Little Apple Pediatric Clinic
Site Analysis Key Neighborhood Characterisitcs
Manhattan Catholic School Sunflower CASA Woodrow Wilson Elementary Our Site: Pediatric Clinic Manhattan Education Center Bus Stop: At Juliette and Laramie Manhattan Public Library Strasser Village Apartments
N
Site Analysis
Demographics: • Kansas State Univeristy academic body • Highschool students • Middle school students • Elementary education students • Families • Working Class • United States Army Community of Fort Riley County
N
Residential Zone
Pubilc Zone
Mental Health in Kansas Behavioral Health Barometer Kansas, 2014; Kansas Action for Children
Mental Health Treatment/ Counseling Among Adults Mental Health Treatment/ Counseling Among Adults Aged 18 or Older with Any Mental Illness in Kansas Mental Health Treatment/ Counseling Among Adults Aged 18 or Older with Any Mental Illness in Kansas
Aged 18 or Older with Any Mental Illness in Kansas
48.3% 48.3%
51.7% 51.7%
Recieved Mental Health Recieved Mental Health Treatment/ Counseling Treatment/ Counseling Did not recieve Mental Health Did not recieve Mental Health Treatment/ Counseling Treatment/ Counseling
Number per 1,000 children under 18 hospitalized for Number per 1,000 children under 18 hospitalized for mental health Number per 1,000 children under 18 hospitalized mental health
for mental health
5.01 / 1000 5.01 / 1000 0.46 0.46
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 - 2014 Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health, 2010 - 2014
Source: Kansas Action for Children,, Riley County Health Department, Trend 2011-2015 Source: Kansas Action for Children,, Riley County Health Department, Trend 2011-2015
Obesity in Kansas The State of Obesity in Kansas
2-4
12.8%
10-17
14.2%
18-25
22.1%
Age 26-44
36.9%
45-64
38.9%
65+
30.5%
Age
0
5
10
15
20
25
30
35
Percent of 100 Percent ofout out 100
Percent of Obese Residents in Kansas
Source: Trust for America’s Health and Robert Wood Johnson Foundation. The State of Obesity 2016 (PDF). Washington, D.C. 2016
40
Physical Activity in Kansas Kansas: State Nutrition, Physical Activity, and Obesity Profile
Adult’s Physical Activity Statistics Shown 7 days prior to survey achieved 300 min. moderate intensity a week
did not achieve any physical activity in the past month
Children’s Physical Activity Statistics Shown 7 days prior to survey achieved recommended 60 min. of exercise per day
attended P.E. sessions at school
did not participate in any physical activity
watched TV for 3 + hours
How do I achieve an optimal environment?
Concept
The idea of cell biomimicry enhances function and efficiency of pediatric services to promote the development of the Manhattan, Kansas community.
Cell as it Relates to a Single Room
1. Cell is the most fundamental and basic unit of nature 2. Contains organelles such as nucleus, mitochondria, and lysosomes 3. All organelles are part of a cell for efficient and functional operation 4. Starts the process of growth and development
1. Exam Room is one basic unit of the Pediatric Clinic 2. Contains furnishings such as height adjustable exam table, side chairs, doctor’s seat with writing table, ADA sink and cabinetry 3. All furnishings are part of the exam room for efficient and functional operation 4. Adjacent rooms represent the process of growth and development
Cell Mitosis as it relates to the Pediatric Clinic
Control Room
Laboratory
Sub-waiting
Nursing Room
Nursing Room
Business Manager Office Business Office
Exam 4
Lab Restroom
Blood Draw Room
Exam 5
Radiology
Exam 6
Breakroom
Doctor’s Office
Business Staff Collaboration
Well Waiting Doctor’s Office
Conference Room
Reception Mechanical Room Staff Restroom Data Closet
Work Room
Check-In
Staff Collaboration Check-Out
Main Entrance
Group Consulting
Doctor’s Office
Nurse Station
Group Consulting Vision and Hearing
Sick Waiting
Exam 1 Waiting Restroom
