Graves + Massa Medical Architecture

GRAVES + MASSA MEDICAL ARCHITECTURE

M E D I C A L + H E A LT H C A R E PO RT FO L I O

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Design Process Christus St Michael Hospital Hyperpod Yale-New Haven Hospital / Center For Restorative Care St Mary’s Expansion Endoscopy New Birthing Center and NICU Emergency Department Renovation Neonatal Intensive Care New & Expanded Diagnostics Center Madonna Rehabilitation Hospitals Rooftop Expansion Energy Plant Infrastructure Steadman Clinic Adult Intensive Care Master Planning Surgical Services Renovation Neuro Operating Room

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Shore Orthopedic RENOVATION CATH / EP LAB Novacare Complex Philadelphia Eagles Long Range Facilities Planning St. Joseph’s Hospital, Chandler Neurosciences St. Joseph’s Expansion University Of Gerogia Health Center Coordinated Registration & Admissions Limited Land Master Planning Process Driven Ambulatory Care University Medical Center Wounded Warrior Home Project Dementia & Alzheimers Care Stryker Medical Devices Praise Project List Office Locations / Contact

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Michael Graves and MMA have collaborated and delivered on complex projects for over 13 years.

The skills and talents between the two firms create a strong platform for design excellence.�

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CREATING HUMAN-CENTERED EXPERIENCES

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A DYNAMIC DESIGN PROCESS PROVIDE THE SOLUTIONS

CONDUCT RESEARCH

IDENTIFY THE PROBLEMS

BENCHMARK THE COMPETITION

DATA-DRIVEN DESIGN ASK RELEVANT QUESTIONS

READ ACADEMIC WRITINGS

INTERVIEW ALL STAKEHOLDERS

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CHRISTUS ST MICHAEL HOSPITAL TEXARKANA, TX MGA&D worked closely with the stakeholders of Christus St. Michael to assess needs, analyze real user data to drive concepts and design, and build consensus to design an optimally functional renovation and addition to the client’s Emergency Department.

Improvements involved functional organization, program adjacency, and circulation (both within the building and through the site) to create significantly increased operational efficiency, as well as to optimize user and health care provider experience. This work was undertaken in the light of mounting competitive pressures from a new, closely located, stand-alone emergency services provided facility. The completed work on the facility has allowed Christus St. Michael to remain the desired healthcare destination for emergency services and care in the region.

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PHASE 1

PHASE 2

PHASE 3

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Redefining the ICU GREENVILLE HEALTH SYSTEM GREENVILLE, SC

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HYPERPOD

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Redefining the ICU GREENVILLE HEALTH SYSTEM GREENVILLE, SC Evidence Based Design MMA has set itself apart from all other design firms with its depth, breadth, and critique of evidence-based literature.

As hospitals grow incrementally over time, healthcare needs coupled with site limitations present new and unique challenges for every project. Many large hospital spaces are not designed or used as effectively as they could be. This ineffective design leads to inefficient use of staff time and ultimately decline of patient care.

MMA is skilled at designing technologically complex environments in antiquated spaces and we are configuring optimal solutions under difficult constraints.

MMA’s designs put staff, operational, and economy of scale efficiencies first. This in turn leads to healthier and happier patients.

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HYPERPOD ICU

SERVICE SPACES

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LIGHTWELL

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Revolutionary Concept In the ever changing climate of Healthcare design and development, one aspect stands out as a true challenge to any Owner. How do you meet your census needs with ever increasing room size requirements set by industry standards and hospitals while only having a limited amount of space to expand?

MMA was recently tasked with the challenge of designing a new 60 bed ICU in an existing space that conventionally could only support 40 beds. MMA’s design team culled from its vast database of research and evidence based design calculations and came to one conclusion. It was possible.

The design was coined the HYPERPOD™. An MMA Registered Trademark Design.

This design effectively reduced the linear footage requirements along an outside wall by up to 35%, while still meeting the code driven natural light requirements to patients. By using internal “Lightscapes”, a small room designed to pass light to another room, MMA was able to fit 8 rooms in the space that could originally only support 5. The design of this concept additionally allowed for increased staff productivity by allowing a single nurse to comfortably monitor 4 or even 8 rooms with a minimal amount of walking.

Each HYPERPOD™ consists of 4 rooms served by a single access hallway or portal. Patients may be observed either from this portal or from nurse landing stations along the main corridor.

