Leland Lawson - Senior Thesis Volume 1 - Research

DESIGNING FOR THE VISUALLY IMPAIRED VISION CLINIC IN PRAGUE, CZECH REPUBLIC

SENIOR THESIS

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LELAND LAWSON

LELAND LAWSON VOLUME I: RESEARCH FALL 2020

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TABLE OF CONTENTS Introduction 7.

8.

9.

Problem Statement + Thesis Statement The Client + Consultant Goals + Objectives

Prague, Czech Republic 12. Site Analysis 14. Building Analysis Precedent Case Studies 18. Lions Eye Institute | Davis Partnership Architects 20. Optegra Eye Hospital | IBI Group 22. UPMC Vision and Rehabilitation Tower | HOK Architects Research 26.

28.

30.

32.

34.

Healthcare Design Considerations Accessibility Designing for People with Vision Impairments Research Study Material + Color Research

Programming 38. Adjacencies 39. Codes Summary 40. Plan Prototypes Sources

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INTRODUCTION

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PROBLEM STATEMENT A healthcare facility to treat people who are blind or visually impaired, the project consists of approximately 50,000 SF among 3 floors, located in Prague, Czech Republic. This thesis focuses on materiality, light, and color to design a new facility for Praga Medica that can effectively advance vision treatment worldwide while also supporting the needs of people with vision impairments locally.

THESIS STATEMENT Light, color, texture, and material differentiation used effectively in an interior space creates clarity, independence, and personal empowerment for people with vision impairments, allowing them to live independent and productive lives.

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THE CLIENT The vision center is a branch of Praga Medica, a highly respected world provider of top quality healthcare. Established in 2009, Praga Medica is a medical tourism provider for people seeking medical services outside of their home country. The vision center treats patients from all over the world who travel to Prague for consultations and treatment from specialty ophthalmologists.

OUTSIDE CONSULTANT Shari Coolbaugh is an Optometrist at Eye Care & Surgery in Roanoke, Virginia. She attended Texas A&M and then completed her optometric studies at University of Houston - College of Optometry.

She will provide insight on designing a healthcare facility from a user’s perspective.

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GOALS AND OBJECTIVES Provide Ease for Visually Impaired Visitors The lighting design will guide users through the space and create hierarchy by defining signage and important landmarks.

Natural light will be limited and heavily controlled in exam rooms and patient waiting areas to provide comfort for patients with dilated eyes.

Clear and Understandable Navigation through the Space Contrasting surface colors and materials will be used to define floor, wall, and passageway boundaries.

Enhance a Sense of Place to Prague Because users of the space will be visiting from different regions of the world, the design will include artwork and imagery in each waiting space as peaceful visual distractions.

Support Wellbeing of Employees Though natural light will be limited in patient areas, all employee spaces will have a view to the exterior.

Promote Health and Safety All material selections will be easily cleanable to protect the health of staff and patients from around the world postpandemic.

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PRAGUE, CZECH REPUBLIC

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PRAGUE, CZECH REPUBLIC Population: 1,305,737 Population Growth Rate: 0.56% Median Age Range: 30-50 years Retirement Age: 65 years

Largest city of the Czech Republic Along the Vltava River Rich history with high tourism Accessible

Currently 16% of the population of Czech Republic is 65+ years

Religion: 50% Athiest Though Prague is filled with churches, periods of institutionalism turned many people away from religion

People Receiving Disability Benefits in Czech Republic: 425,788 In 1991, Czech Republic established the Government Board for People with Disabilities The Czech Republic provides an invalidity pension for people with a 35% decrease in ability to work

Tourism: between Jan 2020-March 2020, tourism reached 1,103,652 Highest tourism between June and August

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Comfortable summers with cold, dry, windy winters Average summer high: 68-77 degrees F Average winter low: 26-36 degrees F

Extreme Daylight Hours Shortest day of the year: December 21st (8 hr 4 min of daylight) Longest day of the year: June 20th (16 hr 23 min of daylight)

The building site was chosen based on accessibility to various forms of transportation and the ability to provide views and separation from noise. People who are blind or visually impaired often rely on their hearing for direction, clarity, and safety. It is important that the site of the vision clinic is understandable and accessible.

