Pediatric Neurology Center Thesis Volume I: Research

Pediatric Neurology Center Singapore 2021 - 2022 Thesis Volume I: Research

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Singapore Pediatric Neurology Center 2021-2022 Thesis Volume I: Research Emma Hilt Virginia Tech

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Mission statement: My mission is to be a wise and confident woman, who listens well and strives for healthier people and a healthier earth. In design, my top priority will be to create places where people know they are seen and supported. As a designer, I have a responsibility to care and innovate thorough solutions that lead people to live healthier and flourishing lives in spaces that help make the earth a healthier place.

ehilt@vt.edu (540) 235-6140 4

Table of contents

Part I: Overview

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Thesis and Problem Statement Goals and Objectives Collaborating Partners

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Part 2: Site

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Singapore Cultural Information Singapore Socioeconomic Information Site Analysis Building Analysis

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Part 3: Contributing Research

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Color Materiality: Singapore Materiality: Healthcare Industry Population Considerations Play and Child Development WELL Building Standard Principles of Biophilic Design Theories of Human Behavior: Attention Restoration Theory Team Research study: Psychological Healing in Interiors Case Studies

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Part 4: Design Preparation

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Codes and Regulations Adjacency and IEQ Assessment Space Plan Prototypes

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Sources

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Overview

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Project Statement Atop a wooded hill in Singapore’s medical district is a specialized three floor pediatric center, dedicated entirely to pediatric neurology. This facility provides specialized neurological care to children ranging in age from infancy to adolescence. By dedicating the entire 49,500 square foot space to pediatric neurology, this facility targets Singapore residents looking for treatment, but also international visitors seeking highly specialized medical care. To maximize human health and wellness, the building Is informed by principles of the WELL v2 building standard and places an emphasis on how to enhance healing, resilience, and learning through the built environment.

Thesis Statement Given the way that the brain responds to external stimuli and the changing nature of a developing body and brain, interior spaces have a significant opportunity to provide a sense of consistency, and to create an environment that healthily stimulates the brain. This center will respond to those areas of opportunity by responding to the developmental needs of children, particularly children with a different set of neurological factors, by providing areas to encourage play, learning, and movement through spaces that offer a variety of both amount and type of stimuli.

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Project goals and objectives Orient patient spaces for a family-centered care medical practice model 1. Ensure all patient rooms have sleeping space for two guests 2. Include amenity support spaces to maintain daily family routines

Integrate spaces to encourage children’s discovery and development through play 1. Create play spaces that address visual, tactile, auditory, and critical thinking skills

Create employee spaces centered around workplace wellbeing 1. Use WELL v2 principles to inform employee space standards 2. Include wellness spaces dedicated to respite and breaks from work

Encourage wellness through connections with nature 1. Maintain all exterior views to central courtyard 2. Use principles of biophilic design to inform building design

Develop a positive sense of place with the local and hospital community 1. Include signage with positive and welcoming presence in lobby that contributes to hospital brand 2. Create landmarks that all space users can identify and reference 3. Include landmarks that have symbolic significance to Singapore

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Collaborating Partners Virginia Tech Child Development Center for Learning and Research Karen Gallagher, M.A.Ed Karen is the director of the Virginia Tech Child Development Center for Learning and Research. Additionally, she is a senior instructor within Virginia Tech’s Human Development and Family Science Department. Karen received her B.S. degree from Virginia Tech with a major in Family and Child Development/Childcare Administration. She also received her M.A.Ed from Virginia Tech in Curriculum and Instruction/Special Education. Karen has worked in early education for over 25 years both as a student teacher, classroom teacher, and administrator. She has also served as a mentor for Virginia Quality for several years and has also mentored Early Head Start programs in the New River Valley. Karen enjoys networking and working with programs in our area and is committed to advocating for young children and their early education providers.

Alexa Gardner, M.A.Ed Alexa is the Curriculum Coordinator at the Virginia Tech Child Development Center for Learning and Research. Additionally, she is an Advanced Instructor within the Department of Human Development and Family Science at Virginia Tech. She has a Master’s degree in Education and her areas of expertise include Early Childhood Education, Reggio Emilia Philosophy and Pedagogy, Educational Psychology, Art and Young Children, Interdisciplinary Curriculum, and Inquiry-Based Learning.