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YALE-NEW HAVEN HOSPITAL CENTER FOR RESTORATIVE CARE NEW HAVEN, CT

Yale-New Haven Hospital offers one of the oldest and most comprehensive geriatric assessment programs in the United States and the hospital’s geriatric services is ranked #18 in US News and World Report’s 2014 Best Hospital rankings.

Previously housed on an older med/surg patient floor, the new unit incorporates architectural elements and signage specifically designed to support the care of patients 65 and older. As part of the design, MGA&D developed a unique signage system to alert clinicians and visitors of precautions and protocols that needed to be followed. The signage was designed to be easily maintained to reduce risk of infection.

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ST. MARY’S ATHENS, GA

St. Mary’s, Athens, Georgia was voted Georgia Alliance of Community Hospital’s ‘Large Hospital of the Year’ for 2006.

In a rapidly growing competitive marketplace, St. Mary’s moved quickly to open up a significant new ambulatory services site on busy Atlanta Highway.

MMA complied with the Owner mandate for a 6 month start to finish design-build project including active MRI and CT environments. The 44,000 square foot interior upfit project was delivered on budget, on-time.

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When asked by St. Mary’s to demonstrate their unique problem solving abilities, MMA responded with an intensive 3 week charette. MMA’s response revitalized a stalled master planning effort launched by another healthcare architect that drug on

for over a year without a consensus being reached. The result was a bold imaginative design that completely revitalized the St. Mary’s image, bolstered morale and enabled a CEO decision to move forward. MMA’s master plan concept provides for

120,000 new square feet without the loss of a parking spot, reconfigures outpatient traffic patterns for customer oriented service, and provides the latest in healing healthcare environments.

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EXPANSION ENDOSCOPY ATHENS, GA This new unit was initially designed as an elevated addition with parking for the GI Docs below. The contractor had prepared a design development budget for the project that met the Owner’s pro forma. Then the oil and gas crisis hit. In 8 weeks MMA and its consultants redesigned the project to sit on the ground floor saving $600,000.00 which equalled the price increase. The project moved forward with the same program elements and features that the original design had but without the covered parking.

The Docs were satisfied however because they were involved all along and understood that marketplace pressures beyond the contractor’s control forced a revision to the design solution.

With MMA as your partner, team members, hospital leadership and physicians stay informed and always have options at their disposal.

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EXPANSION ENDOSCOPY ATHENS, GA St. Mary’s chose to consolidate several existing ambulatory service programs located in various facilities throughout the city into one strategic location on busy Atlanta Highway. An opportunity arose for St. Mary’s to lease an entire brand new Class A business site for these services. MMA modified

infrastructure to suit the needs of health care and designed user friendly, private and convenient facilities. Included are diagnostics, registration, lab, neurosciences labs, rehabilitation and physical fitness programs

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NEW BIRTHING CENTER AND NICU ATHENS, GA

St. Mary’s needed an improved Women’s program and they needed it fast. Hospital leadership and privileged physicians stated that whoever applied for the CON first would gain the marketshare advantage. In 21 days MMA prepared detailed conceptual drawings and computer animation on which the CON was based. The first budget ended up being the final budget and the hospital is now the proud owner of a facility that has taken everyone by surprise. OB’s that initially were against moving to single room care are now outspoken advocates for family oriented birthing. The design concept made it easy for those physicians who were initially against single room care to endorse the design as it allowed for a transition from LDR to LDRP as practice habits gradually changed. The physicians have also been impressed with how the design supports operational and staff efficiencies. MMA can help create an advantage for you.

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YALE-NEW HAVEN HOSPITAL EMERGENCY DEPARTMENT RENOVATION NEW HAVEN, CT

The 13,000 SF renovation to the Emergency Department at the St. Raphael Campus of Yale-New Haven hospital will benefit the entire New Haven community.

The design was developed in conjunction with clinicians to support a “Split Flow” operational model that streamlines the patient intake, registration and triage process to ensure that higher acuity patients are seen immediately while at the same time reducing the waiting time for lesser acuity level patients.

The layout of the new emergency department allows the space to “flex up” or “flex down” to support clinical operations based on patient volume. The design supports immediate assessment upon check-in resulting in significantly reduced waiting times and patient flow congestion. Additionally, patients not assigned to a bed may wait for test results in a comfortable lounge area intended to free up available exam rooms.

