Outpatient Clinic Design by Victoria Sotter

FSU O U T PAT I E N T CLINIC V I C TO R I A S OT T E R STUDIO IV

TA B L E O F C O N T E N T S

02|

precedent & theory

03|

identifying issues

14|

design goals

04|

visual collage

05|

stakeholder analysis

16|

planning analysis

06|

location summary

07|

suite specifics

18|

proposed plan

08|

suite implications

09|

code plan

11|

program matrix

13|

concept

20| 22|

wayfinding

citations

15|

preliminary diagrams

25|

lobby

17|

adjacency matrix

28|

waiting

19|

palette identification

21|

preliminary art

33|

ff&e

24|

diagramming

35|

elevations

31|

staff work

37| 39| 41| 43|

floor plan

ceiling plan

millwork

exam room

research. 1

p r e c e d e n t & t h e o r y. DOCTOR U ARCHITECT | Ater Architects LOCATION | Kyiv, Ukraine

AREA | 38 SQ.M. COMPLETION | 2018

PERSON-ENVIRONMENT THEORY As a direct reflection of each other, a person’s environment directly affects their behavior through positive and negative stimuli. A harmonious environment reduces stressors for the person/group at hand, inducing more positive behavior for those affected. An environment must fit a person for them to benefit, and if demanding or harsh surroundings are implemented, the user of the environment will therefor be less likely to engage positively within the space.

PRECEDENT STUDY Floor plan shows two-room, 38 sq.meter outpatient clinic

Inviting entrance portrays bright colors and simple geometry inducing a positive emotional response

The children’s outpatient clinic in Kiev, Ukraine is a small, two-room, 38 square meter facility located in a residential complex. The goal of the design was to turn the space into a friendly, colorful environment that would make a trip to the doctor a positive experience for younger patients. Typically-exposed medical equipment was hidden throughout in built-in storage areas to create a more relaxed, “non-medical” atmosphere and reduce patient stress. In comparison to the Person-Environment Theory, this is an example of how an environment can be altered to positively enhance the direct emotions of the users of the space. Wood-paneled walls are used for warmth and are not fully extended tot he ceiling to create a space with a suitable scale for younger and smaller patients alike. As a more enlightening environment, children are no longer programed to have such harsh fears of medical institutions.

design implications - clear pathways through the space make the admission process quick and easy

Built-in storage provides for seamless design solutions for medical equipment and patient records, creating less visual stressors for the patient

Low wall panels create more userfriendly, comfortable scale for younger patients

- use of a warm and brightening palette enhances the users positive emotions linked to the space - concealment of medical equipment in seamless design solutions eliminates potential patient stress

identifying issues. SUMMARY As noise can cause anxiety and distractions in clinical spaces, it is important for designers and architects to reduce these sounds for means of a more comfortable space. Though some may think carpet is a good source itself alone for noise reduction, its noise reduction coefficient (NRC) is only 0.20-0.30, while a “good” NRC is typically around 0.80. Added solutions such as wall panels and sound-masking systems help to reduce the amount of noise in high-traffic areas. In addition, it is important to confer with mechanical engineers or electrical experts to be sure no building systems are too noisy. These systems and mechanical rooms should always be located away from occupied spaces and use grated light diffusers to create an acoustically sound environment. Sound masking systems that produce pink or white noise can also be implemented to eliminate sound after a particular distance is met. White noise is a constant background buzz and tends to be softer than pink noise. Pink noise is a frequency-specific sound that is not the best for clinical spaces since it is known to cancel out alarm noises. Sound-masking systems are especially important in the ceilings of areas that need more acoustical privacy (reception, check-in, etc.). The Americans with Disabilities Act (ADA) has greatly affected clinical areas as it requires most all spaces be universally accessible. This in turn makes the clinic safer and more welcoming of all patients. Spaces where complying with ADA and building area code requirements is especially critical includes entries, transitions, registration and checkout areas. As approximately 36% of Americans are overweight, it is important to take into account bariatric seating and adding this into clinic modules. For universal design, it is imperative to be sure ramps, flooring and entry doors comply to ensure transition points are universally accessible. Ramps for main front/rear entries should have a maximum ratio of 1:20, while shorter interior ramps should not extend 1:12. Entries should have automatic doors or wide revolving doors all with at least a 32” clear width when open. Doorways deeper than 24” should have at least a 36” clear width. Hardware should require little to no gripping or twisting. Walls, door jambs, doors and baseboards should be distinctly different colors or textures for visually oriented balance. Flooring material should be smooth for gradual transitions. Changes in floor surface levels between 1/4” or 1/2” need to be beveled with a slope no greater than 1:2. Any change greater than 1/2” must have a ramp. Threshold or trims should be used with carpet to solid floor transitions. Carpet should have a level loop or pile no greater than 1/2” in height. Additionally, drinking fountains must be installed at 2 varying heights, with the lower height accommodating wheelchair users. Lastly, one area of the registration or check-out station should have a lower wheelchair-accessible counter with a minimum knee clearance of 27” and top counter height between 29”-30”. Turning space in these areas should be 5’ minimum in diameter. The minimum width for alcoves is 36” where the depth exceeds 24”. The minimum for these alcoves should be 60” where the depth exceeds 15”.