The location in New Town Prague incorporates both old and new architecture, making a fitting place for the building’s glass façade. The location is popular and accessible, providing visitors with nearby places to stay and things to do. The building is also located across from one of Prague’s largest parks, providing relief from the busyness of the city and creating nice views for visitors. The Yellow Line metro connects to New Town along with multiple bus stops.

The building is located at the corner of Resslova and Karlovo Nám. Directly in front of the building is a metro stop, bus stop, and large park. This provides an accessible location with relief from buildings and noise.

Latitude: 50.0757 Longitude: 14.419

The city of Prague has 3 main metro lines and various bus stations. The building is located directly adjacent to a metro stop along the yellow line, creating ease of access for patients.

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BUILDING ANALYSIS Address: Karlovo Nám. 10, 120 00 Nové Město, Czechia Square Footage: 50,000 Floors: 3

Structural Grid

Building Geometry

Implied Circulation based on Egress

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December 21st, shortest day of the year

June 20th, longest day of the yeaar

The front facade of the building faces East towards the main road, metro stop, and park. The longest arm of the building receives light directly from the North, minimizing glare on the longest stretch of the bulding.

The building consists of a main central zone with 2 extending wings on each end. There are 3 central skylights connecting the 3 floors and providing light. The majority of the exterior walls are glazing with a light shelf attached to the exterior to reduce glare. A courtyard exists between the 2 wings of the building.

Main entryway Main open stairs Egress/ secondary stairwells Courtyard

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PRECEDENT CASE STUDIES

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UNIVERSITY OF COLORADO LIONS EYE INSTITUTE Aurora, Colorado | Davis Partnership Architects 97,000 SF, Completed October 2014 An interview was conducted with Chris Klein, Project Manager of the UCH Lions Institute Project at Davis Partnership Architects “To address the issues of satisfaction and comfort for patients who are predominately sight impaired and have compromised mobility through intentional EBD lighting solutions. In addition, use evidence about color and layout to inform space planning and design to facilitate improved wayfinding and safe navigation�

Problems with the Original Design: Muted finishes did not provide enough contrast, making it difficult for patients to navigate around the space Lacked clarity at entrance because reception was rarely staffed. Patients had no visual cues on how to proceed in the space Lots of natural light causes disruption to patients whose eyes are dilated

Solutions: Space organized with centrally located waiting rooms.

There is a gradual reduction of light from exterior to interior space. The plan is organized to maximize natural light in staff areas and offices The lobby incorporates linear light to emphasize the path of travel and lighter finishes on the reception desk to highlight intended direction better Contrasting colors and textures now contribute to wayfinding

Programmatic Considerations: Space divided into pods based on specialty, each pod including 5-6 exam rooms, technician workstation, and Physician dictation space Waiting rooms and photography rooms shared between pods to cut down on necessary staff Located Physician work areas along windows with patient areas internal to account for vision sensitivity

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General Optometry

Clinical Trials

Eye Bank

Plastics

Low Vision

Cornea

Mechanical Refractive

Shell

Shell Optical Shop

Shell

Pre/Post Surgery

Non-Sterile Surgery Support

Auditorium

Administration

First Floor

Staff

Second Floor

Shell Sterile Processing

Surgery

Administration

Glaucoma Retina

Wet Lab

Shell

Third Floor

Fourth Floor

Shell

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OPTEGRA EYE HOSPITAL London, England | IBI Group 14,531 SF, Opened January 2016 The project involved the merging and unifying of 2 properties to bring together Optegra’s consultant and surgery centers. One project challenge was bringing natural light throughout the building while maintaining privacy and control for patients who are sensitive to light.

The spatial layout coincides with the horizontal split of the space set by the 2 different building structures, arranging space by the type of use. This minimizes travel distances for visually impaired persons.

Basement: Refractive suite used by patients sensitive to light Internal courtyard access

First Floor: Spacious consulting rooms

Second Floor: Surgical 2 operating theaters Stage one recovery room for infection control

Third Floor: Patient Recovery Textures, clean colors, and warm tones to feel more contemporary and less clinical

Fourth Floor: Staff Offices, meeting rooms, dining facilities Roof terrace to promote relaxation and collaboration

The design uses clean, fresh tones, pops of color, and sophisticated materials. Details such as artwork and imagery provide distractions for patients waiting who are unable to read a magazine due to limited vision.

