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Featured Article:

Designing for patient, provider, community and future

Lindsey Coulter

As a general rule, buildings are designed according to what happens inside them; perhaps nowhere is this truer than in the healthcare industry. Traditionally, healthcare leaders have requested - and architecture professionals have delivered - straightforward, streamlined and self-contained facilities focused on provision of care. But as the definition of “care” expands and healthcare missions broaden, so, too, must the spaces in which communities are helped and healed.


For Grace Hebert Curtis Architects, the design process has always been holistic. While conversations might begin on the foundational and functional levels, the firm has long recognized that developing a successful healthcare facility requires planning for the unique needs of every person and population that encounters it. The firm’s recent work with Ochsner Health System to deliver The Grove, a new medical campus in Baton Rouge, is a prime example.


In 2017, Ochsner’s executive team presented Grace Hebert Curtis Architects with a challenging request: Design a flexible, 50-year structure that supports a team-based care model, allows patients to access multiple medical specialties within a single visit, and serves as a beacon along Louisiana’s I-10 corridor. To add another layer of complexity, the building had to be operational within 24 months. The high bar inspired an innovative, human-centered design as well as a delivery model that is quickly becoming the new industry standard.


Designing for today and tomorrow


“Conversations began immediately not only with the Ochsner executive team, but with the doctors, nurses, administrators, and maintenance professionals that would eventually work on the campus,” said Jimmy Hebert Jr., AIA, NCARB, architect with GHC. “These talks informed all aspects of building development and gave our team those invaluable back-of-house insights that also improved the patient-focused spaces.”


Collaborating with healthcare practitioners in particular led to the building’s definitive pod-based spatial organization.


“In modeling the floor plan with nurses and doctors, early on we developed a pod prototype to allow for modularity and plasticity,” said Barry Lann, AIA, NCARB, architect with GHC. “That modularity also ensures elasticity, meaning the building will seamlessly adapt to changing patient and provider needs and uses — today and into the future.”


The resulting 253,540-square-foot campus encompasses a medical office building, a robust micro hospital, and a state-of-the-art surgical center. It supports primary and urgent care through clinics organized in a series of flexible pods. At the core of each pod, a nurses’ station and provider workspaces foster Ochsner’s team-based approach to patient care. Each core is then surrounded by a series of examination rooms, treatment rooms and access to the building’s linear lobby. The creative, growth-minded approach allows clinical spaces to expand and evolve without requiring disruption or renovation to patient areas. Extensive glazing throughout these spaces allows sunlight to penetrate deep into the building, and some areas even offer views of the city skyline.


Complementing the forward-thinking design, the facility is infused with the most up-to-date medical technologies. Patients enjoy the O Bar featuring a fleet of iPads loaded with Ochsner-approved health apps; an aqua therapy suite; a wide-bore MRI suite designed to lower stress levels; germ-eliminating copper linens and surfaces; red night lighting and wireless vitals monitors.

To capitalize on interior real estate and further ease future expansion, the design team thoughtfully located exit stairs and mechanical, electrical, elevator and IT systems along the building’s perimeter.


Close attention to detail and occupant wellness also extends to employee health and safety. Clustering services not only streamlined patient navigation and accessibility, but also facilitates greater staff and provider collaboration. Clinical areas and provider workspaces are spacious, but the distance between them was minimized to reduce walking and fatigue.


Improving the whole patient experience


A commitment to designing for the full patient spectrum also inspired the GHC team to address a more nuanced aspect of the healthcare experience: anxiety. To ease patients’ medical fears and phobias, designers strategically balanced The Grove’s cutting-edge technologies with low-stress interior and exterior spaces.


“Visitors first access the campus via an aesthetically pleasing traffic circle, which kicks off a series of subtle decompression features designed to mitigate anxiety,” Hebert explained.

Upon parking or utilizing the valet service, guests follow paver walkways through serene landscaping that leads to the inviting wood-finished covered entryway. The natural textures and materials continue into the contemporary, hospitality-inspired atrium lobby. The sun-lit space features soft, organic textures. Those textures are repeated throughout the clinical, surgical, laboratory, pharmacy and dining spaces – each with clear, easy-to-understand wayfinding signage.


