Showcase 8- Lentz Public Health Center

R E C R E AT I N G

PUBLIC H E A LT H OF

IN NASHVILLE

Lentz Public Health Center

LOC ATION

CL I EN T

SE RV I C E S

Nashville, Tennessee

Hospital Corporation of America (HCA)

Architecture

Metro Nashville Public Health Department

Civil Engineering Environmental Graphics and Wayfinding Interior Design MEP Engineering Structural Engineering Workplace Strategy

BEFORE: The old facility was originally built as a fallout shelter that could convert into a hospital should a catastrophic event occur. Interior partitions were built of concrete block, making it impractical to renovate.

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LE N TZ PUBLIC HE ALT H CE NT E R

amed after Dr. John J. Lentz, the first health director in Nashville and Davidson County, Lentz Public Health Center has successfully served the Metro Nashville community for more than 50 years. Built in 1958, the original Lentz facility had become a limitation to the continued advancement in service that the Metro Public Health Department (MPHD) sought to provide to the community, due to age, building envelope failure and environmental concerns.

In a unique public-private partnership and land-swap agreement, HCA, in association with MPHD, selected GS&P to provide architecture, engineering, interior design and workplace strategy services for a new 106,000-square-foot facility that would combine administrative office space and public health clinics in a new, more visible location.

“One of the overriding goals of building the new facility was to create a new presence for public health in Nashville,” explains senior architect Ann Trent. “Charlotte Avenue—a major corridor running in and out of downtown—was the perfect place for it. It’s much more accessible to the public than the previous location.”

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One of the overriding goals of building the new facility was to create a new

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presence for public health in Nashville.

ANN TRENT, S ENIO R ARC HITECT

Originally constructed as a fallout shelter that could convert into a hospital should a catastrophic event occur in the city of Nashville, the existing building’s limitations were far too great to consider a renovation effort. Trent explains: “The old facility on 23rd Avenue North was essentially a concrete bunker that was built for permanence, not for flexibility. Every partition was a masonry block wall. So to try and tear those walls down and create open office space was virtually impossible. It also needed upgrades for a variety of issues, including envelope performance, air quality and accessibility. It was clearly time for Metro Public Health Department to relocate to a new, more welcoming space that not only reflected their dynamic character, but also met their growing needs.”

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GUIDING PRINCIPLES

Exemplifying MPHD’s mission to “protect, improve and sustain the health and well-being of all people in Metropolitan Nashville,” the design of the new facility was driven by a key set of guiding principles.

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LE N TZ PUBLIC HE ALT H CE NT E R

“At the beginning of the project, we conducted a workplace strategy. Out of that came guiding principles that were developed by GS&P and the client in tandem,” says Trent.

“Everyone who was brought on board as part of the design and construction team was given a list of the guiding principles, and sticking to those throughout the

project not only helped us support the client’s mission, but also allowed us to achieve all of their objectives.”

Consistent with the client’s culture, values and mission, the guiding principles centered on activating the workplace, keeping it flexible for change over time, and providing a healthy, accessible and sustainable building for the city of Nashville.

GUIDING PRINCIPLES

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Enhance services through hospitality, efficiency, equality, accessibility and flexibility.

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Provide facilities that support community connection, interaction and outreach.

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Provide a place of safety, security and privacy.

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Express a culture of compassion and caring toward a diverse community.

Set an example for healthy living.

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Act as a “good steward� of both the environment and taxpayer dollars.

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Visitors in the main lobby area can look up and see Metro employees literally ‘walking the talk’ of healthy living and physical activity in their workplace.

ANN TRENT

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LE N TZ PUBLIC HE ALT H CE NT E R

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A HEALTHY DESIGN FOR

To help support and encourage a more active lifestyle in the workplace, design elements were integrated into the space that would allow employees to interact with the building.

