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MEDICAL OFFICE PAVILION COMMUNITY HEALTH NETWORK location: Anderson, IN size: 68,000 SF services: Programming, Architecture, Interiors cost: $13 Million, construction completed: March 2017

Through the collaboration of Community Health Network and a private developer, the Community Health Pavilion offers local residents access to new and convenient healthcare services. The building tenants are pivotal medical practices within the community and have moved from other facilities that were not meeting their comprehensive needs. Site influences such as vehicular assess and setbacks required that the building form a square shape. Additionally, its interior spaces were designed around a common entry and specific suite adjacencies that required shared resources. The project’s design process included the involvement of a variety of stakeholders including the developer and pavilion manager, which fostered an innovative approach that is very unique in the breadth of other similar regional buildings.

project features OT and PT with Rehab Full Gym, Locker room, Rehab Pool Shared X-ray Imaging Behavorial Health Services: • Infusion • Shared Lab • MedCheck Suite • Medical Offices • MedCheck Suite • Medical Offices

INTENSIVE CARE UNIT SUITE COMMUNITY HOSPITAL ANDERSON location: size: ervices: cost: completed:

Anderson, IN 12,000 SF, Phased Programming, Architecture, Interiors $4.6 Million, construction September 2017

The Intensive Care Unit grew from twelve patient rooms to seventeen larger patient rooms. The ICU planning and design was a thoughtful consideration of circulation, nurse communication, mechanical needs, and infection control. Custom head wall systems with anti-microbial finishes, patient lifts, bariatric suites, and isolation rooms were included in the project. Touchdown nurses stations with patient observation windows adds to patient care and staff workflow. In addition to the enhancements made in the ICU, the OT/PT area has expanded 35%. Neuro/Ortho now has a newly renovated toilet room in every expanded and upgraded patient room. The Pediatrics Unit is now confined to one side of the floor, for easy access to young patients with better control and security in that area. The Obstetrics Unit includes adding two LDRP rooms, nursery renovation, expanded waiting room, and a spa-like tub room.

DINING COMMONS RENOVATION COMMUNITY HOSPITAL ANDERSON location: size: services: cost: completed:

Anderson, IN 11,752 SF, Phase 1 & 2 Interior Design $3.3 Million, construction July 2016

Phase I – New Servery and Dining Experience: The hospital’s dining experience took on a complete overhaul, making overall navigation easier, providing more room to find and purchase food within the servery, and also showcasing more options for patients and visitors. The master plan design deliberately gave users easy-grab options and offered a variety of seating spaces to allow for group meetings and 24-hour use. Building upon the existing architectural skylights that provide ample daylighting, the overall experience was enhanced with updated finishes and furniture. Phase II – Remodeled Kitchen for Efficiency: The kitchen’s renovation capitalized on keeping the existing dishwashing systems and kitchen hood in place, while re-arranging the periphery areas to create a more modern and efficient space.


Anderson, IN 4,500 SF Programming, Interiors $595,000 Interiors $255,000 technology August 2012 2012 AIA Indianapolis Honor Design Award

Ivy Tech Community College completed the Healthcare Simulation Center as a part of their East Central Regional Campus. Made possible with a partnership from St. Vincent Anderson Regional Hospital, this 4,500-square-foot renovation educates over 1,000 students and medical professionals annually. The purpose of a healthcare simulation center is to provide training and instruction for medical professionals and students to practice real-life procedures. Performing these scenarios helps reduce insurance rates, medical human error, and create an increase in patient care satisfaction. With these enhanced facilities, students can improve their technical skills, critical thinking, and decision making.

NURSING EDUCATION SIMULATION LAB INDIANA UNIVERSITY SOUTHEAST location: New Albany, IN size: 90,000 SF services: Programming, Interior Design cost: $374,000 completed: August 2014 recognition: 2015 American School & University, Educational Interiors Showcase, Citation Winner, 2015 Architectural Portfolio, Outstanding Building

The rapidly growing IU-SE Nursing Department underwent a complete transformation and expansion of their simulation laboratories. This expansion allowed the school to offer a large, twelve bed basic skills lab and create three dedicated high-fidelity simulation labs for sophisticated interactive mannequins. These specialized rooms allow students to learn in a professional atmosphere adjacent to a large control room, which offers real time observing that is unique to IU-SE’s program. Entering the space, a paneled resin feature wall was designed to showcase the main project donors, which creates a bold entrance sequence. The same finishes are brought into the skills lab where the main circulation path is defined and terminated on an accent training wall. Flanking each side of the skills lab area, is a raceway for power and simulated medical gasses specified to allow equipment to move over time. Professionalism and flexibility were driving factors in this tranformation that will allow IU-SE to adapt to changing trends and technologies.


