Bringing a Neighborhood Health Center to Life
Since the mid-1980s, Maria de los Santos Health Center has been the largest provider of primary healthcare services to Philadelphia's Latino community. Part of Delaware Valley Community Health, Inc. (DVCH), Maria de los Santos was operating out of a 15,000-square-foot facility that served as much as a community center as a healthcare facility. The building's waiting room was always a crowded beehive of activity, and the center's outdoor plaza at the corner of 5th Street and Allegheny Avenue in North Philadelphia had become a popular gathering spot for the neighborhood. By the late 1990s, the building was obsolete and in need of expansion and renovation to continue to provide quality healthcare services to its growing clientele.
In 1999, DVCH hired Brawer & Hauptman, Architects, a Philadelphia-based architectural firm with a specialty in healthcare design, to study the feasibility of expansion and renovation of the existing building. It became clear that the tight site and the disruption that a major renovation would cause made such a plan a significant hardship. The focus shifted immediately to a vacant, one-acre site owned by DVCH about a half-block east of the existing Maria de los Santos facility that could be the location for a new building.
The site was not without some significant problems, however. Although the vacant property was within clear view of the existing building, it was generally felt that the building's design would have to provide a strong visual draw to pull clients from the busy intersection a few hundred feet away. And about a third of the site was occupied by a 12-foot-high solid rock outcropping that was not about to go away.
The design that evolved has the entire facility a story above the ground, with the eastern end resting on the rock and the western end covering a grade-level parking garage for the center's staff. The main entrance, a two-story, light-filled glass atrium (figure 1), contains stairs and elevators and presents a glowing beacon along the street, making the Center a highly visible landmark in the neighborhood (figure 2).
In keeping with DVCH's mission, the Center provides primary medical care in pediatrics, ob-gyn, adult medicine, dental care and behavioral health. There are also specialty services offered in health education, social work and HIV/AIDS counseling. Where the old facility had a large central waiting room from which a patient was sent directly to an available exam room, the new facility provides a more decentralized approach. Each specialty has its own smaller waiting area (figure 3), relieving the load on the front desk and shortening the wait for the patient.
The plan of the building resembles a central donut surrounded by several smaller department donuts (figure 4). The central area contains the common spaces such as the medical records, the lab, the dispensary, the billing office, checkout and referrals. Each of the smaller donuts is a self-contained specialty clinic with its own reception desk, nurses' station, exam rooms, toilet rooms, and supply closets. To make the experience easier for the patient, each department has its own color scheme (figure 5): pediatrics uses blues, dentistry uses greens, adult medicine uses shades of yellow and orange, and so on. The floor pattern is designed so that the receptionist can tell an ob-gyn patient to “follow the red tiles” to the ob-gyn waiting area. In addition to the various medical suites, which cumulatively contain about 60 exam rooms, the Center has an administrative office wing (figure 6) with staff and provider lunchrooms, a staff gym and a community room that can be used for neighborhood functions in the evening.
The entrance atrium and the main waiting area feature exposed structure, ductwork, and piping (figure 7), giving the facility a lively industrial appearance, while the clinical and administrative areas are a riot of colors and textures, despite their more conventional construction. Carefully selected artwork (figure 8) and custom bilingual signage (figure 9) further enliven the interior.
One of the more memorable discussions during the design phase of the project was the debate about the elevators and stairs. Since everyone who comes to the Center will have to go to the second floor, the architects wanted the main stair to make a dramatic visual statement as part of the entrance atrium. A single elevator provided access to the main waiting area, and the client was very concerned that the lone elevator was asking for major backups and unhappy patients. The architect was sure that a second elevator would be an expensive luxury in a building with a tight budget. At the last minute, the client asked that a second elevator be added to avoid the inevitable bottlenecks.
Since the Center opened, just about everyone takes the stairs. HD