Sound reduction can be achieved through the use of noise-absorbing wall panels throughout large, high-traffic spaces

Varying counter heights allow for wheelchair access in universal design settings while wall and door color transitions allow for way-finding and dividing spaces for visual clarity

design implications - create a universally sound environment by implementing space not only for ADA accessible seats but also bariatric seating throughout clinic modules - add solutions such as wall panels and sound masking systems to reduce the amount of noise in high traffic areas - incorporate ramps, wide entry doors and smooth flooring to comply with universal design needs - diversify walls, door jambs, doors and baseboards throughout by making them distinctly different colors for visual comfort and oriented balance

visual collage.

After conducting two interviews with care giver representatives, information was gathered on the positive attributes found in their workplace. These attributes can be reflected in the final design of the outpatient facility. Examples of positive factors shown on the right include color-coded wings for helpful way-finding, incorporating plenty of natural light for the wellbeing of both patients and staff, as well as using ceiling-hung signs for directions in large, intersecting hallways. A desire for a large amount of space in the staff break area was expressed in the interview, as well as separation of large spaces with dividers and slim walls to allow for privacy and sound reduction.

design implications

POSITIVE

- space plan to avoid cramped high-traffic areas by implementing wide pathways - incorporate windows to uplift patient and employees throughout the day - reduce confusion by implementing signage throughout the building to give visitors and employees

stakeholder analysis. PHYSICIANS & MEDICAL ASSISTANTS

JANITORS & MAINTENANCE STAFF

AGE: 25-65 EMOTIONAL STATE: Positive, potentially stressed APPEARANCE: Often MOBILITY: Overall good, potential to be sore CONCERNS: Time management, comfort in work environment

AGE: 18-65 EMOTIONAL STATE: Potentially fatigued APPEARANCE: Sometimes, not very often MOBILITY: Physically strong CONCERNS: Safety after-hours, cleanliness

PATIENTS

PHARMACEUTICAL REPS

AGE: Varies (children-seniors) EMOTIONAL STATE: Upset, tired, anxious APPEARANCE: Very often MOBILITY: Varies on potential impairments CONCERNS: Sickly, need to have quick turnaround

AGE: 25-65 EMOTIONAL STATE: Helpful, energized APPEARANCE: Rare, once a week MOBILITY: High, physically active CONCERNS: Needs space for showcases, ease of way-finding

FAMILY & CAREGIVERS

RECEPTIONIST | CLERICAL STAFF

AGE: Varies EMOTIONAL STATE: Worried and fatigued, hopeful APPEARANCE: Often MOBILITY: Varies CONCERNS: Desire to be with patient, need to feel welcomed

AGE: 18-65 EMOTIONAL STATE: Potentially stressed, energetic APPEARANCE: Very often MOBILITY: Overall good, could have sore back CONCERNS: Needs comfortable seating, spacious works area

- include easy & efficient way-finding for visitors of the space

design implications 5

- reduce the noise level for a therapeutic environment in busy, occupied areas - incorporate storage in outpatient rooms to reduce sight of visual stressors

l o c a t i o n s u m m a r y. existing

Located in the southwest corner of Tallahassee, the new outpatient clinic is

Ei se nh ow er St

in an area where no current healthcare is located, making it the first primary care clinic on this side of town. Approximately 7,000 people live within walking distance (1 mile), while 15,000 Front face of site to face northwest, permitting daylight more so as the day continues (to be demolished)

people work within 1 mile. The main

main entry

entry of the building is located in the northwest corner facing Roberts Ave, while the employee entrance stands on the far west end of the building, closest to Van Fleet Street. During morning hours, the southeast side of the building will be heated first with direct sunlight. As the day proceeds, the northwest side of the building will begin

Van Fleet St

to heat.

Minimal parking for patients and staff requires staff to park in adjacent lot

2911 Roberts Ave, Tallahassee, FL 32310

- incorporate materials that will withstand humidity & high temperatures

site implications

- implement light shelves in parts of the building where sunlight is minimal - allow for unobstructed, large entry and reception area for patients coming in at once

suite specifics. UP

F 40' - 0"

SQUARE FOOTAGE

EGRESS/STAFF ENTRY

20,928 SQFT

KEY

TABLE 2902.1

Main Entry Perspective

MAIN ENTRY

entry/exit points 40' - 0"

(FBC,10042.1)

Business Group B - Clinic Outpatient (FBC,304)

FIXTURE COUNTS

EGRESS/STAFF ENTRY

Building Entry

BUILDING INFORMATION BUILDING IS TYPE I CONSTRUCTION PER FLORIDA BUILDING CODE SECTION 601

INTERIOR WALLS MUST MEET PERIMETER AT EITHER WALLS OR MULLIONS --DO NOT INTERSECT AT THE GLASS

811 SF

LINE OF FLOOR ABOVE

DARKENED WALLS MUST REMAIN

Water Closets - 6

29' - 0"

BUILDING TYPE

210 (100 gross/occ)

ELEV

FIRE SEPARATION

ELEV

Lavatories - 4 (6 required)

Space

Drinking Fountains - 3

ALL STRUCTURE MUST REMAIN

le n

20928 SF

MAXIMUM DISTANCES TABLE 1006.2.1

Common Path of Travel 100’-0” 2

Travel Distance 250’-0” Dead-End Corridor Length 50’-0”

