Category: Category A: Built, Less than $25 million (construction cost)

Project: Providence North Portland Clinic

Client: Providence Health and Services

Project Location: Portland, Oregon

Architect: Mahlum

Interior Designer: Mahlum

General Contractor: Lorentz Bruun Construction

Mechanical engineer: CDI Engineers

Electrical engineer: Sparling

Civil engineer: MGH Associates

Structural engineer: DCI Engineers

Photographers: Lincoln Barbour and Mahlum

Artist: Caleb Freese

Construction cost (not including equipment): $2.7 million

Building area GSF: 19,475

Completion date: March 2007

The North Portland Clinic embraces its urban context, reaching out to underserved populations within its diverse neighborhood. Through massing, transparency and integrated artwork, the clinic visually engages local residents and enhances community identity. It has been a catalyst for revitalization along a public transportation corridor that until recently bisected the neighborhood.

Located on the mass-transit MAX line in Portland's urban core, the building reinforces visual connection with the busy streetscape and invites the community inside. An upturned butterfly roof creates the frame for an expansive wall of windows. The interior is divided into three daylit clinical pods, each of which is faced with integrated murals that can be viewed by patients and families within the clinic, as well as those passing by. Created by a local artist, these prominent murals tell the story of this community and its residents, expressing a commitment to the neighborhood and its vibrant history.

The design “heals” a brownfield site, and provides a transition between the high-volume street and the residential neighborhood beyond. In doing so, the clinic supports revitalization efforts in the area, while making community health services offered there more transparent and accessible.

Improvements to patient care and staff performance

The plan diagram breaks from the traditional, internally-focused clinic of nurse stations surrounded by exam rooms, bereft of daylight or access to views. Each of the three clinical pods includes dedicated exam and treatment rooms, support spaces and views to the street. This open design provides a constant visual link between occupants and the neighborhood.

The open plan reinforces the organizational diagram of the building, with a public zone along the street edge, a busy clinical zone in the middle where staff and patients interact, and a more private staff zone behind. Because the community is home to many extended families, the public zone is designed to accommodate waiting patients and family members who accompany them. The clinical zone is designed for maximum efficiency of movement and clear visibility in all directions. Reinforcing separation from the street, this area features lower ceilings, a quiet palette of materials, and a circulation corridor separate from that for patients and visitors. This zoning of program areas and clarity of circulation has allowed staff to greatly increase both patient volumes and successful outcomes.

Challenging conventional thinking

The design solution challenges conventional thinking about how a clinic should look and feel. While many outpatient clinics are internally focused, with little or no relation to their surroundings, the North Portland Clinic strives to link healthcare and the community both visually and physically. From the outset, the team partnered with the community, identifying as a primary project goal developing a design that reflects community values. The clinic's patients range from uninsured elderly with limited transportation options, to young mothers with children in need of immunizations, to HIV-positive neighborhood residents. All asked for a building that would offer a simple, respectful commitment to them. The clinic has been a substantial success and a catalyst for neighborhood revitalization, while bringing healthcare to an underserved community.

Ecological impacts and footprint

Constructed on the site of an old gas station built in 1960, the clinic restores and revitalizes this brownfield site. Located on a primary transit corridor, the clinic is served by light rail, public bus lines and bike lanes. A substantial number of staff and patients arrive by public transportation, on foot or by bike, allowing a reduction of site parking capacity by 40% from the standard five stalls per 1,000 square feet at a typical clinic.

A construction waste management program was implemented by the contractor to divert construction waste from the landfill. Regionally manufactured products are incorporated throughout, including exterior masonry, concrete containing 20% fly ash, and casework. Low VOC-emitting paints, coatings, carpet and adhesives were selected to maximize indoor air quality. Within the clinic's support areas, dedicated spaces have been set up for bulk recycling of non-hazardous waste. Occupants have control of lighting within their work areas, and staff often utilize only natural light at the nurse stations during the day. Powered window blinds inside and sun screen louvers on the exterior provide control of western sun exposure to reduce heat gain and glare.

Healthcare Design 2009 November;9(11):176-178