Master's Thesis

WELLNESS CAMPUS B Y N A M R ATA T U L S I A N E Y NTULSIANEY@ GMAIL. COM

Wellness Campus : The New Era In Healthcare

A Thesis Project Presented to the Faculty of California State Polytechnic University, Pomona

In Partial Fulfillment of the requirement for the Master of Architecture

By Namrata Tulsianey Summer, 2015

MASTERS OF ARCHITECTURE | 2015

Wellness Campus : The New Era In Healthcare

Author: Namrata Tulsianey

Date Submitted: _____________________________________________________________ Department of Architecture

Thesis Advisors George Proctor RA, Professor Dennis McFadden FAIA

Technical Consultant Liz Mahlow, PE

Graduate Coordinator Kip Dickson

California State Polytechnic University, Pomona Summer 2015 MASTERS OF ARCHITECTURE | 2015

ACKNOWLEDGMENT

Firstly, I would like to express my sincere gratitude to my advisor Prof. George Proctor, RA for his continuous support during my Masters in Architecture thesis study and research. His guidance, motivation and immense knowledge has helped during all times. There could not have been a better advisor and mentor for my thesis and master’s program.

Besides my advisor, I would like to thank my thesis committee: Dennis McFadden, FAIA, Elizabeth Mahlow, PE and Prof. Kip Dickson, Graduate Coordinator for their insightful comments and encouragement. They have always motivated me to widen my research from various perspectives.

Last but not the least, my deep appreciation goes to my family. Special thanks to my husband Ashish Thakwani, for his patience and tireless support and contribution of knowledge and assistance.

My gratitude to people cited in the credit or bibliography for information, photographs that contributed to this work.

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Contents I. Abstract/Thesis Statement II. Research A. The Issue B. The Role of Architecture C. Case Studies and their analyses D. Program 1. Program Narrative 2. Detailed Program Matrix, spaces quantiied E. Location & Site III. Ideas A. Architectural Narrative 1. design strategies, methods, and tactics 2. form, space, organization B. Scapes Narrative 1. cultural, economic, environmental context 2. context, site, and landform strategies, methods, and tactics C. Technical Narrative 1. structures, material, construction IV. Design A. Ideagram and Design Description B. Massing Options C. Diagrams D. Site Plan E. Floor Plans F. Sections / Elevations G. Exploded axonometric H. Vignettes inside key spaces I. Wall Section(s) J. Model Photos K. Presentation Boards V. Appendices A. Annotated Bibliography B. General Plan Constraints & Applicable Building Codes Documentation C. Room Data Sheets D. Preliminary Cost Model

THESIS STATEMENT

Abstract/Thesis Statement | 7

With the reorganization of the medical industry, hospital campuses are changing. Campuses will need to be significantly reconfigured with the introduction of a wellness element, which will require changes to the relationships between principal programmatic components and reorganization of the campus grounds.

RESEARCH

Research | 9

Wellness

There are many definitions and interpretations of wellness, all of which establish a healthy balance in the components of an individual’s life. In order to define wellness I have referred the six dimensions of wellness from National Wellness Institute.

The institute was established in the year 1977 with the mission to serve professionals and organizations that promotes optimal health and wellness in individual and communities.

It defines wellness as an active process through which people become aware of and make choice towards a more successful existence. The interdependent model developed by Dr. Bill Hettler, co-founder of the National Wellness Institute, breaks down wellness into eight categories: Physical, Spiritual and Emotional, Social, Occupational and Intellectual wellbeing. The interconnectedness of these dimensions in a balanced way defines wellness.

Research| 10

The Issue DELNORTE

Health Epidemic Statistic

S is kiyou

Modoc Humboldt

Americans are in the midst of a “lifestyle disease�

T rinity S has ta

epidemic. The Centers for Disease Control and Prevention has identified four behaviors which

Las s en T ehama

Mendocino

Plumas

G LENn BUTTE

are, inactivity, poor nutrition, tobacco use, and

Lake

S ierra

C OLUSA Yuba

frequent alcohol consumption as primary causes of disease in the United States, causing increasing prevalence of diabetes, heart disease, and

Nevada

S utter

Placer

S onoma

Yolo

Napa

E LDORADO Marin

S olano

S acramento AMADOR

C ONTRA C OSTA S an F rancis co S an J oaquin ALAMEDA

chronic conditions in both men and women.

Adults with heart disease, diabetes, asthma, or fair

ALPINE

C ALAVERAS T uolumne

S an Mateo S tanis laus

Mono

S anta C lara S anta C ruz

Maripos a Merced Madera

or poor health status are considered to have a

S an Benito F RESNO

chronic disease.

Monterey

Kings

In fact chronic diseases have become a major burden in the United States, as they lead to dimin-

T ulare

Inyo

S an Luis Obis po

Kern

ished quality of life, account for severe disability in S anta Barbara

25 million Americans, and are the leading cause

Ventura S an Bernardino

of death, claiming 1.7 million lives per year.

Los Angeles

Orange R ivers ide

S an Diego Imperial

34%

38%

42%

47%

51%

Research | 11

Need for Wellness

$12,900.00

High Economic Expenditure Statistics $7,900.00 $7,200.00

The current economic model of healthcare deliv-

$5,600.00

ery is extremely inefficient and expensive due to two primary reasons. First, most of the medical $2,400.00

costs are paid for by government and employers instead of patients, so they have little concern about costs. Second, payment is on a fee-for-service basis encourages both providers and users of medical services to increase the number of pro-

Heart Disease

Diabetes

Hypertension

CPOD Asthma All Californians

The bar chart shows the health care spending as per chronic condition.

cedures.

To make matters worse, the costs attributed to treating

chronic

disease

are

estimated

to

account for over 75 percent of national health

7%

11%

10%

36%

42%

28%

expenditures. This is an additional burden on an

12%

10%

Uninsured

60% 42%

Private

11%

Medicaid/Other Pu

already inefficient system. Furthermore, while chronic disease was once thought to be a prob-

9%

lem of older age groups, the number of working-age adults with a chronic condition has grown

56%

12% 10%

by 25 percent in ten years. Health care costs are

41% 37%

high for Californians with any of the target condi-

12%

tions. But the health care cost per capita for people with heart disease is by far the highest:

16%

16%

more than five times that of the general adult population.

Heart Disease

Diabetes

Hypertension CPOD/Asthma All Adults

Insurance Coverage,

by Target Condition and Payer, Adults

Medicare

Research | 12

PERCEPTION ARCHITECTURAL ASSOCIATED THE PRIVACY/ INDIVIDUALISM

ARCHITECTURAL ASSOCIATED WITH HAPPINESS MORE COMMUNITY ACTIVITY

Community Centers / Parks Sports Stadium

Dance Studio

Home

Yoga/Meditation Studio Fitness Center Work place

WELLNESS

Cemetery

Hospitals Prison / Detention Centers

ARCHITECTURE ISOLATED/DETACHED FROM SOCIETY

ARCHITECTURE ASSOCIATED WITH PSYCHOLOGICAL FEAR

- VE

Research | 13

Wellness Campus Society is forever in the state of metamorphosis.

The central community resource acts as a cata-

Ideology and need drive societies to bring about

lyst to bring overall wellbeing. Patient healing is

the change but the process is a slow one. The

greatly influenced by its environment. Conducive

effort of one individual may take a lifetime or

environments dissipate the feeling of fear and

more to become the calling of an entire move-

negativity associated with traditional hospital

ment. In a similar manner, American society

setting. By integrating the wellness component

displays the symptoms of the problem with the

into current configuration it re-energizes the hos-

healthcare system which has become the con-

pital campus which increases the speed of recov-

cern of not one but many individuals.

ery. The goal is to revitalize the hospital environ-

Considering the American healthcare crisis the

ment with focus on overall healing rather than

medical organizations and government have

treatment of particular ailment.

taken considerable steps to improve the system.

The Affordable Care Act will have a huge impact on how healthcare facilities are going to be designed.

Currently the hospitals are dense and a constrained clustered spaces which if not physically, psychologically isolated from the community. The design strategies and location evoke a feeling of fear in patients. The thesis attempts to change the perception of the hospital by reconfiguring the medical campus incorporating the wellness component into the campus. This is an interdisciplinary approach to redefine hospital architecture from a sick care institution to total health environment.

