Children and Adolescent Psychiatric Center Valerie Genovese Contract III Fall 2015
Table of Contents 1.
Healthcare Design Statement
2.
Proposal for project
a.
Museum Inspiration
3.
Case Studies
b.
Inspiration Images
c.
Concept Diagrams
a.
Gracie Square Hospital
b.
New York Presbyterian - Weill Cornell Psychiatry Specialty Center
c.
Seattle Children’s Hospital: Psychiatry and Behavioral Medicine Unit Lutherwood’s Institute for Children and Youth Mental Health
d.
4.
Design Criteria
5.
Program
6.
Site Analysis
7.
8.
9.
10.
11.
a.
Neighborhood/Surroundings Analysis
b.
Building Analysis
c.
Floor Analysis / Site Selection
Project Diagrams a.
Bubble DIagram
b.
Adjacency DIagram
c.
Sequence Diagrams
d.
Parti Diagrams & Circulation
Concept
Schematic Design a.
Priliminary Sketches
b.
Progress Drawings
Materials a.
Material Inspiration
b.
Materials and Furnishing Selections
Appendices
Healthcare Design Healthcare design has been carefully planned and executed through evidencebased design. Through research and studying behavior of patients in existing healthcare environments, interior healthcare spaces have now been able to be designed in a way that has healing effects on patients and become a welcoming environment as opposed to cold and impersonal. Specifically for psychiatric environments, it has been found to avoid harsh colors, jagged movement, and hectic imagery, and abstract art. Patient and family centered design is key to keeping the environment personal and providing services toward exceptional patient experience. Attentive detail to quality and safety is very important for any type of design project. Providing environments with a connection to nature is naturally a very positive, healing experience for patients enduring difficult times in their lives.
Proposal For children within the elementary and adolescent age ranges (6 - early 20s), mental disorders can take a toll while going through difficult and stressful times during their lives. Elementary stage children usually experience issues having to do with questioning their personal competence and feeling inferior, while people during the adolescent range struggle with identity and role confusion. In both these life stages, one is usually comparing themselves to others and feels they should act or be a certain way due to stereotypes and unrealistic images. Psychiatry is the study and treatment of mental illness, emotional distress, and abnormal behavior. Psychiatrists are experts in the study of the mind and mental health. For this out-patient center, there is a specialization for child and adolescent psychiatry. The American Academy of Child and Adolescent Psychiatry defines a child and adolescent psychiatrist as “a physician who specializes in the diagnosis and the treatment of disorders of thinking, feeling and/or behavior affecting children, adolescents and their families.� There are a few specialties within this field of study in which child psychiatrists can focus their studies on. These include affective, behavioral, cognitive, and perceptual abnormalities. Some ailments that children seek psychiatric treatment for include addictive disorders, Attention Deficit Disorder, Attention Deficit Hyperactivity Disorder, Alzheimer’s disease, anxiety, Autism, dipolar disorders, eating disorders, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, mood disorders, phobias, Postpartum Depression, and Schizophrenia. These people typically experience feelings of depression, anxiety, mood swings, and stress.
Case Studies
Gracie Square Hospital
New York Presbyterian - Weill Cornell Psychiatry Specialty Center
Seattle Children’s Hospital: Psychiatry and Behavioral Medicine Unit
Lutherwood’s Institute for Children and Youth Mental Health
Case Study:
Gracie Square Hospital
About
Gracie Square Hospital is under new leadership and is going through a new renovation process. As Gracie Hospital’s services are growing therefore so is their environment. The need to advance their facility and expand their program has come to surface. When speaking with the President and Chief Executive Officer David A. Wyman, he explained that three floors of inpatient care units have been renovated but there is still much more to complete. Gracie Square Hospital staff are looking to create a warm and inviting environment for their patients and staff. They are working on changing their color pallet, lighting, and adding more activity areas.
The Facility
The facility, right now, does not a lot of access to natural light and lacks access to nature and greenery. This is a very important method of healing for patients. It also helps the hospital feel less institutionalized. There is an apparent glare throughout the space, also due to mainly artificial lighting. There is a lack of privacy for patients, staff, and visitors as of now. Future renovations will hopefully create a more hopeful environment for psychological healing.