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CENTRALIZED CLINICAL HUB (CORE)

e process that seamlessly blends privacy, accessibility, nsparency...”

NEW FLEX-EXAM ROOMS (FAST TRACK & HIGH ACUITY)

IENTS ARE GREETED AS THEY ENTER THE ERGENCY DEPARTMENT, AND IMMEDIATELY ESENT” TO A TRIAGE NURSE SHORTLY AFTER EIR ARRIVAL.

E NURSE ASSESSES THE PATIENT’S CONDITION AND EN DIRECTS THEM TO AN EXAM ROOM RESERVED R HIGH ACUITY EMERGENCY CASES, OR FASTACK FLEX EXAM ROOMS FOR PATIENTS WITH LESS RIOUS CONDITIONS

S PATIENT CIRCULATION PROCESS REDUCES TENSIVE WAITS AND IMPROVES THE FLOW OF IENTS THROUGH THE EMERGENCY DEPARTMENT

ED PHASE 2 ENVELOPE

ALIZED CLINICAL HUB

NTRALIZED WORK ZONE AND CONFIGURATION EXAM ROOM “PODS” ALLOW FOR OPTIMAL NICIAN SIGHTLINES AND SHORTEN WALKING TANCES (ACCESS TO MEDICATIONS/EQUIPMENT)

RESULTS LOUNGE

ng, embracing...and caring.”

FLEX-TRIAGE ROOMS

Y, CONNECTIVITY, AND TRANSPARENCY

GREETER & TRIAGE “PIVOT” NURSE STATIONS

HE FRONT END PROGRAM ALLOWS FOR A EAR VISITOR/PATIENT ENTRY SEQUENCE ITH IDENTIFIABLE VISUAL MARKERS

ED BOUNDARY WALL (DIVIDES PUBLIC VS. PRIVATE SPACES)

HE PLANNING AND OPERATIONAL MODEL NHANCES VISUAL CONNECTIONS BETWEEN INICIANS AND PATIENTS

HE CURVED “EMBRACE” WALL ACTS AS A EAR ORGANIZATIONAL TOOL, DIVIDING UBLIC AND PRIVATE ZONES

WAITING AREA (LOUNGE)

HE WAITING LOUNGE FOCUSES ON ONNECTIVITY TO THE EXTERIOR WITH AYLIGHT AND REFLECTIVE GARDENS

EXTERIOR REFLECTION GARDEN (NATIVE INDIGENOUS PLANTINGS)

CURITY STATION PROVIDES PERSONNEL ITH CLEAR SIGHTLINESS OF EMERGENCY EPARTMENT ACCESS POINTS

N INTUITIVE SIGNAGE SYSTEM INTENDED O ENHANCE PATIENT AWARENESS AND AYFINDING.

ED PHASE 1 ENVELOPE

WHEELCHAIR/TRANSPORT CHAIR STORAGE

VALET STATION

SECURITY & SCREENING STATION

AXONOMETRIC: ED PHASE 1 & 2 COMPONENTS

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NEONATAL INTENSIVE CARE ATHENS, GA

The latest in neonate healing environment design and how emotions relate to space is incorporated into St. Mary’s new 20 infant NICU unit. The apprehension an expectant mom might have about where her new baby might be cared for if needing help is now gone as NICU and maternity are now visually connected. Many new facilities locate NICU remote from Birthing. MMA’s design provides emoMMA ARCHITECTS

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tional comfort and security. Transverse daylight axis design concept was accomplished in a building only 85 feet wide! Staff epicenter has visual connectivity with all ares of the unit including the staff lounge. Depending on the infants care plan, families have control over a private or a transparent environment. Overnight accommodations are provided for inside and outside the infants room.

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NEW & EXPANDED DIAGNOSTICS CENTER ATHENS, GA

MMA completely reoriented and significantly expanded St. Mary’s existing Diagnostics unit to present a new face in the new 100,000 square foot Phase 1 Women’s / NICU / Diagnostics expansion. A new private high throughput digital Women’s imaging unit was created, a Toshiba MRI environment was provided, 2 CT scanners were relocated in a back to back configuration to improve staff efficiency and to directly support ED, a new digital ED support acquisition room was provided and several other key spaces to improve patient throughput and staff operations.