1. Cell mitosis is the multiplication of cells 2. Cells communicate with each other to perform specific tasks 3. All cells equipped with tools to perform functional and efficient in unison
Physician Dictation
Exam Restroom
Exam 2
Exam 3
Janitor’s Closet
Expansion (Undeveloped)
Storage, Recycling, and Future Expansion (Undeveloped)
1. Adjacencies are the “mitosis” of rooms 2. Rooms adjacent to each other enhance communication between staff and patients, and operation of pediatric tasks 3. All rooms equipped with tools and furnishings to perform functionally and efficient in unison
N
Organism as it relates to the Master Plan Nutrition Center
Physical Therapy and Exercise
Mental Health Clinic
N
1. Organism is the whole entity fully developed from cells 2. Cells that make up the organism work in unison to function to its full potential
1. Master plan is the whole entity fully developed from the Pediatric Clinic, Mental Health Clinic, Nutrition Center, and Physical Therapy and Exercise 2. Four services within the master plan work in unison to help the development of Riley County
Master Plan Secondary Entry Occpanc: Business Occupancy: Business Preface Cell: The clinic includes three com• The mostthat benefit plimentary services the development of mental, fundamental physical, unit and emotional of naturehealth of the Riley Country residences of all types. A Physical Therapy Package of provides and Exercise service Services: residents in need of access to • Encompass equipment and assistance in a physicalfundamentals health routine. Secondly, there is a current need of health for better awareness of obtaining a healthy diet, so a nutrition • Mental and cooking center is incorporated.• Emotional Lastly, a high rate of mental• Physical illness exists within the community, so a Mental Health clinc is provided.
Square Feet: 3,000 FT.
MASTER PLAN Occupancy: Business Square Feet: 3,400 FT.
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Occpancy: Business Square Feet: 3,000 FT.
HEALTHCARE CLINIC Occupancy: Business Total Square Feet: 21,600 Pediatric Center
Occpancy: Business Sqaure Feet: 12,200 FT.
Physical Therapy and Exercise Nutrition Center Mental Health Clinic
Main Entry
Clinic Floor Plan Models Traditional Model Check-In
Support
On-Stage Off-Stage Model
Staff Work
Consult
Exam
Exam Waiting
Waiting
Check-In
Exam
Consult
Support
Staff Work
Consult
Support
Staff Work
Offices
Exam
Opportunities:
Opportunities:
• patient familiarity with this model • exam rooms in close proximity
• efficient travel between exam and staff space • greater staff communication • increases privacy of staff
Limitations • separation of staff • staff spaces more open to public
Limitations • separation of exam rooms, increase wayfinding
On-Stage Off-Stage Model On-Stage Off-Stage Model
Control Room
Laboratory
Radiology/ Lab
Wait Consult
Waiting
Check-In
Exam
Support
Staff Work
Nursing Room
Offices
Nursing Room
Well Waiting
Consult
Lab Restroom
Sub-waiting
Business Manager Office Business Office
Exam 6
Exam
Business Staff Collaboration
Breakroom
Doctor’s Office
Doctor’s Office
Reception Work Room
Check-In
Waiting Main Entrance
Staff Work
Staff Collaboration
Check-Out
Group Consulting
Group Consulting Vision and Hearing
Consult Waiting Restroom
Exam Restroom
Physician Dictation
Exam Exam 1
Exam 2
Office Doctor’s Office
Nurse Station
Sick Waiting
Reduces used space by 50%
Exam 5
Radiology
Check-In
Exam
Achieves 15% increase in operational efficiencies
Exam 4
Blood Draw Room
Exam 3
Conference Room
Staff Work Mechanical Room Staff Restroom Data Closet
Janitor’s Closet
Expansion (Undeveloped)
Storage, Recycling, and Future Expansion (Undeveloped)
(Pacific Medical Building)
Little Apple Pediatric On-Stage Off-Stage Model
Floor Plan Control Room
Laboratory
Sub-waiting
Nursing Room
Nursing Room
Business Manager’s Office
Business Office
Lab Restroom
Exam 4
Blood Draw Room
Exam 5
Exam 6
Business Staff Collaboration
Radiology
Breakroom
Doctor’s Office
Well-Waiting Doctor’s Office
Conference Room
Reception Work Room
