Primary Care Clinic

Pr

imary h t l Hea

io IV Fall 2019 Final Design Package

. c i n C li

er Stud n Spe Aliso

F

U S

Table of Contents.

02

Precedent and Theory

17

Code Plan

03

Visual Collage

18

Code Study

04

Exam Room Today

19

Wayfinding Inspiration

05

Project Stakeholders

20

Art Package

06

Location Summary

21

Floor Plan

07

Suite Implications

23

Reflected Ceiling Plan

08

Program Matrix

25

Reception + Waiting

10 11 12

Concept

26

Millwork

Design Goals

Branding

13

Adjacency Matrix

27 28 29

14

Preliminary Planning

31

Exam Room

Visual Design Analysis

32

Medical Staff Area

Proposed Plan

33

FF+E

15 16

Pallette Justification

Community Room Wayfinding Strategy

01

Research + Schematic Design.

Precedent + Theory.

Precedent Study Summary Elite Health is a diagnostic and primary care facility located in North Bay Village, Florida. The challenge was designing a space that would treat a wide variety of patient cases while retaining a cohesive and flexible space to accomodate activity and excercise rooms. The facility pulls together a state of the art facility that includes, six exam rooms, a medical procedure room, ultrasound, X-ray and allergy testing areas, a weight-loss center and an activity room for events such as exercise classes, meetings, seminars and workshops by healthcare experts. Beyond the typical exam rooms, Elite Health also promotes activity and wellness through including excercise spaces, which required added design constraints such as traffic flow and noise levels within the facility.

Other considerations included designing for not only treatment but including elements to create an energizing environment as well as soothing spaces. The use of color was purposeful and minimal, which helped to achieve this goal. This primary care clinic is a great example of how healthcare is progressing towards a holistic approach to wellness and looking at how they integrated preventative wellness with treatment is valuable.

Patient rooms are inviting through glass walls and layered lighting that have the option to close off for privacy. This also allows for a casual environment instead of a sterile clinical environment.

The addition of color livens the environment promoting fitness near activity rooms and creating a fun space to break up the monotone facility spaces.

The waiting room has varied seating to accomodate peoples needs. The space is casual and has soft lighting for a feeling of comfort and privacy.

Person-Environment Theory This theory is the connection between people and their environment and people to people within an environment. Factors within the theory include function, competence & congruence. An environment where the space functions in a way that supports a persons needs and abilities, is considered competent. This allows for better user productivity and wellbeing. Additionally, this approach emobodies the principles of the connection between people, and how the environment eiher promotes or deters the connection.

Design Implications Stimulate patient and staff conversation by allowing ample space and seating in each exam room, along with sound and visual privacy to ease patient anxiety.

Suggest various behavioral responses through color and contrast in various spaces to aid all stakeholders in feeling comforted and energized throughout the clinic.

Promote both community conversation and ease of patient tension by specifying various furniture and seating in the waiting room. This will accomodate both patients as well as community members coming in to use the community room .

Matambanadzo, S. (2019, March 8). EliteHealth’s New Primary Care, Diagnostic Center Now Complete. Retrieved from https://www.healthcaredesignmagazine.com/news/elite healths-new-primary-care-diagnostic-center-now-complete/?hilite=’primary’,’care’ Nussbaumer, L. L. (2009) Person-Environment Theory. In Evidence- Based Design for Interior Desginers (p. 26). Fairchild Books.

02

Design Implications.

Space planning to allow for staff to be central to all exam rooms, procedure rooms, etc.

This will allow for effeciency and increased communcation between all staff.

Including non-traditional waiting room seating allows for user control and provides comfort for all users.

Designing exam rooms that emphasize color and constrast allows for patient anxiety to be reduced and provide positive distraction.

In order to improve the chaosProvide enough workstations for medical assistants and staff to reduce stress and anxiety.

All speciďŹ ed furniture and equipment should be ergonomically designed to accomodate all stakeholders and support the wellbeings of all users.

Visual Collage.

03

Relevant Literature.

The Exam Room Today Today’s exam room is an evolving space that requires critical thought processes in order to ensure safety, comfort, privacy and effective care giving for both patient and healthcare provider. A major change in modern healthcare is the addition of personal medical assistants. These are people who take the place of a receptionists and record keepers while also providing the care of a nurse. They allow for patients to be brought directly to their rooms to recieve care as well as staying for the doctor’s visit with the patient to keep records and escort the patient out at the end. As a desginer, it is important to understand that the medical assistant will require extra space in the exam room and the need for a large waiting area is not necessary. Looking at various care models of clinics will allow for designers to understand the need of the clients. Other factors that impact the design of the exam room include, comfort and alleviating “white coat effect”, safety to prevent error and injuries, infection control, and lastly, privacy. These are all crucial in the design of the exam room, and the design implications that support the success of each factor are critical in creating spaces to heal and treat our society.

Design Implications Comfort Providing positive distractions like wallcoverings, art or finish selections that alleviate anxiety and don’t cause an elevation of blood pressure.

-Displaying educational and helpful information for patients to read or interact with while waiting is another example of positive distractions.

Safety Same-handed rooms are exam rooms that are laid out the exact same throughout the facility in order to prevent medical errors and create consistency for medical providers.

-Ensuring clear sightlines between staff work areas and exam rooms allows for staff to ensure care is being provided efficiently as well as ensuring that care is being given properly.

Infection Control Specifying materials that are easily cleanable and antimicrobial will help to prevent the spread of disease.

-Placing sinks or hand sanitizing stations so that both patients and care providers are practicing proper hygiene.

An example of a “same-handed” room layout that has many benefits including safety and acoustic privacy.

Showing how the lack of positive distractions can lead to hypertension as a result of increased anxiety related to an upcoming exam or procedure.

Privacy Specifying materials and surfaces with acoustical properties to ensure privacy of patient to provider conversations.

-An example of this could be specifiying a sound sealing gasket at door jambs or on sliding doors to help conceal noise from traveling through the cracks.

-Using “same-handed” exam room layouts also ensure that care providers are at least 10 feet apart which makes it less likely for patients to be overheard in adjacent spaces.