Case Study:
Gracie Square Hospital ď ľ
The Design ď ľ
David A. Wyman had been working with NYP Interiors to change the color pallet from blue walls to beige and stripping the dark blue to light blue on the flooring. The nursing stations will consist of wood paneling for a warmer feel and added shelving for fresh flowers. Gracie Square is also working with RXART, a non-profit organization that places original artwork in healthcare settings. There are also plans to renovate the entire 6th floor by adding a sallyport for security, administration offices, an exercise room for patients that connects to the outdoor roof garden that will be used by patients and staff. The outdoor roof garden will add a nice element and connection to greenery. The roof will provide activity areas for the patients, such as yoga and meditation. The roof will also be interchangeable for staff to attend employee appreciation parties.
Case Study:
Gracie Square Hospital
Case Study:
Gracie Square Hospital
Current Floorplans: Level 2
Case Study:
Gracie Square Hospital
Current Floorplans: Level 3
Case Study:
Gracie Square Hospital
Current Floorplans: Level 4
Case Study:
Gracie Square Hospital
Current Floorplans: Level 5
Case Study:
Gracie Square Hospital
Proposed Renovation Floorplans: Level 1
Case Study:
Gracie Square Hospital
Proposed Renovation Floorplans: Level 6
Case Study:
Gracie Square Hospital
Proposed Renovation Floorplans: Level 1
Case Study:
Gracie Square Hospital
Proposed Renovation Floorplans: Level 6
Case Study:
New York Presbyterian - Weill Cornell Psychiatry Specialty Center
About
“The Weill Cornell Psychiatry Specialty Center offers expert assessment and treatment of psychiatric disorders by a multidisciplinary team of academically oriented clinicians in a discreet, comfortable outpatient setting. We offer expertise in disorders across the lifespan and an approach that is sensitive to each individual's life context. Our services include assessment, medication management, psychotherapy, couples' counseling, family therapy, group therapy, and neuropsychological and educational testing. Drawing on the resources of Weill Cornell Medical College and our affiliated hospital, New York-Presbyterian, we treat a wide range of psychiatric conditions including depression and bipolar disorder, anxiety disorders, tic disorders, and attention deficit hyperactivity disorder. We also provide specialized services with respect to women's issues and reproductive psychiatry.”
The Office
The New York Presbyterian - Weill Cornell Psychiatry Specialty Center was previously two office spaces now converted into one cohesive space. The facility has been open for two years. The appeal to a “Upper East Side” clientele exclusively accepting only Weill Cornell and Rockefeller University health insurance. With about 20 doctors total and 9 exam rooms, appointments are highly scheduled.
Case Study:
New York Presbyterian - Weill Cornell Psychiatry Specialty Center
The Design
Exam rooms are used for private therapy sessions. They are furnished with a desk, chair, and sofa. Knoll furniture was used for style and functionality. This space is designed in a way for the room to serve flexibly to multiple uses. The use of natural and artificial lighting is very important in these spaces to make the patient feel comfortable. These rooms were purposely placed along the perimeter of the building to get daylight. The exam room design has clean lines and a sterile feel, a key aspect to keeping a patient focused during a session. Doctors also are not able to display any personal items in the room since the desk is used by multiple doctors and one doctor is never stationary. The color scheme is very neutral with pops of accent colors. This was done to also maintain patient focus and not to overstimulate the senses. The exam rooms are sound tight and additional privacy is given with the help of a white noise machine in the adjacent reception/administrative area. Group sessions are held in a medium sized conference room that seats ten people. In addition to a conference table and stylish swivel chairs there is a television, white board, and window that brings in natural light. Group sessions they hold in this conference room include Depression Recovery for Woman, Young Adult Anxiety Group, Young Professionals Anxiety Group, and Pediatric OCD, Anxiety and Tic Disorders Program (POCAT) Summer Intensive Program. Reception and administrative staff are housed in a central pod separating the exam rooms from the waiting area. It is designed specifically at a semi-height so patients are not overwhelmed by full height walls. Check-in is at a side adjacent to the waiting area while check-out is strategically placed within the corridor that patients in group sessions and exam rooms would both use to leave. Two front desk staff usually work at once and they are both able to effectively run check-in/out and other administrative work within this central pod.