Check-In
Staff Restroom
Staff Collaboration Check-Out
Doctor’s Office Triage Zone
Janitor’s Closet
Nurses’ Station
Group Group Consulting Consulting
Main Entrance
Vision and Hearing
Physician Dictation Exam 1
Sick Waiting Waiting Restroom
Mechanical Closet Data Closet
Exam Restroom
Exam 2
Exam 3
Storage, Recycling, and Future Expansion (Undeveloped)
Expansion (Undeveloped)
N
Annotated Floor Plan Business Office:
Staff Collaboration (Best Option)
• Private staff collaboration space for business office • Work room provides additional collaboration zone • Medical record files
• High ceiling with skylights to invite daylight (WELL) • Mobile media carts for information sharing • Medical preparation and storage align wall allows for most open space and light • Flexible collaboation zones • Nurse’s Station has stand/sit desks with personal storage
Breakroom: Control Room
Laboratory
Sub-waiting
Lab Restroom
Blood Draw Room
Radiology
Breakroom
• Various seating options for eating, resting, collaboration • Staff lockers • Food Preparation
Conference Room Waiting Area: • Sick and well waiting • Flexible and movebale furniture accomates various activities: work, rest, play • Fish tank in wall • Provides territoriality • Supports multiple postures
Nursing Room
Nursing Room
Business Manager Office Business Office
Exam 4
Exam 5
Exam 6
Doctor’s Office
Business Staff Collaboration
Well Waiting Doctor’s Office
Conference Room
• adjacency to collaboration • various media and tools for information sharing • more private
Reception Mechanical Room Staff Restroom Data Closet
Work Room
Check-In
Staff Collaboration Check-Out
Reception: • Separate Check-in and Check-out spaces • Direct line of site from entrance • Additional wayfinding features
Main Entrance
Group Consulting
Doctor’s Office
Nurse Station
Group Consulting Vision and Hearing
Sick Waiting
Physician Dictation Exam 1
Waiting Restroom
Exam Restroom
Exam 2
Exam 3
Janitor’s Closet
Storage, Recycling, and Future Expansion (Undeveloped)
Expansion (Undeveloped)
Staff Collaboration Options 11’ Freestanding Partition equipped with white boards and computer monitors
Collaborative Lounge adjacent to media wall
Nurse’s Station
Collaborative Table
standing/sitting desk
mobile white board and computer monitor
Media Collaboration information and media sharing
Medical Preparation medical supply storage
Medical Preparation
14’ High Ceiling
medical supply storage
skylight for natural working environment
Media Collaboration
Nurse’s Station
information and media sharing
desk side personal storage standing/sitting desk
Concentration zone private, focused work
Opportunities:
Opportunities:
array of work zones; multiple seating options for posture; nurse’s desk side personal storage; centralized medical supply
large, private collaboration zone; multiple seating options for posture; medical preparation and supply for each wing of exam rooms; mobile media and information sharing
Limitations:
Limitations:
partition obstructs openness and light
medical prep zones obstruct openness and lightt more busy circulation paths
Doctor’s Office Strategies Doctor’s Office Strategy
Exam 6
Doctor’s Office
Opportunities: Retreat zone Private work Phone calls Treatment research Collaboration with nurse
Opportunities: • Retreat zone • Private work Doctor’s Doctor’s Office Office Strategy Phone calls Limitations: Treatment researchLimits collaboration between doctors Opportunities: Retreat zone Collaboration with Utilizes nursemore space Private work • More personal storage Phone calls
Doctor’s Office Strateg Exam 4
Exam 5
Exam 6
Doctor’s Office
Doctor’s Office
Treatment research Collaboration with nurse Limitations:
aboration
Doctor’s • Limits collaboration between doctors Limitations: Office Limits between doctors • collaboration Utilizes more space
Opportunities: Retreat zone Private work Phone calls Treatment res Collaboration
Limitations: Limits collaboratio Utilizes more spac