Works Cited Cahnman, S.F. (2006, May). Key considerations in patient room design, part 2: The same-handed room. Healthcare Design. Retrieved June 30, 2009, from http://www.healthcaredesignmagazine.com/ME2/dirmod.asp?sid=&nm=&type=Publishing &mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=CB76C8FA220644628164363B07F3608F Guzzo, V.C., Nyberg, G., & Whiteaker, D. (2015). Modern Clinic Design : strategies for an era of change.

Pioli, M. R., Ritter, A. M. V., Faria, A. P. D., & Modolo, R. (2018). White coat syndrome and its variations: differences and clinical impact. Integrated Blood Pressure Control, Volume 11, 73–79. doi: 10.2147/ibpc.s152761 &mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4

04

Project Stakeholders.

Patients background: varies age range: varies (infant - senior) emotional state: anxious, distressed, ill mobility: varies- potential for low mobility socioeconomic status: varies concerns: recieving proper treatment, privacy, positive distractions

Physicians background: high education (MD, MSN) age range: late 20s - 65 emotional state: stable, moderate stress mobility: mobile with soreness socioeconomic status: high income concerns: standing all day, stress inducing environments, areas for refuge and privacy

Medical Assistants background: certification (CMA or RMA) age range: late 20s - 65 emotional state: stable, mild stress, socially taxing mobility: mobile with soreness socioeconomic status: mid income concerns: standing all day, constant social interaction may require space for refuge

Outside Consultants background: varies age range: late 20s - 65 emotional state: stable, mild stress, flustered occasionally mobility: mobile and active socioeconomic status: varies concerns: ability to adapt to various spaces, need for privacy in a communal area, ability for user control in multi use space

Custodial + Maintenance Staff background: GED equivalent or college age range: 18+ emotional state: stable, reliable, solitary mobility: moderately mobile socioeconomic status: varies (typically lower income) concerns: storage, access to supplies, mop sink access, space to complete tasks

Administrative Staff background: college degree age range: early 20-65 emotional state: productive under moderate stress mobility: strong motor skills socioeconomic status: mid to high income concerns: proper equipment/technology, easing patients stressors

Students background: GED equivalent, some bachelor degree age range: 18-24 emotional state: mid-high stress, focused, learning mobility: strong motor skills socioeconomic status: varies concerns: inclusive environment, freedom to learn and ask questions, space to participate

Family + Caregivers background: varies age range: varies (infant- senior) emotional state: worried, anxious, overloaded mobility: varies socioeconomic status: varies concerns: supporting patient, need for proper space, need for positive distractions

Design Implications.

Support all stakeholders through considering spacial needs of each group and providing ample and flexible furniture to accomodate all stakeholder needs.

Reduce patient anxiety through designing organized and clean exam rooms that will allow for providers to care for patient efficiently.

Mitigate medical error through designing for ample space of all stakeholders within exam and procedure rooms which will reduce chaos during examination.

05

Location Summary.

Existing Parking

Site Location

Current Building

2911 Roberts Ave Tallahasee, FL 32304

Climate In Tallahasee, FL the summers are long, hot, and oppressive; the winters are short and cold; and it is wet and partly cloudy year round. Over the course of the year, the temperature typically varies from 41°F to 91°F and is rarely below 26°F or above 96°F.

N

Orientation

PARKING

Entrance “A” is oriented to the North, creating the large facades of the clinic to face West and South.

A

Site is immersed into the Mabry Manor Neighborhood which includes a local elementary school off Eisenhower St, so the clinic will require traffic flow to be diverted from Eisenhower onto Van Fleet for the clinic entrance.

Design Implications.

Enhance patients journey by locating the entrance adjacent to parking so the patient’s travel distance is minimized.

Reduce stress of both patients and care providers by utilizing natural light on the west and south facades of building.

Support the local community by directing clinic patient traffic away from the local school while remaining walking distance (1 mile) for aproximately 7,000 people.

The front entrance to the existing clinic is easily accessible from the parking, and is clearly marked.

View of where the new clinic will be built.

This is where the parking will be with the clinic beyond the parking.

06

Suite Implications.

Currently, the design of the FSU PrimaryHealth Clinic is in the state of temporary use with the desire for a demolishion and rebuild in the next 10 years.

Currently, the procdure room functions effectively and the layout accomodates all the needed equipment. This space supports the person environment theory through allowing for patients in this space to have the support from the environment they are in. The aesthetics could be improved to include positive distractions.

The waiting room functions well to accomodate all users through various seating including bariatric seating.

The transitions in the flooring provide wayfinding for patients which helps to reduce confusion and anxiety. This space would benefit from more positive distraction as well as custom built features to create a unique and inspried space.

*See code study on page 18 for more information on relevant code information

The staff break room is in need of expansion and features to support the users of the environment. Including more lounge seating that is flexible will ease tension of staff which in return, will create a calmer and more positive clinic environment.

The staff “island” is in need of more modifiability as well as the creation of space for staff to work at ease. This will included sound machines as well as frosted glass sliding doors to enhance privacy. Currently, this is very exposed which requires constant escorts for patients.

Design Implications.

Using the person environment theory, design spaces that will support the amount of stakeholders proposed to use each space. Having flexible seating for these various users will allow for added comfort and ease of all users.

Implementing privacy partitions and sound mitigation will increase patient confidentiality and allow better communication between care providers.

Designing architectural features will add positive distractions for patients and ease anxiety, as well as provide wayfinding and direction for all stakeholders.

07

Program Matrix. qty.

1

room.

Waiting

uses.

furniture.

Chairs/sofas Bariatric Chairs Side Tables/ tablet arms Wheelchair seating Adjustable Kiosk Stand Patient check in, adjacent to waiting Chair/stool 10-15 minute zone for 20 patients waiting

1

Check in Area

1

Children’s Play Area

2

Consultation Room Areas

Space for children to have positive distractions Private space for consultation

1

Business Center

3

equipment.

Check in tablets TV Sound system Digital screen/tablets Privacy Glass

electrical.

lighting.

30-50 FC LED Recessed Cans Cove Lights Ambiant Pendants Dedicated Floor Outlets 50-70 FC LED Recessed Cans Outlet for TV Convenience Outlets

sq req.

1,230sf

sq provided.

1,475 sf

50 sf

70 sf

other.