The transformation is from a single use land development to an integrated, multi-use setting.

In

essence, the hospital becomes a new form of civic architecture.

The thesis attempts to change the perception of the hospital by reconfiguring the medical campus incorporating the wellness component into the campus.

Research | 14

Evolution of Healthcare & Hospital Architecture 1945 & 1946 “The scientific imperative treat” which shift the focus towards

1800 & Prior “The moral imperative comfort” Home based remedies was prevalent. Doctors used to visit for serious conditions. This practice was called "Domestic Medicine"

Monasteries places of healing focus on holistic health.

Connection with nature a strong therapeutic element

health

1843 American Medical Association (AMA) formed with focus on regulating practice of medicine

care

Post World War II & Centers for Disease Control and Prevention was established Advancements in Diagnostic tests and vaccines led to eradication of many diseases, decreasing symptoms and fixing immediate problems.

Establishment of insurance companies.

1893 John Hopkins University Medical School established

The primary focus in hospital design was on ward dimensions courtyards & window sizes for abundant light and ventilation.

Research | 15

2010 Affordable Care Act “The economic imperative prevents� which shift the focus

1990 & 1993 Communication advancement like Internet and the World Wide Web bought awareness about healthcare.

Non profit center for health design critical examination of hospital building

health

To make health care more affordable, accessible and of a higher quality, for families, seniors, businesses, and taxpayers alike.

Major impact on Healthcare Architecture

2011

1950 The modern hospital after post war period.

The connection between nature and healing superseded by technical approach.

Landscaping was merely seen as a decoration to offset hospital building or attract prospective customers.

Hospital buildings became sealed with limited or no access to natural light and ventilation.

care

1990 - 2000 Springing of separate disorganized facilities with focus on overall wellbeing - spas, gymnasiums, yoga studios was on the rise.

These facilities helped high stressed individuals reconnect back to nature which aided in disease prevention and relaxation.

However these facilities are completely separate from hospitals.

2015

Small Hospital, Big Idea Competition Kaiser Permanente Health is achieved through wellness/flexibility/adaptability outdoor environment changing the perception of healthcare architecture by making it more accessible to people.

Case Studies | 16

Case Studies

Three case studies were carried out to study different aspects of wellness.

1. Case Sudy I

Wellness & Recreation Center, Georgia College and State University

2. Case Study II

UCLA Outpatient Surgery and Oncology Center

3. Case Study III Adamsville Regional Healthcare, Atlanta Georgia

Case Studies | 17

Case Study I

Wellness & Recreation Center Georgia College and State University Architect : Canon Design Area : 57,000 sq.ft

Case Studies | 18

Circulation

Support Areas Locker Rooms

1500 sq.ft

Service

1560 sq.ft

Aquatics Swimming Pool 6000 sq.ft Therapy Pool

2000 sq.ft

Primary Care

Level 2

Exam Room

6200 sq.ft

Counseling

4500 sq.ft

Conference

240 sq.ft

Gymnasium, Fitness Center

Gymnasium

18,000 sq.ft

Fitness Center

800 sq.ft

Class Room

500 sq.ft

Jogging Track

1/16 mile

Multipurpose

2500 sq.ft

Net Square Footage 44,000 sq.ft Gross Area 58, 000 SSS Building Efficiency Ratio = 75%

Level 1

Case Studies | 19

Useful Programmatic Components

THERAPY POOL

FITNESS TRACK

Beneficial for patients with orthopedic problems.

1/16 mile elevated track which runs around the gymnasium.

PRIMARY CARE

MULTIPURPOSE HALL

Health center has exam room for physi-

Studios for yoga, tai-chi & pilates

cians acts as a primary health care.

Case Studies | 20

Case Study II

Case Studies | 21

Receiving Receiving

1000 sq.ft

Lab Laboratory

2500 sq.ft

Pharmacy

1560 sq.ft

Staff Area Lockers

1500 sq.ft

Lounge

2000 S

Cancer Treatment Radiology

5500 sq.ft

Operating Theatre Level 2

OT

5000 sq.ft

Recovery

3440 sq.ft

Support Processing

2500 sq.ft

Lobby

2000 sq.ft

Waiting

3000 sq.ft

Exam Rooms Exam Room

10,000 sq.ft

Doctors Lounge Storage Area

Net Square Footage = 40,000 sq.ft Gross Area = 50,000 sq.ft Building Efficiency Ratio = 80 % Site Area = 250 x 150 = 37,500 sq.ft Level 1

FAR = 1.6

Case Studies | 22

OUTPATIENT SURGERY AND RECOVERY AREA Layout of operating theatre and recovery area.

LIGHT AND VENTILATION The building has been designed in an efficient manner using natural light for most areas.

EXAM ROOMS Layout of exam rooms and support functions

Case Studies | 23

Case Study III

Circulation C irculation SStrategy trategy

Adamsville Regional Healthcare Atlanta Georgia Architect : Stanley Beaman & Sears Area : 34,000 sq.ft

Case Studies | 24

Dental 2000 sq.ft

Support Areas 3500 sq.ft

Women Infant Clinic 4000 sq.ft

Daycare Center 4500 sq.ft

Level 2

Administration 5000 sq.ft

Primary Care Clinic 9000 sq.ft

Level 1 Net Square Footage = 28,000 sq.ft Gross Area = 34, 000 sq.ft Building Efficiency Ratio = 82 %

Case Studies | 25

USEFUL PROGRAMMATIC COMPONENTS i. DAYCARE CENTER Since the program has a women clinic the daycare center is very useful for visiting patients. ii. DENTAL CLINIC Layout is very efficient.

Program | 26

Program Narrative Society is always undergoing transformation and the most innovative solutions is to rethink how the current spaces can be used. It is not possible to destroy and start from the beginning but a overlay of different design options helps in solving the problem better. As is the case of traditional hospital environments which have a feeling of fear and negativity associated with them. The thesis attempts to revitalize the hospital campus by introducing wellness programmatic components into an existing campus. The campus has varying conditions of public versus private zones, dynamic versus static program and other localized factors, the intention is overlay the three strata to form a new hybrid spaces.

layering

OVERLAP

PROGRAM

existing campus transformed by adding new programmatic components

TIME

VARIATION

STRUCTURE

interaction of old and new components gives variation

HYBRID

NEW CAMPUS MORPHOLOGY

Program |27

WELLNESS CENTER

- TYPE OF USES PUBLIC 25 %

SEMI PUBLIC 55 %

PRIVATE 15 %

WELLNESS PROGRAM

OUTPATIENT FACILITY

- PHYSICAL FITNESS - EDUCATION - RETAIL

- OUTPATIENT SURGERY - PRIMARY CARE - DIAGNOSTIC

ADMINISTRATION

Outline Program AREA 83,825 SQ.FT OUTPATIENT FACILITY 35,000 SQ.FT

DIAGNOSTIC AREA

OUTPATIENT SURGERY

WELLNESS COMPONENT 30,000 SQ.FT

EXAM ROOMS

EDUCATION

EXERCISE

RETAIL

OUTDOOR 30,000 SQ.FT

FITNESS TRACK YOGA /TAI CHI STUDIO

ADMIN 7,000 SQ.FT

PLAZA

Program | 28

Taxonomy or Activies

Fitness 6000 sq.ft

Tai Chi & Yoga 6000 sq.ft

Physical / Emotional/ Social Wellness

Massage 1000 sq.ft

Education & Retail 8000 sq.ft

Mediation 1000 sq.ft

Program | 29

Taxonomy or Activies

Radiology 2500 sq.ft

Clinical 2000 sq.ft

Examination Diagnosis & Treatment

13,000 sq.ft

Treatment Surgery/Recovery 6,000 sq.ft

Blood Donation 3,200 sq.ft

Program | 30

Detail Program

Exam Room

Diagnostic

0

100 100 120 100 100 100

SUB WAITING DRESSING ROOM BONE DENSITOMETER OFFICE RADIOLOGY VIEWING ROOM/PICTURE ARCHIVING XRAY RADIOLOGY MAMMOGRAPHY ROOM TOILET ULTRASOUND ROOM TOILET CT EQUIPMENT ROOM CT CONTROL ROOM CT SCAN ROOM