Level 1 Key Plan 1" = 20'-0"

Building Footprint Option A

40' - 0"

30' - 0"

40' - 0"

30' - 0"

see code plan page

The three-story building is located in Tallahassee, FL and is made of Type I

HIPPA (the Health Insurance Portability and Accountability Act) is enforced to

Construction. This implies the building can withstand significant fire resistance

ensure patient confidentiality, Title II highlights the privacy act, affecting interior

and be built of non-combustible materials such as concrete and steel. As

planning worldwide. For an effort to be made, patient charts, online profiles, and

occupants of this building will be working on the first floor, they are allowed two

conversations must be completely secure to ensure patient confidentiality.

side entrances and exits, as well as one main curtain wall entry located at the

The Joint Commission standards, in turn, focuses on accrediting healthcare

front of the building. Plenty of traffic flow will be carried throughout these three

institutions that comply with the standards at hand.

exit points. 7

8/30/2019 11:35:26 AM

30' - 0"

REQUIRED EXITS

FIRE SEPARATION

41' - 0"

OCCUPANCY COUNTS

suite implications.

WEAKNESSES WAITING AREA To inform the new design, a site visit was conducted to gather what was and was not working with the current configuration. Upon arrival into the existing clinic, the waiting area offers a multitude of seating options. Bariatric seating is provided throughout, as well as child-sized furniture in the childrenâ&#x20AC;&#x2122;s room. The childrenâ&#x20AC;&#x2122;s room is separate from the main waiting area but directly adjacent, allowing parents to safely watch their children play or read a book from afar. Exam table adjusts to upright position for quality comfort

STAFF AREAS The island that is centrally located in the building allows for effective collaborative team work, considering the staff functions primarily as a team.

TREATMENT AREAS The exam rooms contain patient tables that can be adjusted to an upright position, allowing for the utmost comfort and stability. Computers can connect to monitors in the exam rooms in order to prevent a barrier between the patient and doctor, as the patient can maintain eye contact with the doctor while discussing a diagnosis. Additionally, a half door is incorporated in the lab, allowing physicians to see what is going on at all times.

STAFF AREAS Though the island is a great use for collaborative work, it does not offer much privacy from the hallways surrounding each exam room. For noise reduction and privacy, sliding, frosted glass doors should be installed. A sound reduction system should also be incorporated in the space to prevent noise levels from getting too high in occupied areas. The break-room should be expanded to allow employees a comfortable place to settle during a long day of work.

CIRCULATION The hallways are perceived as narrow and sometimes difficult to navigate for both the doctors and the patients when walking past at the same time. They are narrow and could use a wider if not additional back hall for staff use only.

MEETING AREAS The conference room should have two separate entrances for the case of dividing the space into two and maintaining circulation, working along side with the already-installed privacy panel.

Bariatric seating offered repeatedly throughout waiting room

STRENGTHS

Doorways to surrounding halls are exposed causing noise problems and minimal privacy

Med staff area is mostly cluttered with furniture and no privacy for computer screens

design implications - control noise levels by implementing sound-reduction systems throughout space - incorporate exterior hallway for privacy of patients and staff areas - provide more entrances and exits in multi-use rooms to efficiently subdivide the room

code plan. 2

4' - 0"

3.4

7' - 9 3/16"

1' - 0"

3.3

FIXTURE COUNTS Water Closets - 6 Lavatories - 4 (6 required) Drinking Fountains - 3

10' - 2 11/32"

REQUIRED EXITS 3

3.3

1 1 Common Path 42’-11” 3.1 1 3.2

Travel Distance 159’-4”

MAXIMUM DISTANCES 3.1- Common Path of Travel 100’-0” Shown In Plan 64’-11” 3.2- Travel Distance 250’-0” Shown In Plan 159’-4” 9/23/2019 7:22:01 PM

3.3- Dead-End Corridor Length 50’-0” 3.4- Door Clearance 4’-0” | 1’-0” 9

Level 1

planning. 10

program matrix.

QTY

Room

Uses

Furniture

Equipment

Electrical

Lighting

SQFT Req

SQFT Provided

Other

Community Room

Television, kitchen equipment 1-2 Digital Check-in Kiosks, Speaker System, Television

Ambient, recessed cans, track lighting Ambient, recessed, decorative

1,500 SF

1,325 SF

Waiting Room

Flexible tables and seating for 25-40 Seating for 20, bookshelf

Convenience outlets

Communal area for teaching and learning Patient & family waiting area, consultation and check-out space, work area, restrooms

2,000 SF

2,614 SF

Adjacent closet/ niche for storage Include bariatric furniture

150 SF

228 SF

120 SF

118 SF

150 SF

165 SF

Adjacent to exam rooms

150 SF

164 SF

50 SF

52 SF

Leave space for standing equipment 4

Ambient, accent, task, downlighting

900 SF

901 SF

Provide sight lines into procedural rooms

Task lighting, dimmable lights

130 SF

145 SF

Bariatric blood draw bench

Recessed cans

55 SF

Recessed cans

60 SF

56 SF

Separate space for children waiting Private space to examine patients

Desk, 2 guest chairs, office chair for Consultation Areas Toy storage, child-sized furniture, bench Seating for 5 including guest chairs & bariatric seating