Cleanable Surfaces Positive Distractions Clear Sightlines to children’s area Consider Privacy

TV/screen

Convenience Outlets with covers

50 FC LED Recessed Cans

200 sf

200 sf

Cleanable Surfaces Sightlines to waiting

Digital screen/tablet

Convenience Outlets Dedicated Outlet

30-50 FC LED Recessed Cans

100 sf

90 sf

Semi-Private

Space for patients to wait and work

Child-size furniture Book area Seating for adults Desk 2 guest chairs office chair Workstations/table Chairs

Desktops Printer/copier

Dedicated Outlets Convenience Outlets

50-70 FC LED Recessed Cans Task Lighting

75 sf

100 sf

Cleanable Surfaces Consider Privacy

Family Style Restrooms

Fully accessible restrooms

Storage unit Diaper Changing

GFCI Outlets

75 FC LED Recessed Cans

64 sf

64 sf

Unisex Restrooms

1

Check out Desk

Counter for 3-4 staff members

Workstation/counter 3-4 Chairs

Dedicated Outlets Convenience Outlets

50 sf

Consider Privacy

Community Room

Seating for 25-40 people Teaching kitchen Adjacent closet for seating storage

Tables and Chairs Island/Counter Kitchen Cabinets Bar Stools at island Flexible Lounge Seating

40-60 FC LED Recessed Cans Ambiant Pendants 30-50 FC LED Linear Troffers Ambiant Pendants

50 sf

1

ADA Toilet Grab Bars Lavatory Restroom Accessories Digital screen/tablets Destops Printer/copier Kitchen Equipment: Stove, microwave, oven, sink, dishwasher, trash TV/screen

1,000 sf

987 sf

Exam Rooms

Patients recieve treatment Accomodate 5 people

Exam Chair Seating for family Storage Units Mobile Ped Mobile table Seating for 6 Lounge Furniture Adjustable Table

34

GFCI Outlets Dedicated Outlets Convenience Outlets

Diagnostic Equipment TV/Screen Sink Waste Disposal

GFCI Outlets Convenience Outlets Dedicated Outlet

75-100 FC High CRI LED Linear Troffers Undercabinet Lights

120 sf

120 sf

Cleanable Surfaces Patient Privacy Positive Distractions Exam Room #1

TV/ screen

Convenience Outlets Dedicated Outlet

50-70 FC LED Recessed Lights Undercabinet Lights

150 sf

142 sf

Adjacent to exam rooms Patient Privacy

75-100 FC High CRI LED Linear Troffers Undercabinet Lights Overhead Exam Light 75 FC LED Troffer Light

150sf

155 sf

200 sf

250 sf

Patient Privacy Observation Window Dimmable Lights Cleanable Surfaces Positive Distractions Cleanable Surfaces Visual Privacy

200 sf

250 sf

4

Behavioral Counseling

Accomodate 6 people

4

Procedural Rooms

Specific for Procedures

Exam Chair Storage Units Surgical Trays Moveable Tables

Medical Equipment TV/Screen

Convenience Outlets GFCI Outlets

2

Clean Supply Rooms

Storage for clean supply stock

Storage units

No equipment needed

Convenience Outlets

Collection point for soiled goods

Storage Units

Disinfector Sink

GFCI Outlets Convenience Outlets

2

Soiled Supply Rooms

Access from waiting room Closed off from clinical spaces

75 FC LED Troffer Light

Cleanable Surfaces Visual Privacy 08

qty.

room.

uses.

furniture.

Workstations Mobile Peds Center Island Seating Storage/files Storage Unit

2

Medical Staff Areas

Open office seating for 18-20 Use for team meetings also

1

Server

House Server

1

Electrical

House Electrical Equipment

Contractor Provided

1

Lab

Basic Testing

1

Single Restroom

Adjacent to Lab for patient use

Storage Units Lab Table and Chair Blood Draw Chair Supply Storage

3

Staff Restrooms

Restroom for staff use

Storage Unit

1

Custodial Room Staff Break Room

Storage

Supply Storage

Private break room for staff

Seating Tables

2

Staff Locker Room

Locker Room with Shower for LEED

1

Operations Director Office Medical Director Office Portable Equipment Area Conference Room

Private office space

Seating Lockers Storage Workstation Office Chair Storage Workstation Office Chair Storage Storage Units Gurney and Cart

1

1

1

1

Private office space Easy access to gurney and cart Space for staff conferencing

4

Tele-medicine Rooms

Space for skyping patients

1

Circulation

Overall Circulation

Conference Table Chairs Credenza Table Office Chair

equipment.

electrical.

lighting.

sq req.

sq provided.

other.

Desktops Convenience Outlets Printers Dedicated Outlets TV/screen Noise Reduction Machine

75 FC LED Linear Troffers Task Lighting

850 sf

846 sf

Cleanable Surfaces Sound Privacy Privacy from Patient

Server Rack Contractor Provided Contractor Provided

Electrical Panel Dedicated Outlets Convenience Outlets Dedicated Outlets

75 FC LED Linear Troffers 75 FC LED Linear Troffers

50 sf

54 sf

Visual Privacy

50sf

54 sf

Visual Privacy

Lab Equipment Sink Centrifuge ADA Toilet Grab Bars Lavatory Restroom Accessories ADA Toilet Grab Bars Lavatory Restroom Accessories Mop Sink

GFCI Outlets Convenience Outlets

75-100 FC LED Recessed Cans High CRI

300 sf

343 sf

Adjacent Restroom

GFCI Outlets

60 FC LED Recessed Cans Sconce at Lavatory

64 sf

70 sf

GFCI Outlets

60 FC LED Recessed Cans Sconce at Lavatory

64 sf

64 sf

GFCI Outlets Convenience GFCI Outlets Dedicated Outlets Convenience Outlets

60 FC LED Recessed Cans 40-60 FC LED Recessed Cans Ambient Pendants Undercounter Lights 50 FC Overhead LED recessed can lighting 50 FC LED Recessed Cans Task Lighting 50 FC LED Recessed Cans Task Lighting 50-70 FC LED Linear Troffers

60 sf

65 sf

Cleanable Surfaces Non-Slip Surface Pass-Through Window Cleanable Surfaces Non-Slip Surface Privacy from patients Visual Privacy