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UPMC VISION AND REHABILITATION TOWER Pittsburgh, Pennsylvania | HOK Architects 410,000 SF, Opening late 2022 LEED Registered

The UPMC Vision and Rehabilitation Tower is a 9 story tower housing research, office, and conference areas with an attached 4 story building housing surgery, clinical, and pharmacy spaces.

Lighting strategies using contrast and brightness for wayfinding Materials and textures to aid people with canes Glass feature stair connects staff areas and creates a sense of gathering among employees The space includes an interactive healing center with exam rooms, therapy stations, and a central gym that encourages patients to participate in simulations that teach them real life skills A rooftop garden with training ramps and stairs to provide a safe and comforting environment to practice real life experiences

The design successfully uses materials, light, and contrast to support visually impaired patients and enhance wayfinding. The overall interior aesthetic is natural, calming, and bright.

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RESEARCH

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HEALTHCARE DESIGN CONSIDERATIONS

Accessibility All patient areas should be wheelchair accessible and include bariatric furniture Waiting areas, circulation, and exam rooms must accommodate people with different abilities including elderly, parents with children, people with limited mobility or vision, and bariatric patients

Privacy Minimum Floor Rating: Acoustical separation in exam rooms to increase patient safety and minimize distraction Spatial divisions at check in Strategically locate exam doors to decrease sightlines

Between floors (generally)

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Between floors (plant rooms)

60

Recommended STC Rating: Storerooms, utilities

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Toilets, changing rooms, ensuite

40

General office, lounge

45 (35 for wall to corridor)

Interview, consult, exam, inpatient bedrooms

45 (40 for wall to corridor)

AV room, dirty utility or lounge next to inpatient bedrooms

50 (40 for wall to corridor)

Plant room walls adjacent to offices / inpatient bedrooms/suites

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Infection Control Finishes should be chosen for durability, cleanability, and fire safety in order to prevent the spread of disease.

Hand hygiene facilities should be installed in all patient care areas and all areas where careful attention to hygiene is essential

Wayfinding “285 million people are estimated to be visually impaired worldwide; 39 million are blind and 246 million have low vision. The majority of people classified as “visually impaired” are over the age of 50. Those with limited vision rely on strong colour contrast between surfaces, reduced glare, definition of main circulatory routes with tactile and visual cues and large, legible signage.”

International Health Facility Guidelines

Important Wayfinding Elements:

Zones each with a unique identity

Edges clearly defining perimeter of a zone or path

Path and circulation

Landmarks indicating a position

Nodes a point where a decision needs to be made

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ACCESSIBILITY Minimum turning circle: 60 inches Push side door clearance: 24” Pull side door clearance: 48” Minimum door width: 48” Minimum corridor width: 44”

Restroom Accessibility

Mounting Heights

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Accessible Signage

Protruding Objects

Characters minimum 1/32” deep, lowercase, non-italic, sanserif, min 5/8” high, duplicated in braille

Objects with leading edges 27-80 inches AFF cannot protrude > 4 inches horizontally into the circulation path (except handrails 4.5 inches)

Characters with non-glare finish and maximum contrast with background Signs should be located along the latch side of a single door, inactive leaf side of double doors Braille signs should be located 48-60” AFF Braille signs should have an 18” x 18” clear floor space

Height to Finish Floor or Ground from Baseline of Character 40 inches to less than or equal to 70 inches

Greater than 70 inches to less than or equal to 120 inches

Horizontal Viewing Distance

Minimum Character Height

< 72 inches

5/8 inch

72 inches and greater

5/8 inch + 1/8 inch per foot viewing distance above 72 inches

< 180 inches

2 inches

180 inches and greater

2 inches + 1/8 inch per foot viewing distance above 180 inches

< 21 feet

3 inches

21 feet and greater

3 inches + 1/8 inch per foot viewing distance above 21 feet

Greater than 120 inches

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DESIGNING FOR PEOPLE WITH VISION IMPAIRMENTS A summary of findings from 5 different research studies

Signage A low vision wayfinding simulation revealed improper illumination or positioning of signage to be a major cause of low vision patients feeling lost or confused. Signage and terminology should be uniform throughout the space

Lighting Low vision patients heavily rely on light for clarity and direction. Ambient lighting levels should maintain uniformity to minimize confusion. Color contrast plays a major role in differentiating space, objects, and flooring.

