2016 Healthcare Design Remodel/Renovation Competition

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In conjunction with:

Categories: Staff Spaces and Pediatric Care
Sponsored by National Office Furniture

‚ÄčHealthcare Design is pleased to announce the finalists of our 7th annual Remodel/Renovation competition.

The categories chosen for the 2016 competition are Staff Spaces and Pediatric Care.

The 2016 competition drew more than 44 entries. Our expert panelists, designated by CHD (The Center for Health Design), reviewed all submissions and narrowed them down to the Top 3 in each of the two categories.

Awards will be desigated as follows:

BEST IN CATEGORY: the projects selected by our jury as the "Best in Category" will receive top honors and recognition in the magazine AND at the Healthcare Design Expo & Conference in Houston this November.

READER'S CHOICE: the projects receiving the most "reader votes" will be recognized as our Reader's Choice award winners in the magazine.

 

For more information, contact Donna Paglia at donna.paglia@emeraldexpo.com or call 216.373.1210. 

Voting is now open!


 

 

Pediatric Spaces Top 3

 

Staff Spaces Top 3

1.Seattle Children's, South Clinic [Federal Way, Wash.]1.Book Loving Lounge Staff Space (BLLSS) [Changhua, Taiwan] 
2.Children's Minnesota NICU Remodel [St. Paul, Minn.]2.UCSF Ambulatory Care Center (ACC) 5 Heart & Vascular Clinic Renovation [San Francisco]
3.CHKD Nuss Center Renovation [Norfolk, Va.]3.Kaiser Permanente Fontana Medical Center Basement Neurosurgery/Anesthesia Clinic Remodel [Fontana, Calif.]

 

 

Pediatric Spaces Top 3

1. Seattle Children’s, South Clinic [Federal Way, Wash.]

Cost per square foot: $270
Photos (after): Aaron Leitz

BEFORE PHOTOSAFTER PHOTOS

As modern healthcare places a greater focus on the delivery of whole-person care, healthcare facility development is changing in response. Many hospital systems today adopt a decentralized facility planning strategy to bring outpatient care into once-underserved suburban communities—closer to patients—with the intention of easing the demand for acute care. Clinics offer premier care near patients’ homes and workplaces, and the additional convenience of being adjacent to established retail destinations. From the healthcare provider’s perspective, locating ambulatory care and its accompanying parking to a location with lower leasing rates benefits patients while reducing operational costs.

When this provider sought to expand its service to new communities, the opportunity to adapt a vacant former Circuit City store emerged. The site’s shopping center context provides visibility, access, and ample parking, signage, entrance, and egress. Although a full 30 miles the provider’s acute care facility, the big box’s sheer amount of usable, flexible space would facilitate incorporating labs, general X-ray, ultrasound, pharmacy and rehab therapy that resolves the issue of distance between this location and acute care resources.

Inherent elements of the 37,000sf former big box—one level, wide spans between structural columns—would actually advance clinic goals around patient experience and efficient delivery of care. The store’s footprint facilitated a clinic floor plan designed to centralize services within an open, flexible system of workspaces and modules that incorporate principles of Lean design. Key Lean design decisions reduced patient and staff travel distances, decreased storage space, and decreased the total number of specialty treatment rooms, from 20 to just 5. The existing building’s single-floor, monument-free design supported those Lean initiatives.

Yet, despite these positive attributes, challenges did arise in adapting a retail space into a state-of-the-art healthcare facility. Significant infrastructure upgrades were required. However, the building’s flexibility and accessible location led the provider to proceed to convert the empty big box.

As expected, upgrading infrastructure proved to be among the project’s biggest tasks. Electrical and mechanical systems necessary for exam rooms or labs would need to be added or overhauled. Facilitating such upgrades in a space with a 25-foot floor-to-ceiling height included the creation of an internal structural frame to support improvements and provide for a lowered, 10-foot ceiling plane for experiential comfort. This internal frame also works in concert with a seismic upgrade, which facilitated the punching of much greater fenestration into the building envelope.