Childrenâ&#x20AC;&#x2122;s Waiting

Exam Rooms

Behavioral Counseling Rooms

Dedicated space for behavioral counseling

Seating for 6, table/desk, sofa

Procedural Rooms

Operation rooms for surgical procedures

Instrument cabinets and table, see Exam Rooms

Supply Rooms

Built-in storage for products

Medical Team Staff Areas

Storage spaces for clean and soiled products Student and care team meetings

Lab

Examination room for specimen deposits

Millwork, stool, blood draw chair

Lab Restroom

Restroom adjacent to lab for specimen deposits

Custodial Room

Storage for cleaning supplies

Supply storage

Server Room

Computer server storage room

N/A

Rack, cooling system

Dedicated outlet

Recessed cans

50 SF

45 SF

Electrical Room

Electrical source room

N/A

Electrical panel

Dedicated outlet

Recessed cans

50 SF

45 SF

Operations Director Office

Private space for Operations Director

Desk, meeting table for 2-4, locking lateral storage

Dual Monitors, phone, printer

Dedicated outlet, convenient outlets

Task lighting, ambient, recessed cans

105 SF

112 SF

Incorporate near staff area

Medical Director Office

Private space for Medical Director

Desk, meeting table and seating for 2-4, locking lateral storage

Dual Monitors, phone, printer

Dedicated outlet, convenient outlets

Task lighting, ambient, recessed cans

110 SF

112 SF

Incorporate near staff area

Open office seating for 1820, tables, central island

Childrenâ&#x20AC;&#x2122;s games/toys, television Monitor, diagnostic equipment, sink and millwork, waste and sharps disposal Monitor, magazine rack

Dedicated outlets and convenience outlets

Dual Monitors, surgical equipment, see Exam Rooms

Convenience outlets Recessed cans with outlet covers Dedicated outlets, Task lighting, recessed convenient outlets and down-lights, higher CRI GFCI Dedicated outlet, convenience outlets

Accent lighting, task lighting, dimmable recessed cans Dedicated outlets, Downlighting and task convenient outlets and lighting GFCI GFCI Downlighting

Projector, monitor, Dedicated outlet, copier/scanner/printer, convenience outlets shredder, phones, flexible privacy dividers Sink, microscope, bioDedicated outlet, hazard waste disposal, convenient outlets and centrifuge GFCI Toilet, sink, grab bars, GFCI mirror, emergency call button, specimen cabinet and cup storage Mop sink, Mop cart GFCI

Adjacent sight lines to waiting Provide positive distractions

QTY

Room

Uses

Furniture

Equipment

Electrical

Lighting

SQFT Req

SQFT Provided

Other

Portable Equipment Area

Gurney and cart storage area, Alcove storage area

N/A

Gurney and equipment carts, wheelchairs

Convenient outlets

Ambient lighting

150 SF

100 SF

Emergency pickup adjacency

Conference Room

Meeting space

Seating for 8-10, conference table

Dedicated outlet, convenient outlets

Downlights, track, accent

400 SF

451 SF

Ability to divide into two spaces

Staff Break Room

Break area for employees

Seating areas, massage chair

1200 SF

1340 SF

Dishwasher optional

Staff Locker Room

Lockers, benches

40 SF

Staff Restrooms

55 SF

Adjacent to staff break room Include in each wing

Enclave

Table, 2 chairs

50 SF

Family Restroom

Tele-medicine room, shortterm enclave space Public restrooms adjacent to waiting room

Convenient outlets and Recessed cans, accent GFCI Toilets, sinks, grab bars, GFCI Recessed cans mirrors, paper towel dispensers, trash Monitor with webcam Convenient outlets Task lighting, accent

40 SF

Shower and storage area for staff Employee use-only restrooms

TV, Window coverings, phone, conference system, screen, projector, sound bars, privacy divider TV, Window coverings, (2) microwaves, sink, refrigerator, trash & recycle Showers

Telemed Room

Computer room for use of video-calling patients

Desk, office chair, seating for 2

Toilets, sinks, grab bars, mirrors, paper towel dispensers, trash Dual Monitors, phone

N/A

Dedicated outlets, Track lighting, accent convenient outlets and lighting, ambient lights GFCI

GFCI

Recessed cans

55 SF

Dedicated outlet, convenient outlets

Task lighting, ambient, recessed cans

250 SF

316 SF

SQFT TOTAL CIRCULATION TOTAL

13,665 SQFT

Adjacent to reception area

14,466 SQFT 6,462 SQFT 20,928 SQFT

c o n c e p t |h a r m o n i o u s

forms

In an effort to counteract illness, harmony can be used as a tool to enhance the wellbeing of the afflicted. With growth comes health and stability, promoting an inspiring place to heal for the mind and soul. The design element of harmony refers to the formation of a cohesive whole through a multitude of different parts and pieces. These pieces - an enhancing, energizing palette, harmonious forms of curving walls and furniture elements, and a multitude of linear architectural forms- will work together to form the mold for harmonious formations throughout the space. By meeting user needs and designing an inspiring environment to heal, users will experience an uplifting environment of fulfillment, bliss and growth.

design goals.