Contrast Differentiating surfaces can help lead low vision patients through the space. Some considerations include: contrasting flooring, baseboards, and wallcoverings contrasting door frames and door handles with the door material a change in color with flooring change contrasting toilet seat cover from toilet and bathroom flooring

Natural Light Blinds and shades are important to control the amount of natural light entering the space and maintain a uniformity of ambient lighting While natural light and outdoor views can promote wellbeing in healthcare facilities, it can often be irritating and uncomfortable for patients in a vision center. When eyes are dilated, the pupils expand and the eye becomes increasingly sensitive to light.

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Wayfinding is a critical factor of healthcare facilities, and successful wayfinding strategies are much more important for the comfort, safety, and clarity of patients with low vision. Design strategies can be used to make the space less overwhelming and more clear, instilling a greater confidence in the user.

Circulation A study comparing wayfinding techniques in symmetrical vs. asymmetrical healthcare facilities revealed that 63% of people in the symmetrical facility felt completely lost while only 7% at the asymmetrical facility did so. Landmarks and special representations such as wall colors, feature stairwells, elevators, or ramps helped users orient themselves and understand the overall structure of the space.

Objects located along the path of travel should be minimized and only located along one side of the path Large open spaces can feel overwhelming with little clear direction on where to proceed. Open areas should be broken down into smaller, manageable sections with levels of hierarchy to guide the user through the space.

Clarity and Simplicity in Flooring In a study of 3 different patterned carpets, participants found it easiest to walk on carpet with a solid color middle and a simple patterned edge over a fully solid carpet. Carpet patterns and color variation can be used to provide directional cues in space without being overwhelming.

Carpets increase safety and wellbeing by reducing stress, increasing traction, increasing comfort while standing, and improving acoustics and thermal properties Patterns with large motifs and high contrast give rise to the slowest walking Patients with limited vision prefer brighter, more contrasting colors. Floor covering colors can be used to associate different spaces and improve wayfinding Contrasting colors placed near each other can have different effects. (bright saturated blue with dull blue may be more effective than bright blue with bright red) Mixing cut and loop carpet piles of the same tone can provide variation without contrast Small scale simple patterns will keep the environment clear and legible as opposed to vivid, large scale patterns

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RESEARCH STUDY A survey was conducted to understand how lighting impacts current healthcare facilities and gain insight into lighting preferences of healthcare professionals and patients. The same survey was sent to two different participant groups: one of only healthcare professionals and one of a mix of healthcare professionals and patients.

Survey 1: Responses from 22 different healthcare professionals Survey 2: 43 responses: 5 from healthcare professionals, 38 from healthcare patients The survey results reflect the theories of control, behavior settings, decision making, and ecopsychology. Lighting in healthcare facilities can be used to support clarity, direction, and wellbeing for users, and the ability to adjust fixtures in spaces allows users to feel a sense of personal empowerment.

Some questions indicated that many different people think similarly about lighting needs, while other questions indicated that different healthcare facilities and different people have different needs and preferences. The responses included people in general hospitals, academic hospitals, family hospitals, skilled nursing facilities, outpatient and inpatient care facilities, healthcare management offices, an eye care office, and an ambulatory care center.

Current Ability to Control Lighting in Healthcare Facilities Lobby / Reception Nurseâ&#x20AC;&#x2122;s Station Exam Room Hallway

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Desired Ability of Healthcare Professionals to Control Lighting Level and Intensity

Desired Ability of Healthcare Professionals to Move and Adjust the Lighting Angle

The majority of healthcare professionals would like more control over lighting than they currently have The lighting level and movement is most important in exam rooms The locations of switches in exam rooms is important for ease of adjustability

Responses from an Optometrist A response from an optometrist working in an Eye Care Office reflects that natural light is most important in the lobby / reception area and least important in hallways.

Though natural light is preferred in workstations and exam rooms, adjustability and control of natural light is very important for proper procedures.

