016 + Spring 2017

808 KANSAS + KENYA RURAL HEALTHCARE STUDIO

Spring 2017

DESIGN RESEARCH 3

HINKSON CREEK HEALTH CENTER

Year 4, Spring 2016

Nestled within a housing development site in the heart of Columbia,MO, Hinkson Creek Health Center (HCHC) manifests itself as a comprehensive health model for the health professionals and residents of Missouri. This complex houses several services under one roof: from a freestanding emergency clinic, diagnostics department and medical oďŹƒce building to a wellness resource center, Ayurvedic therapy spa and yoga pavilion.

Inspired by international wellness resorts and new-age ambulatory clinics, HCHC has a collegial and an easily adaptable feel that can be reproduced and expanded across various natural settings.

Location : Columbia, MO Partner: Gianne Gonzales

Mentors : Professor Kent Spreckelmeyer Professor Frank Zilm Structures: Jason Hascall Developer: John Shreve HVAC: Jon Flann 5

FAMILY WAITING ROOM

EDUCATION/ WORKSHOP ROOM

DISCHARGE

RESULTS W.

SECURITY

DOWN

FINANCE

D. LINEN

C. LINEN

WORKSHOP

STORAGE HERBAL STORE AND GALLERY

RECORDS ST.

NON-ACUTE

NON-ACUTE

RECEPTION

ELECTRICAL

VESTIBULE

MEDITATION ROOM

ACUTE

MEDITATION ROOM

TRIAGE

CONSULTATION OFFICES

STORAGE

DN

ACUTE ACUTE PHARMACY N. OFFICE ACUTE

COMPOUNDER

OFFICE

ACUTE STORAGE

OBSERVATION

OPEN CAFE

MEDICINAL GARDEN

MASSAGE THERAPY ROOMS

DEMO KITCHEN

AMB. ENT.

DECONT.

OFFICE

MED PREP

STORAGE

EMERGENCY DEPARTMENT

ACUTE

Medicinal Garden

OFFICE

OFFICE

RECEPTION

TRAUMA ROOM

Wellness Kitchen

BLOOD DRAW

UP

RESOURCE CENTER

YOGA PAVILION

LN ESS CE

HEALTH RESORT

WINTER GARDEN

ELECTRICAL

DIAGNOSTIC SERVICES

DI

G

+

DEMO KITCHEN

IMAGING WAITING

CAL U B

Diagnostics Support

CONTROL ROOM

CT SCAN

W. ULTRA.

ME

W

EL

LAB

UNIT MANAGER

D. LINEN

STD RADIO

CAFE

PROCEDURE

G. ULTRA. RESOURCE CENTER

IL D

Staff Support

BREAK ROOM

KITCHENETTE

MAILROOM

ELECTRICAL

CL. LINEN

VIEWING/DIAG

UNIT MANAGER

OFFICE

OFFICE

OFFICE

UP

MEDICAL CLINIC

Rear Boardwalk +Business Offices +Resource Center + Atrial exit to pavilion

CORRIDOR EXTENSION (Future health resort)

GREEN ROOF

PAVILION LAYOUT (Future wellness modules) PAVILLION

CORRIDOR EXTENSION (Future medical services)

COMPREHENSIVE HEALTH AND WELLNESS PROGRAM

Outdoor Yoga Pavilion

High Priority areas Low Priority areas Expansion modules

6

Open Cafe

GOWNING GOWNING

IN

HOMEOPATHIC OFFICES

ER

AYURVEDIC PHARMACY

NT

HERBAL STORE

STORAGE STORAGE UTILITY CLOSET

Radiology Suite

HORIZONTAL EXPANSION SCHEME BY CORRIDOR EXTENSION AND PAVILION LAYOUT

HC HC Hinkson Creek

Health Center

WELLNESS FACILITY

2

1

1

3

MEDICAL BUILDING

1

2

On the other hand, the wellness center is home to a demonstration kitchen that is supported by an open cafĂŠ, meditation areas and a medicinal garden that is landscaped to foster outdoor circulation.

2

ATRIAL CONNECTOR

OUTDOOR PAVILION

Thus, by allowing for corridor architecture through a winter garden that stresses on heavy interaction with green and outdoor spaces, while housing a true wellness-oriented and flexible building program, Hinkson Creek Health Center appeals to the well-being of its patients, staff and community members alike.

3 The imaging department shares a wellness resource center for the community with a green roof above that is connected to the general medical office.