Design for wellness by creating a universally designed environment to welcome all patients of different needs

Create a therapeutic environment by implementing sound-masking systems in high-traffic areas and offer positive distraction by incorporating access to exterior views

Enhance the userâ&#x20AC;&#x2122;s experience with clear pathways through efficient way-finding and lighting

Incorporate design solutions that reduces patient stress by concealing medical equipment throughout exam rooms

preliminary diagrams. UP

STORAGE

ENCLAVE

EQUIP

PROCEDURE ROOMS DIR. OFFICE

EXAM ROOMS

DIR. OFFICE

MED STAFF AREA

SOIL & STORAGE MED STAFF AREA

EXAM /PROCEDURE ROOMS

SOIL & STORAGE

Building Entry

CHILDRENS WAITING

2 811 SF

WAITING

ELEV

CUSTODIAL ELEC SERVER

EXAM /PROCEDURE ROOMS RESTROOMS

COMMUNITY

MED STAFF AREA

C COMMUNITY

RECEPTION

RESTROOMS

STAFF BREAK

LAB

STAFF ENTRY

SOIL & DIR. STORAGE OFFICE

EXAM ROOMS

COUNCELING

ELEV

COUNCELING

MED STAFF AREA

TELEMED ROOM

SOIL & STORAGE

CONFERENCE

WAITING

RESTROOMS

LAB

CUSTODIAL ELEC SERVER

TELEMED ROOM

B STAFF BREAK & LOCKERS

COUNCELING

STAFF LOCKERS

DIR.

40' - 0"

OFFICE

40' - 0"

30' - 0"

40' - 0"

30' - 0"

DARKEND WALLS MUST REMAIN

bubble diagram

blocking diagram

The diagram above captures the range of various sized rooms and their relation throughout the space. The

The blocking diagram explores the connection between public and private spaces

idea of spreading small, less occupied spaces amongst larger, high-traffic spaces is explored

throughout the building, as well as a more accurate size of areas in comparison to

throughout the diagram.

others. This will help with acoustic control as well as privacy control.

Level 1 1 1" = 20'-0"

destinations, landmarks & focal points

zoning with atmospherics PRIVATE

These zones contain rooms occupied by patients, doctors and nurses for examination and observation purposes. For confidentiality of clients, these areas should have strong acoustic control.

SEMI-PRIVATE In these zones, users are constantly moving in and out of the space, and while they are not there all day, still need the acoustic privacy as they are typically located around private spaces.

9/18/2019 7:09:07 PM

planning analysis.

Level 1 1 1" = 20'-0"

PUBLIC These spaces tend to cater more to the public visitors of the space. They tend to be busier than other spaces in the building, and are very open rooms needing attention for acoustic control.

DESTINATIONS This is a location where users are likely to head due to their needs, such as exam rooms, the community room for a learning session, or the waiting room to see the doctor.

LANDMARKS These are areas of practical significance along the users way to a particular destination. Such places may include the reception desk or restrooms as a mark of directions along the way.

FOCAL POINTS These points are areas of visual interest that can be used for wayfinding, such as strong graphics or signs throughout the space to help guide users along the way.

adjacency matrix.

primary

secondary

neutral

undesired

design implications - community room should be adjacent to the main entry and waiting area for ease of after-hour access - lab and lab restroom need direct connection for specimen collection - allow staff entrance to be in same wing as staff break room for direct access to lockers

proposed plan. 26

Short-term enclave allows for private phone calls away from typically occupied areas

Med staff areas look into procedure rooms for patient observation

03 05 04 01

Wide entry & exit doors comply with universal design needs

21 22

Exam Room 1 adjacent to waiting for patients needing separate ventilation

18 01

Medical equipment storage located adjacent to ambulence pick-up area

Children’s area features a glass wall looking into the waiting room allowing family to keep an eye on kids

Bariatric seating incorporated in exam and waiting rooms for universal design needs

Sliding doors control acoustic levels and provide privacy for working staff

Half-lab allows staff to do quick drop-offs or drop-bys without the hastle of traveling to separate wing

Clear 5’-0” pathways enhance users experience with ease of navigating

Storage space for community room

Separate staff hall allows travel to adjacent wing without sight exposure to waiting room

19 29

03 13

07 06

Open reception space allows for stress-free admission process and personal space

12 11

Hidden storage for office equipment allows for seamless, clean reception design

scale | 20” = 1’-0”

palette identification.

As blue is commonly seen in the healthcare industry, it promotes trust and credibility for good reason. More than eighty percent of leading healthcare companies use the color blue due to its association with vitality, strength, power and professionalism.

Typically associated with calmness, serenity, cleanliness, focus and strength, shades of blue will be used throughout the various spaces. For oriented balance and visual comfort, accent features and architectural elements of the space will be distinctly different in contrasting tones.

Accent colors will be incorporated throughout to bring a variation of positive emotional factors to the room. Orange and golden yellow tones will be incorporated to suggest a refreshing, energizing feeling in the facility. These colors are additionally linked to promote happiness and wellness in a space.

wayfinding.