Staff Collaboration
Utilizes more space
Doctor’s Office
Closed Office
Closed Offic
Nurse’s Station
Physician Dictation Physician Dictation
Exam 3
Closed Office
Open Office Exam 1
Exam 2
Exam 3
Open Offic
Open Office
Patient vs. Staff Circulation KEY Patient Circulation Staff Circulation
TRIAGE ZONE
N
Typical Patient Visit Entry to Exam 1 Entry
Exit from Exam 5 Group Consulting 6 Check-Out
2
Check-In
3
Triage Zone Exam Room
4
Nursing Room
Laboratory
Sub-waiting
Nursing Room
Business Manager Office Business Office
Control Room
Exam 4
Lab Restroom
Blood Draw Room
Exam 5
Radiology
Exam 6
Breakroom
Doctor’s Office
Business Staff Collaboration
Well Waiting
2
Doctor’s Office Reception
Staff Collaboration
Check-Out
1
3 Triage Zone
Group Consulting
Mechanical Room Staff Restroom Data Closet
Work Room
6
Check-In
Main Entrance
Conference Room
Group Consulting
5
Vision and Hearing
Sick Waiting
4 Exam 1
Waiting Restroom
Exam Restroom
Doctor’s Office
Nurse Station
Exam 2
Exam 3
Physician Dictation
Janitor’s Closet
Storage, Recycling, and Future Expansion (Undeveloped)
Expansion (Undeveloped)
N
Reception Desk Sliding Countertop; ADA Access, Side Approach
Drawers
Drawers Check-In Recycle
Check-Out ADA Access, Front Approach
• Desk is organically designed to take the form of an cell • Overhanging soundscape acoustic clouds are wayfinding tools • Provokes curiosity of children • Check-out recesses into reception area to eliminate hallway traffic between waiting room and exam rooms
Reception Experience
Elevation A
A
B
Elevation B
Reception Desk Details
Section A
Section B
Section A
Section B
Waiting Room
Buoy Ottoman, Steelcase
Mitra Chair, Steelcase
Paper Table, Steelcase
Campfire Big Lounge, Steelcase
Wayfinding Wayfinding Landmarks EXAM 1
Triage Zone Signage << Exam 1- Exam 3 >> << Exam 4 - Exam 6 >> <<Radiology <<Labratory
Fiber Artwork: Organic Cells
Exam Room Functions Limitations: • Doctor work and treatment zone eliminated • Patient Proximity to Partners- some children may feel uncomfortable
Opportunites: • Connect 3 P’s • Humanize Exeperience • Enhanced Communication • Flexibilty- can be used for consultation Limitations: “Examination Zone” eliminated Patient Proximity to Partners
A
Opportunites: Connect 3 P’s Humanize Exeperience Consultation Enhanced Communication Flexibilty
Connect: Patient Partner Provider
Perspective A
B
Perspective B
Exam Room Functions
• Height adjustable exam table, DRE Med • height ranges from 18” to 31” • allows independent access for children • can be raised to fit the comfortability of doctor • Flat table, pushed against the wall to contain child and maintain safety (Dr. Klinger)
Elevation A
Elevation B
B C
A D
Elevation C
Elevation D
Aesthetic Palette Biophilia- a human’s innate tendency to seek connections with nature • Color pallatte reflects natural pallete of our environment • Analogous color scheme composed of cool greens and blues • Wood and gray tints and tones incorporated to mimic a natural setting • Use of textiles with organic patterns to reflect organic form of cells • Materials with low VOC emissions for WELL Building Standard “Air”
“A Right to Light” Light: Well Building Standard
“Exposure to adequate levels of sunlight is critical for health and well-being, for effects ranging from visual comfort to neurological and phsycological gain” (International WELL Building Standard). Waiting Room Sunlgiht Access: • Use of casement windows and floor to ceiling glass windows allow light to enter the space • Use of clerestory windows to extend sunlight exposure into more spaces
Staff Collaboration Sunlight Acess: • Roof is equipped with skylights for sunlight exposure • Clerestory windows in exam rooms and floor to ceiling glass in the doctor’s offices extend exposure into space
Triage Zone
Circadian Lighting Features Light: Well Building Standard
USAI: True Zero Connect Armstrong Ceiling Application
Circadian Lighting System Midnight Light: None
Light: Low to None
3:00 A.M.
