HCD Expo Tour: Orlando VA Medical Center
The 2017 Healthcare Design Expo & Conference, in Orlando Nov. 11-14, kicked off with a variety of facility tours, including a visit to Orlando VA Medical Center. Opened in 2015, the 950,000-square-foot facility houses a 134-bed hospital and an outpatient facility housing 25 clinics, training and education spaces, an auditorium, medical library, and simulation lab.
During design and programming of the Orlando VA Medical Center, the project team, including the joint venture team of RLF and Ellerbe Becket (which was acquired by AECOM in 2009), focused on providing flexible and collaborative patient room and staff workspaces. That foresight and planning strategy proved invaluable shortly after the facility opened when the VA reorganized its clinical services into patient aligned care teams (called PACTs), built on the concept of the patient-centered medical home clinic model.
Laura Finfrock, construction coordinator, Orlando VA Medical Center, says the clinic building includes 14 pods of six exam rooms arranged around a centralized staff workspace with two doors for each exam room, one leading to an onstage corridor for patients and the other to the offstage staff area. When the VA adopted its PACT model, the layout was already equipped to handle the team-based care approach, with staff members, including behavioral health specialists, social workers, a pharmacist, nurses, and clinicians, utilizing the centralized staff area, which features multiple work settings, including a conference table for meetings and semi-private desks.
Adaptable design features were also incorporated into the hospital, where the project team planned for future changes to the patient population, including sicker patients being admitted to the hospital while less-acute cases receive treatment in an outpatient or home setting. “The people here are very sick so the rooms are acuity adaptable with gases and equipment,” Finfrock says, adding that the average patient stay is 2-3 days.
One of the biggest examples of flexible thinking came early in the timeline of the 10-year project, when the original site that was identified for the project was sold to another buyer after design and planning schematics had already begun. Another greenfield site was chosen and the team began adapting its plans to a new 65-acre location, including figuring out where to locate 1,200 parking spaces for the large facility. The team didn’t want patients and visitors to have to walk long distances on surface lots in the hot Florida sun, while the client didn’t want a massive garage structure built in front of the main entrance.
The solution was to divide the parking into two garages and locate them in the middle on either side of the facility that feed into light-filled corridors that connect to the inpatient building on the south end of the campus and the outpatient building on the north side. The design team then flipped the onstage and offstage areas, putting waiting areas, exam rooms, and patient areas closer to the center of the building near the parking to reduce travel distances, while the back of house areas were moved to the perimeter.
The adaptable planning strategies and design features helped the design team deliver on its goals to create a facility that was monumental, efficient for the staff, and honored vets. “We thought, this is our one chance to do something great for our veterans,” Finfrock says.