PHOTO TOUR: Centegra Hospital-Huntley
Centegra Hospital-Huntley, a 384,000-square-foot, 128-bed facility that offers advanced technology and an architectural design intended to facilitate wellness and recovery, opened in August 2016. Kahler Slater master planned and designed the new hospital to answer expansive growth in the marketplace. Located on an established ambulatory and wellness campus, the location capitalizes on an existing Health Bridge Wellness Center and ambulatory services, as well as proximity to the Del Webb retirement community. These connections build upon its overarching “healthy campus” concept, with a special focus on orthopedics and sports medicine. Additional master planning goals captured with this new hospital focus on patient-centered care
Project details
Facility name: Centegra Hospital-Huntley
Location: Huntley, Ill.
Completion date: August 2016
Owner: Mike Eesley, CEO and president
Total building area: 384,000 sq. ft.
Total construction cost: $141.7 million
Architecture: Kahler Slater
Interior design: Kahler Slater
Contracting: Hammes, Owners Rep
Engineering: Graef (structural/civil), Korda (MEP)
Construction: Power Construction
Building Synergy: South Philadelphia Community Health and Literacy Center
South Philadelphia Community Health and Literacy Center represents a new chapter for three organizations serving South Philadelphia. Designed by VSBA Architects & Planners (Philadelphia), the new 96,000-square-foot building replaces three 1960s-era structures—a public health clinic, a branch of the Free Library, and a recreation center—that existed separately on the site. The new $42 million center, which opened in June 2016 and spans a city block, brings these functions together while also incorporating a pediatric primary care practice owned by Children’s Hospital of Philadelphia (CHOP).
Cheryl Kramer, director of operations and ambulatory health services for the Philadelphia Department of Public Health, was director of the public health clinic in 2012, when a renovation was first considered. She says the clinic was having difficulty managing a high demand for services, with new patients waiting several months to be seen, and hoped to add square footage to accommodate more exam rooms and physicians.
At the same time, a new city health commissioner was appointed—a physician who formerly worked at CHOP—who knew of CHOP’s desire to expand its service area to include South Philadelphia. As leaders of the healthcare organizations discussed opportunities for the site, a collective vision began to emerge that included not only clinical space but a new home for the rec center and library. The result is a unique public-private partnership between CHOP and the city that creates opportunities for collaborative programming between the entities.
Construction began in October 2014, and the project opened in May 2016. The words “South Philadelphia Community Health and Literacy Center” span the width of the building in capital letters, while vertical stripes of blue, green, yellow, red, purple, and orange punctuate the façade. Large glass windows provide glimpses of the activity inside.
A spacious entry plaza greets visitors, while around the corner, the exterior design pays homage to the neighborhood row houses with traditional red brick, punched window openings, and a cast stone base. The rear of the site houses a playground, spray park, and full-size basketball court.
Inside, the 12,000-square-foot Free Library branch is on the ground floor and houses a Community Health Resource Center, with staff trained by the University of Pennsylvania Center for Public Health Initiatives, and features health-related programming like CPR classes and health insurance guidance.
The second floor is home to City Health Center #2, which provides services to adults and children without health insurance. A pharmacy and lab are positioned at the front of the suite, off the elevator lobby, for patients who are stopping in for prescriptions or tests. The 28,500-square-foot health center was also designed to support unexpected care.
“There are many walk-in patients without appointments who need to be triaged, so we provided triage rooms immediately adjacent to the waiting areas, which helps reduce waiting times and allows for a greater number of patients to be seen,” says Seth Cohen, senior associate at VSBA and the project manager and co-designer on the health center project.
The health center’s specialty services are organized by hallway with spaces designed to be flexible to accommodate varying patient flows. There’s a general waiting area as well as dedicated internal waiting spaces for general medicine, pediatrics, and dentistry; the facility has 37 exam rooms.
To help patients navigate the space, color is used extensively on the flooring, walls, and signage, with green used for the general medicine suite, blue for pediatrics, and orange for dental.
The CHOP primary care facility, located on the third floor, is distinguished by a broader color palette, including purple and red colors. Patients and families can check in at the registration desk or by using nearby kiosks, while a reading corner, mosaic mural crafted by patients, play structures, and public computers provide “plenty of opportunities for engagement,” says Cohen.
The CHOP clinic houses 34 120-square-foot exam rooms, organized along four color-coded hallways in an open-square pattern with a nurses’ station, medication room, and staff touchdown spaces in the center.