Importance of Natural Light in Spaces

Color Temperature Preferences of Healthcare Professionals Cool

Warm

Lobby/Reception

Nurseâ&#x20AC;&#x2122;s Station

Importance of Wayfinding Techniques

1

Clear Signage

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Flooring Indicating Direction of Travel

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Lighting Indicating Direction

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Wall Graphics

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Varying Ceiling Heights

Exam Room

Hallway 33

MATERIAL AND COLOR

Manufacturing is the main sector contributing to economic growth in the Czech Republic. This sector comprises 35% of the economy, and nearly 40% of jobs are in the manufacturing industry. The Czech Republic is filled with natural resources such as raw mineral deposits, coal mines, and limestone mines.

Pragueâ&#x20AC;&#x2122;s rich historical architecture consists of many different styles including Romanesque, Gothic, Renaissance, Baroque and Rococo, Historicism, Art Nouveau, and Cubism. This blend of styles defines the character of Prague and draws tourism to the city. In creating a sense of place in an interior environment, it is important to consider the surrounding culture and architecture and its connection to local residents and tourists.

Local Materials

Plaster

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Ceramic

Concrete

Brick

Limestone

Steel

Color in Prague Located in Central Europe, Pragueâ&#x20AC;&#x2122;s color psychology generally coincides with western culture Red: high energy and passion Orange: emotion and warmth Yellow: optimism, clarity, intellect Green: growth, healing, nature Blue: relaxation, serenity, loyalty The Czech Republic flag is red, white, and blue: symbols of independence and pride for the people and the country as a whole. Because Prague was once a communist state, the color red could possibly be associated with revolution and militarism.

Color in Healthcare Design Open spaces and corridors should remain more neutral, using accent walls for wayfinding and creating landmarks Cool tones can be calming and connect to nature and should be balanced with subtle warmer accents and neutrals When creating contast, focus on different tones of light and dark rather than opposing colors Use color to define and differentiate zones Accents of bolder colors can connect to a brand or community Elderly or low vision patients often have difficulty seeing soft, muted colors

Proposed Color Palatte Colors draw from the historical architecture of Prague to establish a sense of place for visitors while balancing comforting cool tones with warm tones that are muted and natural. Different shades of the same color will create contrast in the space, and pops of vibrant, rich color will support wayfinding.

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PROGRAMMING

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PROGRAMMING Must Should Would Be Nice Not Necessary

Square Footage

Special Special Daylight Plumbing Equipment Considerations + View

2000 SF

YES

NO

YES

NO

NO

Optical Shop

800 SF

YES

NO

NO

NO

YES

Waiting Room

1200 SF ea.

YES

NO

NO

NO

NO

Cafe

1000 SF

YES

NO

YES

YES

NO

Communal Gathering Space

5000 SF

YES

NO

NO

NO

YES

Projector

Physician’s Work Area

120 SF ea.

NO

YES

YES

NO

NO

Computers

Technician’s Work Stations

80 SF ea.

NO

NO

YES

NO

NO

Computers + Printers

Photography Rooms

250 SF ea.

YES

YES

NO

YES

YES

Technology

100-200 SF ea. YES

YES

NO

YES

YES

Projector + Technology

Lobby

Exam Rooms

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Open to Public Privacy

Wayfinding

Administration

5000 SF

NO

YES

YES

NO

NO

Lab + Research Space

3000 SF

NO

YES

YES

YES

YES

Technology

Surgery Center

8000 SF

NO

YES

NO

YES

YES

Technology

Mechanical

500 SF

NO

YES

NO

YES

NO

Bathrooms

600 SF

YES

YES

NO

YES

NO

BUILDING CODE ANALYSIS

Occupancy Classification Assembly 1: Lobby, Optical Shop, Cafe, Gathering Space, Waiting Areas Business (Ambulatory Care Facilities): Exam Rooms, Technology Rooms, Workstations, Administration

Occupant Load Factor Assembly (no fixed seats) Assembly (unconcentrated, tables and chairs) Assembly (fixed seats) Assembly (chairs only, not fixed) Business

5 net 15 net 100 net 7 net 150 gross

Occupants Permitted Assembly (no fixed seats) Assembly (unconcentrated, tables and chairs) Assembly (fixed seats) Assembly (chairs only, not fixed) Business