500 sf

795 sf

Cleanable Surfaces Sound + Visual Privacy

120 sf

125 sf

100 sf

110 sf

Cleanable Surfaces Sound + Visual Privacy Consider Privacy

100 sf

110 sf

Consider Privacy

150 sf

223 sf

Consider Circulation Visual Privacy

300 sf

666 sf

Sound +Visual Privacy

43 sf

Sound +Visual Privacy

2 Microwaves Sink Large Refrigerator Trash/Recycle ADA Shower

GFCI Outlets Convenience Outlets

Desktop

Convenience Outlets Dedicated Outlets

Desktop

Convenience Outlets Dedicated Outlets

Medical Equipment

Convenience Outlets

Conferencing AV TV/screens

Dedicated Outlets Convenience Outlets

Desktop/TV AV Equipment

Dedicated Outlets Convenience Outlets

30-50 FC LED Recessed Cans Cove Lighting 60-75 FC LED Linear Troffers 15 FC LED Recessed Cans Cove Lighting

totals.

40 sf

6,734 sf

20,928 sf

Non-slip surface Consider Views

14,193 sf 20,928 sf with circulation

09

Like healthcare, a canyon is vast with multitudes of side channels but also a central force moving forward. The constant movement and change is harnessed in the adapting yet strong geology of the canyon walls. There are many sectors and views in healthcare, but all surround the promotion of wellbeing for all people. A canyon adapts to change and is constantly moving. It has withstood millions of years of change and continues to support the ecosystems surorunding it regardless of the rapid pressures placed by humankind. As such a grand and daunting landscape, a canyon harnesses power and beauty with grace. A canyon embraces the unique and organic structures and functions efďŹ ciently and purposefully. Healthcare is currently facing rapid changes, and designing a clinic that will support the community through modifyability while maintaining composure will cultivate the change. The need for efďŹ ciency and drive is a common theme in healthcare providers, so creating a space to promote this is critical. The power behind wind and water bursting through a canyon is unharnessed, while the overall composure of the land remains grandure and calm. This contrast inspires the design of the clinic to be a powerful and innovative, yet healing and restorative space for all users.

Concept.

10

Ease patient’s anxiety through utililizing interior architecture and wayfinding with implied natural forms and justified use of contrasting color, that will provide positive distractions, fluid wayfinding, and promote efficient circulation for all stakeholders.

Goals.

Support care providers through including private and restorative spaces for respite which will build a calm environment to cultivate an atmosphere of efficient and thourough healthcare.

Optimize spaces to support the needs of all stakeholders through mobility of furniture and technology that will enhance the patients experience to be interactive as well as ease tension between patient and care provider. Promotion of communication will be key in the design and utilizing architectural forms as well as specifiying appropiate and innovative furniture will assist in growing the atmosphere for openess.

11

Justification.

Using color theory and research on environmental psychology of design, the color palette is selected methodically to enhance the users experience in the clinic. Each color has beneficial associations that create a productive and efficient yet restorative space for all users. The partnership between energizing organge and yellow, and calming blue and teal, will allow for opportunity to create spaces with varying energies.

This will add to both the journey of the patient as well as support the needs of care providers.

Kopec, D. A. (2018). Environmental psychology for design. New York: Fairchild Books, an imprint of Bloomsbury Publishing Inc.

Rust Red

Tan

Sky Blue

True Blue

Promotes energy and warmth. Creates a vibrant and active atmosphere that also harvests positivity. A tonal red is a social and vibrant color that can aid in stimulating brain wave activity socially and medically.

Exudes warmth, vitality and is a neutral base color. This will be used throughout to create unity as well as provide comfort through the inclusion of light woods as well. It will visually aid in breaking up a clinical atmosphere.

Linked to calming and relaxation, sky blue will ease stress and cultivate a restorative environment.

Not overwhelming, sky blue can be used in greater amounts to break up mundane white spaces.

Studies show that blue can trigger the healing process through being associated with water that is soothing and cooling.

Using blue throughout will promote healing and create a calm environment.

Pallette.

Nussbaumer, L. L. (2009). Evidence-based design for interior designers. New York: Fairchild Books.

12

Waiting Check in Area Children’s Play Area Consultation Room Areas Business Center Family Style Restrooms

Adjacency Matrix.

Check out Desk Community Room Exam Rooms Behavioral Counseling Procedural Rooms Clean Supply Rooms Soiled Supply Rooms Medical Staff Areas Server

Design Implications.

Ensure patient privacy and promote comfort through the use of acoustical materials throughout such as sound mitigating door jambs and acoustical panels and consideration of sightlines.

Promote efficiency of care provided through adjacency of medical staff areas and exam and procedure rooms.

Electrical Lab Single Restroom Staff Restrooms Custodial Room Staff Break Room

Enhance patient’s experience through creating an efficient journey with ample wayfinding to ease anxiety of patients.

Staff Locker Room Operations Director Office Medical Director Office

Key Critical

Portable Equipment Area

Undesirable

Conference Room

Neutral

Tele-medicine Rooms

*Spaces left blank are adjacencies that don’t affect the space planning 13

Preliminary Planning.

Starting with preliminary design, blocking and bubble digrams are utilized as tools to space plan according to the adjacency requirements as well as circulation consideration for all stakeholders. Starting with bubble diagrams, adjacencies are considered, then moving into blocking, square footage and circulation is considered.