Case Study:
New York Presbyterian - Weill Cornell Psychiatry Specialty Center
Case Study:
New York Presbyterian - Weill Cornell Psychiatry Specialty Center
Floorplan
Case Study:
New York Presbyterian - Weill Cornell Psychiatry Specialty Center
Floorplan
Case Study:
Seattle Children’s Hospital: Psychiatry and Behavioral Medicine Unit
About
“Our focus in the PBMU is to give your child short-term care during a mental health crisis. From the time your child comes into the hospital, we follow a set of steps (clinical pathway) based on your child's diagnosis. The steps are designed to stabilize your child's behavior and to teach your child and family skills that can help after your child leaves the hospital. These skills can help you and your child cope and help you prevent crises in the future.”
The Design
The Psychiatry and Behavioral Medicine Unit is an in-patient facility that was designed by ZGF Architects keeping the children users in mind. This facility treats ages 3 to 18 years old and was designed to create a playful, natural, and safe environment that did not feel sterile.
Patient rooms feature large windows to allow natural light and views to flow into the space to encourage the healing process. Warm and natural materials aid as a connection to nature as well as wayfinding. A connecting staircase between levels 4 and 5 has just recently opened this spring to allow patients to move about the unit.
The interior of the unit is very bright and colorful, which is interesting since bright colors can be over-stimulationg for patients with mental disorders. Patient rooms are more subtle with the use of accent colors alongst a heavier use of natural wood.
Case Study:
Seattle Children’s Hospital: Psychiatry and Behavioral Medicine Unit
Case Study:
Seattle Children’s Hospital: Psychiatry and Behavioral Medicine Unit
Case Study:
Seattle Children’s Hospital: Psychiatry and Behavioral Medicine Unit
Floorplan: Level 4
Case Study:
Seattle Children’s Hospital: Psychiatry and Behavioral Medicine Unit
Floorplan: Level 5
Case Study:
Seattle Children’s Hospital: Psychiatry and Behavioral Medicine Unit
Floorplan: Level 4
Case Study:
Seattle Children’s Hospital: Psychiatry and Behavioral Medicine Unit
Floorplan: Level 5
Case Study:
Lutherwood’s Institute for Children and Youth Mental Health
About
“Lutherwood is proof that the “Visioning Approach” works, enabling design for behavioral health to address the paradoxes of openness vs. security, control vs. empowerment, privacy vs. supervision, and operational efficiency vs. optimal experience. A transformative project for children age 12 to 17, it embraces a model of recovery through design that respects the individual, staff, family, and community.”
The Design
16,500 new square feet was added and 6,000 square feet renovation was completed at Lutherwood in May 2011. A double-height gathering space was created as the facility’s central “heart” and used for child and family therapy. Transitions from public space to private space within Lutherwood are made possible by narrowing interior streets, lofty ceilings, and clerestory lighting. Key areas are strategically placed in the café, reception, and the interior street facing therapy rooms to enforce safety and security. The café also functions as a youth job skills training center. Secure glazing used allows direct viewing of main and upper level. The street offers exhibit space, gathering areas, visual cues, and views to nature making it very therapeutic and crucial to healing. Natural elements are also incorporated into the interior through the use of neutral wood and stone accents as well as an abundance of natural light.
Case Study:
Lutherwood’s Institute for Children and Youth Mental Health
Design Criteria
Create a home-like environment that is welcoming for patients
Public spaces should be lively and stimulating for patients
Come up with unique and exciting flooring patterns for public spaces
Use curved, organic lines and forms within the design instead of harsh, angled lines
Use of natural light is very important to incorporate in healing environments
Different lighting options should be available in patient exam rooms, so that the patient can be comfortable in their desired environment
Create exam rooms that should encourage patient focus
Include a variety of unique furniture pieces that uses clean lines yet also feels sterile
Clocks should be placed in exam rooms to keep doctors on schedule
Incorporate areas of solitude for those who do not wish to interact
Include a white noise system for added privacy
Incorporate natural materials to add a healing connection to nature
Use of soothing color palates that are not too bright and less simulating then others
Use art as a healing tool within the space
Separate different age groups if possible
Close off shared balcony space for safety
Avoid stairs and/or elevator in transferring patients from one building or floor to the other since lateral transitions can be overstimulating for some patients
Site Analysis:
The Financial District The Financial District is a neighborhood located at the southern tip of Manhattan in New York City. This area covers roughly the area south of City Hall Park but excludes Battery Park and Battery Park City. The former World Trade Center compound was located in the vicinity until the September 11 attacks; the neighborhood now includes its successor One World Trade Center. The hearth of the Financial District is habitually considered to be the corner of Wall Street and Broad Street, both within the district. Also referred to as FiDi, the Financial District encompasses many of the city's major financial establishments. The district roughly overlaps with the borders of the New Amsterdam settlement of the late 17th century. The Financial District has grown in its population to approximately 43,000 as of 2014. This statistic is virtually double the 23,000 recorded in 2000.