300 SF 800 SF 1500 SF 500 SF 14, 480 SF

60 53 100 71 96 295 total occupants

Egress Diagonal for Assembly: 75 feet (sprinklered) Diagonal for Business: 100 feet (sprinklered) Fire stairs must be 75 feet apart Maximum Travel Distance: 1st Floor: 94 feet 2nd Floor: 110 feet 3rd Floor: 110 feet

Fixtures Needed Water Closets: 5 Male, 6 Female Lavatories: 4 Male, 4 Female Water Fountains: 3 Service Sinks: 3

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PLAN PROTOTYPES

0" 9' - 0" 9'9'--0" 9' - 0"

Exam Room | 108 SF

15' - 0" 15' - 0"

15' 15'--0" 0"

12' - 0" 12' - 0"

12' 12'--0" 0"

0" 9' - 0" 9'9'--0" 9' - 0"

Extended Exam Room | 135 SF

Administrative Office | 100 SF

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6' - 0" 6' - 0"

6'6'--0" 0"

10' - 0" 10' - 0"

10' 10'--0" 0"

10'--0" 0"10' - 0" 10' 10' - 0"

13'--6613' 1/2" 13' 1/2" - 6 1/2" 13' - 6 1/2"

Technician Workstation | 78 SF 26' 8"26' - 8" 26' - 8" 26' - 8"

9' - 2"

12' - 0"

20' - 10"

12' - 0"

15' - 0"

22' - 2"

Photography Lab | 264 SF

29' - 0"

28' - 0"

1/2"

37' - 0

37' - 0" Optical Shop with Storage | 812 SF

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6' -

10' - 0"

13' - 6 1/2"

37' - 4"

26' - 8"

Cafe | 1000 SF

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9' - 2"

12' - 0"

28' - 0"

20' - 10"

Lobby / Registration | 189 SF

29' - 0"

32' - 6"

28' - 0"

37' - 0"

37' - 0"

Waiting Room | 1200 SF

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SOURCES

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SOURCES

Prague, Czech Republic 2020 World Population Review. Retrieved December 05, 2020, from https://worldpopulationreview.com/world-cities Basic information about Prague: Welcometoprague.cz. (2012-2020). Retrieved December 05, 2020, from https://www. welcometoprague.eu/basic-information-about-prague Czechia. (2020, December 05). Retrieved December 05, 2020, from https://www.euro.who.int/en/countries/czechia Czech unemployment rises in June, reaching levels last seen in 2017. (2020, August 03). Retrieved December 05, 2020, from https://news.expats.cz/prague-employment/czech-unemployment-rises-in-june-reaching-levels-last-seenin-2017/ Employment, Social Affairs & Inclusion. (n.d.). Retrieved December 05, 2020, from https://ec.europa.eu/social/main. jsp?catId=1106 Government Board for Persons with Disabilities. (2009-2020). Retrieved December 05, 2020, from https://www.vlada. cz/en/ppov/vvzpo/uvod-vvzpo-en-312/ Religion (2019, May 20). Prague Guide. Retrieved December 05, 2020, from https://www.prague.fm/religion/ Vision Correction: Prague Medica S.R.O. (2020). Retrieved December 05, 2020, from https://www.medicalservicesprague.com/medical-treatments/vision-correction WeatherSpark.com. (2020). Retrieved December 05, 2020, from https://weatherspark.com/y/77807/Average-Weatherin-Prague-Czechia-Year-Round

Precedent Case Studies DiNardo, A. (2016, July 8). Ambulatory Care / Clinics. Retrieved December 05, 2020, from https://www.healthcaredesignmagazine.com/projects/ambulatory-care-clinics/photo-tour-optegra-eye-hospital/ Evidence-Based Design in Practice: Healthcare Design Case Studies from EDAC Champion and Advocate Firms. (2015).

EDAC from The Center for Health Design, 6. Retrieved December 5, 2020.