Staff Entry

Staff Entry

Behavioral Counseling Exam

Bubble Diagram

Blocking Diagram

Exam Locker

Key

Locker Exam

Staff RR

Exam Rooms

Both Staff + Patient

Exam Rooms

Staff RR

Custodial

Exam

Exam

Patient

Clean + Soil Supply

Exam

Staff

Staff

Critical Adjacency

Entry into Clinical Wings

Main Circulation

Exam

Exam

Key Both Staff + Patient

Behavioral Counseling

Exam

Staff Lockers + Restrooms

Patient

Behavioral Counseling

Clean Supply

Soil Supply

Exam

Exam

Exam

Medical Staff Area

Exam

Medical Staff Area

Exam

Exam

Exam

Main Entry

Main Entry Exam

Exam

Procedure Rooms

Procedure Procedure

Exam

Exam

Lab RR

Lab Exam

Conference

Lab RR

Community Room Lab

Staff Entry

Medical Staff Area

Procedure Rooms

Behavioral Counseling

Exam

Exam

Exam

Exam

Soil Supply

Exam

Procedure

Medical Staff Area

Behavioral Clean Counseling Supply

Procedure

Lab RR

Lab

Fam RR

Waiting + Business Center + Check in/out

Fam RR Child’s Play Area

Conference Consult Consult Community Room

Lab RR Lab

Portable Equipment, Server, Electric

Offices

Staff Break Room Exam

Exam

Exam

Exam

Exam

Staff Break Area

Exam Portable Equip. + Ambulance Pick Up

Electric

Exam Rooms

Staff RR

Server

Clean + Soil Supply

Behavioral Counseling

Staff Entry

Waiting- Check in/out, Child’s Play, Consultants, Business Center

Fam RR

Check in/out

Family Restrooms

Exam Rooms

Office

Office

14

Visual Design Analysis.

Zoning with Atmospherics

Destinations, Landmarks + Focal Points

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The diagram shows all destinations, landmarks and focal points in order to deďŹ ne the visual user experience throughout the spaces. Focal points are strategically placed in order to provide wayďŹ nding to guide users to destinations. All focal points are identiďŹ ed to guide design features that will be key components for overall experience within the clinic.

15

Code Plan.

Plan shows code requirements such as common path of travel and max travel distance. This plan also illustrates the required egress pathway widths and turning circles abiding by ADA guidelines.

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(2017). Florida building code - Accessibility (6th ed.). Tallahassee, FL: State of Florida.

(2017). Florida building code (6th ed.). Tallahassee, FL: State of Florida.

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Code Study.

Summary.

The FSU Primary Care Clinic will be a Type I construction that will follow the local building code jurisdiction for Tallahassee, Florida. Codes will be applied to the programming for the first story of the three story building, which will function as an outpatient clinic. Applicible codes will include, the Florida Building Code for Building, Plumbing, Mechanical and Accessibility 6th editions (2017), as well as the National Electric Code (NEC) 2014 edition and the Florida Fire Prevention Code (FFPC) 6th edition.

Code Findings.

304.1 1004.1.2 2902.1

Occupancy Type Classification Group B - Business (clinic, outpatient) Occupancy Counts 20,928 / 100 = 209.28 round up = 210 Occupants Plumbing Counts (4) water closets per code, (6) water closets per program requirements* (6) lavatories required (3) drinking fountains** *urinals are not included per program requirements **shall not protrude more than 4” into path of egress

1005.3.2

Egress Width Requirement 210 x 0.2 = 42” code required minimum BUT 44” egress width accessibility code requirement

1005.7.1

Door Swing Requirements Can’t swing more than 7” into space or egress path

1010.1.2.1 1006.2.1

Key Plan.

Existing Exits Exit Arrangement (1007.1.1) No less than 1/3 length of sprinklered building 180 (^2) + 180 (^2) =c (^2) 32,400 + 32400 = c^2 square root = 254.5 /3 = 1/3 rule =85 Feet Minimum Distance between exits

Door Swing Requirements Assembly occupancy classifications- doors must swing outwards.

Common Path of Travel Maximum Distance = 100’ (sprinklered building)

1029.7

Travel Distance Maximum Distance = 250’> (sprinklered building)

1020.4

Dead End Corridors Maximum Distance = 50’

1006.2

Count of Exits 2 Exits required

803.11

Interior wall and ceiling finish per fire code Stairs: Type B Corridors + Closed Rooms: Type C

(Health Insurance Portability and Accountability) ensures privacy of health information, security of electronic records, administrative simplification, and insurance portability. This will require the design to provide private spaces for care providers to store and record medical records that will be private from patients.

The Joint Commission is the accrediting body for healthcare institutions and evaluates healthcare organizations. They aim to continuously improve the safety and quality of care Comission provided to the public.

HIPPA Joint

(2017). Florida building code - Accessibility (6th ed.). Tallahassee, FL: State of Florida.

(2017). Florida building code (6th ed.). Tallahassee, FL: State of Florida.

(2019, January 4). Health Information Privacy. Retrieved from https://www.hhs.gov/hipaa/index.html (n.d.). Retrieved from https://www.jointcommission.org/

18

Wayfinding Inspiration.

Color.

Simple Icons.

Implied in Ceilng.

Floor Graphics.

Use of simple, contrasting color will guide users and easily be recognized throughout space.

Icons that are intuitive and universally understood will reduce confusion as well as simplify wayfinding.

Implied wayfinding will guide human behavior to understand the natural flow of the space while keeping design cohesive and unified.

Floor graphics and change in flooring materials will be easily recognized by all users by adding interest to flooring patterns as well as included graphics that are easily understood by all stakeholders.

19

Art Package.

The goal is to create a cohesive and meaningful package that will provide positive distraction in exam rooms, promote rejuvenation for staff and patients and create unity throughout the clinical space. Through both sculptural art as well as traditional framed art, the package will vary, allowing for interesting and dynamic touches throughout. This will tie to the concept of a canyon through the movement and textures implied by the concept.

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Final Design Deliverables.

Rendered Floor Plan.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Staff entrance ensures privacy and eases white coat anxiety in the waiting area. This also streamlines the staff’s journey.

Staff Entry

CHECK IN DESK + KIOSK WAITING AREA UNISEX RESTROOMS COMMUNITY ROOM CONSULTATION ROOMS CHILDREN’S PLAY AREA EXAM ROOM 1 EXAM ROOMS BEHAVIORAL COUNSELING ROOMS CLEAN SUPPLY SOILED SUPPLY MEDICAL STAFF AREA PROCEDURE ROOM LAB RESTROOM STAFF RESTROOM PORTABLE EQUIPMENT + AMBULANCE PICK-UP ELECTRICAL ROOM SERVER LAB BLOOD DRAW AREA MEDICAL DIRECTOR OFFICE OPERATIONS DIRECTOR OFFICE STAFF BREAK ROOM CONFERENCE + CLASSROOM CUSTODIAL LOCKER ROOM

Behavioral counseling rooms are located separate from exam room halls for added privacy and to create a space that feels different than a clinical exam room

H

I

H

H

Sliding doors with translucent panel and locking gasket will allow for natural light in exams rooms and ease of egress while providing sound and visual privacy to patients

Z

Z

Staff restrooms are spread throughout clinic to support care providers in assisting in efficiency.