The rec center is accessed through a separate entrance at the rear of the building and includes a computer lab, support spaces, and a large multipurpose room for indoor games and activities.
By bringing these diverse services together under one roof, the center enables interplay between the service providers. A committee meets monthly to develop joint programming such as a recent health fair, and CHOP physicians work with the rec center to provide structured programming for kids around fitness and maintaining healthy weights. CHOP staff distribute library card applications to new patient families, and a nurse conducts a monthly story hour on a health-related topic.
The building also answered the original need to increase healthcare services to the area, with the city health clinic managing nearly 50,000 visits per year, and CHOP managing approximately 35,000 visits annually.
Jennifer J. Salopek is a freelance writer in McLean, Va. She can be reached at [email protected].
H.R. Gray Names New President, Director Of Construction Operations
Tom Merritt and Kristen Braden have been promoted to the respective positions of president and director of construction operations of H.R. Gray (HRG), a subsidiary of Haskell. (Jacksonville, Fla.)
Merritt has more than 14 years with HRG and formerly served as the vice president of business operations. He has more than 20 years of public sector knowledge with more than 10 years of private sector experience in the professional engineering and construction management field. Prior to joining HRG, Merritt served as deputy director of public utilities and director of the public service department for the city of Columbus, Ohio.
Braden has more than 15 years of experience in the construction industry. She has extensive experience with both public and private sector projects including water/wastewater, roadways, airports and offshore oil and gas production facilities. Prior to joining HRG, Braden worked with ExxonMobil in project management roles, followed by a construction litigation career. She will assume overall responsibility for day-to-day HRG construction operations.
Jim Joyce, PE, past president of HRG, will transition to the role of company chairman and will be focused on external relationships, client development, and overall strategy. George Daily, past executive vice president/chief operating officer, will be moving into a senior advisor role focused on construction operations, strategy, and development activities.
Northwestern Medical Center Celebrates Opening Of New MOB
Northwestern Medical Center recently opened it’s new multispecialty medical office building (MOB) in St. Albans, Vt., according to a press release. The $32 million project is the third and final phase of the facility’s comprehensive master plan.
The two-story, 44,000-square-foot MOB, designed by E4H Environments for Health Architecture (Burlington, Vt.), will house urgent care, primary care, orthopedics, and outpatient phlebotomy services.
The MOB has its own separate entrance, but connects directly to the newly-opened Medical Clinics Building near the hospital’s main entrance via an enclosed walkway.
Research Matters: Patient Rooms And Stress
To use an evidence-based design process, you have to know what the best available evidence is. But research is published faster than anyone can read it. In this blog series, The Center for Health Design’s research team will provide insight into a few healthcare design research matters through a snapshot of 10 studies published since the 2016 Healthcare Design Expo & Conference. Serving as an inside look at a session held at the 2017 HCD Expo, the blogs will identify why this research matters and help readers ride the waves of an ocean of research without drowning.
The research
A 2017 article by Andrade and colleagues, who tested Roger Ulrich’s theory of supportive design, offers findings that suggest how certain design elements may reduce patient stress.
Why does it matter?
There is mounting evidence of the link between the physical environment and health outcomes. Stress is a particular outcome of interest in the healthcare setting because reduced stress has been linked to improved patient satisfaction and recovery. There is no “magic bullet” design solution for stress reduction, but a better understanding of the link between design and stress can help healthcare leadership make better design decisions.
While there are many assumptions about how the environment affects patient stress, there are few formal theories to help us understand the mechanisms–or underlying psychological processes–behind the effect. There are also few studies that test existing theories, which makes it hard for designers to know if they should rely on these theories or not.
This study is important because it helps to fill that gap by testing Ulrich’s theory of supportive design. This theory suggests that there are three ways a healthcare setting can reduce patient stress: by providing a sense of control over the environment, by facilitating social support, and by serving as a positive distraction from some of the negative circumstances surrounding the patient experience. This study is also unique in its cross-cultural approach, which the authors used to explore how design affects stress depending on culture.
How was the study done?
In a nutshell, the researchers predicted that hospital rooms affect patient stress and that the effect can be explained by the number of desirable elements in a room: more desirable elements equals less stress. To test this, researchers counted the number of favorable design elements in each patient room (defined through a refined measurement of quality developed in earlier research by Andrade and Devlin) and classified them in terms of positive distraction, perceived control, and social support. Researchers then surveyed 236 patients recovering in the rooms, using a questionnaire about those three factors.