Site Analysis:
Surroundings A number of surrounding tourist attractions in the area include the Federal Hall National Memorial, South Street Seaport Historic District, New York City Police Museum, Museum of Jewish Heritage, Skyscraper Museum, Museum of the Native American Indian, Museum of American Finance, and the National September 11 Memorial & Museum. Bowling Green is the starting point of traditional ticker-tape parades on Broadway, also known as the Canyon of Heroes.
Site Analysis:
17 Battery Place
Building Type: Residential, Commercial Office
Architect: Henry J. Hardenbergh, Clinton and Russell
Address: 17 Battery Pl, New York, NY 10004
History:
The original building was constructed from 1902-1904 as a speculative office building designed by architect Henry Hardenbergh. It was converted to apartments in 1999. A previous office tenant in the mid 20th century was the Moran Towing Company, operator of a fleet of tugboats. The annex is also known as Greater Whitehall. The adjacent 31-story skyscraper is located at 26 Washington Street. It was built from 1908 to 1910 as an extension to the Whitehall Building due to the success of that building. The annex was designed by the architectural firm of Clinton & Russell. When completed, it was the largest office building in New York City at the time. The over-all ground area for the two buildings is 51,515 square feet according to a 1910 engineering record. Both were contracted by the George A. Fuller company. On February 8, 2000, the pair of buildings were designated a landmark by the New York City Landmarks Preservation Commission
Site Analysis:
Site Selection
Selection:
17 Battery Place Rooftop
9660.277 sq. ft.
21st floor – 26 Washington St
21st Floor
17509.304 sq. ft.
Avoiding stairs and/or elevator in transferring patients from one building or floor to the other will aid in patient comfort since lateral transitions can be overstimulating for some patients
Bubble Diagram Administration
Treatment
Social Areas
Reception
Facility Service
Ajacency Diagram Waiting Conference
Security
Consultation
Storage Offices
Reception
Human Resources
Restrooms
Restrooms
Administration
Group Exam Facility Service
Treatment
Private Exam Comfort Room
Maintenance
Storage
Social Areas Dining
Kitchen
Restrooms Lounge
Rooftop
Recreation
Doctor Path Sequence
Exam Room (Private or Public)
Comfort Room
Treatment
Offices
Conference Room
Administration
Reception
Consultation
Patient Path Sequence
Private Therapy Room
Consultation
Group Therapy Room
Comfort Room
Lounge
Treatment
Waiting Reception
Dining
Social Areas
Recreation Areas
Family Path Sequence
Dining
Family Lounge Social Areas
Consultation
Waiting
Reception Family Sequence
Rooftop
Parti Diagrams
Parti Diagrams & Circulation
Art Analysis:
Asia Society Museum
Fluting
Radial Symmetry
Shadow
Depth
Repetition
Line
Consistency
Variation
Comfort
Scale
Levels
Set of three large bangles; Baggao, Cagayan province, Luzon; Ca. 10th-13th century; Gold
A: W. 2 11/16 x Diam. 2 15/16 in (6.8 x 7.5 cm)
B: W. 1 9/16 x Diam. 2 13/16 in (4.0 x 7.2 cm)
C: W. 1 1/16 x Diam. 2 15/16 in (2.7 x 7.5 cm)
Bangko Sentral ng Philipinas, G6P-1983-0003, G6P-1983-0005, G6P-1983-0006
Art Analysis:
Guggenheim Museum
Linear
Symmetry
Shadow
Gradient
Repetition
Liner
Consistency
Powerful
Contrast
Scale
Bold
Text
ARTIST: Glenn Ligon
b. 1960, Bronx, New York
TITLE: Prisoner of Love #1 - #3
DATE: 1992
MEDIUM: Oil and gesso on linen
DIMENSIONS: 80 x 30 inches (203.2 x 76.2 cm)