O

H H

Staff phone rooms allow for integrated technology, streamlining care delivery and enhancing access for remote patients via video technology

Under staircase planter boxes will provide cane detection.

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Staff locker rooms are near the staff entrance before medical staff area for efficiency and to reduce path of travel.

H

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All exam rooms layouts are identical to reduce medical error.

L The open waiting layout supports personenvironment theory through creating spaces for all people to feel competant in the environment while promoting social interaction

Main Entry

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Curved walls enhance the concept as research shows curved forms ease tension while supporting wayfinding through sightlines.

Staff areas are centralized and private from patient pathways and view points.

N T

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Flooring transitions provide support wayfinding into exam rooms while reflecting the ceiling cove lighting feature

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Outside consultants provide community support and giving the space for patients to access from the waiting room allows for comfort and ease

D

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The south ambulance pick up uses the existing turn around and provides ease of access as well as privacy for patients.

P

Level 1 Furniture + Finish Plan Scale: 1” = 20’0”

Q R

U V

Community Room is central and adjacent to waiting to promote community interaction. The space includes a teaching kitchen.

Staff break room provides spaces for respite and rejuvenation

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Furniture Key Plan.

Flooring Specifications.

Carolina Hug Guest Chair Midmark Ritter Exam Table Steelcase Pocket Mobile Table Steelcase Node Series Chair Steelcase Leeta Lounge Chair Steelcase Leeta Lounge Sofa Steelcase Solid Surface Table Group Meeting Table, Chairs and Screen Physician’s Stool on Casters Steelcase Sync Adjustable Desking System Coalesse Bob Lounge Chair Mobile Workstation Cluster Task Chair with Arms on Casters

Arizona Tile: Essence Tile Glazed porcelain tile, commercial rated for durability and cleanability, rated for wet room applications, mop and cleaning agent cleanability, sealant required maintenance

Teknoflor: Urbanscapes, Soho

Teknoflor: Urbanscapes, Gramercy Park

Specified to enhance wayfinding, phthalates free, resilient and durable, cleanable, no buff floors means no bacteria, dust or wax particles are thrown into the air during cleaning, mop and cleaning agent cleanability, no extra maintenance, 12 year warranty

100% virgin vinyl and without any phthalates, resilient and durable, cleanable, no buff floors means no bacteria, dust or wax particles are thrown into the air during cleaning, mop and cleaning agent cleanability, no extra maintenance, 12 year warranty

Carolina Lasata Patient Recliner Mobile Table and Chairs on Casters Cafe Table and Chairs Barstool Table and Chairs Steelcase Lagunitas Lounge Seating Magnus Stackable Chair Mobile Medical Supplies Cart Medical Gurney Carolina Basil Seating System Carolina Boost Pediatric Stools Carolina OFS Neom Chair Carolina XO Tapered Cube Table Steelcase Coalesse Await Table Carolina Elani Longe Chair

Tarkett: Drop Cloth

Mohawk Group: Mellow D Tile, Pause 967

EPD available and 27% pre-consumer recycled content, 3 mm thickness is resilient and durable, mop and cleaning agent cleanability, cove base application 4”, 20 year limited warranty

Ashlar tile, 58% pre consumer recycled content, stain resistant fiber technology, heavy foot traffic durability, lifetime warranty

Coalesse Lounge Chair + Ottoman

Custom Modeled Childrens Niche

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Reflected Ceiling Plan.

Ceiling Types.

Acoustical Ceiling Grid @ 11’-0” AFF

Exam rooms include undercabinet lighting to cancel out shadows Armstrong Acoustical Seamless Ceiling System @ 11’ -0” AFF

Top Akustic: Topperfo Perforated Solutions: wood perforated ceiling system @ 10’-6” AFF

Fixture Key. Dropped Cove Lighting Ceiling Feature @ 9’-6” and 10’-6” AFF (Layered Gyp Ceiling) Focal Point Seem Y Acoustic LED

Eureka Scout Pendant

2-Story Volume

Recessed Linear LED Troffer 6” Recessed Can Fixture

ELEV

ELEV

Eureka Wall Mount Plate LED Air Return Register

Air Supply Diffuser

Exit Sign Symbol Turf Straight Acoustic Baffles @ 10’-6” AFF

Level 1 Reflected Ceiling Plan Scale: 1” = 20’0”

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Fixture Justifications.

Eureka Lighting: Scout 10” Pendant Hung @7’-0”,12W, LED HO 2700K PHASE DIMMING 120V, minimalist aesthetic, focal pendant, high CRI, dimming capabilities

Eureka Lighting: Plate, Wall Mounted Sconce 7W, LED 3500K (Natural) 120-277V ADA compliant, linear LED strips, dimmable, die-formed steel with chrome plated finish

Focal Point: Seem 1 Acoustic Trio Direct/Indirect LED, eco-friendly technology is used to maximize sound absorption and reduce ecological impact, acoustic housing is 50% made of recycled plastic bottles

Focal Point: Seem 1 Recessed Linear 3000K, 3500K or 4000K with both 80 and 90 CRI options, dimming capabilities, LED, frosted acrylic lens provides uninterrupted illumination, without pixels or shadows, energy star efficient

Focal Point: 6” downlight trimless recessed can Standard delivered lumen outputs 700, 900, 1100, 1300 and 1500, energy star efficient, parabolic reflector cone ensures glare free optics

Ceiling Feature to Enhance Wayfinding.

Along all patient hallways, dropped ceilings are designed to guide patients and families to reduce confusion and anxiety. The ceiling feature has integrated cove lighting. Also along the hallway, wall mounted fixtures provide layered lighting and additional breaks between exam rooms.

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Reception + Waiting.