Additionally, patients reported their anxiety level (stress). The researchers collected data at hospitals in both the United States and in Portugal to see if there were any cultural differences.
What was learned?
The findings support part of Ulrich’s theory. Desirable elements in the patient room had a significant effect on stress and the effect can be partially explained (mediated) by how much social support and positive distraction the room provided. But the effect was not explained by the level of perceived control. In other words, if you are a patient and the room you’re recovering in has numerous features that make it easy for you to get support from friends and family and gives you positive things to be distracted by, you may feel less stressed. However, features in the room that give you a sense of control over what happens in your room may not make a difference in your stress level.
Additionally, the findings show a cultural difference in how the features affect patient stress. U.S. patients tend to value conditions for control and social support more than Portuguese patients do, while conditions for positive distraction are more important for Portuguese patients.
Are the results definitive?
While the findings give us better insight into the relationship between design and stress, there are many challenges in field research, and the authors point out that there may be other variables beyond those included in the study that explain the entire effect. Additionally, while the findings show that desirable elements have a positive impact on stress, the authors acknowledge the complexity of the healthcare environment, and how there may be a certain point at which there is too much of a good thing (Doherty & Stavropoulou, 2012). That is, filling a room with desirable elements may reduce stress to a certain point, but there may be a threshold at which numerous desirable elements become chaotic and overstimulating.
Findings from this study showed that stress was not influenced by elements that facilitate environmental control; however, this does not mean that sense of control is not important to recovering patients. Patients in this study participated at least 24 hours after orthopedic surgery, but were still in a state of recovery. The authors mention that there were varying levels of fatigue and in a few instances participants had to stop in the middle of the survey because they were not feeling well. Active control over the environment is not likely top of mind during early recovery, but in later stages this could change. Healthcare designers shouldn’t discount the importance of providing the option for control to address the needs of patients at varying stages of recovery.
The inclusion of both Portuguese and U.S. patients provides some helpful insight into the effect of culture in this relationship, but each sample size was small, and larger samples in a greater number of countries would help to better understand the role of culture.
The takeaway
This research shows that when the environment enables social support and positive distractions, patients experience less stress. Culture plays an important role in how the patient room affects patient stress, indicating that different cultural values or expectations may produce different perceptions of healthcare environments.
Many of the design elements included in this study (e.g., television, paintings, windows, whiteboards, an extra table, chairs for visitors, WiFi) are relatively inexpensive and do not require major renovation. Decision-makers should consider the cost-benefit of these interventions when working towards improved patient satisfaction and health outcomes.
Interested in the topic? Visit The Center for Health Design Knowledge Repository for more.
Summary of: Andrade, C. C., Devlin, A. S., Pereira, C. R., & Lima, M. L. (2017). Do the hospital rooms make a difference for patients’ stress? A multilevel analysis of the role of perceived control, positive distraction, and social support. Journal of Environmental Psychology, 53, 63–72. https://doi.org/10.1016/j.jenvp.2017.06.008
HGA Welcomes Craig McInroy
Craig McInroy, AIA, has joined the San Francisco office of HGA Architects and Engineers (HGA) as associate vice president and healthcare principal.
He will help direct strategic growth and client relations for the office’s Healthcare Practice Group serving clients in northern California.
McInroy has more than 30 years of healthcare planning and design experience on large, complex hospitals, clinics, and academic facilities.
Before joining HGA, he directed healthcare work with several architecture firms, including AECOM where he was a principal and project director and Anshen + Allen where he also served as a principal.
Texas Children’s Hospital Opens MIBG Suite
Texas Children’s Hospital recently opened a new I-131 metaiodobenzylguanidine (MIBG) suite in Houston to treat children with high-risk neuroblastoma, according to a press release.
The suite, which includes thick lead protection specified by the hospital’s physicist to provide radiation shielding, was designed by Dewberry.
The facility has three rooms: a lead-lined patient room, an adjoining room with a lead-lined viewing window where family members can spend the night, and an entry area where clinicians can consult and observe the patient.
Texas Children’s Hospital’s MIBG Suite is designed with radiation shielding elements including lead-lined floors, walls, and ceilings with 3/8-inch lead bricks; lead-lined steel doors; and the viewing window with five-inch thick lead glass.