300

400

500

600

700

800

900

300 300 180

100 100 400 120

BLOOD SPECIMEN COLLECTION ROOM TOILET LABORATORY CLINICAL CHEMISTRY LABORATORY GENERAL STORAGE REFRIGERATED STORAGE SHIPPING/RECEIVING TOILET STAFF

POD I ALCOVE WEIGHT STATION ALCOVE HEIGHT ACCESSIBLE STATION CONSULTATION ROOM MULTIPURPOSE EXAM ROOM MULTIPURPOSE PROCEDURE ROOM TOILET- PATIENT ALCOVE MEDICATION ALCOVE RESUSCITATION CART WORK STATION /TEAM WORK AREA WORKROOM PATIENT ALIGNED CARE CLASSROOM MEDICAL STORAGE TOILET STAFF COMMUNICATION ROOM HOUSEKEEPING AIDS CLOSET UTILITY ROOM CLEAN UTILITY ROOM RECYCLED UTILITY ROOM SOILED PNEUMATIC TUBE STATION

200

600 300 300 120 150 80

40 40 120 120 180 75 20 20 240 100 240 100 60 100 60 120 80 80 20

Legend Area in sq.ft.

Count

Program | 31

Detail Program

Physiotherapy

Blood Donation Center

Outpatient Surgery

0

100

EXERCISE AREA TREATMENT CUBICLE EXAM ROOM OFFICE THERAPIST TOILET STORAGE

300

400

500

600

700

800

1000

1200

150

RECEPTION & CONTROL WORK STATION/PATIENT EDUCATION PREPARATION AREA PRE-OPERATING ROOM/HOLDING AREA TOILET ALCOVE- PATIENT PERSONAL STORAGE STAFF ROOM DOCTORS TOILET LOCKER ROOM MEN & WOMEN MEDICATION ROOM STERILIZATION UTILITY ROOM CLEAN UTILITY ROOM SOILED STORAGE OPERATING THEATRE SCRUB UP AREA EQUIPMENT ROOM CONTROL AND COMMUNICATION CENTER POST RECOVERY NURSE STATION

WAITING AREA & RECEPTION DONOR RECORDS INTERVIEW ROOM EXAMINATION ROOM HEMOGLOBIN SCREENING COLLECTION AREA STAFF WORK BASE LINEN SCREENING (POST DONATION) DONOR LOUNGE PANTRY BLOOD STORAGE LABORATORY TESTING STAFF AREA CLEANER WASTE TOILETS

200

40

60 80

100 120

120 60 200 120 120 100 100

200 120

100 120 120 800

150

100 120 80

100

80 700

60 20 120

200

100 400

300

180

40 60 100

120 100 100 100 120

1200

Legend Area in sq.ft.

Count

Program | 32

Detail Program 0

100

Administration

EXERCISE TRACK GYMNASIUM LOUNGE CONTROL DESK STUDIO STORAGE STAFF AREA

Wellness

LOCKER ROOM WOMEN LOCKER MEN LOCKER LAUNDRY STORAGE THERAPEUTIC POOL POOL FAMILY CHANGING PUMP ROOM CHEMICAL STORAGE YOGA/TAI CHI STUDIO GROUP THERAPY TRANQUILITY SPACE MASSAGE CENTER MASSAGE THERAPY COUPLE MASSAGE CHIROPRACTOR ROOM CHIROPRACTOR OFFICE ALTERNATIVE MEDICINE OFFICE CONSULTATION ROOM LAB

300

400

500

600

1000

2000

3000

6000

12000

300

STAFF LOUNGE STAFF TOILETS CONFERENCE TEAM WORK AREA

SUPPORT AREAS ALCOVE WHEELCHAIR VESTIBULE RECEPTION+WAITING KIOSK PATIENT CHECK IN ALCOVE VOLUNTEER PATIENT EDUCATION TOILET PUBLIC MALE TOILET PUBLIC FEMALE

200 100

400 240

90 150

3000

40 40

100 200 200

12000 300

100

6000 200

300 1000 1100

100 100

1800

100 100 100

1000 1000 1000

120 120 100 100 120 120

150

Legend Area in sq.ft.

Count Count

Program | 33

Detail Program 0

100

200

Retail

Cafeteria

RESTAURANT KITCHEN STORAGE & UTILITY

120

DEMO EDUCATION/KITCHEN MARKET AND DEMO MOBILE TEST KITCHEN GROCERY LAB OFFICE CLASSROOM BUSINESS ROOM

NET AREA GROSS AREA GROSSING FACTOR

400

500

600

700

800

1000

1200

350

120 120 120

NUTRITION OFFICE NUTRITION CONSULTATION FAMILY CONSULTATION

PHARMACY DRUG DISPENSING SYSTEM DISPENSING WINDOW PRESCRIPTION RECEIVING WINDOW CONSULT ROOM PHARMACY TOILET STAFF PHARMACY DATA PROCESSING HEALTH STORE

300

180

800 400

200 800 120

100 60 80

120

60 1200

140 600

83,325 SQ.FT.

Legend Area in sq.ft.

Count

6LWH _ 34

Mapping of Hospitals Legend 6LWH ZLWK ([SDQVLRQ SODQ +RVSLWDO +RVSLWDO ,QWHUFRQQHFWLRQV :HOOQHVV &HQWHUV

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6LWH _ 36

Site Selection - Criteria The case study for my thesis is Los Angeles and Orange county. The process of selection for a suit-

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able hospital campus forms the basis of my project because the wellness component will be introduced into the existing campus. This component will form the public interface for the hospital campus. The first step towards was to identify the

Location on campus

hospitals campus in region and which medical network they belong. The criterias established for site was divided into following six categories. Ĺ? 0HGLFDO 1HWZRUN Ĺ? /RFDWLRQ RQ &DPSXV Ĺ? 3URJUDP &RPSRQHQWV

3URJUDP &RPSRQHQWV

Ĺ? /DQGVFDSH &RPSRQHQWV Ĺ? 'HPRJUDSKLFV Ĺ? $FFHVVLELOLW\ Based on above criteria I selected below three sites.

/DQGVFDSH &RPSRQHQW

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'HPRJUDSKLFV

WR FDPSXV YV $GDSWLYH UHVXVH 2XWSDWLHQW IDFLOLW\ YV 'LDJQRVWLF IDFLOLW\ YV :HOOQHVV IDFLOLW\ 2SHQ VSDFHV YV QR 2SHQ VSDFHV +LJK GHQVLW\ YV /RZ GHQVLW\ 9LVLELOLW\ YV (DVH RI XVH

Accessibility

Site | 37

Site Selection - Comparison Matrix

VALUE

10%

25%

30%

20%

5%

10%

CRITERIA

SUB CATEGORY

A

B

C

D

E

F

G

H

I

J

K

L

M

N

GOOD SAM HOSPITAL

MISSION HOSPITAL

KAISER PERMANENTE

100 %

Good Samaritan Mission Hospital Kaiser Permanente

0% Cumulative Points Chart LEGEND

50% 100% A - Innovative C - Extension to F - Outpatient Facility Preference Preference B - Adaptability Building G - Diagnostic Facility D - Extension to H - Wellness Facility Campus E - Adaptive Reuse

I - Open Space J - No Open Space

K - High Density L - Low Density

M - Visibility N - Ease of Use

Site | 38

Good Samaritan Hospital - Medical Network NETWORK Proposed Hospital Affiliated Hospital Church Church Affiliation

HOLLYWOOD

Medical Affiliation SILVERLAKE AK AK

MIRACLE MILE

DOWNTOWN LA W-ADMS EXPO PARK

VERMONT SQUARE

SOUTHPARK

The Good Samaritan hospital was established in

downtown & Silverlake, Korea town. Each year,

the year 1911 to save the community. It is histori-

Good Samaritan Hospital admits approximately

cally affiliated with the Episcopalian Church. Pas-

17,000 patients excluding newborns and handles

toral Care services are available for several

more than 93,500 outpatient visits. Considering

religions denominations. Medically it is affiliated

the transformation in the medical industry the hos-

with USC Keck School of Medicine and UCLA. Situ-

pital is undergoing expansion. There is a proposal

ated in the densely populated community of

for a new 193,000 sq.ft medical and outpatient

westlake it serves the surrounding communities of

facility which makes it the ideal site for my project.