Optegra Eye Hospital. (2020, August 17). Retrieved December 05, 2020, from https://www.ibigroup.com/ibi-projects/ optegra-eye-hospital/ University of Colorado Hospital - Rocky Mountain Lions Eye Institute. (2015, October 05). Retrieved December 05, 2020, from https://davispartnership.com/projects/university-colorado-hospital-rocky-mountain-lions-eye-institute/ University of Colorado Hospital / Rocky Mountain Lions Eye Institute, Aurora, Colorado. (2015, January). Retrieved December 05, 2020, from https://www.healthdesign.org/insights-solutions/university-colorado-hospital-rocky-mountain-lions-eye-institute-aurora-colorado UPMC Vision and Rehabilitation Tower at UPMC Mercy. (2020, August 11). Retrieved December 05, 2020, from https:// www.hok.com/projects/view/university-of-pittsburgh-medical-center-vision-and-rehabilitation-hospital/

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Research Healthcare Design Considerations International Health Facility Guidelines. (n.d.). Retrieved December 05, 2020, from http://www.healthfacilityguidelines. com/ Robert F. CarrNIKA. for VA Office of Construction & Facilities Management (CFM)Revised by the WBDG Health Care Subcommittee. (2017, June 04). Hospital . Retrieved December 05, 2020, from https://www.wbdg.org/building-types/ health-care-facilities/hospital Accessibility 2010 ADA Standards for Accessible Design. (2012, December 7). Retrieved December 05, 2020, from https://www.ada. gov/ Designing for People with Vision Impairments Baskaya, A., Wilson, C., & Ă&#x2013;zcan, Y. Z. (2004). Wayfinding in an Unfamiliar Environment: Different Spatial Settings of Two Polyclinics. Environment and Behavior, 36(6), 839â&#x20AC;&#x201C;867. https://doi.org/10.1177/0013916504265445 Rousek, J.B., Hallbeck, M.S. (2011). The use of simulated visual impairment to identify hospital design elements that contribute to wayfinding difficulties. International Journal of Industrial Ergonomics, Volume 41, Issue 5 (pages 447-458).

Sinoo, Marianne M, Kort, Helianthe S.M, Loomans, Marcel G.L.C, Schols, Jos M.G.A (2016). A nursing home staff tool for the indoor visual environment: the content validity. Journal of Nursing Education and Practice, Volume 6, Number 11.

Steven J. McNeil & Laura S. Tapp (2016) The design and initial evaluation of visual cues in carpets to assist walking, The Journal of The Textile Institute, 107:3, 376-385.

Yigi Tao, Zhoghua Gou, Stephen Siu-Yu Lau, Yi Lu, & Jiayan Fu (2018). Legibility of floor plans and wayfinding satisfaction of residents in Care and Attention homes in Hong Kong. Australasian Journal on Ageing, Volume 37, Issue 4 (pages E139-E143).

Material and Color Czech Flag colors - meaning and history. (n.d.). Retrieved October 15, 2020, from http://all-czech.com/learnmore/flagof-the-czech-republic/ Kantz, E. (2018). 2018 Color Trends for the Healthcare Segment. Retrieved December 05, 2020, from https://mcdmag. com/2017/11/2018-color-trends-for-the-healthcare-segment/ McGeary, K. (2019, March 07). An Architectural Tour of Prague. Retrieved December 05, 2020, from https://passionpassport.com/architectural-tour-prague/ Omondi, S. (2019, May 21). What Are The Biggest Industries In The Czech Republic? Retrieved December 05, 2020, from https://www.worldatlas.com/articles/what-are-the-biggest-industries-in-the-czech-republic.html PricewaterhouseCoopers. (n.d.). Manufacturing & Industrial Products. Retrieved October 15, 2020, from https://www. pwc.com/cz/en/odvetvove-specializace/zpracovatelsky-prumysl-a-vyroba.html Supplement of Czech Business and Trade. (2008). Czech Building Industry, 6-28. Retrieved from mpo.cz The Czech Republic Has Been a Manufacturing Industry Leader for Decades. (2019, April 04). Retrieved December 05, 2020, from https://cdmcmachine.com/czech-republic-manufacturing-industry-leader-decades/ Tofle, R. B., Ph.D., Schwartz, B., Ph.D., Yoon, S., MA, & Max-Royale, A., M.E.Des. (2004). Color in Healthcare Environments- A Research Report. Coalition for Health Environments Research. Retrieved 2004, from http://www.

CHEResearch.org

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