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Site

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Singapore Cultural Information Values

Structure

Group oriented

Harmony

Multiculturalism

Efficiency

Social Structure

Men and women are respected equally, with men often conscious of how their actions come across towards women.

Elders are highly respected in Singaporean culture.

As the birth rate slows, the elder population is becoming even more emphasized.

Family sizes are shrinking, given the slowing birth rate and fewer couples that are having children.

Communication Style Singaporean culture is all about keeping harmony. Because of this, their communication style is indirect and positively-focused, in order to maintain a good reputation and peaceable state.

They are restrained and keep a distance, preferring larger personal space areas, until it is appropriate to adjust those boundaries.

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Singapore Socioeconomic Information

5.7

million people

21,646

Size

people per sq. mile

270 sq. miles

Life expectancy: 84.07 years Birth rate: 1.14 births per woman Average resident age: 42.2 years old

Life Cycle

Infant mortality rate: 1,4 deaths per 1,000 live births 6th best healthcare system out of 195 countries 4th best mental healthcare system out of 15 Asian Pacific Territories

16.3% Secondary only

Literacy rate: 97.1% Average years of schooling: 11.3 years

Education

25.4% Below secondary

33.% University or higher

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25.3% Some higher education

Education

10% Taoist

5% Hindu

0.6% Other

14% Muslim

33.2% Buddhist

18.5% Non-religious

Religion

Demographics

18.8% Christian

7.4% Ethnic Indian 55% Men

1.4% Other

15% Malay

76.2% Chinese

45% Women

Gender

Ethnicity

$54,530 USD average annual income per capita

Economy

Primary Industries Manufacturing Financial Services Technology (medical equipment, aerospace, clean energy, healthcare)

Areas of success Sustainable water solutions Busiest container port in the world Growing economy No foreign debt Efficient, safe, clean infrastructure

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Site Analysis College Road, Singapore

Health Academy Health Services

Ministry of Health

Health Promotion Board

Parking

Site

Singapore General Hospital

Heart Center

Highway Rehabilitation Center

To Coast and Docks

N Singapore medical district

Average daily temperature ranges from 75 degrees to 90 degrees all year round

Geography

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Singapore is only 1 degree up from the equator

Average monthly rainfall ranges from 6 to 12 inches

Nearby countries include Malaysia (direct neighbor), Indonesia, Philippines, and Thailand

View from parking

View from secondary drive

Parking

Hill up from drive path

Prevailing wind direction

Sun path direction View from primary drive

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Building Analysis 49,500 Square foot healthcare facility

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Axis

Massing

Circulation

Vertical circulation

Daylight

Entry/Exit

Exterior facade

Positive and negative space

Broken grid accent

Building to Site relationship

Plan view

Elevation view 17

Contributing Research

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Color Symbolism in Singapore Due to the mixture of cultures, color has a range of meanings in Singapore, much more so than in the United States. Singapore is made up of Chinese, Malays, and Indians, which are all cultures that place special emphasis on certain colors. Additionally, Singaporeans practice different religions, including Buddhism, Christianity, and Islam, which have their own cultural interpretations of color.

Red

Orange

Yellow

Symbolizes luck, joy, fertility, fortune, and summer to those in Chinese cultures Symbolizes, happiness, plenitude, good health, and immortality, and is sacred in Indian culture Symbolizes royalty in Chinese, Malay, and Muslim culture

Green

Associated with Mohammed in Muslim culture, symbolizing respect and worship

White

As the Asian funeral color, symbolizes mourning and death, also associated with humility

Black and purple

Considered unlucky in most of Southeast Asia

Biological response Our eyes have certain cones dedicated to processing different color wavelengths. If our cones processing one color are activated for too long, they will be exhausted and transmit the visual input at a lower quality, leading to visual fatigue. As a result, cones for other wavelengths will take over sending visual information to the brain, resulting in persistent images in our vision that have the form of what we are looking at, but in a different color (i.e. staring at a red door, then looking away at a white wall and seeing an image of the door but in a blue-green shade). Eyes can become overloaded due to too much visual stimulation over time, whether due to the amount of light coming in the eye, or the concentration of a hue. These biological factors need to be taken into consideration when deciding how to apply and distribute color in interior spaces.