9:00 P.M. Light: Medium to Low
Light: None
6:00 P.M.
6:00 A.M.
Light: None
• Humans have biological response to light and dark cycle known as our circadian rhythm • Circadian lighting is aligned with the natural light and dark cycle of the solar day • mimics natural lighting to induce our bodies response to levels of productivity and rest (USAI Lighting)
Light: Medium
9:00 A.M. 3:00 P.M. Light: Medium to High
Light: High
Noon
Acoustic Considerations Comfort: Well Building Standard “Sound Barriers” intent is to reduce sound transmission and acoustic disruptions through sound barriers.” (International WELL Building Standard)
Control Room
Laboratory
Lab Restroom
Sub-waiting
Nursing Room
Nursing Room
Business Manager Office Business Office
Exam 4
Blood Draw Room
Exam 5
Radiology
Exam 6
Breakroom
Doctor’s Office
Business Staff Collaboration
Well Waiting Doctor’s Office
Conference Room
Reception Mechanical Room Staff Restroom Data Closet
Work Room
Check-In
Staff Collaboration Check-Out
Main Entrance
Group Consulting
A
Group Consulting
Doctor’s Office
Nurse Station
Vision and Hearing Sick Waiting Waiting Restroom
Section A
Physician Dictation Exam 1
Exam Restroom
Exam 2
Exam 3
Janitor’s Closet
Storage, Recycling, and Future Expansion (Undeveloped)
Expansion (Undeveloped)
Careful detailing of interior partitions and ceilings improve sound reduction • To reduce acoustic sound from exam room: acoustic batt insulation, acoustic sealant, • Soundscape acoustic clouds applied • Staff collaboration has large open space with high ceiling: acoustic cloud vault system
Appendix
Technical Information
• Exit Distance and Common Path of Travel • Door Acessibility • ADA Door Accessibilty Diagrams • Turning Radii • International Building Code • Minimum Corridor Width • Codes Issues • Restroom Acessibility • Recycle Program • Bibliography
Technical Information
Exit Distance and Common Path of Travel Sprinkled Building: Exit Doors and Exit Access Door Ways must be at least 1/3 the diagonal distance Common Path of Travel Travel Distance (Including Common Path)
Control Room
Laboratory
Diagonal Distance Distance Between Exits Point at which to Make a Decision
Sub-waiting
Lab Restroom
Blood Draw Room
Radiology
Breakroom
Exit Signage
Nursing Room
Nursing Room
Business Manager Office Business Office
Exam 4
Exam 5
Exam 6
Doctor’s Office
Business Staff Collaboration
Well Waiting Doctor’s Office
Conference Room
Reception Mechanical Room Staff Restroom Data Closet
Work Room
Check-In
Staff Collaboration Check-Out
Triage Zone
Main Entrance
Group Consulting
Doctor’s Office
Nurse Station
Group Consulting Vision and Hearing
Sick Waiting
Physician Dictation Exam 1
Waiting Restroom
Exam Restroom
Exam 2
Exam 3
Janitor’s Closet
Storage, Recycling, and Future Expansion (Undeveloped)
Expansion (Undeveloped)
N
Technical Information Door Accessibilty Refer to next slide for diagrams
TRIAGE ZONE
N
Technical Information ADA Door Accessibility Diagrams
Figure 404.2.3 Clear Width of Doorways
Figure 404.2.4.2 Maneuvering Clearances at Doorways without Doors, Sliding Doors, Gates and Folding Doors
Figure 404.2.4.1 Maneuvering Clearances at Manual Swinging Doors and Gates
Technical Information International Building Code Occupany Type: Business 4
Required: 3 Lavatories (Unisex)
2
Required: 2 Exits
4
Required: 31 Water Closets (Unisex)
11 Required: 1 Service Sink 3 Required: 1 Water Fountain
TRIAGE ZONE
N
Technical Information Turning Radii
ADA Standards Chapter 304.4 • Turning Radii are 60”
TRIAGE ZONE
N