DESIGN ELEMENTS Illuminated signage catches the eye as users navigate throughout the space

Large signage systems with sound-reducing backing such as cork lessens noise in long corridors

• Avoid using small lettering or graphics in highdistance spaces • Keep wall mounted signs 48”-60” above finished floor • Ceiling hung signs must be 6’-8” min above finished floor • Create high contrast level between signs and their backgrounds • Maintain a low gloss finish to prevent glare for the users

Using exam room numbers not only on the wall but also protruding can add more clarification within spaces

Phyiscal paths to follow along long routes in color can make the space more seamless with less cluttered signage

• Incorporate color-coded elements, illumination and contrast within way-finding to make for a stress-free, welcoming environment • Avoid wall mounted signs that protrude more than 4” from the wall

Implementing contrast helps the user better sight the signage along busy paths

Long ceiling-hung extrusions create an opportunity for signage in one spot for heavy traffic, large areas 20

preliminary art. 1

Many patients interviewed in case studies regarding art in healthcare institutions frequently express a presence of nature visuals in the space around them (Lankston, 2010). Nature graphics induce a state of calm, positive emotional responses. Image 1 represents an abstract replica of this concept. The art itself has the potential to maximize the benefits of health care as it adds a positive distraction for waiting patients. The use of colors in image 2 promote feelings of peace gathered in an abstract form, and will further mirror the color scheme of the design. These types of art pieces will be used on the walls of waiting rooms, exam rooms, and even long corridors where patients are in constant need of visual distractions while going about their visit. Image 3 provides a visual of a sculptural piece that will be used in the waiting room to separate zones of seating- evoking a feeling of privacy within a public space. Artwork used in the exam rooms will be small in scale while artwork used in larger spaces such as reception and waiting will be greater in scale. 2

citations.

PRECEDENT & THEORY Morris, A. (2019, January 15). Ater Architects creates a friendly interior for a children’s clinic in Kiev. Retrieved from https://www.dezeen.com/2019/01/15/ater-architects-clinic-kiev-interiors/#/ Nussbaumer, L. L. (2009). Person-Environment Theory In Evidence-Based Design for Interior Designers (pp. 26). New York: Fairchild Books. PALETTE IDENTIFICATION Why Most Medical Logos Are Blue: Medical Websites & Healthcare Marketing: Doctor Multimedia. (2017, October 14). Retrieved from https://doctormultimedia.com/medical-logos-blue/. PRELIMINARY ART Lankston, Louise, et al. “Visual Art in Hospitals: Case Studies and Review of the Evidence.” Journal of the Royal Society of Medicine, The Royal Society of Medicine, Dec. 2010, https://www. ncbi.nlm.nih.gov/pmc/articles/PMC2996524/. IDENTIFYING ISSUES Vickery, C. G. (2015). Clinic Planning Concepts In Modern Clinic Design: Strategies for an Era of Change (pp. 138-141). Hoboken, NJ: Wiley.

design solution. 23

diagramming. Using a blocking diagram in an axonometric view, spaces are divided

Staff zone

between primary care staff, pateints and visiting community members. Patient zones are stretched in singular zones to keep wayfinding simple while

Patient zone

staff zones are incorporated ocassionaly in between. A community zone is offered for teaching or learning opportunities for community member needs.

Community zone

Exam Room hallway

Emergency pick-up

Main Entrance

Staff entrance

l o b b y.

Evoking serenity and clarity, the lobby serves as an aspirational space free of harsh lines and enveloped in a multitude of curving forms. The entrance features a custom

reception

desk

with

ADA

compliant

counter

for

universal

design needs. Design elements such as floor to ceiling dividers and acoustical ceiling panels support the concept of harmony. A neutral palette with hints of blues and terracotta help to bring color to the already light and airy space.

f f & e | l o b b y.

1 | Armstrong Rejuvenations™

Restore™ Maple Lane in Agave Flooring

justification | Bacteria resistance, Noise reduction capacity, Eases discomfort of joints and muscles in feet

2 | Armstrong Striations BBT™ in Atmosphere Flooring

justification | Meets WELL® Building Standards requirements for: Cleanability, VOC Reduction, Toxic Material Reduction

3 | 3form Profile Panels™ Meridian Wall Panel

justification | Flammability resistance, Abrasion resistance, Bleach cleanable

4 | Formica Blonde Cedar Laminate

justification | FSC Certified Wood, lowemitting material, low glare, promote healthy environment by allowing for bleach cleanability

5 | Formica White Ash Laminate justification | see above

6 | Steelcase Gesture Task Chair

justification | up to 85% recycable, lowemitting materials, regional materials

7 | DesignTex Catalyst in Riverstone

justification | Water-based/Solvent (WS), Bleach Cleanable (4:1),100, 000 double rubs

5 8

8 | Kim Knoll Framed Art - Misty Mornings

justification | abstract nature scences promote a calming, positive emotional response for users of the space

waiting.