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Materiality: Singapore Singapore’s resources Singapore does not have many natural resources, particularly due to its small size. However, they do have a lot of money, as they have deep water petroleum reserves which are exported to other countries. This gives them a stable cash flow to spend on industrial building elements, such as steel, glass, and prefabricated construction, including prefabricated panels, stairs, and prefinished volumetric construction. Prefabricated construction and recyclable materials like steel are booming in the Singapore construction industry, particularly because of how quickly they can be procured and the minimal impact to the environment (as these recycled materials do not take virgin resources out of the earth). In several cases, the use of prefabricated construction has led to projects being finished months ahead of schedule.

Steel

Volumetric construction

Panels

Stairs

$ $ $

Glass

Singapore’s cultural mindset Another reason Singapore pushes prefabricated construction is due to the way in which they address productivity. Singapore places a high value on productivity and efficiency, and skilled workers like tradesmen and laborers are viewed as a hit to productivity. They reason that they could direct their efforts into more immediately productive work and pay to have prefabricated construction arrive for projects more quickly and more safely, meaning less risk and more efficiency.

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Materiality: Healthcare What’s working Stainless steel is being heralded as an important building material when it comes to sustainability and health. With virtually no chemical content, toxicity concerns are much lower compared to other building materials, such as plastics.

Steel also yields good environmental benefits, as it is highly recyclable. Lastly, it offers much of the excellent durability and cleanability standards needed for healthcare. Another metal that is getting attention in the healthcare industry is copper. Copper has inherent antibacterial qualities that make it a helpful choice for settings where bacterial spread is of utmost concern. However, antibacterial surfaces pose a small threat to users; if a bacterial strain is able to mutate to the point where is immune to the antibacterial surfaces, then that surface is ineffective and has led to more resistant strains of bacteria. For this reason, it is important to make sure cleaning regimens are being addressed to prevent the spread of dangerous pathogens. Lastly, bio-based products are important in the fight against plastics. Naturally derived products that offer the same durability, cleanability, economics, and aesthetic range are essential to eliminating plastics from the built environment.

Stainless Steel

Copper

Rubber

What’s not working

X X Vinyl

Plastic

Often seen in healthcare projects, vinyl offers notable benefits, including excellent durability, cleanability, and low cost. However, between off-gassing, manufacturing, and breakdown, vinyls and petroleum based products (i.e. plastics) are bad for environmental and human health. These materials contain chemicals that are proven to be carcinogens and endocrine disruptors, an immediate concern for those involved in manufacturing. Given that communities that manufacture these products are afflicted by these toxins, healthcare institutions shoot themselves in the foot when they specify these materials. The more these products are being created, the more health crises there will be for medical professionals to handle. Healthier alternatives to plastics include bio-based flooring products, like cork, rubber, linoleum, etc., stone and wood countertops, wooden and metal casework, and bio-based textile coatings derived from various plant oils and animal fats.

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Population Considerations Who are we designing for and what do they need?

The patient Pediatric care Working with children in medicine provides an interesting combination of factors for the healthcare team to navigate. While children have nearly the same range of health issues as adults (if not more), their bodies are growing and changing rapidly, making full health somewhat of a moving target. Additionally, the ability children have to describe individual experiences and symptoms fluctuates with age. Because children are still part of an immediate nuclear family, the family unit is very important to the healthcare process of children.

With the rise in time spent indoors and with family, the pandemic has led providers to see a rise in abuse and neglect, which has been concerning and produced more healthcare issues, in addition to COVID-19. The rise in telehealth care has been beneficial and very pivotal to the healthcare scene.

Between tight schedules, safety concerns, and antsy/anxious children, telehealth has become a flexible way for patients to still be in regular contact with their providers.

Neurological care Neurology covers multiple scopes of care, including movement disorders, cognitive disorders, brain disorders, personality disorders, etc. so neurological care needs to address all of those. To treat and work on those under neurological care, there are certain types of important rehabilitative activities, including help with Activities of Daily Life, speech therapy, mood regulation, excretion training, motor control and mobility exercises, social skills training, cognitive therapy and training, nutritional support, and education.