This clinic opened in August 2015, on-schedule and under-budget by 2.5% of construction cost estimates. Staff members report that duplicate medical record collections have been eliminated and return-visit scheduling communication has improved, attributing both to the clinic’s design.

The success of the project allows the main provider campus to focus on acute care as planned, and the brand has since designated this design as the prototype for ensuing clinics. This project sets a precedent for retail-to-healthcare conversion nationwide, and presents adaptive reuse as a viable option for producing stellar decentralized facilities, all in support of advancing the direction toward greater preventive care.

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2.  Children’s Minnesota/NICU Remodel [St. Paul, Minn.]

Cost per square foot: $140
Photos (after): ©2016 Corey Gaffer

BEFORE PHOTOSAFTER PHOTOS

The 50-bed NICU unit at Children’s Hospital in St. Paul, MN was ahead of its time in the 1990s when it was one of the first units in the country to utilize all private rooms. Since then, though, the rooms had not been refreshed. That created a number of significant challenges to providing quality care and a comforting patient and staff experience: confusing corridor circulation and way-finding made it difficult for families to navigate the space, traveling between Level II and Level III NICUs was inconvenient for staff, accessibility to the adjacent Mother Baby Center under construction was jeopardized and outdated finishes projected a tired, uninviting atmosphere and were difficult to maintain.

The client sought a solution to their space issues along with a sophisticated environment that would complement the delivery of world-class healthcare and cater to patients/adult visitors yet still feel like a whimsical nursery—all on a limited budget. Multiple design charrettes and visioning sessions inspired a design concept of Strength, Growth, and Hope, tenets that resonated with the type of care provided at this facility and which came to life in the form of an ‘enchanted forest.’ In the waiting lobby, visitors are greeted with a custom tree form that symbolizes the concepts of strength, growth and hope within the comforting embrace of the tree canopy. Working with an artist to develop custom imagery, playful creatures (fish, bird, bunny, ladybug) provide a touch of whimsy and a wayfinding element to help identify pods of rooms inside the unit. Custom lit elements provide additional indirect lighting at desk and ceilings to reinforce the sense of a tree canopy. Inside patient rooms, a redesigned footwall creates easily-distinguished clean and dirty areas for improved staff work flow and additional family storage, which was non-existent before.

The design team was also able to create a new entry sequence and improved flow for additional family space (kitchenette, computer space, shower, restroom, lounge) as well as enclosed, private educational space. A combined registration and HUC desk improves efficiency for staff and visibility to the entrance and family waiting space.

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3.  CHKD/Nuss Center Renovation [Norfolk, Va.]

Cost per square foot: $220
Photos (after): Dave Chance Photography
 
BEFORE PHOTOSAFTER PHOTOS

Over the past thirty years, Children's Hospital of The King's Daughters (CHKD) has grown into an international center for chest wall deformity treatment and research. The minimally invasive Nuss Procedure was pioneered at CHKD by its own Surgeon-in-Chief Emeritus, Dr. Donald Nuss.

The challenge was to make the renovated Nuss Center feel like its own center within the hospital while also acknowledging its relationship to/with the Pediatric Surgery department. PF&A designed the floor pattern to intertwine through the two waiting rooms and continue seamlessly across the hallway between them, symbolizing the relationship between the two phases of treatment. The waiting rooms were also designed with custom glazing for two reasons: to increase the perceived space by minimizing hard barriers and to simultaneously provide a visual barrier that eases insecurities by offering privacy to passersby.

The Nuss Procedure is a minimally invasive approach to correcting pectus excavatum, and involves surgeons inserting a curved metal bar under the ribs and sternum to reshape the chest wall. Though the floor pattern was one of the more prominent adaptions of the metal bar motif, it is subtly mimicked in other details as well, including the architectural wall panels, door, and casework pulls. Graphics are also used throughout the space to tell the story of the Nuss Procedure and to brand the center apart from the hospital. The story is translated through customized quotes, images, and timeline graphics in the waiting room to educate patients. Furthermore, the custom Nuss Center logo, custom dry-erase measuring grids, and staff scheduling boards are used throughout the space which help to cohesively brand the Nuss Center experience. 