Site | 39

Good Samaritan Hospital - Planning & Zoning Regulations LANDUSE Parking 7.5% Manufacturing 7.5% KE

D B LV

VIR GIL AV E

SILVER LA

ELYSIAN PARK AVE

TEM

BE VE RLY BLV D

PLE

L VD SU NSET B

Residential 40%

ST

ALV AR AD O

ST

UN ION AVE

RA M

PAR T

BLV D

£ ¤101

ST AU DR YA VE

3RD

BE

6TH ST

1S T

RS T

B LV D

2N D

BIX EL ST

LUC AS AVE

IRE

WIT ME

WI LS H

ST

ST

ST

M.

WO OD BLV D

OA

4T H

ST

8TH ST 5T H

ST

BLA

IN E

ST

GR AN D

AV E

ES

FIG UE R

HOOVER ST

JAM

7 TH

HA R

TF O RD AVE

HO PE

ST

Commercial 30%

ST

ST SP RIN G

ST

HO PE

ST

BR OA DW AY

OL IVE

ER FL OW

ST

HIL L

ST

6T H

ALB A

Open Space 15%

OB LV D

NY ST

PIC

ST

UN ION AVE

OLY MP IC B LVD

IN

ST

S

T

MA

9T H

VE NIC EB LVD

ST

LO

S

L GE AN

ES

residential, commercial, open space and manufacturing uses. The land use and zoning map have similar uses. The hospital site falls under commercial zoning.

PE DR O N SA

PIC OB

¦§¨

10

LV D

LE AV E

multifamily

MA P

Westlake has a mix of

ST

¦§¨110 WA SH IN G TO NB LVD

Site | 40

Good Samaritan Hospital - Mobility MOBILITY Proposed Site 101

Freeways Metro-link Railroad Bicycle Friendly Roads Bicycle Paths

110

101

The proposed site is located in the

community

of

Westlake

10

which is easily accessible by I-110, US-101 & I-10. They are is connected by Metro-link which goes till 10

Union Square.

110

Site | 41

Good Samaritan Hospital - Health Related Services AMENITIES Proposed Site Hospitals Public Open Space Wellness Centers

Macarthur Park a public recreation open space is located on Wilshire Boulevard a few block away from the Good Sam hospital. City of Hope hospital is located next to the site on Wilshire boulevard.

Giraradi

Asia Journal Office American Best Value

City Center Inn

Wells Fargo Parking

Guest House

Gas Station

Wells Fargo ATM

Office Building 1200 West &7th St

Felipes Bike Shop

La Estelle Market

Historic Mayfair Hotel

KFC Restaurant Shopping Complex

E & L Auto Body Parts

Hotel Holland

Union Plaza Market

Food For Less

Stuart Hotel

WORK/CONSUME

Asian Pacific American

Los Angeles Police Department

John H. Liechty Middle School

Virtual Academy City of Angels

Southern California University

Belmont Community Adult School

INSTITUTE

Investigating Surrounding Context

Site Analysis | 42

HEALTH

Union Dental Clinic

Pacific Clinics Acupuncture

Kidney Center Of Los Angeles

Universal Care Medical & Dental

Good Samaritan Medical Office Good Samaritan Main Hospital

Wilshire District Medical Group

Good Samaritan Cancer Center

Wilshire Dialysis Center Good Samaritan Medical Office City Of Hope, Medical Office

HEALTH

INSTITUTE

Los Angeles Art Center

Los Angeles Art Center

Children's Home Society of California

Miguel Contreas Learning Complex

Para Los Ninos - Evelyn Thurman Gratts Primary School

422 Witmer Apartments Tuscan Villas Andalucia Heights Visconti Elegant Resort Apts 428 Condo

In an effort to explore the latent potential of the surroundings program distribution , local idiosyn-

442 Apartments

crasies 481 Hartfort Avenue Fourth Street Lofts 476 Condo

5 storey Apartment Building 5 storey Apartment Building 5 storey Apartment Building 5 storey Apartment Building 5 storey Apartment Building

Residential Apartments

Parking Piero Apartments 1319 Apartments 1308 Ingahram Apartments Parking Parking Vero Apartments Condo Corporation Piero Apartments 737 Harlseton Apts

San Lucas Apartments San Lucas Apartments Temple City Lights

1050 glo Apartments

WORK/CONSUME

Organic Cafe

Ten Ten

LIVE Unite Here

Legal Center

Chase Bank

LIVE

and

regional

patterns

were documented to reveal local programmatic I and define new opportunities.

Site | 44

Good Samartian Hospital - Surrounding Context

The sections helps in analysing the vertical street scapes. The entire Wilshire hcorridor has a height varying from 60’ to 90’.

GOOD SAM: MAIN HOSPITAL

W 6th Street

Section A GOOD SAM: MAIN HOSPITAL

GOOD SAM: PARKING

Section B

Witmer Street

GOOD G SAM :CANCER HOSPITAL

+120’

+90’ VERO HOA- HOUSING APARTMENTS

+ 60’

+ 30’

SITE

Wilshire Boulevard

Ingraham Street

GOOD SAM: MEDICAL TOWERS

GOOD SAM :CANCER HOSPITAL

+120’

+90’ GOOD SAM: PARKING

+ 60’

S Lucas Avenue

Site | 46

Demographics Westlake

Total Population 2000 : 108,839 2008 : 117,756

16.56 % 9 years or younger

14.38 % 10 - 19 years

8.5 % 20 - 24 years

19.12 % 25 - 34 years

400 350

36.09 % 35 - 64 years

300 White

250

Hispanic

200

Asian 150

Black

100

5.35 % 65 years or older

ALL

50 0 < 15 Years

15 -44 Years

45-64 Years

65+ Years

Site | 47

Good Samaritan Hospital - Site & Surrounding Zoning : Commercial (CW) Area of Site : 7.02 acres

LOMA DRIVE

5TH ST

Area of Parcel A: 1.46 acres Setback: 10 feet, 3ft min + 1 feet for each story

6TH ST

LUCAS AVE

SHATTO STREET

WITMER ST

not to exceed 16 feet.

A

Height Restrictions: unlimited Parking Requirements : 2 for 1 medical office

WILSHIRE BLVD

LUCAS AVE

WITMER ST

6TH ST

3 2

12

8

1

2. EMERGENCY 3 STOREY

7

10

1. MAIN HOSPITAL 6 STOREY

11

3. PARKING 3 STOREY 4. RADIOLOGY DEPARTMENT

4

5

5. WOMEN CARE 6. LINEAR ACCELERATOR

6

7. AUDITORIUM 8. MECHANICAL PLANT 10. MRI ADDITION 11. MEDICAL OFFICE 12. GUEST HOUSE

WILSHIRE BLVD

Site | 48

Good Samaritan Hospital - Site & Surrounding

Figure & Ground

Open Space

Building Pattern Vehicular and Pedestrian

Site | 49

Good Samaritan Hospital - View of Campus

WITMER ST

LUCAS AVE

6TH ST

WILSHIRE BLVD

Site | 50

Good Samaritan Hospital - Programmatic Components

Physician Office 50%

Obstetrics 18%

Radiology & Cancer Center 56%

Inpatient 26%

Women Center 13% Business 22%

Emergency 14%

Administration 24%

Diagnostic 28% Administration & Education 22%

Outpatient Surgery 13% 1

Medical Office

Administration 14% 2

3

2

1

Hospital

3

Main Hospital

Site | 51

Good Samaritan Hospital - Building Analysis 1 1. RECORDS 2. OFFICES 3. CORE 4. STORAGE 1.

3

WITMER ST

4

2

1.

2

2 3

2-3

5-8

1. WOMEN WELLNESS CENTER 2. DIAGNOSTICS 3. CORE 4. CONSULTATION

1. MEETING ROOM CONFERENCE ROOM 3. CORE 4. EXAM ROOM

1.