As a center for pediatric neurology, this facility provides an intersection of these two types of care.

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The healthcare team Families Especially in pediatric medicine, the presence of the family unit is essential. Families need to be present to provide familial care and structure for the patient as well as be an integral part of the healthcare team of the child. Since family members may be staying with the patient during their stay, the medical facilities need to include amenities, resources, and support services to provide necessary care and structure for the family.

One of the most important things in empowering the family to make the best decisions for the patient is taking special care to address and maintain their wellbeing. This can look like providing areas of respite for time to rejuvenate, but also making sure that important routines can be maintained, such as eating patterns, exercise, connection with nature, and keeping up with work and the outside world.

Healthcare workers Taking care of employees in healthcare settings is vital to the success of the healthcare system and, as research is showing, has been historically overlooked. While previous metrics of success in medical settings focused on treatment and the individual, new metrics are making sure to include employee wellbeing in assessments of healthcare systems. Maintaining employee wellbeing requires support on two levels. One, workers need to have resources and the ability to take care of themselves individually, and two, administration, routines, and the healthcare infrastructure need to be set up to protect the wellbeing of workers. Now, on-the-job respite opportunities are essential and expected in healthy workplaces, given that burnout rates increased 10% from 2018 to 2020. Additionally, safety, flexibility, control, stress-relief opportunities, and proximity to work areas are essential to address. The return on investment for caring for employee wellbeing is crucial; employees that are burned out are twice as more likely to leave a practice.

Turnover amongst employees can be costly, with hiring costs sometimes totaling two to three times a workers annual salary. Facilities that tend to employees wellbeing see better employee performance and retainment, leading to better scores on patient satisfaction surveys.

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Play and Child Development An integrative tool in learning and development Throughout all of human history, children have played. They did not have to be taught, but simply knew how to play. Realizing this ingrained instinct to play, researchers and experts on child development have begun to capitalize on how to learn about children through play and aid them in important developmental processes. Research has shown that play based learning has proven to have developmental benefits in several skill areas, including language skills, mathematical skills, spatial skills, creative thinking, socioemotional development, and sensory skills.

A C B Language

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Creative thinking

Spatial

Social and emotional

Sensory

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Mathematics

One of the main reasons play is so successful as an aid to child development is because it is comprised of contexts that facilitate learning. For example, children are forming all kinds of connections between new vocabulary, spatial reasoning, imagined ideas, and planning when they play make believe.

Researchers studying the science of learning have identified four aspects that lead children to successful learning: being mentally active, being engaged, being socially active with peers, and building meaningful connections. Teachers and caretakers can take particular learning objectives and implement them into guided play activities, capitalizing on all four of these learning components that lead to successful development. For children that may have mental or physical challenges, guided play allows for an alternative to typical classroom instruction that hits on necessary academic milestones, as well as biophysical and cognitive development that is not viable in other settings.

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WELL Building Standard Advancing Human health The WELL Building Standard is a rating system that seeks to advance human health and wellness in buildings. WELL outlines ten categories that address different aspects of human health and has features that design teams can meet in order to achieve a WELL building rating. The WELL Certification has been created through thorough researched by the International Well Building Institute. As they have created their Certification standards, they have been guided by the following values.

Equitable

Global

Evidence based

Technically robust

Customer focused

Resilient

The following ten concepts make up the WELL building standard, each one relating to a specific area of biological, psychological, and social health.

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Air Achieve high levels of indoor air quality

Water Ensure quality, distribution, and control of drinking water

Nourishment Provide for and encourage nutritional eating

Light Promote visual, mental and biological health through lighting

Movement Promote physical activity in every day life

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Thermal Comfort Promote human productivity via thermal preferences

Sound Bolster occupant health and wellbeing through acoustical comfort

Materials Reduce human exposure to healthimpactful chemicals

Mind Promote mental health to address cognitive and emotional wellbeing

Community Build a culture of health that accommodates diverse population needs 25

Principles of Biophilic Design Innate Human Connection to Nature

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Non-visual connection with nature

3

Non-rhythmic sensory stimuli

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Thermal and Airflow variability

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Presence of Water

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Dynamic and Diffuse Light

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Connection with natural systems

Natural Analogues

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Visual connection with nature

Nature of the Space

Nature in the space

Biophilic Design is a concept that has been seeing increased attention in the design world in recent years. It hinges on the idea that all humans have an innate connection to the patterns and rhythms of nature. Science has shown different ways this theory manifests, including a correlation between nature and stress reduction, greater productivity, faster healing, more creative thinking, and overall better wellbeing. Sustainability consulting firm Terrapin Bright Green has outlined fourteen patterns of biophilic design to identify ways biophilia can be applied in design.