“One of the guiding principles of this project was to embody healthy living and inspire physical activity, and our design achieves that in a number of ways,” says Trent. “When you enter the facility, a monumental stair is prominently featured within the three-story atrium. Its placement encourages staff and patrons to use the stair as opposed to the elevators. There’s also an interactive

Certain design elements promote a more active workplace, such as the 1/8-mile walking loop around the third-floor perimeter, the staff fitness center, and the monumental stair in the lobby.

art component that detects people’s movement up and down the staircase, which makes taking the stairs a more fun experience.”

Further promoting movement and activity, the design team incorporated a 1/8-mile indoor walking loop around the perimeter of the third floor.

“The walking loop surrounds the work stations, and staff will often hold ‘walking’ meetings on the track,” says Trent. “Visitors in the main lobby area can look up and see Metro employees literally ‘walking the talk’ of healthy living and physical activity in their workplace.

It sends a subtle message.”

Also supporting better health, printers and breakrooms were centralized on each floor to encourage staff to get up and walk, while an on-site fitness center allows employees to exercise before or after work, or during their lunch break.

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26TH AVENUE NORTH

ICI

L FE

A

E RE ST

T 1/4-MILE COMMUNITY WALKING LOOP

STORMWATER QUALITY BASIN

HCA PROPERTY

MTA STOP

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LE N TZ PUBLIC HE ALT H CE NT E R

B-CYCLE STATION

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U AVEN E T T LO CHAR

THE STORMWATER QUALITY BASIN

STORMWATER QUALITY BASIN

B I KE

L ANE

B I KE

L ANE

Aside from being home to a public service institution, the facility engages the community in a number of ways via interior and exterior features that can be shared.

For example, the multipurpose room on the building’s ground floor can be utilized by any Metro agency or community group, even after hours. Amenities such as the atrium (as a pre-function space) and the demonstration kitchen are also available for shared events.

At the exterior, the site features a ¼-mile outdoor walking loop that is open to the public, and a street-front plaza that features a solar-powered bus shelter, bike rental, site furnishings and bike racks.

“Metro Public Health Department’s mission ties into Mayor Karl Dean’s NashVitality initiative, which aims to activate the city,” says Trent. “Bike lanes were added along Charlotte Avenue as Lentz Public Health Center was being constructed, and we implemented a solar-powered B-cycle kiosk on the front plaza offering a convenient location where people can engage in the city’s bike-share program.”

“The public transportation aspect was also important because a large number of clientele who go to Lentz take public transport,” adds architect and project coordinator Ryan Rohe. “It was significant enough that it was one of the main improvement factors that Metro talked about over the old building. Accessibility to public transportation was so much more difficult at the 23rd Avenue location. With Charlotte Avenue’s bike lanes, sidewalks, and a dedicated bus line that’s a straight shot to just about anywhere in the city, the new health center was primed and ready to be a much more accessible facility for the general public.”

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SUPPORTING

Slightly smaller than the original Lentz Public Health Center, GS&P designed the new three-story facility to effectively support the evolving clinical and administrative needs of five public health bureaus: Population Health; Community Health; Environmental Health; Family, Youth and Infant Health; and Finance and Administration. Combined, the departments provide a wide range of public health services under one roof, including immunizations, food inspection services, dental care, TB screening, pest management services, nutrition counseling, disaster preparedness and automobile emissions program management.

“People are amazed at what’s inside this building,” notes Trent. “It’s

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LE N TZ PUBLIC HE ALT H CE NT E R

especially impressive if you think about the fact that within 106,000 square feet there are the five different public health bureaus and their associated direct lines of service clinics.”

Clinic space is located on the building’s first and second floors, with administrative space to support more than 300 employees located on the second and third floors.

“The workplace strategy, along with a clinical process map, was developed in order to drive design decisions that boosted efficiency of space, flexibility, user satisfaction, and ultimately building effectiveness,” says Rohe. “The end result is a facility that doesn’t feel anything like your typical clinic—it feels more like a high-end office building.”

As part of the workplace strategy, an adjacency diagram was developed to drive design decisions.

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“

...the goal was to say that everyone is welcome.

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RYAN ROHE, SE NI O R A RC HITECT

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CLOCKWISE FROM FAR LEFT: Administration and low-volume clinics are located on the upper floors; both entrances can be monitored from a single security counter in the main lobby; Women, Infant and Children’s is a high-volume clinic located on the ground floor.