2

SITE

4

1

3

4

3

2

WILSHIRE BLVD

Site Plan 4

1. ENDOSCOPY 2. RETAIL 3. CORE

1. WOMEN WELLNESS CENTER 2. DIAGNOSTICS 3. CORE 4. CONSULTATION 1.

2

3

4

IDEAS

Architectural Narrative | 53

Architectural Narrative

3RUH IURP *UHHN Ç&#x2018;Ç?Ç&#x2019;Ç?Ç&#x201C; PHDQV ´D PLQXWH RSHQLQJÂľ 3RURVLW\ RU ´WKH VWDWH RI EHLQJ SRURXVÂľ LQ WKH FRQWH[W RI organic chemistry and the study of plants and animals indicates the existence of small openings. In biology and LQ PHGLFLQH SRURVLW\ LV GHILQHG DV ´WKH DWWULEXWH RI DQ RUJDQLF ERG\ WR KDYH D ODUJH QXPEHU RI VPDOO RSHQLQJV DQG SDVVDJHV WKDW DOORZ PDWWHU WR SDVV WKURXJKÂľ 7KH IRUPV VL]HV DQG GLVWULEXWLRQ RI SRUHV DUH DUELWUDU\ 7KHLU functionality is associated with circulation and filtration with respect to the external environment.

The thesis re-interprets porosity, in order to be used in a new hospital campus, to guide the production of a sponge-like building morphology. The table describes the contextual definition of porosity in relation to my thesis. 7KH FRQWH[WXDO GHILQLWLRQ RI SRURVLW\ ZDV SDUW RI WKH ´SHUPHDELOLW\ K\SRWKHVLV¾ WKDW D SRURXV PRUSKRORJ\ would produce positive effects at an campus and building scale, i.e. better air and light circulation, better accessibility and visibility at an urban scale, and better communication between interior and exterior spaces at D EXLOGLQJ VFDOH 7KH ´SHUPHDELOLW\¾ K\SRWKHVLV HVWDEOLVKHG QHZ UHODWLRQVKLSV DPRQJ WKH IDFWV SURYLGHG E\ WKH building program.

POROSITY

POROUS, PERMEABLE

HONEYCOMB

opening up hospital campus to surrounding people.

SCREEN, NET

SPONGE

visibility & privacy material pattern

SIEVE- LIKE, SIEVE

PERVIOUS

transparency versus opaque

PORE

OPENING

apertures, courtyards

Architectural Narrative | 54

Design Strategies, Tactics & Methods Network of Visual porosity

Patterns

Solid & Void

Formal/Spatial Org. Strategies

Incremental & Whole Operational models

Scope

adaptive reuse

partial design - addition to campus

complete design

interdisciplinary team

matrix organization

hierarchies

ecologies

whole

incremental

circulation

function

site water

active

Site

passive

orientation

urban links

orientation

ext. spaces

Spaces/Forms

parking

service

access

entry

flat spaces

tall spaces

small spaces

Theory(ies)

big spaces

procedural

behavioral

functional

formal

Program | 55

Design Thinking Matrix

Green

Scapes Narrative | 56

Scapes Narrative The thesis attempts to use landscape as an element of therapy for transformation of the hospital campus.

The site is located in a dense urban environment of West lake which offers no space for gardens However connection with nature plays an essential role in healing of the individual. The landscape for the wellness center is divided into two zones semi public and public spaces. The public spaces cater to space for retail and plaza for community gathering and the semi public cater to yoga & tai chi studios , fitness track which may be visible but not accessible to everyone. Architecturally landscape will act as a connector between the old campus and new outpatient and wellness facility helping in transformation of the campus.

+

= OPEN SPACE

GRID FIGURE GROUND

+

FIGURE GROUND

BUILT WITH OPEN

=

OPEN SPACE

WOVEN LANDSCAPE HORIZONTALLY & VERTICALLY CONNECTING

Scapes Narrative | 57

Scapes Narrative Factors which play an essential role in landscape strategies are described in the section below. The strategies apply for horizontal and vertical open spaces.

Restorative & Coping Resources Movement & Exercise Mild Exercise Physical Rehabilitation

Social Support Among patients, visitors, staff

Sense of Control Research shows that a sense of control whether

Natural Distraction

Control

actual or perceived affects the personâ&#x20AC;&#x2122;s ability

Plants, flowers, wildlife

Temporary Escape, Access to privacy

positively to cope with a stressful environment.

Experiences related to illness and injury are stressful because the patient needs to undergo unpleasant diagnostic procedures, medication, pain and dependency on other people. These

Stress Restoration & Buffering

factors are beyond the control. Designed gar-

Enhanced Coping

dens can help patients gain control over their condition. Easy accessibility whether passive or active can have a positive psychological effects

Improved Health Outcomes

on patients. It provides temporary escape from their present condition.

Physical Movement and Exercise Socializing plays a major role in reducing stress for

Exercise is associated with significant health ben-

both patients and staff. Gardens help in fostering

efits and helps in improving overall wellbeing. It

social contact which results in emotionally sup-

plays an essential role in cardiovascular health

portive interaction among patients. The design

and alleviating depression especially for elderly

and planning should facilitate on site access for

and people suffering from chronic diseases.

patients and staff, gathering spaces for small and

There are different types of exercises recom-

large groups and provide a setting for conducive

mended for different types of illness. However,

atmosphere for social interaction. Although social

mild form of exercise like walking, gentle yoga

support plays an essential role in health improve-

are always encouraged by doctors. The gardens

ment it is important to remember privacy plays an

should cater for providing spaces for physical

important role in a garden environment.

movement and exercise.

Tehnical Narrative | 58

Technical Narrative

The building is divided into two structural systems. System a is the Skeletal Structure which forms the frame for the campus on the Wilshire boulevard. System b is the monolithic concrete tube which is inserted into the frame and connects the inpatient zone to the new wellness center. The two systems also act as the driving force behind the program distribution where the lower four floors are for wellness activities and the upper two floor are the outpatient zone. The floor to floor height for the system is 14â&#x20AC;&#x2122; except for the fitness center and theraphy pool which are double height spaces. The two system are on the third level through itness track which runs on top of the monolithic concrete structure and punctures the skeletal framewok.

Sustainble strategies

like cross

ventialation, terrace gardens are will be benefiial for the wellness campus help in lowering the carbon footprint.

STRUCTURE

ENVIRONMENTAL

ENVELOPE

SKELETON

SUSTIANABLE STRATEGIES

SKELTAL FRAME

STEEL STRUCTURE

TERRACE

CURATIN WALL

METAL DECKING

AIR & VENTILATION

CURTAIN WALL

LANDSCAPE

CONCRETET UBE MATERIAL PALETTE

Tehnical Narrative | 59

Monolithic Concrete Structure

Skeletal Framework Curtain Wall, Steel Columns Metal Deck Slab

The massing diagram shows the two structural systems. System a is the skeletal steel structure and system b is the monolithic concrete tube. The skeletal framewok provides tranparency which frames the monolithic concrete tube.

Detail A : Metal Decking Slab

Detail B: Curatin Wall

DESIGN

Ideagram and Design Description| 61

Ideagram & Design Description

Ideagram and Design Description| 62

Ideagram & Design Description With the reorganization of the medical industry,

light circulation, accessibility and visibility at an

hospital campuses are changing. Campuses will

urban scale, and communication between

need to be significantly reconfigured with the

interior and exterior spaces at a building scale.

introduction of a wellness element, which will require changes to the relationships between

Society is always undergoing transformation and

principal

the most innovative solutions is to rethink how the

programmatic

components

and

reorganization of the campus grounds.

current spaces can be used. Hence, the Good Samaritan hospital, Los Angeles is chosen to be

Americans are in the midst of a “lifestyle disease”

the case study for the thesis. The programmatic

epidemic. The Centers for Disease Control has

components

identified four behaviors which are, inactivity,

campus are a combination of wellness activities

poor nutrition, tobacco use, and frequent alcohol

and outpatient facility. The intention is to overlay

consumption as primary causes of disease in the

the three strata of public versus private zones,

United States.

dynamic

which

versus

help

static

in

revitalizing

program

and

the

other

localized factors to form new hybrid spaces.