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Biomorphic forms and patterns

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Material connection with nature

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Complexity and order

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Prospect

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Refuge

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Mystery

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Risk/Peril

Theories of Human Behavior: Attention Restoration Theory Importance of Nature as a restorative experience

Developed in the 1990s, a time of technological advancement and more indoor entertainment by Rachel and Stephen Kaplan

Overview

Part of the body of Stimulation Theories: Our senses can be underwhelmed, overwhelmed, or properly met

Attention Restoration Theory *Note: The Kaplans argue that time in nature is the most impactful restorative experience Effortless Attention Brain has time to rest, does not require energy to engage, happens through restorative experiences

Restored Ability to concentrate, energy dedicated to the task at hand

Directed Attention Goal-oriented or intentional focus

Attentional Deficit Mental fatigue due to stimuli overload, inability to concentrate

Investigations have been conducted in the workplace, schools, prisons, and healthcare settings. In all of the studies, time spent away from tasks and in nature proved to be beneficial; lower crime rates, higher productivity and feelings of wellbeing, reduced negative moods and fatigue, and quicker and more pleasurable healing experiences. In the context of healthcare, gardens have led to more favorable outlooks on recovery in patients as well as happier and more energized healthcare workers. While empirical evidence to support and verify this theory is still developing, observational and self-reporting studies are showing mental, physical, and emotional benefits of providing individuals with periods of effortless attention in nature to restore their attentional and mental capacity.

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Team Research study: Psychological Healing in Interiors Supporting psychological wellness during recovery This semester, I conducted a research study with two other colleagues to study ways to improve psychological wellness during recovery from trauma and illness. The following details the process and results of our study.

Objective Our goal was to understand people’s current experiences with healing and recovery so that we can understand how the interior environment can play a role in improving that experience.

Guiding question How can we create a psychologically supportive space that promotes healing?

Methods Two surveys Survey one: General Public

Survey two: Professional Expert

Goal: gathering first person recovery data Demographic: Sent to individuals who are/have been a) in distress b) in recovery Respondents: college students, those facing mental health crisis, those facing pregnancy crisis

Goal: gathering third person (professional observation) recovery data Demographic: Sent to those who a) interact with distressed/recovering individuals b) have expertise as to healthy psychological functioning Respondents: Behavioral therapists, medical professionals, neuroscientists, emergency management personnel, child development experts

Question topics Line, color, shape, pattern, wayfinding, furniture, light, activity, scale, enclosure, biophilia, stimuli, acoustics, artwork, and control

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Findings There were three areas that garnered the most responses between the preference questions and the free response opinion questions.

Identity of the Individual

Environmental Characteristics

Behaviors for healing

Giving the individual choice and control over their environment

Utilizing natural elements and natural light

Emphasis on talk therapy and conversation

Establishing privacy and seclusion to create environment of safety

Emphasis on mindful activities, ranging from still activities to high movement

Including symbols of positivity and unity within the human experience Implications

Control Empowering the individual to feel in control of their environment has a range of applications. It can include furniture choice, adjustable furniture, adjustable lighting options, thermal control, acoustic control, and the ability to navigate space independently.

Symbolism The inclusion of cultural symbols can go a long way in creating a shared bond amongst individuals. An individual in distress may see a cultural symbol of positivity, resilience, or peace and know that their healthcare providers and peers all understand that same connotation, creating an atmosphere of unity Nature As has been proven in studies in the effect of nature on healing, inclusions of nature in the built environment bring peace and stress relief.

Privacy A sense of seclusion is key to a sense of security between the individual and their healthcare team. By eliminating feelings of vulnerability, anxiety levels decrease and more mental effort can be directed towards to body’s natural pursuit of healing.