The Nuss Center performs more procedures than any other treatment center in the world, so there was a dire need for the space to grow. Exam rooms were added to accommodate the high traffic of patients.  The average exam room size was increased and additional seating was provided to accommodate family members. The new design also provides much needed additional staff space including offices, a dedicated research room, conference room, and two work rooms. 

The design objective was met by thoughtfully designing the Nuss Center to reflect the ingenuity and significance of the program, making it truly the worldwide “Center for Excellence”.

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Staff Spaces Top 3

1.  Book Loving Lounge Staff Space (BLLSS) [Changhua, Taiwan]

 Cost per square foot: $62
 
BEFORE PHOTOSAFTER PHOTOS
Book Loving Lounge Staff Space (BLLSS) originated from the idea of the president of the health care system, Dr. Ming-Ho Huang. He thinks the medical staff need a space to relax their body and reduce pressures. As doctors take care of patients, they need lounge space more than patients for food and beverage, commerce, leisure, hotel functions, such as VIP rooms in international airport. The core treasure value of employee is “Concentrate on quality, Innovate in skill and Treat patients as relatives” and “Trust, Assist each other and Joy in work.” It would offer better medical care quality in clinic medicine.
 
The facility and furniture layout in BLLSS are designed according to and comparable to the level of international airport lounge. In addition to comfortable dining and leisure environment for the staff, professional catering staffs offer services 24 hours a day. Food services staff owned national F&B licenses and graduated from national university of hospitality. The staff space offers and operates breakfast, lunch and dinner. Staff can enjoy free hot tea and other hot meals in the morning, afternoon time, snack and early morning snack. Vocations life style, large space more than 3,500 square ft, facilities and devices are free; besides, especially in multi-functional conference room hybrid F&B room, it owns high quality video meeting device, tele-communication, bright books reading area, internet area, and 24 hours meal area. The massage area, shower area and popular proprietary lounge would be took a rest before or after medical staff works.

The core concept of the whole interior design is natural. Through feeling and warm design, economical crafts are the main characters. Hybrid reality, rhythm notes furniture, lighting and crafts, takes innovations into life environments with natural sun light, birds, garden, clouds, grassland and greenwood. To deeply touch the movement of heart in living space! Let staff in a hospital would dream of mountain and water. Let heavy works can be released, and forms a warm, spring, and energetic new staffs. Only staff satisfied, the enterprise would get more satisfied customers and gain the next sustainable development environments.
 

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2.  UCSF Ambulatory Care Center (ACC) 5 Heart & Vascular Clinic Renovation [San Francisco]

Cost per square foot: $533
Photos (after): Michael McLane
 
BEFORE PHOTOSAFTER PHOTOS
The 5th Floor of the Ambulatory Care Center (ACC) Building offers sweeping views of downtown San Francisco all the way to the tips of the Golden Gate Bridge. The 10,000 square-foot space houses the now consolidated UCSF-Parnassus Heart & Vascular services ambulatory programs. Originally constructed in 1973, the building is undergoing extensive renovation as part of UC San Francisco's Long Range Development Plan.
 
The interior clinic space was designed to reflect the contrast of the urban city view with the lush greenery of the surrounding park. The use of contrast is also demonstrated by the “on-stage/off-stage” concept that delineates the public facing spaces from the staff and clinician-only spaces.

Furniture and finishes mirror both the natural hues of the park (brown, green, and yellow) and the monochromatic hues of the city (silver, grey, black, and white). The reception desk itself acts as a reflection of the city. The silver texture pattern of the ceiling and light fixtures resemble clouds and evoke a sense of the fog that hangs over the city and the bright sunshine that breaks through.

The raw concrete columns were left exposed inside the space to contrast the warm wood utilized on the entry wall. Large patterned panels of glass were placed between the wood planks to reflect the breathtaking exterior views and break up the long runs of wood.

Artwork used throughout the space drew inspiration from the graphic style of x-ray images of items found in nature. Color tones used in the furniture, artwork, and accent paint are deep, highly contrasting, and bold. Resin panels used in the corridor and exam rooms protect the space from wear and tear.