Currently the hospitals are dense and constrained clustered spaces which if not physically, are

There are three layers to the campus. The first

psychologically isolated from the community. An

layer is the existing campus which shows all the

interdisciplinary approach is adopted to redefine

building of the hospital. The second layer explore

hospital architecture from a sick care institution to

the grid lines of West lake which help in defining

total health environment, making it a new form of

the system for the building. The intersection nodes

civic architecture.

indicates the point where their are existing

The thesis re-interprets porosity, in order to be

building. The third layers are points and lines

used in a hospital campus, to guide the

which help in deriving a system for new campus.

production of a sponge-like building morphology.

The contextual definition of porosity was part of the “permeability hypothesis” that a porous morphology produces positive effects at a campus and building scale, i.e. better air and

Massing | 63

Massing

Based on the site anaylsis and the design description the design process went through a series of iterations after which the most suitable one is selected which is massing 3. Each iterations helps in exploring different design aspects and has certain pros and cons. After running throughthe different options the final massing is selected.

Massing | 64

Massing Options

Southwest Campus View

1

2

Northwest Campus View

Northeast Campus View

Massing | 65

Massing Options

3

4

5

Massing | 66

Massing Option I

Lobby & Waiting

Admin

Operating Theater Diagnostics

1

Exam Rooms

Therapy Pool

Changing Room Fitness Track

Multiprurpose Studio/Terrace

Gymnasium Blood Donation Center Lounge Lobby Cafeteria, Nuitrition & Demo Kitchen

Retail

Massing | 67

Massing Option II Admin Operating Theater

Diagnostics 4

Therapy Diagnostics & Eam Rooms

Yoga Fitness Changing Room Exam Rooms Gymnasium

Nutrition

Retail

Diagrams | 68

Selected Massing Option Diagrams

wi lsh ir

ie at inp e

blv d

o

ie at ut p

nt

zo

ne

4 1 1

3

5

6

2

1

1. PARKING 2. SERVICE AND INPATIENT ZONE 3. MAIN HOSPITAL 4. GUEST HOUSE 5. MEDICAL BUILDING 6. EMERGENCY BUILDING

nt

zo

ne

Diagrams | 69

Selected Massing Option Diagrams

ir lsh wi

le ou eb

Southwest Campus View

rd va

Northwest Campus View

Northeast Campus View

Gateway to Campus: The campus is divided into two sections the inpatient zone & outpatient zone. While tranforming a hospital the most important thing was not to distrub the security and the circulation pattern of the inpatient. Therefore the plot facing the Wilshire boulevard was chosen which behaves as a new face to the campus. Inside this skeleton framewok a concrete tube is inserted which visually links the inpatient zone to tranformation which is happening in the campus.

Site Plan/Floor Plans | 70

Site Plan

4

7

6

1. RETAIL 2. THERAPHY POOL 3. CHANGING ROOM 4. OUTDOOR SPACE 5. RECEPTION 6. OFFICE 7. OUTDOOR CAFETERIA 8. MASSAGE CENTER

1

5 2

2 8 3

3

2

1

4

A

B

C

E

F

G

H

I

J

L

M

N

01

Site Plan/Floor Plans | 71

First Floor Plan The wellness campus has four entry points , two vehicular from the inpatient zone and another drop of point from medical building.

The other two are pedestrian from Wilshire boulevard. The idea behind entry points from Wilshire boulevard makes the campus more accessible to surrounding community aligning itself with the idea of porosity.

7

2

3

1. RETAIL 2. MEDICAL LIBRARY 3. CHURCH 4. OUTDOOR SPACE 5. THERAPY POOL 6. YOGA STUDIO 7. FITNESS ROOM 8. CHIROPRACTOR

4

1

4

6 2

8

5

3

1

6 4

A

B

C

E

F

G

J

L

M

N

02

Site Plan/Floor Plans | 72

Second/Third Floor Plans

4

1

7

1. CAFETERIA INDOOR SEATING 2. CAFETERIA OUTDOOR SEATING 3. KITCHEN 4. MEDICAL LIBRARY 5. FITNESS TRACK 6. OFFICE 7. MEETING ROOM

2

3

3

1

5

2

6

4

B

A

J

C

K

L

M

N

03

1

4

1. CAFETERIA INDOOR SEATING 2. CAFETERIA OUTDOOR SEATING 3. OFFICE 4. MEETING ROOM

2

1 3

2 3

4

A

B

C

E

F

J

K

L

M

N

04

Site Plan/Floor Plans | 73

Fourth/Fifth Floor Plan

8

4

1

1. RECEPTION & WAITING 2. DIAGNOSTIC - LAB 3. OFFICE - ADMIN 4. SERVICE AREA 5. EXAM ROOM POD 1 6. EXAM ROOM POD 2 7. EXAM ROOM POD 3 8. EXAM ROOM POD 8

2

3

3

1

1

1

7

6

5

2 4

A

C

B

D

E

F

G

H

J

I

K

L

M

N

05

1

2

1. RECEPTION & WAITING 2. DIAGNOSTIC - LAB 3. OFFICE - ADMIN 4. SERVICE AREA 5. RECOVERY ROOM 6. OPERATING THEATRE

6

6 3

1

3

2

1 1

5

5

4

A

B

C

D

E

F

G

H

I

J

K

L

M

N

06

Elevation | 74

Elevation

Elevations | 75

Progam Diagram | 76

Program Diagram

Adminstration 6000 sq.ft

Outpatient

Diagnostic 14,000 sq.ft

Operating theatre 21,000 sq.ft

Examination Room 21,000 sq.ft

Wellness

Administration 8000 sq.ft Cafeteria 12,000 sq.ft

Retail 16,000 sq.ft

Fitness 42,000 sq.ft

Exploded axonometric | 77

Exploded Axonometric

Outpatient volume: The upper -level of the building is arranged into two floors accomdating the examination rooms, diagnostcs, operating theatre and adminstration. Each floor has two entry points to allow distribution of circulation load.

Through the design, the outpatient Ou tpa tie nt

department is segragerated from the wellness volume providing clear visual communication creating an architecture that fosters and promotes faster

Ou tpa tie nt

healing.

Wellness Volume: The lower-level of the building is arranged into four floors which We lln es s

accomdates

the

wellness

activities including theraphy pool, fitness center & track, massage center , retail & health cafeteria. Accessible from all the sides, the wellness volume

We lln es s

We lln es s

is gateway which frames the hospital campus.

Vignettes inside key spaces | 78

Vignette 1 - Left Side Perspective View

Vignettes inside key spaces | 79

Vignette 2 - Campus Enterance View

Vignettes inside key spaces | 80

Vignette 3 - Fitness Track View

Vignettes inside key spaces | 81

Vignette 4 - Wilshire Enterance View

Vignettes inside key spaces | 82

Vignette 5 - Therapy Pool

Wall Sections | 83

Wall Sections Sketch shows the pattern for the frosted glass. + 84’ LEVEL

FLASHING

Scapes Narrative | 57

OPENABLE WINDOW

FIXED WINDOW

HORIZONTAL STEEL PROFILE

+ 70’ LEVEL TRUSS

REINFORCED CONCRETE OVER METAL DECKING

+ 56’ LEVEL

WOOD/CARPET/TILE FLOORING DEPENDING ON THE PROGRAMMATIC FUNCTION 1/2” THK PLYWOOD FIXED THROUGH BLOCKING WHICH IS NAILED STEEL TO JOISTS WOOD CEILING IS FIXED

+ 42’ LEVEL

+ 28’ LEVEL

Namrata Tulsianey

Model Photos | 84

Model Photographs

Main Hosital and the Tube

Site Plan

Model Photos | 85

Elevation

The model photographs give an overall view of campus with the surroundings. It also gives a realistic picure of the space restrictions and how these limitations have becomes the guidelines for the new addition to the hospital.

Entrance View

APPENDICES

Annotated Bibliography | 89

Annotated Bibliography Books Gallup,Joan Whaley, (1999). Wellness Centers: A guide for design professional, John Wiley & Sons Inc., New York.

