Ambulatory ARRAY-ARCHITECTS.COM Table of Contents Firm Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Ambulatory Care Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Capital Health Hopewell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Cleveland Clinic Indian River Hospital . . . . . . . . . . . . . . . . . . . . . 20 Montefiore Medical Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Children’s Hospital of Philadelphia . . . . . . . . . . . . . . . . . . . . . . . . 32 Catskill Regional Medical Center . . . . . . . . . . . . . . . . . . . . . . . . . 38 Saint Elizabeth Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Mount Sinai Health System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 PAGE 2 PAGE 3 Firm Profile We are a team of architects and designers with unique backgrounds, but we all have one thing in common­—we share a strong desire to use our expertise and knowledge to design solutions that will help people in moments that matter most. The complex, changing world of healthcare requires a team of effective communicators and true collaborators. Our 35+ year history of being dedicated to healthcare holds countless stories of discovering optimal solutions with our clients. Our core mission is the same as that of our clients, improve the quality of our work, increase our efficiency and motivate our staff to reach for success. PAGE 4 We are not architects, who do healthcare. We are healthcare architects. PAGE 5 PAGE 6 “An Ambulatory Care Center should sit at the heart of the community. The care should be surrounded by contemporary services.” PAGE 7 PAGE 8 Ambulatory Care Centers There has been a significant amount of change in healthcare that particularly impacts Ambulatory Care Centers. Array’s planners recognize the changing requirement of Ambulatory Care Centers to serve more patients with more complex procedures in a more efficient manner. Ambulatory services are a critical lynch pin in the development of comprehensive, integrated networks of care that can deliver services cost-effectively and achieve high levels of patient satisfaction. Architects must orchestrate a process that allows for improvements and adjustments to operations while maximizing space utilization and throughput. The current and future trends in ambulatory care underscore the high-growth, high-change nature of ambulatory care facilities and the need for flexible design—now and into the future as they continue to serve more people in more ways. Successful ambulatory care facilities are designed to maximize flow. At Array, we develop distinct circulation areas for both patients and staff, introduce intuitive wayfinding to enhance and streamline the patient care process, and then fine-tune our designs through simulation modeling. Multispecialty clinics are becoming more popular where services are rotated with a number of practices sharing the same space. This arrangement allows for increased space utilization, increase integration across specialties, and less capital cost. The expectation is for improved patient outcomes, increased patient satisfaction and greater market share through cross referrals. PAGE 9 Healing Environments “Environments have the power to set our expectations, lift our spirits and inspire hope. This is what motivates me to create spaces that mitigate the challenges faced by all who enter a healthcare facility.” Patricia D. Malick, CHID, EDAC, IIDA, Lean Green Belt Principal and Practice Leader, Interior Design Capital Health Hopewell MOB & Cancer Center PENNINGTON, NJ PAGE 12 As a companion building to a new state-of-the-art 237-bed Replacement Hospital for Capital Health, Array in association with HKS, designed a new 328,000 SF Cancer Center and Medical Office Building. Joined to the new Hospital by a two-level pedestrian mall, the building consists of five floors with suites ranging from 1,000 SF to 10,000 SF. The building houses a combination of hospital-based outpatient services and physician practice suites. First floor services include a comprehensive Cancer Center with state-of-the-art linear accelerators and cyber knife therapies to treat outpatients. Additional first floor functions include an outpatient Imaging Suite programmed with radiography, nuclear medicine, 3.0T MRI, CT and PET/CT equipment. A Spa is situated with access to Oncology in support of a holistic approach to patient needs. Services tailored to patients include wig fittings and lymphatic massages. The Spa is also open to staff and the public. Infusion programs are vertically connected by the lobby atrium and pedestrian mall. The infusion bays have access to and views of a roof garden developed over the Cancer Center’s first floor with a coffee bar