Thank You to the City of Presidio for providing us this opportunity to Julie Zook for pushing healthcare into new realms of study and practice
The Team
Salvador Sanchez Texas Tech College of Architecture Masters of Architecture G. Fall 2018
Zack Morris Texas Tech College of Architecture Masters of Architecture G. Spring 2019
before we begin... AN ARCHITECTURAL QUESTION What makes a hotel similar to a hospital? What makes it different?
A CITY QUESTION How do you provide specialized care to a rural location?
TYPOLOGIES Typologies, as defined by dictionary.com, is a systematic classification or study of types. Both hotels and clinics are very distinct typologies, each with their own unique features. This graduate design studio focused on the building typology and what made them what they are. In order to understand what we mean regarding typologies, I will define a basic idea of what these typologies are. Hotels are identified with luxurious materials, grand spaces, and identical standardized rooms with some larger, higher quality rooms. Hospitals and Clinic typologies are identified with high levels of spatial organization, with high levels of control and visual sightlines for the medical staff. Understanding and analyzing these building typologies have allowed us to determine key differences and similarities between the two. Based on the concept of procession, hospitality and healthcare typologies are essentialy the same. There are elements in each that make it different (measurements, blood work, spa, workout, etc.) We are attempting to show how these typologies are similar, and to blend these two together, thereby destroying the pre-conceived notion and image of what these buildings are.
THE CITY OF PRESIDIO
The city of Presidio, located at the US/Mexican border, is a small bordercrossing city in the state of Texas. It has a population of approximately 5,000. The population demographic is roughly 77% Hispanic, followed by Caucasian, African, and Native-American. The majority of the population are employed by either the United States Border Patrol and Customs, the local Independent School District, or what local businesses within the city. The shares the Rio Grande with the city Ojinaga, a well-established Mexican city with a pop[ulation of approximately 28,000. With the two cities being so close, people from either side could cross over the border, either to work, play or visit people, and return at their leisure.
DEMOGRAPHICS
• 1,285 Households • 49.3% Have children under 18 • 18.8% Individuals • 10.5% 65+ years old and live alone • Average household size is 3.24 • 37.2% under the age of 18 • 8.7% 18 to 24 • 25.5% 25 to 44 • 17.4% 45 to 64 • 11.1% 65 years of age or older
• Median age of 28 years old • Median Household Income is $18,031 • Male Median Income is $20,469 • Females Median Income is $15,000 • 40.4% of families below the poverty line • 43.0% of individuals are below the poverty line • 64.5% of those age 65 or over are also below the poverty line
RURAL HEALTHCARE
The city of Presidio, located at the US/Mexican border, is a small bordercrossing city in the state of Texas. It has a population of approximately 5,000. The population demographic is roughly 77% Hispanic, followed by Caucasian, African, and Native-American. The majority of the population are employed by either the United States Border Patrol and Customs, the local Independent School District, or what local businesses within the city. The shares the Rio Grande with the city Ojinaga, a well-established Mexican city with a pop[ulation of approximately 28,000. With the two cities being so close, people from either side could cross over the border, either to work, play or visit people, and return at their leisure.
The City of Presidio
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PROGRAM ELEMENTS
As we began to study and analyze the city, we mapped out all of the major commercial, governmental and medical programs provided within the city limits. As we saw what the city provided, we determined what program elements we wanted this building to provide.