It also features an outdoor boardwalk that is accessible by the atrium, overlooks the green belt of the Hinkson Creek and is designed to encourage a social atmosphere.

7

UPPER LEVEL P.O.

P.O. P.O.

P.O.

DOWN

CONSULTATION OFFICES

CONSULTATION OFFICES C. LINEN

MEETING ROOM

STORAGE

D. LINEN

CONSULTATION OFFICE

VITALS

DOWN

RECEPTION

RECEPTION

STORAGE

VITALS

Its centralized atrium features a winter garden as a green corridor that unites its emergency department with its wellness center and culminates as a nature footpath to its rentable pavilion overlooking an organic waterchannel.

BREAK ROOM

Procedure Room

DOWN P.O.

P.O.

SHARED OFFICE P.O.

CHANGING ROOMS

P.O.

ELECTRICAL

DOWN

EDUCATION ROOM

RESOURCE CENTER

GREEN ROOF PATIO

DN

GROUND LEVEL

FAMILY WAITING ROOM

DISCHARGE

RESULTS W.

SECURITY

DOWN

C. LINEN

FINANCE

D. LINEN

WORKSHOP

STORAGE HERBAL STORE AND GALLERY

RECORDS ST.

NON-ACUTE

NON-ACUTE

RECEPTION

ELECTRICAL

VESTIBULE

MEDITATION ROOM

ACUTE TRIAGE

STORAGE

DN

ACUTE ACUTE PHARMACY N. OFFICE ACUTE

COMPOUNDER

OFFICE

ACUTE STORAGE

OBSERVATION

AMB. ENT.

DECONT.

OFFICE

MED PREP

STORAGE

ACUTE OFFICE

OFFICE

RECEPTION

TRAUMA ROOM

BLOOD DRAW

UP

STORAGE STORAGE

LAB

UNIT MANAGER

DEMO KITCHEN

UTILITY CLOSET ELECTRICAL D. LINEN

IMAGING WAITING

CONTROL ROOM

CT SCAN

W. ULTRA.

STD RADIO

CAFE

PROCEDURE

GOWNING GOWNING

G. ULTRA. RESOURCE CENTER

BREAK ROOM

KITCHENETTE

MAILROOM

ELECTRICAL

CL. LINEN

VIEWING/DIAG

UNIT MANAGER

OFFICE

OFFICE

OFFICE

UP

PAVILLION

8

This also encourages medical retail by looping around thepharmacy and herbal store and waiting areas, successfully alleviating patient stress and providing meaningful distractions.

1” painted steel mullion

10” DUCT

Radiant cooling from the ceiling (return vents)

T-shaped purlin glulam connection Double curvature insulated glazing

2’-6” DUCT

1’-6” DUCT

8” DUCT

Mechanical Rooms: Wellness Center : 1013 SF Atrium : 1215 SF Climate-controlled boundary

Roof drain Stone roofing ballast 60 mil EPDM roofing membrane Rigid insulation 6 mil vapour barrier

Metal cap Metal flashing Glulam beam Metal bearing plate

8” DUCT 2’-6” DUCT Mechanical Room: ER and Diagnostics Center : 1914 SF

Heating from the floor (supply diffusers)

1’-6” DUCT

11’

Radiant heating slab: Underfloor hydronic tubing systems embedded in the concrete foundation heat the floor of the central atrial corridor, thus providing an energy-efficient solution to the winter garden

WINTER GARDEN ATRIUM

Recessed can lighting 18” diameter stainless steel ducts Light cove

WELLNESS DEPT. SECOND FLOOR

2’-6” DUCT

ELEMENTARY ENGINEERING RESOLUTIONS

2 1/2”Runner 3/4” Suspended ceiling grid Pendant lighting Steel column Glazing

11’-6”

Cantilevered beam bridge between parts of the complex

Glulam arch Steel shoe with drain slot

WELLNESS DEPT. FIRST FLOOR Fibreglass batt insulation Floor Finish

Medical Office Building Girders at 25’-0” o.c.

Joists at 6’-0” o.c.

LEVEL TWO

Concrete anchor 1” diameter radiant tubing 3/4” plywood subflooring

3” Concrete slab on 3” metal decking Steel beam and joists assembly

Wellness center W n (2 levels): G 0 o.c.

Girders at 20’-0” JJoists at 6’-0”” o.c.

8” diameter Supply duct with VAV box 1/2” Gypsum board

Depth: 18” steel girder 12” steel joist 24” Glulam beam WELLNESS DEPT. MECH. ROOM Concrete floor slab 6 mil vapour barrier 2” Rigid insulation board 1/2” Protection Board

Emergency Room and Diagnostic Services Girders at 25’-0” o.c.