Circulation improvements included adding a secondary access corridor for staff providing a secondary entrance into the exam rooms. Clerestories were introduced in most exam rooms to bring as much light as possible in from the exterior windows.

The staff lounge, later dubbed “the treehouse,” was placed in a window-filled corner room nestled in the lush trees and landscaping outside. A large open room titled “the hub” was used for touch-down space for clinicians.  A flexible conference room can be converted into two smaller consult rooms when needed.

Key  project goals included consolidating the client’s Heart and Vascular services ambulatory programs at one location, improving patient and caregiver satisfaction by creating a comfortable and attractive environment, improving satisfaction and efficiency of caregivers and staff by creating a space that promotes a logical workflow, making optimum use of the panoramic views to benefit the patients, their families and the staff, and developing the project in a participatory but efficient process by including insights from key stakeholders – staff, patients and caregivers but adhere to scope reflected by the project program.

A patient tracking system was implemented to enable faster response times. The on-stage/off-stage layout allows for privacy, direct access from touch-down space to patients, easier access to the caregiver, and also provides areas of respite for the clinician.
 

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3.  Kaiser Permanente Fontana Medical Center Basement Neurosurgery/Anesthesia Clinic Remodel [Fontana, Calif.]

Cost per square foot: Not Available
Photos (after): Chris Grant
 
BEFORE PHOTOSAFTER PHOTOS
Before medical records went digital, an entire department was needed to organize and manage all the hard copy medical records. At the Kaiser Permanente Fontana Medical Center, the medical records department was located in the basement, and as hard copy medical records were updated to digital, this basement space gradually fell into disuse. Kaiser Permanente decided to completely renovate the basement and move in their Neurosurgery/Anesthesia Clinic.

A windowless environment lit with fluorescent lighting is the last place that providers and staff want to work in all day—and it’s not ideal for members either. However, for the Neurosurgery/Anesthesia Clinic Remodel, we utilized Kaiser Permanente’s Total Health Environment (THE) Toolkit to design and create a nature-inspired, light-filled environment that supports Kaiser Permanente’s Total Health brand and creates opportunities for collaboration amongst providers, staff, and members. But without windows and natural light, the design team had to devise alternative methods to bring the feeling of those elements into the basement.

The design team focused on LED lighting solutions to brighten up the dark basement. Color-changing LEDs in the front porch waiting area and pre-op/post-op rooms slowly cycle through soothing colors, creating a calming effect that also helps break up the monotony of a windowless space. In the post-op room, members can control their own lighting colors, or let the nurses choose their color based on their status.

Even though there aren’t any windows, the clinic still has “views” to nature. The design team worked closely with the LED lighting company to create custom LED panels that combine lights with nature photography. The public square-inspired front porch waiting area features cloud graphics that mimic the sky, and LED clerestories at the providers’ offices appear to open up to a forest canopy.

The front porch waiting area isn’t your typical back-to-back chairs in a row—the seating is designed to cater to different waiting preferences while still accommodating up to 48 members at once. Members can choose to sit in a more private, individual seat, in a row of family-oriented group seating, or opt for the refreshment area where fruit and beverages are available to snack on. Or there’s even the option to forego sitting altogether and instead stand at one of the standing stations. All seating and standing areas are equipped with power outlets so members can charge their phones or tablets while they wait.

The providers’ offices are efficiently-sized to allow for the programming of the provider collaboration area. This collaboration area features comfortable seating, a kitchenette, and encourages conversation.

The biggest influence on the design concept was undoubtedly the challenge of creating a light-filled, nature-inspired space in a windowless basement. Paint colors, carpet, countertop materials, and furniture choices—all these components were carefully curated from the THE Toolkit to bring in elements of light and nature for members, providers, and staff. Maple and walnut wood finishes feel natural next to cool light blue and white walls. Wood flooring and carpet tiles soften the waiting area, and together with versatile furniture and color-changing LED clouds, members and staff now experience a Kaiser Permanente branded environment that falls in line with their expectations of what a Kaiser Permanente environment should feel like—full of natural light, comfortable seating, collaboration areas, and with connections to nature.

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