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PROPOSED PROGRAM ELEMENTS
We evaluated what program elements the city had, by tabulating the total number of hotel and hospital beds, and total square footage of social gathering places (i.e. restaurants and bars). We then factored in a 10-15% population increase, and that gave us a target number to provide in our building proposal. Listed below showed the results of our observations, as well as our proposed numbers. EXISTING HOTEL ROOMS - 64 TOTAL BIG BEND INN - 8 rooms RIATA INN - 20 rooms THREE PALMS INN - 36 rooms
EXISTING EXAM ROOMS - 6 TOTAL SPECIALTY - 2 rooms EXAM - 4 rooms THREE PALMS INN - 36 rooms
EXISTING BARS - 1500 SF HINDI’S SPORTS BAR - 700 SF PRESIDIO TRADING POST - 800 SF
EXISTING HEALTH EDUCATION - 0 SF NONE - 0 SF
EXISTING RESTAURANTS - 5 TOTAL EL PATIO RESTAURANT THE BEAN CAFE OASIS RESTAURANT EL CHANGARITO PONCHOS PIZZA
BIG BEND INN - 8 rooms
RIATA INN - 20 rooms
SPECIALTY - 2
THREE PALMS INN - 36 rooms
TOTAL - 6
EXAM - 4
EXISTING EXAM ROOMS - 6
EXISTING HOTEL ROOMS - 64 TOTAL
HINDI’S SPORTS BAR 700 SF
EXIST
PROPOSED HOTEL ROOMS - 30 TOTAL PUBLIC HOTEL - 18 rooms RESIDENCE - 12 rooms
PROPOSED EXAM ROOMS - 12 TOTAL SPECIALIST - 4 rooms EXAM - 8 rooms
PROPOSED BAR SF - 12 SF SPECIALIST - 4 rooms EXAM - 8 rooms
PROPOSED RESTAURANT SF - 12 SF SPECIALIST - 4 rooms EXAM - 8 rooms
PROPOSED HEALTH ED. SF. - 12 SF SPECIALIST - 4 rooms EXAM - 8 rooms
RESIDENCE - 12 rooms
PUBLIC HOTEL - 18 rooms
SPECIALIST - 4
TOTAL ROOMS - 30 rooms
TOTAL - 12
EXAM - 8
PROPOSED EXAM ROOMS - 12
PROPOSED HOTEL ROOMS - 30 TOTAL
PONCHOS PIZZA EL CHANGARTIO OASIS RESTAURANT THE BEAN CAFE EL PATIO RESTAURANT HINDI’S SPORTS BAR 700 SF
PRESIDIO TRADING POST 800 SF
TOTAL SF 1500SF
6AM
8AM
FLEX/LOBBY 300 SF
SEATED/EATING 500 SF
TOTAL SF 800 SF
PROPOSED BAR SF - 800 SF
10AM
NOON
2PM
4PM
6PM
8PM
10PM
EXISTING RESTAURANTS
EXISTING BARS SF - 1500 SF
6AM
8AM
10AM
NOON
2PM
4PM
6PM
PROPOSED RESTAURANT
HEALTH CONF. 0 SF
LEARNING KITCHEN O SF
TOTAL 0 SF
HEALTH CONF. 1100 SF
LEARNING KITCHEN 400 SF
TOTAL 1500 SF
EXISTING HEALTH EDUCATION - 0 SF
8PM
10PM
PROPOSED HEALTH EDUCATION - 1500 SF
FLEX/LO 300 S
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NETWORKING
As we developed the scheduling for the doctors, we needed to understand who would utilize this facility, both in city, as well as outside the city. The primary coverage area would be within 100 miles of Presidio, with more severe cases being transported to either El Paso, Lubbock, San Angelo or Midland/Odessa. Another development was the networking of the doctors and specialists. We needed to be able to find specialists and hospital systems that would be willing to loan out their doctors for specific periods of time. The easiest systems would be utilizing universities and learning hospitals, which would allow students to gain exposure to areas of need, which could inspire future doctors to locate their practices in or near Presidio.
LUBBOCK - 369 5HR 44M
SAN ANGELO - 316 4HR 51M
EL PASO - 254 3HR 51M
MIDLAND/ODESSA - 25 3HR 56M
ALPINE - 86 1HR 22M
City Precedent: Métropole Douce A drawing analysis of the city of Paris by Finn Geipel and Giulia Andi. This idea illustratd the idea of the urban archipelago. The drawing illustrates an interpretation of the Parisian metropolitan area as an interconnected cluster of gray and green islands.
LUBBOCK - 369 mi. 5HR 44MIN. SAN ANGELO - 316 mi. 4HR 51MIN. EL PASO - 254 mi. 3HR 51MIN. MIDLAND/ODESSA - 251 mi. 3HR 56MIN. ALPINE - 86 mi. 1HR 22MIN.
TERLINGUA - 62.2 mi. 1HR 07MIN. MARFA - 59.8 mi. 56MIN. LAJITAS - 49.8 mi. 1HR 19MIN. CANDELARIA - 49 mi. 1HR 28MIN. PLATA - 44.0 mi. 1HR 37MIN . RUIDOSA - 37.1 mi. 1HR 07MIN. SHAFTER - 19.9 mi. 23MIN. REDFORD - 15.9 mi. 23MIN.