A PLACE OF , & Safety and security in the new facility were greatly improved over previous conditions. In the former building, patrons and employees had open access to corridors. In the new health center, administrative departments and areas where patient health information is stored are secured behind locked doors.

The new facility’s north and south entrances are visible from a single security desk, while the atrium provides a high degree of visibility for the groundfloor activity, as well as movement

from floor to floor via the monumental stair. Passive observation is a security feature of the lobby and the views that look onto the parking lot and public plaza facing Charlotte Avenue.

“It’s public health, so the goal was to say that everyone is welcome,” says Rohe. “Anyone can walk in, but there’s a security desk as you enter the building, and the populations are separated from there. For instance, those seeking care for women, infants and children go to the right, other services are to the left.”

“Some of Nashville’s most vulnerable come to the center for healthcare

needs, so higher-risk populations, such as those diagnosed with TB, are directed to different entrances that are remote and segregated for public safety,” adds Trent. “The way the building is designed, the public lobby is connected to the monumental stair, and the monumental stair connects public lobbies on the upper levels that are secured. So nobody goes anywhere without someone letting them in.”

Coming up with design solutions for the different populations, however, came with a number of challenges.

“We had to approach every clinic like it was its own project,” explains Trent.

“Every clinic had its unique needs and clientele. So the design solution for one clinic wasn’t necessarily the solution for another. In terms of placing those populations programmatically, we located all of the high-volume clinics and agencies on the ground floor. The smaller specialty clinics were placed on the second floor along with administration.”

“We achieved a certain amount of flexibility with the clinic zones, which are designed to expand and contract as the needs change for the various bureaus,” adds Rohe. “The exam rooms are all identical, so there’s no hierarchy—it’s very generic and very flexible.”

As a testament to the design’s success, volumes for the Women, Infant and Children’s clinic increased an average of 264 visits per month during the third and fourth quarters of 2014.

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& BUILDING DESIGN SOLUTIONS Designed for LEED Silver certification, significant energy conservation and reduction measures were incorporated into the new facility, including a building envelope design that outperforms the requirements of Metro’s current code.

“In terms of thermal performance, the entire envelope of the building is much better performing than the previous facility when it comes to maintaining temperature and humidity on the inside,” says Trent. “We optimized energy performance to the tune of 14-16 percent over the typical baseline energy consumption for a building of this type.

“In regard to air quality, the facility features a mechanical system with specially designed pressurization for airborne diseases. Specifically, in the TB Prevention Clinic, the system provides 100-percent outside air and it’s all negative pressure, so none of the air inside the clinic gets into the other spaces surrounding it—it’s exhausted straight out and fresh air comes in.

Building-wide, the design provides 30 percent more fresh air than is required by code.”

Also enhancing air quality, GS&P, in association with former bureau director of environmental health, Brent Hager, designed a ground-breaking system for radon mitigation.

“This region of the country is one of the most concentrated locations for high amounts of radon gas, which is known to

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LE N TZ PUBLIC HE ALT H CE NT E R

cause lung cancer,” explains Trent. “We worked with Brent Hager on a mitigation system for the building and designed it specifically for the site conditions. It’s a fairly robust system of ventilation pipes that are below the building slab. The pipes collect the radon gas and vent it out through the roof and into the atmosphere. The radon numbers for the building are at historic lows, and the design has become the basis of design for pending Metro Codes.”

Other sustainable features include a state-of-the-art lighting system controlled by daylight sensors and occupancy sensors; water-efficient plumbing fixtures; an on-site retention pond that collects stormwater, allowing for slower, cleaner and more manageable flows into the stormwater system; and a 20,000-gallon rainwater cistern that collects roof rainwater and supplies a subsurface drip irrigation system for sod and plantings surrounding the building.

“Being good stewards of both the environment and of taxpayer dollars by utilizing sustainable and smart building design solutions was one of the key drivers for the project,” notes Trent.

“This new facility embodies that tenet in multiple ways that are already contributing to a better quality of life for the community.”

