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
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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-
0HGLFDO 1HWZRUN
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\SRWKHVLVÂľ 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\Âľ 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
PARCEL A
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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
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1. STAFF LOUNGE /LOCKERS 2. EQUIPMENT STORAGE 3. OPERATING THEATRE 4. RECOVERY ROOM - PHASE I & II 5. SCRUB AREA 6. STORAGE 7. SOILED LINEN - CLEAN & CONTAMINATED SOILED HANDLING 9. WAITING AREA / CHANGE ROOM PATIENTS 10. CONTROL POINT
4
5
6
6
8
Room Data Sheet | 103
Examination Room Area 5000 sq.ft
ONSTAGE
6 4
4
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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