adjacent to the roof garden. Second floor functions accessed from the mall include a four-OR ambulatory surgery suite. Floors three through five are dedicated physician office space. Corridors overlooking the five story atrium connect the MOB/Cancer Center with the Medical Center and allow for easy access for physicians who have rounds to make. 570,000 SF New Hospital 330,000 SF Medical Office Building Left: Atrium Photography: Blake Marvin/HKS, Inc. PAGE 13 Capital Health Hopewell MOB & Cancer Center PENNINGTON, NJ PAGE 14 “Wow I can’t believe this is a hospital.” Al Maghazehe, PhD, FACHE Chief Executive Officer & President, Capital Health Patient safety, family-focused care and operational efficiency were the focal points for the design. The design team segregated inpatient and outpatient flow to support an exceptional patient experience. Additional dining options are available on the first floor – adjacent to the Main Entrance reception desk as well as on the second floor of the outpatient side of the facility, providing a place for a quick meal and respite while waiting for an outpatient surgical or infusion patient. The inclusion of multiple gardens surrounding the Hospital and their integration into the natural landscape allows the building to be an extension of the environment. The result: a new hospital that reflects the history of Capital Health, offers patients and their families an enhanced experience and supports the technology of modern medical care. Collaborators: AKF Engineers Anchor Health Properties HKS, Inc. O’Donnell & Naccarato Skanska Target Building Construction The Lighting Practice Wells Appel Top Left: Waiting and Reception Top Middle: Infusion Top Right: Waiting Bottom Left: Emergency Family Waiting Bottom Right: Water Feature within Healing Garden Photography: Blake Marvin/HKS, Inc. PAGE 15 Capital Health Hopewell MOB & Cancer Center PENNINGTON, NJ PAGE 16 Because patient and family engagement was so critical to the overall vision, the design team was tasked with not only designing hospital functions but also gift shops, a spa, public resource library, business center, coffee shop and bistro. The Oasis Spa was designed to offer full spa services to the public, visitors and patients, with a particular focus on cancer support. Top Left: Waiting Top Right: Oasis Spa Bottom Left: Bistro Dining Area Bottom Right: Gift Shop Photography: Blake Marvin/HKS, Inc. PAGE 17 Wellness “As a father, I am even more focused on the value of wellness and prevention and setting a good example for my children. As an architect, I want to empower others to do the same.” Jonathan M. Bykowski, AIA, Lean Six Sigma Black Belt Principal and Practice Leader, Continuous Improvement Cleveland Clinic Indian River Hospital Health and Wellness VERO BEACH, FLORIDA In conjunction with Anchor Health Properties a universal exam room for all specialties and and Indian River Medical Center, Array designed primary care. Using this universal room in a a 72,000 SF integrated medical home model standardized pod configuration allows Indian health and wellness campus. This phase River to flex the boundaries of each individual features a multi-specialty physician practice service line on a moment’s notice without the center with integrated diagnostics and health need for renovation or cost. education. The building shares a healing garden with our recently completed cancer center and is designed to allow provider synergy between the programs. The full project is designed to promote prevention, education and healthy living in addition to providing chronic disease management and interventions. The project Built for optimal flexibility, a series of early features cross discipline care coordination process and design prototyping work sessions and a unified patient experience while being a with stakeholders from each practice yielded market differentiator for Indian River. Top: Exterior Bottom Right: Waiting Area Bottom Center: Work Space Bottom Right: Exterior Photography: Halkin Mason Photography PAGE 20 PAGE 21 Emblem Health Medical Office Building BROOKLYN, NY PAGE 22 A new 160,000 SF seven-story Medical Office Building with elevated parking, is designed to provide outpatient medical services at a bustling Brooklyn intersection. Serving the community in this urban setting, the building was strategically located near major mass transportation to attract patients to the health system’s expanding services. The project is one of the largest and newest buildings in the neighborhood and will act as a catalyst for community growth. Urgent Care and Imaging, which have high walk-in patient volumes, were placed at the ground floor, setback and surrounded in highly visible