While waiting for appointments, it is crucial to minimize any stress factors patients may face when entering the space. A light palette helps to ease the mind while natural elements such as a self-contained waterfall feature and abstract artwork adds as a positive distraction to the space. Bariatric seating is offered to aid universal design while a variety of seating options accommodates a range of all ages and needs.

waiting.

ff&e | waiting. 1 | Armstrong Rejuvenations™

Restore™ Maple Lane in Agave Flooring

justification | Bacteria resistance, Noise reduction capacity, Eases discomfort of joints and muscles in feet

2 | Nemschoff Whisk Plus Chair

justification | ergonomic arms and clean-out design allows for comfort and easy cleaning

3 | DesignTex Linnen in Salt Water 2

justification | cleaned with Water-based Solvent (WS) or Bleach (4:1)

4 | chilewich Plynyl® Carpet Tiles

justification | Contains Microban® antimicrobial protection, low VOC, Green Label Plus ™ certified

5 | Harmonic Environments Harmonic Wall Panels™

justification | Agion anti-microbial coating (resists mold, bacteria), Requires no harsh chemicals for sanitation, PVC & Lead free Plumbing, enclosed system

6 | Coalesse Await Table

justification | smooth surface allows for easy cleaning and disinfecting

7 | USG Ensemble® Acoustical Drywall justification | easy maintenance, optimized sound absorption, reflective finish reduces fixture and energy use

8 6

8 | Kim Knoll Framed Art - Mossy Stones

justification | abstract nature elements promote a calming emotional response for users of the space while neutral tones create cohesive environment

9 | Bludot Minimalista Coffee Table

justification | smooth surface requires no harsh chemicals for sanitation

10 | Bernhardt ibis Lounge 10 9

justification | Slim clean-out design allows for easy cleanability, upholstery easy to clean and removable

11 | DesignTex Rumeli in Delta Blue

justification | cleaned with Water-based Solvent (WS) or Bleach (4:1)

staff work.

To build the momentum of a working environment, harmonious elements are incorporated to draw users into a calming space. Free flowing forms add curvature to straight walls while ceiling and floor elements reflect the idea of pieces coming together to support the design concept. Multiple sit-to-stand desks are incorporated as well as group seating options. Windows allow direct sightlines into procedural rooms to give opportunity for monitoring patients while continuing with work.

ff&e | exam room. 1 | Armstrong Rejuvenations™ Restore™ Maple Lane in Agave Flooring 9

justification | Bacteria resistance, Noise reduction capacity, Eases discomfort of joints and muscles in feet

2 | Steelcase Umami Lounge System

justification | Easy to clean upholstery allows for continuous disinfection of the space

3 | USG Wallforms™ Wall Panels

justification | Chemical resistance for cleaning purposes, felt backing

4 | Steelcase Verge Stool

justification | Low-emitting material, easy to clean surfaces

5 | Steelcase Convey Modular Casework

justification | Soft-close hinges reduce noise levels, bacteria resistance, sleek surface makes easy to clean

6 | Formica White Ash Laminate

7 | Kim Knoll Art - Mossy Stones

justification | FSC Certified Wood, lowemitting material, low glare, promote healthy environment by supporting sustainable design justification | abstract nature elements promote a calming emotional response for users of the space while neutral tones create cohesive environment

8 | Midmark Ritter® 204 Manual Exam Table

justification | One-piece, seamless drawers for easy cleaning of spills, holds up to 500 lbs

9 | Steelcase Countertop in Cameo White

4 3

justification | low-emitting material, low glare, durable

10 | DesignTex Scale in Facade

justification | Water-based/Solvent (WS), Bleach Cleanable (4:1),100, 000 double rubs

ff&e | halls.

1 | Armstrong Rejuvenations™

Restore™ Maple Lane in Agave

justification | Bacteria resistance, Noise reduction capacity, Eases discomfort of joints and muscles in feet

2 | USG True™ Wood Grilles Ceiling Panels

justification | FSC certified wood, felt backing allows for sound insulation and vibration damping qualities

3 | USG Wallforms™ Wall Panels

justification | Bleach cleanable, felt backing

4 | Gerflor Linea’Touch Decowood Railings

justification | low maintenence, fight against bacteria with bactericidal joints and antibacterial smooth materials

5 | Kim Knoll Framed Art - Lakes on Lakes

justification | the illusion of organic shapes along with the reflecting neautral palette gives users a calming, stress-free experience as they travel through the space

6 | Kim Knoll Framed Art - Shoreline justification | see above

elevations. ADA compliant room sign surface mounted

Solid core wood door with metal door frame

4’-0”

Signage panel placed on stand offs

exam room hall 3/16” = 1’-0”

Wood handrail over finish transition

finishes

Rubber wall base

USG True™ Wood Grille Panels

Lumicor Resin Panel

Wayfinding for Wing 1 of facility

Donor wall to pay tribute to sponsors Open circle showcases opportunities for future donors

Restroom signage painted on wall

donor wall 1/4” = 1’-0”

Wood slats with sound absorbing slots

Donor panels flushed with wood slats

Window treatment recessed in ceiling

Waterfall panel feature

Kitchen space for staff use only

Lounge area

Wall base

staff break room 3/8” = 1’-0”

floor plan. 26

Short-term enclave allows for private phone calls away from typically occupied areas

Med staff areas look into procedure rooms for patient observation

Childrens area features a glass wall looking into the waiting room allowing family to keep an eye on kids

Wide entry & exit doors comply with universal design needs

21 22

Exam Room 1 adjacent to waiting for patients needing separate ventilation

18 01

Separate staff hall allows travel to adjacent wing without sight exposure to waiting room