Talk therapy Spaces need to be oriented for conversation. This means furniture, space planning, and a spatial quality that makes conversation possible, natural, and open. One provider even pointed out that being seated at the same level as an individual created a better sense of empathy and togetherness, leading to greater trust and soothing in the individual.

Mindful activity Sometimes mindful activity needs very little space, such as meditation, writing, drawing, or deep breathing, so spaces need to be tuned into the human scale and not disproportionately large or small. Other times mindful activities involve full body movement, such as yoga, dancing, or exercise, and spaces need to be large enough to accommodate full body movement without feeling intrusive or restrained.

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Khoo Teck Puat Hospital, Singapore 1.1 Million square feet 590 beds Winner of the Stephen R. Kellert Biophilic Design Award from the International Living Future Institute

“With Khoo Teck Puat, we see that biophilic design elements and attributes should not only be considered as part of the design process, but also as part of the healing process.”

- Architect Stephen Kiernan

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Description This design is based on the site, responding to the existing pond by creating a V-shape mass that opens up to its possibilities, embracing the nature. This v-shape allows breezes from the exterior to come into that center space, reducing energy usage. Believing strongly in the power of nature during healing, the architects designed the central courtyard to span high into the air, bringing nature to patient windows on higher levels. This design appeals to multiple senses, with views and smells of plants and natural elements, sounds of falling water, and breezes from open air elements. The architect designed the courtyard and responding architecture around a winding path with terraced levels, allowing for little alcoves and places of retreat for patients and families.

The incorporation of this open air courtyard has also made it a social destination for the community, with many people often coming to walk around and enjoy the beauty of the design.

Relevance to my project This hospital sets a design precedent for hospitals in Singapore. Across multiple Singapore hospitals, there is a heavy reliance on biophilia, nature, and specifically, plant life. This biophilia is characteristic of other built designs in the country (i.e. the airport). Overall, as a very clean and nature-focused country, it is important to respond to the national attraction to and benefits of nature by integrating it into my hospital without being repetitive of other projects.

Things I am taking with me: 1. Nature as a healing component 2. Path through a mass to create individual moments 3. Contributing to social infrastructure - giving back to patients and community 4. Sensory experience

Path and alcoves through green space

V-shaped mass with central courtyard

Nature brought up to patient level

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KPIS Kindergarten, Thailand 15,070 square feet

Description In designing this kindergarten space in Bangkok, Thailand, Please Feel Invited Architects pursued the design of a space that would provide learning opportunities for children at all times. Largely, they played off of the natural curiosity of children to take walls, make them interesting, fun, and engaging, and incorporate learning and development opportunities, such as visual, tactile, and motor skill development. Not only did they incorporate these elements into the wall surfaces, but they expanded the volume of the wall to meet the needs of certain space challenges, such as storage, access, and visibility.

In doing this, they provided a structure to house toys and play stations that can often be bulky. They coupled this with storage spaces and display boards to allow for growing space needs and rooms with new and developing functions. As a final detail, they designed the walls specifically so that functions only appropriate for adults, would only be accessible higher above.

“In every area where children are stopped while doing activities or in between the joints of the functional area, they can learn and develop their own vision in various fields.

Anytime.”

- Architects Please Feel Invited

Relevance to my project Studying how children are curious and need to play for their development is the key of this design. Through playing, children’s natural curiosity guides them and they learn so much about the world, in turn keeping their brains and bodies healthy. Additionally, the creative approach to spatial challenges is a good example of addressing necessary spatial requirements that will lead to a functional, accessible, and convenient user experience.

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Things I am taking with me: 1. Creative approach to spatial volumes 2. Use of architecture to help children develop important skills 3. Combining needs for different users in a tailored and safe way

Wall design includes developmental skills

Interactive wall combines play, safety, and storage

Wall’s at child’s height are for play, higher is for adult use

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28,000 square feet

Center for Autism and Developmental Disorders - Maine Behavioral Healthcare Portland, Maine, USA Description This project addresses the complex and interrelated set of needs that comes for children with autism and other developmental disorders. This space incorporates multiple services, including child day treatment, child and adult outpatient treatment, and clinical research. Spaces range from classrooms, where students use advanced audiovisual technology and biosensors that allow study on physiology and emotion, to a gym space with practice stairs to work on developing fine motor skills, to a life skills room, where individuals can practice developing life skills in environments that might be overwhelming to them, such as the grocery store, the hair salon, dentist, etc. Architectural firm E4H worked closely with the client and their research, working largely from evidence-based design, to specifically address how materiality (such as color tone, familiar materials, and low VOC emission materials) can provide stability both psychosocially as well as physiologically.