Joists at 6’-0” o.c.

LEVEL ONE

Glulam roof structure for atrial corridor and outdoor pavilion

3” Drainage mat Compacted gravel layer 4” diameter Drainage pipe Concrete footing

9

Communicable Disease

BIOCONTAINMENT STORYBOARD

Assembly of PortAll

Donning Outside the Room

PortAll: Providing continued teamwork through the use of a temporary ante room Normal Operations in Sealed Barrier for Biocontainment

Premier sense of location

Simplicity of mechanism

Observed Doffing Procedure

Transparency of process

PortALL GUIDING PRINCIPLES

10

Targeted Cleaning with Bleach

Preparedness quotient

‘PortAll’ PORTABLE ANTEROOM

Year 5, Fall 2016 Health Systems Institute, Georgia Tech Institute of Technology As part of my Health and Wellness internship component, I ventured taking a multidisciplinary workshop class at the esteemed Georgia Tech, “Healthcare Design of the Future” which fostered research and development of tangible prototypes to solve a specific issue: Preparedness of a healthcare facility towards a biocontainment emergency such as an Ebola outbreak. Each team employed a healthy combination of designers, engineers, programmers and medical talent alike. My team’s assigned dimension and end-result aimed at improving team preparedness and efficiency between medical professionals in the event of a biocontainment emergency by creating a temporary anteroom that can be quickly assembled- the PortAll.

INITIAL PATIENT MAPPING ANALYSIS

Location : Prototype for Hospital Serious Communicable Diseases Unit Partners : Jack Bordoni, Julie McCallum, Lauren Zuccarello

Mentors + Experts : Professor David Cowan Dr. Craig Zimring Emory Healthcare Piedmont Atlanta Hospital HKS Architects Steelcase Health

11

Portable Kit Contents:

Installation Kit Bag

Structural Poles

Mounting Bracket

Structural Connections

Heavy Duty Tape

Constructing the Exploded Prototype: PortAll Ante Room:

Structural Disposable tarp Door zipper

7’-6”

Ante Room Tape seal 5’-0”

5’-6”

PortAll is a collapsible anteroom structure, mounted to the top of the patient room door, that can be easily pulled out and assembled for a rapid response situation. Nurses can quickly open the kit box, snap in the support bars, and secure the clear tarp walls. Staff can use this space to effectively don and doff personal protective equipment (PPE) while providing a clear, unobstructed view for verbal and visual communication. This addresses the problem of the lack of and sparsity of biocontainment rooms within healthcare facilities and allows for any patient room to be easily converted.

By utilizing a small footprint of the patient room, medical staff can continue to use the patient corridor without significant disruption in work flow.

12

Left: Kit of Parts Right: Accompanying manual

Clear Plastic Sheathing

Our contemporary world is plagued with the dangerous possibility of serious communicable diseases outbreaks at any moment- however, current healthcare facilities are generally lacking in the ability to effectively treat patients in a mass biocontainment emergency.

Currently, about 10 hospitals around the U.S. have specific units designed for such conditions but possess limited bed capacity. These rooms are highly isolated and require a large amount of dedicated space for staff to effectively work. The wall between the patient room and anteroom of the existing biocontainment units presents a physical obstacle to both communication and teamwork among hospital staff.

Given this context, our goal is to provide immediate conversion of a typical patient room into a biocontainment unit. This means allowing as much collaboration and coordination as possible, including exchange of information and statistics, as well as materials. Such a strategy can be explored through a solution of physical space- the PortAll.

Preparation for Biocontainment

Biocontainment

Modification: Rubber outline to PortAll with gasket mechanism, self-adhering tape and rubber braces

Current: Steel pipe with elbow connections that glue to surfaces

Modification: Spring-loaded poles that can telescope on ball swivels attached to the floor and ceiling, and can have light/ materials snapped on

Modification: Fast-cap Trademark magnetic dust barrier doors that seal with magnetic tape

Current: Plastic sheathing taped to surfaces

Current: Plastic zipper with adhesive mechanism

Current: Orthogonal shape renders unused corners

Modification: Skewed walls slanted away from the walls not allows for more electrical and physical

Current

PHYSICAL SUPPORT

SEALING ACCESS FUTURE DESIGN IMPLICATIONS BASED ON EXPERT FEEDBACK

SHAPE DESIGN

Modification

13