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MADONNA REHABILITATION HOSPITALS OMAHA, NB Madonna, which is establishing a new state-of-the-art hospital in Omaha, specializes in acute rehabilitation cases requiring longer-than-typical stays, and therefore the facilities especially the patient rooms, are being specially designed to accommodate the needs of patients and their families. The project contains approximately 255,000 sq.ft. and 110 patient rooms.

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ROOFTOP EXPANSION ATHENS, GA

MMA was awarded Mission Impossible for this rooftop expansion after St. Mary’s dismissed the former Top 10 Healthcare architect for not sticking to budget. The need to implement this program to capture available market place beds was critical.

MMA’s mission was not only to put the project back on track but to also increase unit size from 16 to 20 beds with little additional space. MMA configured an efficient net to gross circulatory concept that worked within an extremely limiting existing floor structure that greatly constrained plumbing and mechanical rough- in placements. MMA utilized all future floor load bearing capacity of the existing underlying bed tower to meet new stringent seismic design criteria for this single story addition. Brasfield & Gorrie Contractor and Collins Project Management successfully enabled construction in 7 months during the winter season.

Mission Impossible: -Fit 20 beds in roughly the same square footage and budget as the original architect’s 16 bed scheme and maintain $1.68 M construction cost.

-Meet newly enacted IBC 2000 seismic requirements on an existing 1970’s structure.

-Immediately create a Phase 1 partial 2 bed unit to capture 2003 Medicare reimbursement advantage.

-Construct over an ICU Unit at the front entrance.

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-Seven month construction schedule which included a $2.5 million Infrastructure/ utility backbone.

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ENERGY PLANT INFRASTRUCTURE ATHENS, GA

To support 120,000 square feet of long range growth at St. Mary’s and to bring power distribution to current code, MMA implemented a major new rooftop utilities backbone connecting the Central Energy Plant to the areas of new expansion.

The extraordinary technical challenge involved independent structural analysis of 6 previously built additions to confirm the existing structure’s ability to support the 700 pounds per lineal foot of utility / rack weight and support design to accommodate new seismic criteria.

Included is a new 4 branch power distribution penthouse with 45,000 pounds of electrical gear constructed over the existing surgical suite (equivalent to 3.5 MRI magnets)

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STEADMAN CLINIC VAIL, CO

For the Steadman Clinic and Steadman Phillippon Research Institute, world leaders in orthopedic medicine, MGA&D designed a 70,000 SF ambulatory care center that accommodates both clinical care and research. The building, which is connected to the Vail Valley Medical Center by a bridge, also houses the hospital’s Howard Head rehabilitation center.

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Vail Medical Research Municipal Development

1805 29th S Suite 20 Boulder, Colora phone 303.44

PROJ. NO. 111057 DRAWN:

Author

CHECKED: Check

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revit local files\VMRMD\110570.00-VMRMD_A12_DDowling.rvt

APPROVED: Approv

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3D-VIEW-11

DATE:

JAN 11

REVISIONS

© OZ ARCHITECTUR

Vail Medical Rese Municipal Develop ISSUED FOR: 80% SCHEMATIC

SHEET TITLE:

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ADULT INTENSIVE CARE ATHENS, GA

St. Mary’s challenge to MMA was to cosmetically improve the outdated appearance of the adult ICU unit. MMA initialized the design process by analyzing the functional effectiveness of the support and staff core and proposed both a functional and visual reordering of the unit. The result is a modern unit with greater efficiency and less clutter, improved infection and security control, and increased patient information confidentiality.

The design allows for future core expansion under the Women’s Center project as well as future HVAC upgrades.

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MASTER PLANNING SURGICAL SERVICES ST MARY’S

St. Mary’s was experiencing a bed shortage and turning away 800 ED admissions a year. The solution was unclear. Lack of a coherent long range plan caused space that was originally earmarked for surgery to be lost to other needs. When asked

by St. Mary’s to solve OR space shortages, plan for growth and combine their remote outpatient site with IP surgery for operational savings, MMA responded with a comprehensive look at all the ‘halo’ conditions surrounding not just the OR but other interventional service lines as well. The result was the refinement of an option that combines AM Admit, extended care and other pre surgical testing beds in one location connected to a comprehensive flexible post anesthesia arena greatly enhancing staff and anesthesia efficiencies as well as patient convenience and privacy. Surgical patients can be discharged without having to go back through the main lobby. The suite is configured for future growth. Improvements include all new electrical and code compliant filtered air distribution to the existing OR’s.