“You have to design for children in a wide age range, for children with mobility challenges, and for children with behavioral disorders. Each of these criteria brings its own set of challenges which must be balanced to create a cohesive whole.”

- Architect Jon Boyd 34

Relevance to my project This project shows how effective interior design can be when it comes to addressing the needs of special populations, such as those with developmental disorders, which is what I will be focusing on at my hospital. The use of evidence and research is key in this project, and everything from shaping architectural space to FF&E selections reflects the research. Lastly, the room tailored to developing life skills shows the way that designers can be part of an integrated healthcare team when it comes to shaping the treatment and full health of an individual.

Things I am taking with me: 1. The importance of evidence-based design 2. How color and social connotations of material can affect the mind 3. The use of architecture to address developmental needs for special populations (physical, mental, social)

Gym space has amenities to develop motor skills

“Practice room” gives patients life skill development opportunities

Low VOC, acoustic finishes control space offering warmth and familiarity

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Design Preparation

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Code Assessment Occupancy Classifications Institutional Group I-2

Sleeping areas

Treatment areas

Outpatient areas

Rehabilitative areas Business Group B

Imaging/Technician areas

Offices/Administration areas

Assembly group A-2

Work Cafe

Dining Hall Lobby Assembly Group A-3

Employee Gym

Guest Gym

Square footage allocations

1st Floor Patient and Family care

2nd floor Staff Space

Occupancy I-2 - 210 people B - 106 people A-2 - 579 people A-3 - 32 people Total - 927 people Egress Minimum distance between exits: 140’ 9” Is the building sprinklered: Yes Maximum travel distances

First floor: 95’

Second floor: 115’

Third floor: 115’ Maximum dead end corridor length: 20’ Minimum egress corridor width: 72” (96” in areas where bed movement is required) Exit signs should be placed to be visible on egress paths of travel, anywhere there is a change in direction or at the exit.

3rd floor Rehabilitation and Outpatient treatment Plumbing Water Closets

Men: 11

Women: 13 Lavatories

Men: 8

Women: 8 Water Fountains: 5 Service Sinks: 2

ADA Clear distance on PUSH side of door: 12” Clear distance on PULL side of door: 18” Minimum door size: All fixtures need to meet ADA requirements, or provide equal experience alternatives.

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Adjacency and IEQ Assessment Necessary spatial relationships Office suite Exam rooms Nurse stations Waiting areas and reception Storage Lobby Dining hall Locker rooms Labs Technician/testing rooms Employee gym Guest gym Work cafe Rehabilitative play spaces Family wellness rooms Employee wellness rooms Bathrooms Operating rooms Social therapy rooms Garden Track Aquarium Art room Patient rooms Employee lounge

Essential adjacency Ideal adjacency Convenient adjacency

Indoor Environmental Quality Assessment Assessing particular user needs for environmental quality is critical in ensuring the most supportive spaces in this setting. Regarding light, patient spaces need to offer a high degree of adjustability, as some conditions will require high levels of light during visually demanding tasks, while other conditions require low light, such as sleeping or mitigating a panic response. Additionally, the presence of natural light and exterior natural views have been shown to reduce levels of anxiety in patients in recovery. Employees doing task work need to have adequate lighting levels at their work areas during all times of the day. Regarding acoustics, patient-provider confidentiality is a legal mandate, so spaces need to control noise and focus on speech privacy. Sound transmission is also a concern given the noise from machinery and activity 24 hours a day.

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Space plan prototypes

Exam room

Inpatient sleeping room

Sample collection lab All space plan prototypes taken from Medical and Dental Space Planning by Jain Malkin

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Radiography imaging room Ultrasound imaging room

Operating room

CT imaging room All space plan prototypes taken from Medical and Dental Space Planning by Jain Malkin

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Sources

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