UP

UP

ELEV

A Space for All Ages Located centrally, the reception and waiting area provides variety in seating options to accomodate all users. The custom check in millwork integrates a check in kiosk to streamline the check in process for appointments. A children’s play room is visible from all areas of the waiting to allow for safety while also providing an encapsulating space for younger patients. Private consulation rooms are provided to outside consultants, supporting the holistic wellness approach of FSU Primary Health. Ceiling features provide positive distractions and create a “world within” feeling that reflects the goals of the design concept.

UP

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Undercounter drawers

Wire management grommets

2' - 0"

2' - 6 1/16"

4' - 7 11/32"

1' - 3"

9' - 3"

1' - 3"

12' - 0 3/16"

Check-in Desk Enlarged Plan Scale: 1/2” = 1’0” 4' - 7 11/32" 3' - 3"

0' - 7 11/32"

0' - 9"

0' - 9"

WRITEABLE + MAGNETIC SURFACE COUNTER PLYWOOD SUBSTRATE LAMINATE TRANSACTION TOP SUPPORT, 16” O.C.

Integrated Toe Kick Lighting

Check-in Desk Axon

DESK FACE WOOD DETAIL FASTENER/SUPPORT 2' - 6"

ADA Transaction Top

STAINLESS METAL PULLS 3' - 3"

Workstation Top with integrated wire management grommets

LAMINATE DRAWER FRONTS

Scale: NOT TO SCALE

1/2” PLYWOOD SUBSTRATE CURVED PLYWOOD FACE 5/8” PLYWOOD SUBSTRATE LAMINATE TOE KICK

Reception Millwork Design.

Check-in Desk Section Scale: 1 1/2”=1’0”

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Waiting Room Branding.

Universal Icons for Wayfinding

Custom Branding and History Graphic

Carolina: Boost Ottomans

Carolina: Basil Seating System

Wall Base: Teknofloor, Soho

Custom Ceiling Feature

Branding Waiting Room Wall Elevation Scale: 1/2” = 1’0”

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Upper Storage Millwork Flipper Doors

Angled Demonstration Mirror

Large Aggregate Terrazzo Backsplash with Sealant

Island with Stovetop: Concrete Terrazzo Countertop

Laminate Fronts UP

ELEV

ELEV

UP

Community Room Teaching Kitchen Elevation Scale: 1/2” = 1’0”

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Goals Patient and physician pathways are separate to promote efficiency and provide patient privacy.

Utilize the ceiling feature to guide patients and clearly define entrances to exam rooms to ease patient anxiety.

Increase medical provider communication and efficiency through interior pathways that are separate from patient pathways.

Key Custom ceiling feature with integrated cove lighting. Two layers @ 10’ and 10’6’ AFF - Wood veneer with gyp. substrate

Patient pathway

Physician + staff pathway

Wayfinding Strategy.

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Wayfinding Elevation.

Lumicore Resin Wall Panel

Perpendicular Mounted Signage

Wood Laminate Handrail

ADA Compliant Wall Sconce for Layered Lighting

Integrated Cove Lighting

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ADA Compliant Room Signage

Universal Icon Signage

Materials Used.

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All patient hallways integrate wayfinding strategy in order to provide a clear path for users to navigate the space. All exam rooms are labeled both above the door perpendicular, as well as adjacent to the latch side of the door. All signage is ADA compliant, with braille included. A resin panel protects from damage to the wall and allows for added cleanability. Handrails are located per ADA requirements in all hallways. Universal icons are located at each corner guiding users to destinations.

Core Floor Base

Translucent Resin Door for Privacy

Doors sealed with gasket for acoustic privacy

Exam Room Hall Elevation Scale: 1/4” = 1’0”

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Exam Room.

Exam Room Zoning Diagram

To reduce medical error, all exam rooms are same handed. The patient and providers have separate entries, that ensure privacy for patients as well as promote efficiency for care providers and staff. Patients and guests are always face to face with providers for transparency to reduce white coat anxiety.

Each exam room has a patient door and staff door to create designated zones for efficient and comfortable examinations. The angle of the exam table allows for view of family and guests as well as the medical provider and screen. There is ample space for all users. Patients and guests do not have to cross clinical equipment easing white coat anxiety.

Family/ Guest

Patient

Care Staff

Upper Cabinet Storage Medical Equipment Screen Mobile Ped for Physician Wall mounted Accessories + sharp disposal Undermount stainless steel sink Midmark Exam Table Guest Chair: Wall Mounted Storage Guest seating: bariatric seating option Physician’s stool on casters

Exam Room Axon Diagram

Exam Room Elevation

Scale: Not to Scale

Scale: 3/4” = 1’0”

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Medical Staff Workspace.

UP

UP

ELEV

ELEV

Medical Staff Respite In both the East and West Wings, medical staff are provided a central â&#x20AC;&#x153;islandâ&#x20AC;? for work and respite between patient visits. By the inclusion of mobile workstations, staff are able to adapt to collaborative and teaching uses as well as individual work needs. The acoustic perforated wood ceiling feature provides sound mitigation along with gasket sealed sliding doors. Phone rooms are provided for both personal staff use as well as patient and physician skype appointments. Informal seating is provided for physicians to take a quick break and refresh, ensuring the best care is given to each patient.

UP

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FF+E. Floors Tarkett: Drop Cloth

Exam Table Midmark: Ritter 204

EPD available and 27% pre-consumer recycled content, 3 mm thickness is resilient and durable, adds to aesthetic of exam room

Cleanability, versatility, storage and customizable, integrated electrical power, safety through add on features

Floors Teknoflor: Urbanscapes, Soho

Exam Rooms.

Designed to enhange wayfinding, 100% virgin vinyl and without any phthalates, resilient and durable, cleanable, No buff floors means no bacteria, dust or wax particles are thrown into the air during cleaning, mop and cleaning agent cleanability, no extra maintenance, 12 year warranty

Ceilings Armstrong: ACOUSTIbuilt Seamless Acoustical Ceiling System 0.80 NRC Rating, up to 87% light reflectance, recyclable material, Smooth non-directional, monolithic, drywall-like visual.