storefront, under a continuous marquee, to help connect to the urban fabric. Vehicular traffic is directed discretely off the street, up a ramp into three levels of parking, cloaked in a back-lit veil of custom perforated soft white metal panel. Physician practices are located on the top three floors of the building with a draped in articulated glass wall. The folding glass wall was parametrically designed to respond to mitigate late afternoon solar gain, as well as provide stunning views of the city from the waiting areas. PAGE 23 Emblem Health Medical Office Building BROOKLYN, NY The spatial organization supports each patient’s clinical, emotional and physical needs and provides a safe and efficient facility allowing caregivers to deliver healthcare in a compassionate environment. Activity rooms and dining areas feature partial height partitions and glass walls to provide visibility from the support zones and also allows natural light to flow through the central areas. Large scale, impactful art serves as a wayfinding device at key entry portals, complemented by soothing colors and materials. Previous Page: Exterior Top Left: Infusion Top RIght: Waiting Bottom Left: Exterior (side view) Bottom Center: Waiting Bottom Right: Exam Room Photography: Halkin|Mason Collaborators: Cauldwell Wingate Cerami Asscoites Cosentini Dewberry FNA Associates HDLC Metropolis Reuther + Bowen Thornton Tomasetti Timothy Haahs VD Associates PAGE 24 PAGE 25 Ambulatory “Except for the beds, ASCs have all the elements of a hospital. Programming one can be like solving a complex, three-dimensional jigsaw puzzle. I enjoy figuring out the most efficient way to put all the elements together to achieve throughput goals.” Jeffrey P. Drucker, AIA Vice President, Northeast & New England Regions Montefiore Medical Center Ambulatory Surgery Center BRONX, NY PAGE 28 Montefiore Medical Center selected Array to consolidate ambulatory services from three campuses and outpatient clinics into a new state-of-the-art Ambulatory Tower that would become the benchmark for their expanding Ambulatory Care services. Array provided planning and design services for a new 12-story Ambulatory Surgical Center on a site that received prior zoning approval for a hotel. To avoid obtaining a variance, which would result in significant cost and delays, the footprint and setbacks could not be altered. Array developed a unique design solution incorporating dedicated elevators for staff and materials within the operating suites and support areas. Although the 12 ORs and four procedure rooms (sized to become additional ORs if needed) are split between three floors, simulation modeling showed that the dedicated elevators facilitated patient flow and reduced room turnaround time. Opposite: Exterior Canopy Rendering: Array Architects PAGE 29 Montefiore Medical Center Ambulatory Care Center BRONX, NY PAGE 30 Left: Waiting Area Middle: Prep/Recovery Bay Right: Operating Suite Above Center: Main Lobby & Waiting Rendering: Array Architects Collaborators: BR+A Engineers Reuther & Bowen Cauldwell Wingate Jones Lang LaSalle PAGE 31 Montefiore Medical Center Ambulatory Care Center BRONX, NY PAGE 32 “State-of-the-a art ambulatory tower that would become the benchmark for ambulatory care services.” - Client Left: Exam Room Right: Pre-Op / PACU Bottom: Elevator Lobby & MRI room Middle: Team Center Photography: Halkin Mason Photography PAGE 33 Oncology “After having the privilege of working with heroes who cure, treat and receive care in our cancer environments, I will never underestimate the importance of creating uplifting, inspiring spaces.” Lisa N. Lipschutz, RA, ACHA, EDAC, Lean Green Belt Principal and Senior Planner Children’s Hospital of Philadelphia Child Care Physician Practice FLOURTOWN, PA PAGE 36 The Children’s Hospital of Philadelphia (CHOP) engaged Array Architects to fitout their new physician practice in suburban Philadelphia. The physicians currently lease space in a one-story medical complex surrounded by specialists and small businesses. By expanding their primary care practice in Flourtown, they can maintain their current patient base while attracting new patients to a stand-alone facility with ample parking. Array has recently completed, or is currently working on, similar physician suite expansion projects in Haverford, Newtown and Springfield, PA Opposite: Exterior Canopy Rendering: Array Architects PAGE 37 Children’s Hospital of Philadelphia Child Care Physician Practice FLOURTOWN, PA PAGE 38 Top Left: Exam Room Corridor Middle Left: Exam Room Bottom Left: Staff Workroom Opposite: Reception/Waiting Photography: Jeffrey Totaro PAGE 39 Engagement Management “As an architect, I live for fulfilling and evolving