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RENOVATION NEURO OPERATING ROOM 9 ST MARY’S.

Offering the latest in Stryker digital communications and PACS integration, St. Mary’s new neurological operating theatre is part of a comprehensive new neurosciences initiative. MMA assisted the hospital in combining improved stat digital ED diagnostics with a new dedicated NCCU and neurosciences bed unit to launch this strengthened service line. The challenging aspect of this initiative was the reallocation of non surgical space within an already undersized OR to create the room needed for the new operating room.

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Melanie Nash, OR Director was skeptical at first. CSPD was undersized, the anesthesiologists complained about lack of space. The physicians locker rooms were too small, the hallways were used for storage and pre and post op were marginal at best. Sounds familiar? How were we going to fit in a new OR without any additional space. St. Mary’s asked MMA to help. Through long range surgical planning, building relationships with the staff and the Docs, a level of trust was created that allowed the tough inevitabilities to be forged and agreed upon. The result is the launching of a needed marketplace initiative and revenue generating service without having to expand the building. MMA can be your partner for your tough assignments as well.

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ST MARY’S MEDICAL OFFICE BUILDING

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TRANSFORMING SPACES C R E AT I N G T H E A RT O F STYL I S H E NVI R O N M E N TS

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SHORE ORTHOPEDIC SOMERS POINT, NJ

In a competitive market for orthopaedic services, Shore Ortho sought a building that would be attractive to patients and communicate the quality of the physicians’ practice. By using lean design principles, MGA&D also streamlined daily operations, and thereby made treatment more cost effective and faster, with obvious benefits for both the medical practice and its patients. MGA&D’s graphic design strengthened Shore Ortho’s brand identity.

MGA&D’s client, the developer Scarborough Properties, paired MGA&D with a contractor early in the design process, resulting in the equivalent of integrated project delivery. Ongoing cost and schedule analysis of systems and materials allowed high-quality but economical development and a construction period of a mere 6 months.

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The floor plan is organized by a clear circulation system of 5-foot wide corridors that differentiate the patient and staff zones, and ensure privacy (exceeding HIPAA standards) and efficiency for both. Natural light throughout the building conveys a sense of transparency and openness.

Controlled views to the outside, especially to a private semienclosed garden, create a sense of wellbeing. Physical therapy facilities feature large windows with a view to the garden and an outdoor therapy terrace.

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Shore Orthopaedic Floor Plan identifying the different zones of the facility and clear circulation.

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RENOVATION CATH / EP LAB ATHENS, GA MMA is skilled at designing technologically complex environments in antiquated space. Accommodating new Phillips Allura bi-plane systems, with overhead rolling weights that of a small car , in low 12 foot floor to floor heights with insufficient structural capacity to carry the load is MMA’s specialty. The final design is not perceived as a renovation at all but instead appropriately as a flagship service line of the hospital.

MMA, with its history of accomplishing technically challenging initiatives, had to assure the Owner in the first 2 weeks of the engagement that the new technologies would work in their 1966 era building.

Going beyond just meeting the demanding parameters of this project, MMA also showed Hospital Leadership how non-invasive diagnostics could be connected the labs and to the Emergency Department below.

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NOVACARE COMPLEX PHILADELPHIA EAGLES PHILADELPHIA, PA

The 110,000 SF NovaCare Complex contains training facilities and offices for the Philadelphia Eagles professional football team, and an outpatient physical therapy center operated by NovaCare.

The project pioneered a new approach to professional sports training facilities. The administrative wing contains offices, a 189-seat auditorium, high-tech team meeting rooms, and food service facilities MICHAEL GRAVES ARCHITECTURE & DESIGN

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with a dining terrace and bleachers overlooking the main practice field. The training wing contains extensive strength and conditioning facilities: an 8,000 sq.ft. weight room, aerobic exercise rooms, and a therapy pool with a hydraulic floor. The site includes several outdoor practice fields and a modified pre-fab building used for indoor practice and events.

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LONG RANGE FACILITIES PLANNING ATHENS, GA

Projects resulting from MMA’s Phase 1 and Phase 2 $54 million Master Facilities Plan for St. Mary’s Health Care System inc.