Additionally, the north-northeast orientation allows sunbeams to dance across the interior in the morning hours, and extended mullions reduce solar penetration and heat load later in the day. This creates moving shadow lines throughout the space and a calmer, more pleasant environment for both patients and employees.


To offer added privacy and minimize points of contact, patients can check in at the reception desk or at semi-private individual kiosks. They can then wait for their appointment in a variety of smaller-scale and more intimate seating areas — complete with hospitality-grade furnishings and charging stations — or they can visit the coffee bar.


Caring for the community


The Grove also gave Ochsner and GHC an exciting opportunity to explore care on a broader scale. Recognizing that wellness in particular doesn’t just happen within the confines of a hospital or clinic, the client and designer team operationalized the communal aspect of Ochsner’s mission.


“The Grove really embraces the community’s area master plan, which aims to foster a sense of continuity and place,” Hebert said. “Our designers collaborated with city officials to connect the campus to an existing biking and walking trail, and we developed a new public outdoor fitness station that is open to all.”


Additionally, the team considered the logistics and aesthetics of the building’s footprint and environment. Bountiful landscaping integrated throughout the campus will gradually transform the site into a green oasis as trees and foliage mature. The central plant was located off of the main site to better accommodate future development and pedestrian access needs, and intentional investments were made to improve surrounding infrastructure.


The building itself was designed for waste reduction and sustainable resource use throughout its development and life cycle. Extensive planning and analysis streamlined parking and storage specifically, allowing more space and resources for clinical and treatment areas and improving operational flow.


“Most importantly, however, The Grove filled a care void,” Hebert said. “It introduced a number of critical healthcare services and resources to a largely underserved population, while also contributing to overall community health, wellness and aesthetics.”


Thanks to a responsive design that builds on and improves existing public resources, The Grove demonstrates a meaningful and sincere investment by Ochsner in Baton Rouge and its residents. And by thinking (and designing) through each step in the care journey, anticipating stress points and opportunities, GHC’s design invites patients to reimagine healthcare and the spaces in which it is delivered.


Raising the delivery bar


The Grove is further distinguished among peer facilities for its remarkable use of rapid construction logistics. The project showed the client and industry that a new delivery model is not only possible, but valuable to continuity of operations and necessary to improving the bottom line. The flagship facility trims unnecessary expenses in day-to-day operations, but also saved the client significantly by reducing time to completion and construction loan interest.


“The Grove presented a very tight, very aggressive construction schedule,” said Lann. “Critical, strategic decisions were made at every step to design around systems and assemblies that could be rapidly deployed and installed. We planned in such a way that we could safely proceed with pouring the foundation, erecting the steel structure and beginning general construction activities while we were still working with staff to design a tailored, flexible interior.”


To adhere to the 24-month schedule, the project utilized curtainwalls and massive precast concrete wall panels. HVAC and plumbing systems were fabricated off-site, stacked, and then lifted into place on-site. The innovative approach expedited installation of multiple stories of piping and systems, keeping the project within budget and schedule. That economical theme was infused into every aspect of the facility.


“Everything was done to make operations as efficient as possible, from patient flow to staff flow to back-of-house operations and support,” Lann added. “The building reduces waste and resource use at multiple points, and it makes excellent use of storage space because it was designed around the client’s ability to keep it supplied.”


This meant valuable square footage didn’t have to be wasted on storage. Instead it was devoted to clinical and treatment spaces, allowing staff to serve more patients per day and reducing patient wait times to see providers. Meanwhile, style wasn’t sacrificed. Contrasting insulated metal panels and precast exterior finishes imbue the facade with a sense of movement, and a large grill establishes the Life-Mark logo as a focal point, delivering on the client’s request to position the facility as a true architectural landmark.


In embracing this forward-thinking design and delivery model, Ochsner received a bespoke facility that reset the best practices bar. Patients might not be able to identify the specific design decisions that contribute to their excellent experience, but they feel them in the ease of wayfinding, the comfort and luxury of furnishings and finishes, the warmth of the sunlit lobby, and in the quality of service and efficiency of operations. Similarly, staff and providers will value each way the design reflects and responds to their specific needs — today and in the future.

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