Verderber, Stephen, and David J. Fine, (2000). Healthcare Architecture in an Era of Radical Transformation.

CT: Yale UP, New Haven.

Futagawa, Yukio, (2012). OMA: Recent Projects ,A.D.A. Edita, Tokyo.

McCullough, Cynthia S, (2010). Evidence-based Design for Healthcare Facilities.Sigma Theta Tau International, Indianapolis.

Guenther, Robin, and Gail Vittori, (2013). Sustainable Healthcare Architecture, John Wiley & Sons Inc., New Jersery.

Roger Lee, (2006). Healthcare Space No. 3, Visual Reference Publiations, New York Cama, R. (2009). Evidence-based healthcare design. Hoboken, N.J.: John Wiley & Sons.

David Charles Sloane & Conanat Sloane, (2003). Medicine Moves to Malls, John Hopkins University Prerss, Balitmore & London.

Koolhaas, R. (1995). Small, medium, large extra-large. New York: Monacelli Press.

Paul Lewis, Marc Tsurumaki, David J. Lewis, (2013), Lewis. Tsurumaki. Lewis Intensities, Princeton Architectural Press, New York.

Lewis, Paul, Marc Tsurumaki, and David J. Lewis. Lewis. Tsurumaki, (2008). Lewis: Opportunistic Architecture.

Princeton Architectural Press, New York.

Nussaume, Y. (2009). Tadao Ando (English ed.). Basel: Birkh채user.

Annotated Bibliography | 90

Morphosis Architects, (2011), Combinatory Urbanism, the complex behaviour of collective form, Straf Doge Cafe, Culver City.

BIG â&#x20AC;&#x201C; Bjarke Ingels Group, (2015), Hot to Cold, an odyssey of architectural adaptation, Taschen, Hohenzollernring.

Sharon Johnston, Mark Lee, (2013), 2G, N.67,Johnston Marklee, Editorial Gustavo Gill, Barcelona.

Anthony di Mari , Nora Yoo, (2012), Operative Design, Catalogue of Special Verbs, The Netherlands: BIS Publishers, Amsterdam.

Mari, Anthony Di, (2014), Conditional Design: An Introduction to Elemental Architecture. The Netherlands: BIS Publishers, Amsterdam.

François Blanciak, (2008). Siteless: 1001 Building Forms. Cambridge, MA: MIT,Print, Massachusetts.

William J. Mitchell , (1999), Etopia Urban Life, Jim -but not as we know it, MA: MIT,Print, Massachusetts.

Francis D.K. Ching, (1999), Building construction Illustarted , Fourth Edition, United States of Amercia.

Gilles Deleuze, Felix Guattari, (1998), A Thousand Plateaus: Capitalism and Schizophrenia, Paperback, London.

Kumar, V. (2013). 101 design methods: A structured approach for driving innovation in your organization. Hoboken, N.J.: Wiley.

Klanten, R. (2008). Data flow: Visualising information in graphic design. Berlin: Gestalten.

Simmons, H., & Olin, H. (2011). Olin's construction: Principles, materials, and methods (9th ed.). Hoboken, N.J.: Wiley.

Pyo, M., & Kim, S. (2013). Architectural and program diagrams. Berlin: DOM. Lovell, J. (2010). Building envelopes an integrated approach. New York: Princeton Architectural Press.

Boswell, K. (2013). Exterior building enclosures: Process and composition for innovative skins. Hoboken, N.J.: Wiley .

Koolhaas, R., & Cambridge, M. (2014). Elements of architecture. Venice: Marsilio.

Annotated Bibliography | 91

Websites ObamaCare Facts: Facts on the Affordable Care Act. (n.d.). Retrieved July 8, 2015, from http://obamacarefacts.com/obamacare-facts/ Get 2015 health coverage now. Health Insurance Marketplace. (n.d.). Retrieved July 26, 2015, from https://www.healthcare.gov/ Global Global. (n.d.). Retrieved July 26, 2015, from http://perkinswill.com/work/willson-hospice-house-site-design

Southern Regional Technology & Recreation Complex by Sorg Architects. (2014, January 20). Retrieved July 26, 2015, from http://www.archiscene.net/education/southern-regional-technology-recreation-complex-sorg-architects/

All. (n.d.). Retrieved July 26, 2015, from http://www.folonisarchitects.com/work-all#/ucla/

Minimalist Design: 25 Beautiful Examples and Practical Tips â&#x20AC;&#x201C; Design School. (2015, February 18). Retrieved July 26, 2015, from https://designschool.canva.com/blog/minimalist-design-beautiful-examples-and-practical-tips/

(n.d.). Retrieved July 26, 2015, from http://www.healthcaredesignmgazine.com

The Crossroads of Care. (n.d.). Retrieved July 26, 2015, from http://www.nbbj.com/work/american-university-of-beirut-new-medical-center/

Health Facilities Management - Hospital Design, Construction & Operations. (n.d.). Retrieved July 26, 2015.

Discovery Meets Recovery at New LEED Gold Cedars-Sinai Building. (n.d.). Retrieved July 17, 2015, from http://www.hok.com/design/type/healthcare/cedars-sinai-advanced-health-sciences-pavilion/

Barkow Leibinger. (n.d.). Retrieved July 26, 2015, from http://www.barkowleibinger.com/

(n.d.). Retrieved July 10, 2015, from http://cityplanning.lacity.org/

Good Samaritan Hospital. (n.d.). Retrieved July 26, 2015, from http://www.goodsam.org/

Annotated Bibliography | 92

Journals Zborowsky, T., & Kreitzer, M. (2009). People, Place, and Process: The Role of Place in Creating Optimal Healing Environments. Creat Nurs Creative Nursing, 186-190.

Rakel, D., & Jonas, W. (n.d.). Creating Optimal Healing Environments. Integrative Medicine, 15-22.

Chandra, C., Kumar, S., & Ghildayal, N. (2011). Hospital cost structure in the USA: What's behind the costs? A business case. International Journal of Health Care Quality Assurance International J Health Care QA, 314-328.

Tam, D. (2012). Building the "Fable Hospital"--The CEO's Perspective: An Interview with Michael H. Covert, President and Chief Executive Officer, Palomar Pomerado Health. HERD: Health Environments Research & Design Journal, 12-20.

Annotated Bibliography | 93

Statistics Reports Mattke S, Liu H, Caloyeras JP, et al. Workplace Wellness Programs. 2013.

Center for Disease Control and Prevention. Mortality in the United States, 2012.

Center for Disease Control and Prevention. Mental Health among Women of Reproductive Age. Center for Disease Control and Prevention. Infant Mortality, 2014.

Moos, Merry-K. Preconceptional Wellness as a Routine Objective for Women's Health Care: An Integrative Strategy, Journal of Obstetric, Gynecologic, & Neonatal Nursing, 2003, vol 32, issue 4 Braunstein, Leslie. How Changing Healthcare Delivery Will Affect Land Use. Urban Land Magazine, May 22 2013

General Plan Constraints & Building Codes | 94

Planning Code & Bulding Code Documentation

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General Plan Constraints & Building Codes | 95

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PARCEL B

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Room Data Sheet | 96

Room Data Sheets

AREA RELATIONSHIP DIAGRAM WELLNESS DEPARTMENT Medical Libaray Central Space Doctorâ&#x20AC;&#x2122;s Lounge Wellness Center Yoga Studio Cafeteria Building Operations

