Alan Karchmer; ©SmithGroupJJR 2016
A full-scale, functional patient room mock-up was constructed off-site for Holy Cross Germantown Hospital in Germantown, Md. The process helped the clinical staff and designers to realize necessary changes and incorporate them into the completed labor and delivery suite, such as adjusting the height of staff work surfaces and providing extra storage areas.
It can be difficult for someone who isn’t an architect to understand a space plan just by looking at 2-D drawings. Designers frequently use 3-D modeling and rendering, often in real-time rather than in finished plans and drawings, to show the design intent of a building. But this method doesn’t always provide a sense of scale and function. One way to address this challenge is through the use of an architectural mock-up: a full-scale representation of a particular component of the design.
Mock-ups are typically used for elements that will be repeated throughout the building, such as a patient room, or to prototype and test new design ideas or operational models. Each type of mock-up has its own purpose, costs, and benefits and can be completed in varying degrees to allow clinical and support staff to simulate different patient care scenarios, making sure that the design provides an adequate and functional space to perform their tasks while providing a healing environment for patients. In a 2016 survey conducted by SmithGroupJJR of healthcare design professionals, owner’s representatives, and owners, 100 percent of the respondents said they used a mock-up process in the past five years. Of that group, 98 percent said that the process was integral to the design and/or very beneficial to the final design of the facility. Respondents’ preferences for mock-up type were more mixed, with a majority recommending some sort of physical representation, such as outlining a space with tape or using cardboard walls; only one-half favored a fully functional build-out, primarily due to space, time, and cost constraints. Virtual reality mock-ups were used least of all but are increasing in popularity as the technology improves and prices come down.
Here’s a look at some frequently used mock-up processes.
Tape out the space. When time and resources are limited, you can get a sense of how staff and patients will operate in a space by using tape on a floor to outline walls, key fixtures, and other elements. This activity can be done quickly, allowing design and user teams to rapidly explore and refine multiple options. It also gives the clinical team a sense of scale, proportion, and maneuverability without the cost of building a full room. It can be used to mock-up a single room or an entire department. Organizations will often use an old warehouse or even parking lots when utilizing this method.
Foam core/cardboard mock-up. This approach is an inexpensive way to create a 3-D space that can help the staff better understand a design concept, including wall placement, casework, and door swings, as well as other large objects that can sometimes create pinch points within a space. This is the most commonly used mock-up and is often done at an off-site location due to space constraints in most hospitals. Much like the taping scenario, it can be used to mock-up a single room or an entire department.
Off-site, full build. Fully built-out and equipped mock-ups of patient rooms, clinical spaces, and even nursing units or departments offer users the benefit of seeing and touching the final finishes, storing materials in the casework, testing out different cleaning products, etc. Most importantly, multiple patient scenarios can be tested, allowing clinical staff to confirm that the room functions as required for them to perform their daily tasks. Plumbing and lighting fixtures, switch locations, circuiting, and nurse call responders are often supplied and installed in working condition to provide as true a representation as possible. It’s best to build this mock-up at an off-site location to allow the hospital staff to test these scenarios without decommissioning a bed on an existing unit. However, this process requires equipment to be transferred and staff members to travel to the off-site location, adding another task to their busy workloads.
Virtual mock-ups. As technology continues to provide new tools to the design world, the possibility of virtual mock-ups has emerged. After an architect builds a 3-D space in a computer, the clinical staff can use a headset and a 3-D avatar to maneuver virtually through the space. Some virtual reality systems still require the vertical plane perimeter of the room to be built. This can be done using foam core or gypsum, and then the tester can walk around viewing the 3-D room and equipment in the headset. Other types of 3-D systems will allow the user to navigate through the entire building.
In-situ, full construction. Even after building a mock-up and getting approval from staff members and the design team on the room function and flow, it may still be beneficial to build out a room at the start of construction. This process allows the owner to test the space for function, durability, and workflow and the contractor and subcontractors to install individual components and receive feedback on them before building the remaining rooms. The design team also gets one last chance to take a holistic view of the space, make tweaks, and review the contractor’s quality of work to better prevent change orders down the road.
No matter which approach you take, mock-ups can be an effective tool to gain consensus and insight into the design process and healthcare delivery. The value of physically engaging with a space before it’s built can uncover new solutions and opportunities, gain staff consensus, and lead to better design decisions as well as avoid costly mistakes. Considering the many benefits, it’s a worthwhile and relatively minor investment of time and money that will prove its value many times over.
Brenna Costello, AIA, ACHA, EDAC, is a principal at SmithGroupJJR. She can be reached at Brenna.Costello@smithgroupjjr.com.