ARTWORK TYPE: Painting
Inspiration Images
Concept Sketch:
New York City
Preliminary Sketches
Reception Sketches
Preliminary Sketches
Patio Sketches
Mid-Semester:
Floorplan
Mid-Semester:
Axonometric
Material & Furniture Selection:
Mood Board & Inspiration
Material & Furniture Selection:
Material Schemes
Material & Furniture Selection:
Main Reception – Central Park
Arabescato Marble
Ebonized Oak
Material & Furniture Selection:
Private Therapy Rooms
Arabescato Marble
Material & Furniture Selection:
Private Therapy Waiting – Columbus Circle
Arabescato Marble
Appendicies Works Cited "The Application of Color in Healthcare Settings." Information Technology Integration in Healthcare Settings (2010): n. pag. Healthdesign.org. Web. Architectural Design Manual. Pella, IA: Pella Corporation, 2004. Web. "BH 2012 Design Showcase." BH 2012 Design Showcase. N.p., n.d. Web. 02 Dec. 2015. "The Mental Health Policy Implementation Guide." PsycEXTRA Dataset (n.d.): n. pag. Web. "Patients & Families." American Psychiatric Association. N.p., n.d. Web. 02 Dec. 2015. "PHOTO TOUR: Seattle Children's Hospital Psychiatry And Behavioral Medicine Unit." PHOTO TOUR: Seattle Children's Hospital Psychiatry And Behavioral Medicine Unit. N.p., n.d. Web. 02 Dec. 2015. "Psychiatry." Types of Treatment. N.p., n.d. Web. 02 Dec. 2015. "17 Battery Place Property Profile Overview." NYC Buildings. N.p., n.d. Web. 02 Dec. 2015. "University of Minnesota Masonic Children's Hospital." University of Minnesota Masonic Children's Hospital. N.p., n.d. Web. 02 Dec. 2015. "Welcome to Lutherwood." Lutherwood. N.p., n.d. Web. 02 Dec. 2015. "What Are Anxiety Disorders?" American Psychiatric Association. American Psychiatric Association, n.d. Web. 02 Dec. 2015. "Whitehall Building." NewYorkitecture. N.p., n.d. Web.
"The Application of Color in Healthcare Settings." Information Technology Integration in Healthcare Settings (2010): n. pag. Healthdesign.org. Web.
"The Application of Color in Healthcare Settings." Information Technology Integration in Healthcare Settings (2010): n. pag. Healthdesign.org. Web.
Architectural Design Manual. Pella, IA: Pella Corporation, 2004. Web.
Architectural Design Manual. Pella, IA: Pella Corporation, 2004. Web.
"BH 2012 Design Showcase." BH 2012 Design Showcase. N.p., n.d. Web. 02 Dec. 2015.
"The Mental Health Policy Implementation Guide." PsycEXTRA Dataset (n.d.): n. pag. Web.
"The Mental Health Policy Implementation Guide." PsycEXTRA Dataset (n.d.): n. pag. Web.
"Patients & Families." American Psychiatric Association. N.p., n.d. Web. 02 Dec. 2015.
"Patients & Families." American Psychiatric Association. N.p., n.d. Web. 02 Dec. 2015.
"PHOTO TOUR: Seattle Children's Hospital Psychiatry And Behavioral Medicine Unit." PHOTO TOUR: Seattle Children's Hospital Psychiatry And Behavioral Medicine Unit. N.p., n.d. Web. 02 Dec. 2015
"Psychiatry." Types of Treatment. N.p., n.d. Web. 02 Dec. 2015.
"Psychiatry." Types of Treatment. N.p., n.d. Web. 02 Dec. 2015.
"17 Battery Place Property Profile Overview." NYC Buildings. N.p., n.d. Web. 02 Dec. 2015.
"Welcome to Lutherwood." Lutherwood. N.p., n.d. Web. 02 Dec. 2015.
"What Are Anxiety Disorders?" American Psychiatric Association. American Psychiatric Association, n.d. Web. 02 Dec. 2015.
"What Are Anxiety Disorders?" American Psychiatric Association. American Psychiatric Association, n.d. Web. 02 Dec. 2015.
"Whitehall Building." NewYorkitecture. N.p., n.d. Web.