Since the early 1980s, Legacy Community Health Services has been a piece of the Houston landscape, where it was started in an effort to offer locals a place to go for anonymous STD screenings and treatment. Today, it serves more than 40,000 patients a year, providing comprehensive primary health services as a Federally Qualified Health Center.

“We’ve grown to offer everything from vision to dental, behavioral health, and financial services. And all of these departments had been spread out to different buildings within a couple of miles of each other in this one particular area of town,” says Legacy’s Facility Design Manager Joel Kalmin, of what inspired Legacy’s recent project at its Legacy Montrose Clinic.

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It became apparent that as the location’s offerings grew, its surroundings needed to, as well. The result is an eco-friendly 40,000-square-foot, four-story facility designed by Gensler that opened in late 2011, where all of those services are now housed under one roof.

Kalmin, who previously worked in hospitality and residential design, came on board with Legacy after the outset of the project and took the reins of the Legacy Montrose Clinic’s interior design—his first healthcare design project.



Because of Legacy’s own legacy within the community, it was important that the new facility encompass its past as well as represent the future.

“We wanted the building to be fresh and contemporary, and it also needed to feel warm and be a place where our clients would not feel intimidated,” Kalmin says. “We have adult care, pediatrics, male and female HIV services, and we have to encompass the entire community under one roof, so that was a challenge. By doing that, by knowing what our market was, we stripped down to what our basic needs were, and that was to provide a comfortable environment.”

Initial design goals were set by individual department heads, who collaborated with their teams to determine specific wants and needs. Kalmin partnered with Gensler to follow up with those teams to understand workflow and potential changes that could be made.


A jolt of color

One thing immediately apparent at the Legacy Montrose Clinic is the bold use of color in its design. Kalmin says he was inspired by a visit to The Museum of Fine Arts, Houston, where he came across “Water Lilies” by Claude Monet.

“The colors were just so vibrant and optimistic, and that was the attitude I needed to have on this project,” he says.

From citrus notes to a deep blue, accents abound throughout the clinic, where Kalmin used paint as a tactic to bring in color without any threat of permanence. “I was willing to go out on a limb by having brighter colors because it was only paint. For us, and this building, we plan on being in there 20 or 30 years, so to keep up with the times, all I have to do is change a wall color,” he says.

However, another star in the overall palette of the clinic is what offsets the color: white. All of the desks in the clinic are white as well as the majority of all other surfaces.

“This was my first true medical facility, and what’s unusual is I rarely ever use white and I rarely ever use color,” he says. “I wanted to bring a sense of chic hospitality to this environment because this area of Houston is very hip, very cool. And you can’t go wrong with white. It’s so beautiful in mass. It makes all that use of bright color pop even more.”

And the bursts of color serve a number of purposes, from wayfinding to team building for staff members. Each floor is a different color, and departments are coded by their corresponding floor color—for example, blue is primary care and purple is administrative offices.

“We own a couple of other clinics, and I’m in charge of redesigning those other facilities, so I’m taking these new colors and orchestrating them into these other facilities because our clients as well as our employees are then able to go from clinic to clinic and still have a sense of direction. I think that’s really important for a comfort level,” Kalmin says.

Additional design elements were added to the space through the use of artwork and playful wallcoverings, such as graphics in the break room of colons and semicolons to remind staff members to “pause.”

Art was selected over a two- to three-week period and about 70% of the pieces were donated by artists.

“We didn’t want to have anything specific, and we just really wanted to be contemporary and abstract. The colors, again, needed to be optimistic and encourage the patients to be more creative and ask questions,” says Kalmin.


Staff spaces

While the patient needs being fulfilled at the Legacy Montrose Clinic have grown over the past 30 years, so, too, have the needs of its employees. So the facility chose to transform its work environment through this project, too.

“A lot of the employees were used to very small spaces, as well as their own private spaces and offices, so the board decided to abolish any type of private offices and there are none in this facility whatsoever, including the executive director—she only has a three-quarter wall, and a third of that is all glass,” Kalmin says.

The move was influenced by some of Legacy’s board members and chiefs who have worked for Fortune 500 companies that promoted a creative team environment through the use of an open concept floor plan.

“That in healthcare
and nonprofits is not exactly expected,” Kalmin says. “So we went on a huge limb and provided this new environment, and I guarantee that at least 70% of the initial feedback before the building was completed was negative. In the end, I would say we have a 99% convergent rate.”

The process of going to an open concept was complicated by more than achieving buy-in from the staff, though.

“The growth of the organization changes on a monthly basis, depending on our grants. We could be awarded a grant overnight at a couple hundred thousand dollars, which means we have to hire within a few weeks and we have to adjust our floor plan due to our growing needs,” Kalmin says.

The answer was found in specifying modular furniture to accommodate the clinic’s changing needs.


Looking back

In the end, Kalmin says design expectations laid out at the beginning of the project were met, and then some.

“The goals were all accomplished and, in some aspects, some things we didn’t even know were goals ended up being met, such as a higher return ratio of patients for follow-up visits,” he says.

And after completing his first interior design project for a healthcare facility, Kalmin says he’s made very few mistakes. He identified parallels between hospitality and healthcare, which both serve clients, whether guests or patients, in addition to their staffs.

But, still, there was a slight learning curve.

“Durability and creating a truly clinical environment was really challenging because I didn’t understand the clinical environment. That was an interesting process to learn, and it’s still evolving,” Kalmin says. HCD


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