Solid Surface for Sink Counter Wilsonart: Chalk White Durable, bleach cleanable, suitable for wet environments, sink hole cutout

CF Stinson: Verdure “Sesame” Viny, Advanced Soil and Stain Resistant Top Coat, exceeds 100,000 double rubs - heavy duty, plant based plasticizer

Clinician Stool Steelcase: Verge Stool Durable (steel frame) and cleanable (urethane seat), 25% recycled content, casters for mobility, available in various heights

Extra Guest Seating Carolina: Maren Folding Chair Wall mounted storage, vinyl upholstery, lightweight, flexible seating, durable metal frame, vented back

CF Stinson: Fuse “Cinnabar Viny, Advanced Soil and Stain Resistant Top Coat, Exceeds 250,000 double rubs - heavy duty

Visitor Chairs Carolina: Hug (Bariatric + Classic) Clean through design, options for bariatric and normal sizing, non-marring adjustiable glides, Greenguard GOLD certified.

CF Stinson: Prisma “Juniper” Vinyl with polyester backing, Zeron® Protective Finish is antimicrobial, exceeds 100,000 double rubs - heavy duty

CF Stinson: Criss Cross “Quicksilver” Vinyl with polyester backing, Exceeds 500,000 double rubs - heavy duty

Millwork Carolina: Mile Marker Systems Endless customizable solutions for millwork, durable and cleanable surfaces, integrated sink and disposal systems, flexible and interchangeable systems

Millwork Finish Herman Miller: Light Maple Laminate Laminate for upper and lower millwork, bleach cleanable, specified for clinical use

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FF+E. Floors Teknoflor: Urbanscapes, Soho Designed to enhange wayfinding, 100% virgin vinyl and without any phthalates, resilient and durable, cleanable, No buff floors means no bacteria, dust or wax particles are thrown into the air during cleaning, mop and cleaning agent cleanability, no extra maintenance, 12 year warranty

Reception + Waiting Rooms.

Ceilings Armstrong: ACOUSTIbuilt Seamless Acoustical Ceiling System 0.80 NRC Rating, up to 87% light reflectance, recyclable material, Smooth non-directional, monolithic, drywall-like visual.

Floors Mohawk Group: Mellow D Tile, Pause 967

Seating Carolina: Elani Lounge

Ashlar Tile, 58% pre consumer recycled content, stain resistant fiber technology, heavy foot traffic durability, lifetime warranty

Cleanable upholstery, comfort and privacy from wingback headrest, durable legs with protective bases Maharam: Brindle “Torch” Polyester, bleach cleanable, 100,000 double rubs, PFOA-Free Stain Resistant, 5 year warranty, greengaurd certified

Seating Carolina: Orchestra Collection

Seating Carolina: Neom Lounge

Cleanable upholstery, clean out option, durable laminate legs and arms with arm caps, bariatric and tandem configurations

Cleanable upholstery, metal arms with arm caps, options for integrated power, durable legs

Maharam: Ellipsis “Lazuli”, “Dolphin”, “Sunshower” 100% Polyurethane wtih protective Topcoat, healthier hospitals compliant, greenguard certified, bleach cleanable

Walls+ Millwork Herman Miller: Light Maple Laminate

Tables Carolina: XO Tapered Cube Table

For custom millwork and modeled design features, cleanable, suitable for clinical spaces for infection control

Durable laminate finish, bleach cleanable, various heights available for customization

Maharam: Ellipsis “Lazuli”, “Dolphin”, “Sunshower” 100% Polyurethane wtih protective Topcoat, healthier hospitals compliant, greenguard certified, bleach cleanable

Children’s Seating Carolina: Boost Child sized furniture, cleanable upholstery, lightweight for mobility, various shapes available

Maharam: Ellipsis “Lazuli”, “Dolphin”, “Sunshower” 100% Polyurethane wtih protective Topcoat, healthier hospitals compliant, greenguard certified, bleach cleanable

Art Inspired by image Wall graphics and art will enhance the concept and support the natural aesthetic of the reception and waiting spaces

Walls Sherman Williams: Arcade White Base paint color- neutral white to add warmth to space, flat finish to reduce glare.

Tables OFS: Heya Table

Children’s Furniture Carolina: Cascade

Durable laminate finish, bleach cleanable, provides occasional work table, easily moveable

Child sized furniture, cleanable and durable, lightweight for mobility, various shapes available

Seating ERG: Malibu Clean out option, integrated power, durable legs and upholstery, ergonomically designed, fits aesthetic of space, 52% recycled content Maharam: Mister “Notice” 100,000 double rubs, greenguard certified, PFOA-Free Stain Resistant Finish, bleach cleanable, sunbrella fabrics

Children’s Furniture ERG: Brighten Collection Child sized furniture, cleanable and durable, customizable configurations, clean out options, durable table laminate surface Maharam: Mister “Notice” 100,000 double rubs, greenguard certified, PFOA-Free Stain Resistant Finish, bleach cleanable, sunbrella fabrics 34

FF+E. Floors Teknoflor: Urbanscapes, Soho Designed to enhange wayfinding, 100% virgin vinyl and without any phthalates, resilient and durable, cleanable, No buff floors means no bacteria, dust or wax particles are thrown into the air during cleaning, mop and cleaning agent cleanability, no extra maintenance, 12 year warranty

Resin Wall Panel Lumicore: Luminous Solid Surface Resin

Ceilings Armstrong: ACOUSTIbuilt Seamless Acoustical Ceiling System

Sliding Doors 3Form: Haiku Varia Resin Panel

Halls.

0.80 NRC Rating, up to 87% light reflectance, recyclable material, Smooth non-directional, monolithic, drywall-like visual.

Ceiling Feature Herman Miller: Light Maple Laminate For custom millwork and modeled design features, cleanable, suitable for clinical spaces for infection control

Protect walls from scuffing, durable and cleanable, contrasting color for ease of wayfinding, 100% recyclable product.

Interlayered resin panel to provide visual and acoustic privacy for exam rooms, cleanable and durable, ecologically responsible product, recycled material

ADA Handrail Inpro: Hardwoods HR8 Handrail 5 1/2” high with a 1 1/2” , the surface is protected with a durable, low VOC UV-coated finish, ADA comppliant, ash finish Inrpo: Custom matched wood Bleach cleanable, durable, matched to ceiling feature

Walls Sherman Williams: Arcade White Base paint color- neutral white to add warmth to space, flat finish to reduce glare.

35

FSU PrimaryHealth: Studio IV

Fall 2019.