Athens, Georgia. Several of these projects were designed and executed simultaneously by MMA: • 100,000 square foot Women’s/Diagnostics/NICU facility • Adult Intensive Care Unit modernization • ED Pediatric renovations • CT Scanner consolidation • Gift Shop • Physician’s Lounge • Operating room renovations/ new OR • Inpatient Neuro Sciences/ NCCU renovations • Central Scheduling Unit • EMS facility planning • Infusion Therapy renovations • $2.5 Million Endoscopy unit • Chapel • $2.4 M rooftop utility infrastructure • Rooftop 20 bed Inpatient Acute Rehab Unit • Inpatient Rehab gym/ therapy area.

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From LDR to LDRP/ Putting Families First When asked by St. Mary’s to redesign for a change in operational birthing concepts, MMA responded with an even more vigorous three week effort than the previous LDR (Labor, Delivery, Recovery) effort. The new design yielded greater program advantages than the original design including more square feet without a budget increase. MMA’s continued investigation and understanding of the issues facing St. Mary’s since the original three week master solutions exer-

cise allowed MMA to sharpen their pencils and create an even better benefit for the dollar. The result is a state of the art LDRP (Labor, Delivery, Recovery, Postpartum) Women’s and NICU Center that is destined to gain St. Mary’s a strategic marketplace advantage in those service lines.

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ST. JOSEPH’S HOSPITAL, CHANDLER NEUROSCIENCES, TBI SAVANNAH, GA A previous architect master planner devised plans on the assumption that existing facilities were designed for future vertical expansion. The Owner developed project implementation plans and capital expenditure budgets based on those recommendations. When MMA was commissioned to design the first phase of a complete neurosciences services overhaul they immediately conducted and in depth survey of existing conditions including deep piling investigations that confirmed that the existing 1960 era facilities were not structured for vertical expansion. MMA’s expertise in configuring optimal solutions under difficult constraints enabled the Owner to move forward with a rooftop expansion even under stringent seismic and hurricane forces.

The new NICU design is extremely efficient, flexible and is designed to work integrally with the Phase 2 step down Neuroscience expansion.

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ST. JOSEPH’S EXPANSION

SAVANNAH, GA St. Joseph’s/ Candler Health System, Savannah, Georgia is a leading Magnet health care provider in a rapidly expanding market.

The 2 hospital system contacted MMA to design their new flagship state of the art Neurosciences Intensive Care Unit as the first phase of improvements to the entire neurosurgical service line.

The design incorporates all of the leading patient care and family design features and is configured for future growth. Located at the front door to the hospital, the new design will establish an aesthetic platform from which subsequent projects will borrow from to begin the modernization of the 60’s era plant.

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UNIVERSITY OF GEROGIA HEALTH CENTER ATHENS, GA

UGA’s recently completed $17 million expansion and renovation to their comprehensive student health services facility will make it one the largest in the nation.

MMA was commissioned to identify various alternatives to help

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meet growing demand and to develop a whole new image for one the most important emerging East Campus gateways. MMA developed detailed conceptual options up to F (any of which would have solved the functional

and space challenges) but Option C best met the University President and Administrations identity and corner resolution vision.

MMA resynthesized and corrected detailed space programming prepared by a previous architect.

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UNIVERSITY OF GEROGIA HEALTH CENTER ATHENS, GA

$17 million student center recently completed on time and on budget.

110,000 square foot comprehensive health services facility comprised of office based, ambulatory and outpatient care environments and is JCAHO certified. According to Dr. Jean Chin, MD, MBA, Director: “MMA solved what we thought was an unsolvable problem”. MMA’s scope formulation, budgeting and programming accuracies yielded a final deviation of only 200 sf from the original conceptual phase program prepared by MMA.

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COORDINATED REGISTRATION & ADMISSIONS ATHENS, GA

MMA reconfigured patient intake patterns as part of St. Mary’s largest capital expansion. Outpatient registration had been handled in the ED intake area and for a 40,000 visit ED this was not patient friendly.

MMA’s solution consolidated inpatient registration and outpatient admissions, same day surgery and inpatient surgery case scheduling, and adjunct scheduling operations to make the patient/ organization interface as transparent , friendly and as organized as possible. The new service is located not more than 75 feet from the patient parking deck and just across the main lobby from vehicular drop-off. All coordinators, intake personnel and volunteers are in visual contact with one another and patients/ families are always connected with a person. The new atrium is a calming, organizational feature that is designed to initiate the wayfinding process in an understandable way. MMA is expert at distilling key functional flaws within a healthcare setting and proposing creative, cost saving solutions.