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SCHEDULING
Week of the Year Days of the Week
Specialist
THE SPECIALISTS
Once we determined who would use the facility, the next major question became how to provide this level of care to a medium sized clinic, as well as providing room for these specilaty healthcare providors. Items we had to consider were staff and equipment, in addition to the providors themselves. We researched into how long each specialty would need to be on location, as well as how often the doctor would need to return for follow-up evaluations over the course of a single year. We took this data and developed a yearly schedule, blocking out both exam rooms and living quarters for the providors as needed.
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THE SITE
We studied a few potential site locations in our visit to Presidio City. When we arrived, we chose the site on O’Reilly almost immediately, due to its location, as well as the context of the park, and all of the commerical buildings. This location was unique in that it is “L shaped,” and that it opens onto two sepearate roads, which allows us to create two different interactive “nodes” of the building.
THE PROPOSAL
The building will house both an out-patient clinic, as well as hotel, with a bar/restaurant and coffee bar. The clinic on the first floor houses five exam rooms, an imaging room, two flexible multi-purpose rooms to utilize for specialized procedures, as well as a teleconferencing room to use for both telemedicine and distance collaboration between colleagues. The second floor of the clinic would house three physicians, and nine aides and/or nurses. The hotel would house fifteen rooms, a swimming pool, a workout room, a restaurant and bar. These amenities would be utilized by the both the hotel guests, as well as clinic patients for physical therapy.
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Site Interaction
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The site we chose had a unique condition, in that it opened up on two streets. Also, one of these site openings faced the only park in all of Presidio City. We wanted to utilize and include the park in our design, in order to create a public gathering spot that would encourage community engagement.
two building’s processes are very similar in that you check in at a lobby, to go to a room for a variable period of time, and finally checking out back at the same lobby as you leave the building. Once we established the similarities, we wanted to find ways to blur the differences, as well as enrich the clinic to have the same feel and experience as a hotel.
The Hotel Visitor
The Clinic Patient
PROCESS MAPPING
While developing the project, we broke down the two typologies to find key similarities and differences among them. We saw that the two building’s processes are very similar in that you check in at a lobby, to go to a room for a variable period of time, and finally checking out back at the same lobby as you leave the building. Once we established the similarities, we wanted to find ways to blur the differences, as well as enrich the clinic to have the same feel and experience as a hotel
*Images courtesy of No Country for Old Men
POOL
IMAGING
RESTAURANT/BAR
WOMENS
KITCHEN
MENS
HOTEL LOBBY
CLINIC LOBBY
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EXAM ROOM
EXAM ROOM
EXAM ROOM
EXAM ROOM
EXAM ROOM
EXIT
CHECK-OUT
ROOM
LOBBY
CHECK-IN
Clinic Patient
EXIT
CHECK-OUT
ROOM
CHECK-IN
LOBBY
Hotel Visitor
imaging multi-function
exam rooms
GROUND FLOOR
Separating the building into two separate “realms” of clinic and hotel allowed us to maximize the building square footage. After analyzing the building processes, we tried to mimic the design layout of the hotel in the clinic as much as possible.
PROGRAM GUIDE ADMINISTRATION CIRCULATION CLINIC
lobby
HOSPITALITY HOTEL MERCANTILE/BUSINESS OUTDOOR/PRIVATE PUBLIC/GATHERING
hotel offices fitness pool
GROUND FLOOR PLAN
restaurant/bar
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RESIDENCES RESTAURANT STORAGE VERTICAL CIRCULATION
SECOND FLOOR physician’s residences
offices
Separating the building into two separate “realms” of clinic and hotel allowed us to maximize the building square footage. After analyzing the building processes, we tried to mimic the design layout of the hotel in the clinic as much as possible.