challenges of healthcare design, and as engagement manager, I am dedicated to creating team enviroments that ensure the shared success of each project and its team members.” Alex Berman, AIA, LEED AP BD+C Studio Director, National Capital Region Catskill Regional Medical Center Medical Office Building HARRIS, NY PAGE 42 Catskills Regional Medical Center’s new Montreign medical office building is a highly adaptable clinical platform designed to adapt to the needs of its community over time. The 12 exam room space is designed to support a range of general and specialty medicine along with the opportunity for urgent care services supported by an imaging suite comprised of X-Ray and CT capability. Exam rooms are designed to maximize flexibility with a cart system for storage of supplies based on the use of the room for the day. A central team work area is designed with a mix of space types for “heads down” focused work and face-to-face or digital collaboration. Care was taken to shield the work space from the corridor to preserve visual and auditory privacy. Exterior Photography: Halkin Mason Photography PAGE 43 Catskill Regional Medical Center Medical Office Building HARRIS, NY PAGE 44 Process-led design employs a rigorous and engaging approach to quickly define goals and obstacles. Process-before-design encourages the integrated team to focus on experience, quality, outcomes, and work flow before specific spatial configurations begin to limit innovation. Process mapping, visual programming, virtual and physical mock ups and rapid prototyping were used in parallel during the early design phases to ensure the optimal solution. Top Left: Waiting Top Right: Exterior Bottom Center: Exterior Photography: Halkin Mason Photography PAGE 45 Patient Experience “As Director of Design and Construction for a top-10-ranked Medical School for 15 years, I had the opportunity to sit in the client’s seat and work with many architectural firms. I strive to bring that perspective to all of our projects.” George Shmidheiser, RA Principal and Practice Leader, Project Operations St. Elizabeth Healthcare Ambulatory Care Center COVINGTON, KENTUCKY PAGE 48 Following a merger/acquisition of two hospitals located in the Cincinnati metropolitan area, St. Elizabeth Healthcare recognized a need for a new Ambulatory Care Center to serve as a ‘Gateway for Health’ to increase its profile in the Cincinnati metropolitan area’s growing market. Array sited this new, three-story, 120,000 SF Ambulatory Care Center facing a major interstate to increase public awareness. A “Main Street” circulation design provides convenient access to all services including a central registration and reception desk, community conference space, bistro, gift shop and patient education center. This spine follows the length of the building with access to Imaging and Lab Services and the 10,000 SF Urgent Care Center. The Urgent Care Center establishes an optimal patient experience with a focus on convenience. Patients are warmly greeted, then invited to use the latest technology for registration. Retail amenities ensure patients and visitors have an engaging, positive experience. Exterior landscaped views and an intimate reflection garden, beautiful artwork and rich colors and textures serve as orienting devices for both patients and staff. Exterior Photography: J. Miles Wolf PAGE 49 St. Elizabeth Healthcare Ambulatory Care Center COVINGTON, KENTUCKY The Ambulatory Care and Urgent Care Center provides many necessary services to this growing area of northern Kentucky. The facility establishes an outpatient experience where the patient can be scheduled more conveniently and treated more quickly in a less clinical environment. The building was strategically located on a major interstate that fronts the site and has a direct exit to the facility. Ambulatory Care services are located on the first floor for public access and cross utilization of staff. Easy access to services was accomplished by the creation of a “Main Street” circulation design that fronts all services. Collaborators: Anchor Health Properties Champlin Architects Health Strategies & Solutions KLH Engineers Messer Construction THP Limited Top Left: Private Gowning Bottom Left: Main Street Corridor Middle Right: Patient Registration Bottom Right: Physical Therapy Photography: J. Miles Wolf PAGE 50 PAGE 51 Mount Sinai Health System Center for Health and Healing NEW YORK, NY PAGE 52 The Center for Health & Healing’s primary focus is on wellness and offers an integrated, preventive approach to medicine. Their clinic was recognized as one of the first healthcare spaces in the US to incorporate sustainable materials as well as Feng Shui principles. Demand for