Anderson, IN Interiors + equipment coordination June 2005

The project includes support spaces, equipment rooms, MEP systems upgrades, structural adjustments, and very close coordination with equipment cabling and shielding. The quality of the equipment and success of the space quickly allowed this unit to support many intervention procedures beyond its original intended use. The location of this facility was decided by several factors including a study of vibration and utilities.

KARDATZKE WELLNESS CENTER ANDERSON UNIVERSITY location: size: services: cost: completed:

Anderson, IN 133,000 SF Programming, Architecture, Interiors $12 Million, construction September 2002

Anderson University needed a new wellness center to house numerous athletic, academic, and administration programs, which would assume a broad role for the university’s larger campus community. The facility was also intended to be a strategic addition to the school’s sports medicine program, to help attract and retain top academic talent. Because of the building’s central location, it needed to act as a welcoming environment for students to meet, relax, and study. krM’s approach to this project mirrored the university’s wellness principles: academic, physical, and spiritual elements working in unison to create a fulfilling whole. The Center does not just serve as a recreation center – it actually helps students and faculty facilitate self wellness in many capacities.

SURGERY CENTER COMMUNITY HOSPITAL ANDERSON location: Anderson, IN size: 7,000 SF Addition 9,000 SF HVAC Upgrade services: Programming, Architecture, Interiors cost: $5.5 Million completed: May 2013

Community Hospital Anderson has been one of the leaders in exploring robotic surgery through the DaVinci System. The use of the DaVinci System for surgeries and the need for improved waiting areas, surgery area storage, a new entry for staff, and other changes, was achieved through this project. The expansion is in the area of the facility that is dense with buried utilities, existing points of egress as well as the ongoing surgery schedule. The project was carefully planned to avoid disruptions and accommodate these challenges. The end result includes two new state of the art operating rooms, surgical storage, a comfortable waiting area, reception, check-in stations, a new secure staff entrance and a new hospital receiving dock.


Anderson, IN 6,300 SF Programming, Architecture, Interiors April 2013

The same day surgery area has been changed to accommodate better and larger access to patient bays, new finishes, furnishings, improved nurse work areas and better work flow processes. Features: • Remodeled 18 prep/ recovery bays • New centralized nursing station • Change of staff flow and processes

location: Anderson, IN size: 18,000 SF services: Programming, Interiors cost: $4.6 Million, construction (included in ICU phased project) completed: April 2017

NEURO/ORTHO, OBSTETRICS, PEDIATRICS, OCCUPATIONAL & PHYSICAL THERAPY COMMUNITY HOSPITAL ANDERSON Community Hospital Anderson needed to increase the number of beds and quality of rooms for the Intensive Care Unit and Neuro/Ortho Surgery Recovery Unit. After studying options to expand the current ICU with a building addition, it was found equally cost-efficient to relocate four units and expand one within the hospital through a series of carefully planned projects. These projects would upgraded units and expand overall space. One of the primary challenges for the project was enabling all patient care areas ito be able to maintain their size and operations throughout construction. The project was strategically phased and constructed in eighteen months and included upgraded facilities for Neuro/ Ortho, Obstetrics Unit, Pediatrics Unit, Occupational & Physical Therapy, and the Intensive Care Unit.


Anderson, IN 3,500 SF Interior Design November 2015

krM provided design services to the Callahan Neurosurgery Group previously and was asked to expand the space, including a new waiting room, exam rooms, and offices.