1416% BTUs Cumulative 178.4 89.2

Under Typical Baseline Energy Consumption

30%

More Fresh Air Than Required by Code

NO

Potable Water to Irrigate

0.0

ABOVE: The building envelope was designed to optimize energy performance by maintaining internal temperature and humidity.

RIGHT: The facility features a mechanical system with specifically designed pressurization for airborne diseases. A custom radon mitigation system was also installed.

BELOW: State-of-the-art lighting is controlled by daylight and occupancy sensors.

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TO THE CITY AT LARGE Recreating the face of public health in Nashville, the new Lentz Public Health Center serves the Metropolitan Nashville area in a brand-new way, providing the community with easy access to a firstclass facility that is safe, innovative and sustainable. The design was honored in the ULI Nashville Excellence in Development awards in the Public Sector-Large category.

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LE N TZ PUBLIC HE ALT H CE NT E R

“The client wanted a welcoming, iconic building with its own distinct presence, and its form truly opens out to the public saying ‘come one, come all,’” says Trent. “The way in which the design embodies the mission of the public health department is not only an example to other clinics and corporate environments, but to the city at large. Their mission is expressed in the building and in the activity of the building. And that mission isn’t just about the programs inside. It’s about enhancing the community and leading by example.”

“This building is a big change for us,” stated Dr. William S. Paul, director of Nashville’s Metro Public Health Department, at the facility’s ribbon-cutting ceremony. “For those of us who work here and those who visit us, it is literally a breath of fresh air. The building represents a substantial commitment to a healthier Nashville, both for the services we will provide, and also as a model of healthy design for a healthy workplace.”

Nashville Mayor Karl Dean also echoed the project’s significance and success at the opening ceremony.

“This facility is part of a series of investments that we as a city are making to provide the resources our citizens need to make the right choices—the

healthy choices—for themselves and their families. I am also excited that this project is supporting the revitalization of Charlotte Avenue.

“Shortly after breaking ground on this building, we opened the new 28th/31st Avenue Connector only two blocks away. It connected our city in a way that helped address the divide created when the interstate was built decades ago. Combined, these two projects are a tremendous shot in the arm for Charlotte Avenue, and it’s exciting to see new economic development following in the area. Clearly, the new Lentz Public Health Center will benefit our city in a number of ways, and serve as a prime example of how important health is in our community.”

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...the new Lentz Public Health Center will benefit our city in a number of ways, and serve as a prime example of how important health is in our community.

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KARL DEAN, NA S H VI L L E MAYO R SHOWCASE

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TE AM PM William M. McCowan, aia, ncarb, leed ap

PP Ann Seton Trent, aia, ncarb, leed ap PC Ryan R. Rohe, aia, ncarb, leed ap PD Jeffrey W. Kuhnhenn, aia, leed ap ID Jack E. Weber, iida, mcr, leed ap EOR John R. Horst, p.e., leed ap, cpd

Tisha Bandish Eric Bearden, aia Helga Bolyard Stephen Brown, p.e.

Pamela Bybee Kenneth Church, rls Adrienne Ciuba, aia, ncarb Chandra Clonan Anthony N. Coles Tracey Curray Stephen Dodson Bruce K. Dretchen Joyce Ferguson Martha T. Fox, iida, ncidq, leed ap Matthew L. Freudenthal Jason B. Fukuda, p.e., s.e.

James D. Graham Gregory K. Gurney Justin Hethcote, p.e., leed ap bd+c, cxa Douglas E. Karaszewski, leed ap Melissa Long, eit Diane Marable Blaine Matthews, p.e., leed ap William C. Mays Elaine McDowall David V. McMullin, p.e., leed ap Louis Medcalf, fcsi, ccs Terence S. Mulvaney, rla, clarb Sydney Reddoch Trey Rudolph, rla Marc A. SauvĂŠ, lean Mike Summers Bryan A. Tharpe, p.e.

Bogue M. Waller Jr., p.e.

Johnathan C. Woodside, p.e., leed ap o+m, c.e.m., gbe

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