The Center’s services drove the need to expand their practice. Array designed an expansion plan which doubled their practice space onto another floor of the same building, allowing the original practice to operate during design and construction. Array recently completed the renovation of The Center for Health and Healing incorporating design tenets based in the Feng Shui design methodology in conjunction with evidencebased design concepts. The new 10,000 SF floor includes a gym with physical therapy services and treatment rooms; reception and waiting areas; clinical space with consultation and exam rooms; massage room; and, support areas. Feng Shui findings were based on an energy profile which consisted of an analysis of compass orientation, astrological influences, building footprint and floor plan analysis. Using these findings, space layout was adjusted to promote harmony with nature, culture and community. Reception Photography: Jeffrey Totaro PAGE 53 Capital Health Hopewell MOB & Cancer Center PENNINGTON, NJ PAGE 54 Using Feng Shui principles, space layout was refined to promote harmony and balance. Feng Shui tenets: • Enhanced healing potential throughout the floor was capitalized by adding mineral quality crystals in wall cavities and ceilings requiring positive energies. • Enhanced brand recognition and client loyalty by designing bold dramatic graphics at entry of elevator lobby. • Natural daylight brought into formerly dark areas. • Enhanced income generation and business growth by incorporating red, orange and green accents and special textured materials. The project accomplished Mount Sinai’s Center for Health & Healing’s goal to transform the quality of healthcare and its delivery toward a more holistic model conscious of the role played by the environment in the healing process. Demand for the Center’s services grows and is expected to increase as healthcare in the United States continues to shift from one focused on illness and reaction to one of wellness and prevention. Collaborators: Alex Stark Kallen & Lemelson Wexler Associates Linmar Construction Top Left: Exam Room Corridor Top Right: Waiting Bottom Left: Staff Room Bottom Right: Physical Therapy Photography: Jeffrey Totaro PAGE 55 Interiors “Knowing that the environment can affect the healing process, I strive to create comfortable, inspiring and supportive spaces for patient, family and staff.” Stephanie Story, LEED AP BD+C, NCIDQ Senior Interior Designer Mount Sinai Health System Beth Israel Medical Group NEW YORK, NY PAGE 58 Beth Israel Medical Center, part of Continuum Health Partners, offers a broad-based fully integrated health services network throughout the New York City metropolitan region. After their lower Manhattan family practice patient base increased beyond the capacity of their offices, Continuum committed to quickly expand the services offered at the medical facility. Continuum selected a building at the corner of 8th Avenue and 23rd Street for the expanded practice. The project included the renovation of a three-story building adjacent to a popular restaurant The design features a new curtain wall and façade that incorporates the client’s brand with LED-illuminated panels and signage. The exterior now draws patients to the space and defines the entrance with a matte silver façade that is lit blue in the evening. The entry canopy defines the practice entrance and leads to an inviting building lobby and concierge desk that speaks to Beth Israel’s patient and physicianfriendly environment. Continuum’s new facility provides a multitude of resources for their patients. The new walk-in, primary care medical practice is located on the 2nd floor, while the 3rd floor serves the specialty practices such as dermatology, radiology, ophthalmology, orthopedics, GI, cardiology and pain management. Reception Photography: Jeffrey Totaro PAGE 59 Mount Sinai Health System Beth Israel Medical Group NEW YORK, NY This 16,500 SF renovation is now a benchmark facility for Continuum and is considered a ‘Center of Excellence’ for ambulatory care. The architecture promotes Beth Israel’s brand, announces the presence in the neighborhood and helps attract new patients. The interior design promotes better workflow and clinical efficiencies for the staff. The warm, light and airy design lends an overall positive feel which heightens staff morale and patient satisfaction. Top Left: Reception and Waiting Top Middle: Reception Top Right: Exterior Bottom Left: Nurse Sub Station Bottom Right: Nurse Station Photography: Jeffrey Totaro Collaborators: Kallen & Lemelson Wexler Associates Linmar Construction PAGE 60 PAGE 61 Boca Raton / Boston / Columbus / New York City / Philadelphia / Washington