PROGRAM GUIDE physician’s aides residence
ADMINISTRATION CIRCULATION CLINIC HOSPITALITY HOTEL MERCANTILE/BUSINESS OUTDOOR/PRIVATE PUBLIC/GATHERING RESIDENCES RESTAURANT STORAGE VERTICAL CIRCULATION
SECOND FLOOR PLAN
hotel rooms
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TRAVEL PATHS
GROUND FLOOR
GROUND FLOOR
Medical Staff Travel Paths
Visitor Travel Paths
Patient Travel Paths
Understanding the users of the building is key to the design and layout of said building. The primary users of the building fell into three distinct categories: patients, visitors and the medical staff. These diagrams represent where people would be able to access in a typical day. For example, patients would utilize the clinic primarily, but they would also be able to access the pool and workout facility in the hotel for physical therapy, as well as regular excercise. Medical staff would have the most expansive interaction because they would utilize elements from both the clinic as well as the hotel amenities.
GROUND FLOOR
SECOND FLOOR
SECOND FLOOR
SECOND FLOOR
Medical Staff Travel Paths
Visitor Travel Paths
Patient Travel Paths
VISIBILITY
While refining the building design further, some metrics were applied to research the viability of the clinic layout. One major metric was visibility of spaces. What I mean is, how many rooms or spaces are visible at any given location within the building. Utilizing software called Depthmap, it analyzed how well rooms are visible throughout the building. The more red an area is, the more you can see, where the more blue it becomes, the less you can see.
High Visibility
Low Visibility
CONNECTIVITY
The second metric we used to determine the buildings effectiveness was Spatial Connectvity, or the ability to access multiple rooms or spaces from specific areas. The color grading was similar to the visible interactivity. The more red an area is, the more connected the room is, where blue is more secluded.
High Connectivity
Low Connectivity
CLINIC LOBBY
TYPICAL HOTEL ROOM
HOTEL LOBBY
TYPICAL PHYSICIAN’SRESIDENCE
Hotel Section
Overall Section
Clinic Section
MATERIALITY
Materiality was a discussion point that created an interesting challenge for us. What would be a good building material that would reduce cost of transportation to Presidio. With Ojinaga being the closest major provider of building materials, we needed to utilize something that would be within easy access of the builders. Homes and buildings in Presidio did not have the typical appearance in most US cities, so utilizing similar building styles and building methodologies would allow construction times to reduce, thereby saving money on bringing in workers from other parts of the state. One material that made the most sense was concrete. Wood and concrete mix were readily aavilable and did not require specialized building knowledge. The exterior of the building would be board-formed concrete, which would allow the building to blend in more with the surrounding context, which is primarily concrete block and plaster.
SITE INTERACTION
Developing the interaction with the park was a major priority in the choosing and design of the project. When we were on site collecting information, we saw that there was a school bus stop on our site. When we found out about this, we wanted to create a protected bus stop for the students and parents that wait for the bus to arrive. Another goal of this site was to create a social node for the city, bringing both people from out of town, as well as residents together for special events. For example, the site could be set up to host a drive-in movie night for the entire town to come out and hang out while watching a family-friendly film. Other ideas were to utilize the courtyard and park for festivals and city-held events.
ENVIRONMENT
The major premise to this project was determining what design elements defined a hotel, as well as a clinic/ hospital. From our researching of building typologies, we determined that materials played a major role in the creation of the environment. Creating an environment of wealth and luxury would change a person’s response when they interacted within the space. Typically, hospital environments used durable, easy to clean materials, which, when dealing with patients, made sense. Recently, however, architecture firms began using materials that were used more in commercial office buildings and hotels to soften the “harsh” impression that a hospital would express.
HOTEL INTERIOR
Using materials similar to the exterior, we attempted to create a warm, cozy feel to the buildings interior. Using natural, warm materials, like wood and stone help create a more comfortable feel to the visitors. Contemporary designs currently are utilizing more natural materials and crisp edges to create a naturalist modern design. This design could begin to inspire future projects in Presidio, moving it from a small, sleepy town, into a more up to date city.
CLINIC INTERIOR
Once we were able to find a style that worked with the hotel, we wanted to utilize these elements and materials into the clinic. Since clinics have typically used materials that were easy to clean, it created a sterile, uneasy environment for patients and family members. Using warm and natural materials helps to ease the tension and apprehension of patients, as well as their families. Our hope is to continue to remove the stereotypical image of a clinic by the use of the planning, as well as the use of interior materials. With these changes, we hope to redefine the typology for future designers.
