Patch Adams
PROJECT NARRATIVE Executive Summary
The Patch Adams initiative, in regards to healthcare, is like no other. As such the design of a facility to house the clinic’s needs would also need to be like no other. In accordance with the clients’ unique approach to healthcare and the desired atmosphere that such a clinic would have, it was readily evident that the Patch Adams Free Clinic of Philadelphia was neither a case of Institutional or Healthcare oriented design. It was therefore necessary to create a new, hybrid building type; one that combines elements of community, heath, agriculture, and business, into an all-encompassing symbol of well-being. Through the careful analysis of health and institutional architecture, along with inventive and practical design intuition, the developed program is meant not only to serve the immediate and future needs of the surrounding Philadelphia community, but as a precedent for free health clinics under Patch Adams directives. Designed to meet the needs of the under-served community of Tioga in Northern Philadelphia, the project is located on a 4.82 acre plot at 1729 West Allegheny Avenue. The site, boasting over 200,000 square feet is located in what has been determined to be a food and healthcare desert (a region in which residents do not readily have convenient access to basic nutritious food, or diagnostic healthcare). To remedy the situation as Patch Adams sees fit, the project seeks to create an urban Free Health Clinic with an agricultural/food producing component. Based upon the immediate surrounding community, and the extents of providing healthcare to those community members that need it most, the health clinic has been sized to serve approximately 500 users at a given time. The building, approximately 18,000 square feet in size will include several major programmatic components including: General / Diagnostic Healthcare Dental / Optical Services Fitness / Preventative Healthcare Education & Nutrition / Job Training Agricultural Production / Retail Multifunction / Community Outreach space Administration The project also encompasses the notion of a “community owned” health clinic; the end objective being that through ownership of the physical health clinic, the community will essentially take ownership of their personal wellbeing. Because of budgetary restrictions, namely due to the nonprofit nature of the project, and the fact that community members will run day to day functions and maintenance of the clinic, the building will serve as a model of architecture that is both user friendly and self-sustainable.
The idea of user friendly refers to sensible program layout and adjacencies, clear signage, and an atmosphere that suggests comfort, and the more human/personal aspects of medicine. A self-sustaining architecture in this case then refers to the building making optimal use of the earth and environment in a way that is responsible to the community, and surrounding ecosystems. Ultimately, the charge is to design a net zero building, that is, one in which the building produces the same amount of energy that it uses. This is achievable only when sustainable design practices are used, including: solar orientation, passive heating and cooling strategies, wind analysis, and rainwater collection and distribution practices. The Patch Adams Free Clinic of Philadelphia is unique in its charge in that once built, it will be the organization’s first urban health clinic—one that is capable of moderate to large-scale agricultural production. Given an otherwise rural site in an urban context, the design intent relies heavily on site and agricultural integration into the free clinic. Looking at the existing site context of the Westmoreland Avenue neighborhood, 18th street was a main vehicular and pedestrian circulation path. By extending this notion of path into the site, and creating a pedestrian street that connects Allegheny and Westmoreland, the site and building become one cohesive device that facilitates the notion of bringing two different user groups from different ends of the site to the center. From that point there emerges social interaction and exploration of the clinic and entities within the site. The design stresses the importance of “de-institutionalizing” the conventional health oriented architecture. In many respects the project uses the idea of “positive distractions” which manifest themselves in the form of strategically placed “nature moments” and grand site gestures to move the user to and from the clinic itself as well as the rest of the site. The pergola implemented into this design is a prime example of a grand site gesture, as it not only creates a sense of enclosure along the main path, but serves as a device that creates moments along the path. It is from the pergola that people enter the clinic building, walking paths, gardens, greenhouses, and recreation areas—it is the main axis of site circulation. The way in which the building is placed on the site in regards to view corridors define the notion of positive distractions. Every exam, waiting, fitness, consultation and dining space is oriented so that it looks onto a specific site feature whether it is orchards, gardens, water features or the public plaza; the connection between exterior and interior program always exists. In conclusion the proposed program and design seek to make the clinic one that is deeply rooted within the community and the surrounding urban fabric and landscape. The strong connection that exists between the site and clinic is key to making the experience at this health clinic relaxing, tranquil and far from institutional.