19 29

03 13 04

07 06

Storage closet for community space Open reception space allows for stress-free check-in process and maintaining personal space

Windows offer sightline into procedural rooms

Medical equipment storage located adjacent to ambulence pick-up area

Bariatric seating incorporated in exam and waiting rooms for universal design needs

Clear 5’-0” pathways enhance users experience with ease of navigating

Half-lab allows staff to do quick drop-offs without the hastle of traveling to separate wing

Sliding doors control acoustic levels and provide privacy for working staff

12 11

scale | 20” = 1’-0”

Hidden storage for office equipment allows for seamless, clean reception design

Nemschoff Whisk Side Chair

Midmark Exam Table

Turnstone Bivi Seat

Steelcase Umami Lounge

Turnstone Lounge Chair

Steelcase Coalesse Visalia Bench

Steelcase Health Verge Stool

Coalesse Montara650

BluDot Minimalista Coffee Table

Steelcase Health Convey Storage

Steelcase Coalesse Await Table

Steelcase Coalesse Montara650

Bernhardt Ibis Lounge

Steelcase Think Chair

Steelcase Coalesse Lox Chair

Steelcase Desk Steelcase Think 465 Series Steelcase Turnstone Alight Ottoman Steelcase Flex Adjustable Desk Steelcase Nurture Regard Seating Set Steelcase Verb Teaching Station

BluDot Bench Steelcase Locker System

Coalesse Enea Lottus Table Coalesse Enea Lottus Chair Turnstone Bassline Table

Coalesse Lagunitas Seating

Bolia Palm Veneer Lounge Chair Steelcase Coalesse Enea Stool Steelcase Exec Chair

Steelcase Coalesse Montara650 Table

Steelcase Coalesse Montara650 Chair

Coalesse Bindu Seating Turnstone Credenza

Steelcase Turnstone Campfire Table

Steelcase Gesture Chair

Steelcase Coalesse Switch Chair

Steelcase Node 480 Series Chair

Steelcase Victor2 Storage Unit

Coalesse Joel Seating

Steelcase Verb Easel

Recpetion Desk

Coalesse Together Seating

Steelcase Elective Elements Storage Steelcase Verb Chevron Table

Steelcase Coalesse Oculus Chair

furniture key plan

Furniture 1/8” = 1’-0” 1/8" = 1'-0"

ceiling plan. 26

Dropped ceiling panels with recessed cans between

Recessed linear lights 24 03

Custom LED light pattern installed recessed into dropped ceiling

Two story volume

Supply and return slots installed throughout longest linear side of rooms

Dropped acoustic ceiling feature with droppped linear lights within gaps

18 01

Recessed linear lights line walls in hallways

19 29

02 05

09 07

12 14

scale | 20” = 1’-0”

DOS curve

11’-0” AFF 12’-0” AFF

Delray Recessed Mount

LINESSE Linear Recessed

justifications

100W Pendant Disk

Upper | cUL listed, frosted acrylic diffuser allows for diffused light and less harsh glare

48" Linear Lamp

Middle | UL listed, no VOC powder coat paint, disinfection light with the power to continuously and safely disinfect using white light

Track Lighting Fixture

Lower | Engery saving LED light source, meets ADA regulations, UL listed

6" Recessed Incandecent Can Exit Sign

Linear Air Supply & Return

Cooper 161-W Sconce

Wall Sconce

ceiling key plan

1/19/2019 4:06:25 PM

Electrical 1/8”Legend = 1’-0” 1/8" = 1'-0"

millwork. Under counter rolling pedestal filing cabinets for storage purposes ”

8”

3’-

1’-

1’9”

Wire Grommets located at back edge of lower counter

”

2 3’-

17 ’-

3”

Formica White Ash Laminate Transaction Counter

4’-1”

Formica Blonde Cedar Laminate Base, Work and Accessible Counter

materials

2’-4” 41

enlarged plan 3/8” = 1’-0”

Lowered work surface allows for privacy and space for office supplies 2’-6” AFF

Wood laminate on 1/2” plywood

LED Light strip

Laminate on 1/2” plywood

Metal bracket

Blocking

Laminate on 1/2” plywood

section cut 1” = 1’-0”

Built-in LED lighting strips wrap around front view

ADA accessible check-in counter 2’-4” AFF

Section 2 1" = 1'-0"

exam room. Bariatric seating with arm rests for added support

Under sink clearance for wheelchair accessibility

Sanitizer dispenser ADA turning circle

Drop down ceiling to allow for calming cove lighting effect Wall-mounted monitor for ease of patient stress and diagnostic display Sharps disposal and glove storage Tack board for clinic flyers Warm wall art represents neutral palette accompanied by dimmable sconces Concealed trash disposal

exam wall 3/8” = 1’-0”

elevation exam plan Diagnostic equipment

1/2” = 1’-0”

Window with shade treatment

zoning

Guest bariatric seating

Midmark exam table 3

Tack board for pin-up health information Sink with equipment storage

Physician’s stool on wheels

A color coded diagram illustrates spaces divided amongst patients, their caregivers and staff. This allows for consideration of privacy amongst groups while sharing the space of a single room.

exam axon 1/2” = 1’-0”

V I C TO R I A S OT T E R STUDIO IV