OUTPATIENT DEPARTMENT Operating Theatre Examination Room Office Area

Medical Library

Room Data Sheet | 97

Medical Library 4,000 sq.ft

Group Study Space 300 sq.ft

Faculty Collaboration Suite 256 sq.ft

Doctor’s Lounge

Medical Library 8,000 sq.ft

TV Area 320 sq.ft

Kitchen Table 160 sq.ft

Lounge Seating 150 sq.ft

Storage Kitchenette 120 sq.ft 90 sq.ft

Lounge Seating 70 sq.ft

Central Space

Doctor’s Lounge 2,050 sq.ft

Central Public Space 4,000 sq.ft

Waiting 1,200 sq.ft

Meeting Room 320 sq.ft

Entry Area 300 sq.ft

Security 40 sq.ft

Bistro 40 sq.ft

Lounge Table Seating Seating 120 sq.ft 100 sq.ft

Individual Space 20 sq.ft

Operating Theatre

Room Data Sheet | 98

Recovery 2000 sq.ft

Control Point 200 sq.ft

Waiting 300 sq.ft

Examination Room

Operating Theatre 6000 sq.ft

Observation Room 800 sq.ft

Briefing Room 400 sq.ft

Break Room 375 sq.ft

Office

Exam Rooms 6000 sq.ft

Office 6,000 sq.ft

Shared Meeting Room 400 sq.ft

Shared Storage 360 sq.ft

Shared Waiting 200 sq.ft

Admission Kitchenette Dean 180 sq.ft 180 sq.ft

Registrar Vice President 150 sq.ft 150 sq.ft

Room Data Sheet | 99

Storage 200 sq.ft

Clean Sup. Room 160 sq.ft

Equipment Room 200 sq.ft

Reception 200 sq.ft

Equipment Room 200 sq.ft

Director 120 sq.ft

Reception 100 sq.ft

AV Support 200 sq.ft

Staff 80 sq.ft

Operating Theatre 130 sq.ft

Clean Exam Room Sup. Room 130 sq.ft 160 sq.ft

Copy Work stations Area 64 sq.ft 100 sq.ft

Staff Room 120 sq.ft

Lockers 70 sq.ft

Staff Room 120 sq.ft

Shared Lockers 64 sq.ft

Soiled Linen Room 120 sq.ft

Lockers 70 sq.ft

Scrub 30 sq.ft

Staff Work Stations 64 sq.ft

Soiled Linen Room 30 sq.ft

Wellness Center

Room Data Sheet | 100

Circuit Strength 1,200 sq.ft

Theraphy Pool 15,00 sq.ft

Therapy Pool 1000 sq.ft

Weights 600 sq.ft

Lockers 800 sq.ft

Yoga Studio

Wellness Center 5,000 sq.ft

Studio I 2000 sq.ft

Prefuntion 700 sq.ft

Cafeteria

Yoga Studio 4000 sq.ft

Cafeteria 4,000 sq.ft

Seating 2000 sq.ft

Kitchenette Service Bar Storage Vending Area 1000 sq.ft 500 sq.ft 100 sq.ft 80 sq.ft

Storage 100 sq.ft

Room Data Sheet | 101

Individual Lockers 1.5

Building Operations

Restroom 400 sq.ft

Building Support 1,100 sq.ft

Maintenance Storage 300 sq.ft

Receiving/ Holding 200 sq.ft

Security Control Office 200 sq.ft

Custodial Storage 200 sq.ft

Room Data Sheet | 102

Room Typologies Operating Theater Area 7000 sq.ft

CLEAN CORRIDOR

5

2

1

3

5

3

3

3

7 3 9

3

3

3

10 5

4

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4

5

6

6

8

Room Data Sheet | 103

Examination Room Area 5000 sq.ft

ONSTAGE

6 4

4

4

1.

7 2 5 8

4

4

4

4

3

8

1. CHILDREN PLAY AREA/WAIT AREA 2. STORAGE 3. RECEPTION 4. EXAM ROOMS 5. TEAM AREA 6. TOILET 7. STORAGE 8. OFFICE

Room Data Sheet | 104

Chiropractor Room Area 3500 sq.ft

5

3

1

6

4

6

7

1

8 2

2

1. THERAPY BAY 2. TREATMENT /MASSAGE 3. DOCTORS ROOM 4. X RAY 5. BREAK ROOM 6. WASHROOM 7. FILES STORAGE 8. RECEPTION/WAITING

2

2

2

Room Data Sheet | 105

Laborartory Room Area 2500 sq.ft

1

2

3

1. LABORATORY TESTING 2. STERILIZATION AREA 3. WAITING

1

1

2

Room Data Sheet | 106

Physiotheraphy Room Area 2000 sq.ft

2 1 2

5

6

4 3

1. PHYSICAL EXERCISE 2. TREATMENT BAYS 3. CHANGING ROOM & WASHROOM 4. DOCTORS ROOM 5. STORAGE 6. LOCKERS

3

Room Data Sheet | 107

Fitness Room Area 4000 sq.ft

3

1 2

1. FITNESS AREA 2. LOCKERS/ LOUNGE/ CHANGING ROOM 3. RECEPTION

Project Cost | 108

Project Cost The Good Samaritan hospital is looking to expand its facilities in the next two years. Therefore, a new proposal for the campus was devised for the upcoming expansion. The current transformation in the healthcare industry plays an essential role in determining the program of the building which has substantial effect on the cost. The total cost of the project comes down to $ 80 million .

BUDGET PROPOSAL SPACES AdministraƟon Library Cafeteria/MulƟpurpose Kitchen Loading/Trash Room Janitor Space Lockers Restrooms Faculty/Staī Restrooms Restrooms 1st-6th Mechanical Electrical Storage Massage OperaƟng theatre ExaminaƟon Room /Pod Yoga Studio Theraphy Pool

QTY.

NET S.F. 1 1 1 1 1 5 3 1 7 12 5 5 5 2 2 5 3 3

TOTAL BUILDING CONSTRUCTION COST

12000 8000 3200 1200 300 80 80 240 120 240 120 100 170 3000 10000 4000 3500 1500

TOTAL NET 12000 8000 5200 1200 300 240 240 240 840 2880 600 500 850 6000 20000 20000 10500 4500

FUNCTIONAL COST 235 250 185 355 125 125 125 240 225 240 125 125 125 120 300 175 150 125

NET X F.C. 2820000 2000000 962000 426000 37500 30000 30000 57600 189000 691200 75000 62500 106250 6000000 3500000 1575000 562500

NET S.F. X 1.3 15600 10400 4160 1560 390 520 312 312 1092 3744 780 650 1105 7800 26000 26000 13650 5850

GROSS S.F. x F.C. 3666000 2600000 769600 553800 48750 65000 39000 74880 245700 898560 97500 81250 138125 7800000 4550000 2047500 731250 23675665

13944775

Project Cost | 109

Project Cost

SITE UNIT COSTS SITE UNIT COSTS QTY. UNIT COST TOTAL COST Chain Link Fence 1797 16.5 29650.5 Concrete Paving 28418 8.85 251499.3 Light Pole Per 2500 S.F. 10983 3500 17500 Asphalt Paving 39492 6.8 268545.6 Site Drainage 246048 0.8 196838.4 Curb & GuƩer 2617 20 52340 IrrigaƟon 161974 0.45 72888.3 Turf (Hydro Seed) 154205 0.55 84812.75 Landscape (Shrubs) 7770 5 38850 Trees 24" Box 40 525 21000 Play Area SoŌ Scape 1935 9.5 18382.5 Play Ground Equip. Allowance 1 50000 50000 On Site UƟliƟes 1 275000 275000 Oī Site UƟliƟes 1 300000 300000 ExcavaƟon & RecompacƟon 246048 1.6 393676.8 Fine Grading 246048 0.55 135326.4 Signage 2 80000 160000 Fire Hydrants/Pipe (3) 3 32000 96000 TOTAL COST FOR SITE CONSTRUCTION 2,462,310

TOTAL CONSTRUCTION COST

SOFT COSTS EscalaƟon 2 Years Design ConƟngency PROJECT COSTS Land Survey Geotechnical Escrow/Closing Plan Check Fees Furniture & Equipment TesƟng InspecƟon

TOTAL SOFT COSTS

16,283,310

QTY. UNIT COST TOTAL COST 2 % Const.

651332 15 % Const.

2442496 5.65 1 1 1 2% Const.

53610 2% Const.

1

TOTAL COST OF PROJECT (PROJECT BUDGET)

955000 20000 10000 25000 8 150000

5395750 20000 10000 25000 428880 150000 6029630

69,949,790

80,000,000

N AMRATA T ULSIANEY M ASTERS OF A RCHITECTURE S UMMER , 2015 NTULSIANEY @ GMAIL . COM