PURDUE POLYTECHNIC INSTITUTE, INNOVATION & EDUCATION CENTER location: Anderson, IN size: 90,000 SF services: Programming, Architecture, Interiors cost: $15 Million, construction completed: April 2017

Together with the vision of many community parters: the Purdue Polytechnic, the Flagship Business Enterprise Center, the City of Anderson, and several private partnerships. From the beginning, it became important for the project to celebrate the rich design and manufacturing history of the Anderson/Madison County Region. By forming a nexus of industry, academia, and government economic activities, the community partners were able to develop a continuum of education and application of STEM disciplines, from secondary education through college, and bridging into careers. Through these intentional partnerships, program planning and alchemy, an educated skilled labor force will emerge and contribute to the economic vitality of Anderson and East Central Indiana. Industry partners create the attraction and success by contributing developed markets, intellectual property, and end-users - domestic and international - while university and college participants integrate industry projects into curriculum and hands-on training that is immediately relevant outside the classroom.

ADDITIONAL PROJECT EXPERIENCE HOSPITAL MASTER PLANS Community Hospital Anderson Starting in 2004, krM worked with Community Hospital to develop a campus master plan addressing site circulation, building linkages, utility routes and likely locations of future spaces. Outpatient Imaging Center Community Hospital Anderson The Outpatient Imaging Center includes four exam rooms, two ultrasound rooms, a CT scan room, a general radiology exam room, a patient lobby, and several staff work areas. 8,400 SF HealthPlex - Brookville, IN Fayette Regional Hospital krM designed a new freestanding building, the HealthPlex, which has a state-of-the-art diagnostic imaging center, full service on-site laboratory, expanded urgent care capabilities and full-time family care. 22,500 SF Callahan Medical Suite Community Hospital Anderson krM provided design services to the Callahan Neurosurgery Group previously and was asked to expand the space, including a new waiting room, exam rooms, and offices. 3,500 SF Hyperbaric Wound Care Center Community Hospital Anderson Working closely with the equipment supplier, krM proved layout designs for the wound care center within the hospital. This included space and equipment layout, interior planning, interior design, med gas line routing, O2 tank planning and coordination with the ISDH. The result is a 4 chamber hyperbaric wound center. HEALTH & WELLNESS Community Hospital Anderson • Central Indiana Neurology Suite • Pediatric Unit • Histology Lab • Sleep Lab • OB Suite renovation

• Urology Associates • Pharmacy renovation • Patient Accounts • OR #8 renovation • Main Corridor renovation • Kabir & Malik Office • ICU Waiting Room renovation • Blood Draw Suites (multiple locations) • Main Entrance renovation • Emergency Room waiting area renovation • Cafe renovation • Pediatrics Wing renovation • OB Wing renovation • Guest Services and Lobby renovation • ICU Suite renovation • Medical Office Building master plan Community Hospital Network • New Medical Office Pavilion Fayette Regional Health • Heart Care Center & Rehab Area • Administration Office Renovation • Anderson Center for Sight, Surgery Center & Suites MEDICAL EDUCATION & ENGINEERING PROJECTS IU Southest • Judge Carlton & Sue Sanders Laboratory for Nursing Education Ivy Tech, South East • Nursing Simulation Lab IUPUI • Physical Education and Tourism Management (PETM) Natatorium: Office/Classroom Furniture • Hine Hall renovation • Health Science Classroom renovation Purdue Polytechnic Institute • Education & Innovation Center Anderson University • Hartung Hall, Science Building • Kardatzke Wellness Center

EVIDENCE-BASED DESIGN We have found evidence-based design to be an ongoing effort to bring the design process of clinical understanding, research and outcomes into the process of working with clients and their experiences. We have become familiar with the book "Healing Spaces" by Ether M. Sternberg M.D. Her writing consolidated many thoughts on how the quality of the place can affect healthcare outcomes and can be supported by science. Since that time, we have incorporated research of how spaces affect healthcare outcomes for the patient and the staff's ability to provide consistent quality care.

example: ICU Patient Rooms EBD Research and Prototype Rooms developed and put into use prior to the actual project. One of two fully functional and used prototype rooms shown above. The two rooms had differences to test, including overall room size.

We have studied the EBD processes through the HERD journal and other Center for Health Design publications. We have studied the three EDAC EBD process guides, and regularly attend seminars on the topic. We believe in this process and bring it to each project. For the reconfiguration of the ICU at Community Hospital, we provided research in space design and patient outcomes. This education process allowed the client and krM to engage in objective discussions that both complimented and sometimes conflicted staff preferences and experiences. One of the most important steps was to build two complete prototypes in an existing ICU area that allows the staff to test the rooms prior to the complete project. While every aspect of the evidence and suggested direction was not implemented, it allowed staff to objectively consider it to the proposed design and patient outcomes.