Technical Information Minimum Corridor Width
Minimum Corridor Width 60” (CH 402) All 60” or more Minimum Corridor Width 44” (CH 402) All 44” or more
Minimum Corridor Width 60” (Ch 402) All 60” or More Minimum Corridor Width 44” (Ch 402) All 44” or More
TRIAGE ZONE
N
Technical Information Restroom Accessibility
18”
56” GRAB BARS 60”
48”
Figure 306.3 Knee Clearance
Figure 604.5.2 Rear Wall Grab at Water Closets
Figure 604.3.1 Size of Clearance at Water Closets
Figure 604.5.1 Side Wall Grab Bar at Water Closets
30”
BABY CHANGING STATION
Reference: Part E ii Toilet Room Accessibility Word Doc Made on Illustrator
Technical Information
Code Issues and Room Annotations 2010 ADA Standards Codes Issues
Figure 404.2.4.1 Maneuvering Clearances at Manual Swining Doors and Gates
What I would do Differently: • Reconfigure the entire business office • Switch Manager’s Office with Business Office • Design a smaller work room or integrate it into the business office as open casework
Control Room
Laboratory
Sub-waiting
Nursing Room
Nursing Room
Business Manager Office Business Office
Exam 4
Lab Restroom
Blood Draw Room
Exam 5
Radiology
Exam 6
Breakroom
Doctor’s Office
Business Staff Collaboration
Well Waiting Doctor’s Office
Conference Room
Reception Mechanical Room Staff Restroom Data Closet
Work Room
Check-In
Staff Collaboration Check-Out
Main Entrance
Group Consulting
Doctor’s Office
Nurse Station
Group Consulting
Triage Zone Vision and Hearing Sick Waiting
Figure 404.2.4.1 Maneuvering Clearances at Manual Swinging Doors and Gates
Physician Dictation Exam 1
Waiting Restroom
Exam Restroom
Exam 2
Exam 3
Janitor’s Closet
Storage, Recycling, and Future Expansion (Undeveloped)
Expansion (Undeveloped)
N
Technical Information Recycle Program
Recycle Program Freestanding Recycling and Trash Bin, Steelcase • Took this idea, and custom made for the waiting area • Also implemented two bins in countertop space in prominent rooms • Exam rooms recycle and waste bins are included in drawers • restricts access from children • used for medicall recycle and waste • Storage and expansion contains stock pile of trash and recyle • Recycle goes to company in Manhatta that sorts recycle waster for the clinic
TRIAGE ZONE
N
Bibliography “Behavioral Health Barometer Kansas, 2014”. SAMHSA, Center for Behavioral Health Statistics and Quality, National Surveys on Drug Use and Health. (2010-2014). Retrieved from: https://www.samhsa.gov/data/sites/default/files/State_BHBarometers_2014_1/BHBarometer-KS.pdf “Circadian Rhythm Lighting”. USAI Lighting. (March 16, 2015). Retrieved from: http://www.usailighting.com/circadian-rhythm-lighting “Kansas: State Nutrition, Physical Activity, and Obesity Profile” Overweight adn Obesity. (September 2012). Retrieved from: https://www.cdc.gov/nccdphp/dnpao/ state-local-programs/profiles/kansas.html “Our Standard”. International WELL Buildling Institute. (2017). Retrieved from: https://standard.wellcertified.com/light/right-light “PMB Utilizes Toyota Lean and Dean on-stage/ off-stage Principles in the design and operation of the new LEED Certified St. Jude Heritage Medical Plaza”. Pacific Medical Buildings. Retrieved from: http://www.pacificmedicalbuildings.com/wp-content/uploads/2015/09/Heritage-Medical-Plaza-Case-Study-screen. pdf “The State of Obesity in Kansas”. The State of Obesity. (2016). Retrieved from: http://stateofobesity.org/states/ks/ “2016 Kids Count”. Kansas Action for Children. (2016). Retrieved from: http://kac.org/wp-content/uploads/2012/11/2016KansasData.pdf