EQUIPMENT PLANNING As a part of our design process, we regularly plan for medical equipment. We recognize that this equipment, many times, cannot be fully known at the beginning of the design process but in fact, needs to be discovered through extensive planning. Our work has included: • Incorporating detailed equipment requirements into project designs. • Developing RFPs for select equipment types. • Coordinating efforts of multiple disciplines in the equipment implementation. • Inventory of existing equipment. • Space planning to accommodate existing and new equipment. • Selection of equipment finishes and integration into project interior design. example: Community Hospital Anderson • Interventional Radiology • Hyperbaric Wound Center • Imaging Center (CT, Xray, mamo) • Surgery Rooms Fayette Regional Hospital • Brookville MRI • Heart Care Center

We identify the inventory of existing equipment, allocate space, plan for the existing equipment, and work with the client to program, locate, design and specify new equipment. We have developed outline specifications for new equipment that is flexible for equipment vendors to respond, but not so tight that it becomes a completely price-competitive bid. We have found that this is a blend of creating guidelines for vendor responses and developing a relationship with the users that will evaluate and make final selection of the equipment. By advocating for this process early in the project, the equipment selections are made earlier and the design of the spaces can be more accurate in terms of mechanical connections, space planning and user anticipation for each space.

INFECTION CONTROL We are fully engaged in the conversation in infection control risk assessment both in the design and in the construction process. We understand the ramifications of infection control in hospital construction projects. Infection control is both embedded in the design for use after completion and required during construction. The example shown to the left is a sliding door concept that was carefully reviewed by the Community Hospital staff and discussed with ISDH for cleanliness during design before being included in the project

example: Community Health Anderson, ICU Patient Room

Examples Embedded in the Design • Staff and patient flow that encourages separation of traffic • Hand washing in the flow of staff patterns • Accommodation of air flows • Surfaces that are shaped and specified to not collect dirt and can be easily cleaned • Minimize fabrics Examples During Construction • Continual conversation and support during construction administration • Following Class I,II, III, or IV infection control standards during construction based on ICRA Matrix and Patient Risk Group • Vigilance to observe concealed spaces and not leave behind dust and other contaminants in the new space.

New Medical Office Building

CHA Surgery Center, New OR’s

AU/Purdue Conference Center

Ivy Tech Sim Lab

CHA Same Day Surgery

krM ARCHITECTURE A design studio of talented craftspeople, krM is dedicated to creating architecture and transforming buildings to serve the universal needs of people. Every detail and innovation flows out of the passion we have for the people who will use the spaces we create. As advocates for the communities we serve, we seek to design environmentally sustainable spaces that educate, inspire, heal and transform. Our firm has gained a reputation for award-winning design and was recently recognized as the 2016 AIA Indiana Distinguished Firm of The Year and with the 2016 Madison County Entrepreneur Award. Learning environments, adaptive reuse, and spaces for communities have formed the core of krM’s work. krM currently employs twenty-two people between its three offices – Indianapolis, IN; Anderson, IN; and Ann Arbor, MI. Throughout its history, the firm has had a commitment to breathing new life into older buildings, with two of its offices located in historic

“These projects could not have been delivered any better - on time, on budget, and met every expectation.” Joe Royer, Anderson University Executive Director of Facilities & Property Management

buildings - the Stutz Business Center in Indianapolis and the Historic Postal Building in Anderson Indiana - spaces we renovated ourselves. We support a highly active and collaborative design process that works in partnership with our clients and engages our consultants’ expertise. As part of a highly collaborative process, the firm’s partners lead and manage each project from beginning to end. We have participated in regional and national conferences and led many speaking engagements to better understand the opportunities and trends affecting our industry. As project delivery has evolved over the years, krM has responded with the latest technologies and closely collaborated with contractors and consultants to provide the best service to each and every client.

www.krMarchitecture.com Indianapolis, IN • Anderson, IN • Detroit, MI

Contact Mike Montgomery, AIA, LEED GA Partner, Architect e. mmontgomery@krMarchitecture.com p. 765.649.8477

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krM Architecture, Health & Wellness  

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