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UNIVERSITY OF GEROGIA HEALTH CENTER ATHENS, GA

Wayfinding clarity, discreet mental health and health promotion settings and built in ability to expand are several hallmarks of the new design. New and improved fast track and emergent care functionality, security, quality control and error reduction objectives in key clinical settings were several core design prerequisites. Environments improve staff morale, utilization and efficiency, customer satisfaction and are great places to work. The Women’s Clinic Nurse Manager said it best: ‘The renovations are functionally perfect’.

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LIMITED LAND MASTER PLANNING ATHENS, GA

Maximizing Program in Limited Space MMA ARCHITECTS

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When St. Mary’s Hospital, Athens, Georgia embarked on the largest capital facilities expansion in their history, they needed the confidence they could do so without preempting future growth alternatives. St. Mary’s had limited land on which to expand and MMA developed a plan that allowed them to ultimately replace their entire acute campus component with only 10% additional land.

The history of hospital expansion speaks for itself. Just when you think you have enough land, you don’t. MMA treats all master planning exercises as an urban high density land planning challenge. This does not mean that non institutional healing environments, greenspace and clear wayfinding are sacrificed. MMA is expert at showing a client how their campus can achieve a maximum density configuration in an intelligible, attractive way.

The positioning of Medical Office Buildings on a hospital campus has significant master planning implications. St. Mary’s new 80,000 sq. ft. MOB and parking deck design was originally devised by the developer’s

non-medical architect. MMA protected St. Mary’s long range growth interests with a different design that even the developer acknowledged was a better design.

MMA became part of the design team as a result.

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PROCESS DRIVEN AMBULATORY CARE PROTOTYPE

31,000 square foot, 8 component, process engineered ambulatory care facility designed for low cost, highest net to gross efficiencies, and optimal staff to physician/care giver ratios. MMA developed the detailed plans you see here and achieved complete buy in from all 8 user groups within 6 weeks from being authorized to commence work. Environments are evidence based driven, peer reviewed, and mock tested so upon opening day no process, whether it be IT or materiel related will be untested.

Facility is expandable along major axis with clear intuitive wayfinding.

MMA is a member of the collaborative healthcare research team at NXT and other research driven enterprises advancing thought on the patient experience. MMA’s straightforward design process involves all stakeholders in a collaborative, cross pollination environment where process improvements are the natural outcome. MMA client testimonials document a vast improvement in staff and workplace satisfaction in completed projects.

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UNIVERSITY MEDICAL CENTER PROTOTYPE

The Center Pointe ambulatory care center’s primary purpose is to be a community based primary and subspecialty care integrated group practice. Center Pointe is designed to fundamentally alter referral patterns and utilization in a tertiary system’s secondary catchment markets. The experience of 500 on-staff physicians, having practiced and continuing to practice in multiple facilities though the upstate, was brought to bear in configuring the idealized patient and provider centered environments in the first of its kind group practice model for the states largest tertiary medical system.

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GREENSBORO CRITICAL ACCESS HOSPITAL GREENSBORO, NC

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TRANSFORMING SPACES C R E AT I N G T H E A RT O F STYL I S H E NVI R O N M E N TS

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WOUNDED WARRIOR HOME PROJECT FORT BELVOIR, VA

In November 2010, MGA&D was commissioned by Clark Realty Capital to design the Wounded Warriors Home Project. The project calls for the design of single family prototype homes intended to serve the needs of wounded soldiers and their families as they continue to serve on active duty at Fort Belvoir, Virginia. The design of these prototypes is intended to provide for the needs of a varied group of people who have been injured and/or adversely affected by their military service.

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STORAGE B114 69 SF

GARAGE B113 651 SF

LAUNDRY BEDROOM

BEDROOM

B117

B115

147 SF

147 SF

MUD ROOM B109 89 SF

B110

CLOSET

78 SF

B111 4 SF

LIVING ROOM B102

MASTER BEDROOM

CLOSET

CLOSET

B123

B118

B116

12 SF

12 SF

355 SF

CLOSET

POWDER ROOM

B128

B108

15 SF

51 SF

HALL

HALL

3 SF

19 SF

MASTER BATHROOM

B122

5 SF

BEDROOM/THERAPY

CLOSET

B119

B101

172 SF

DINING ROOM B103

116 SF

B126

58 SF

B127

B121

BATHROOM

B100

37 SF

CLOSET

LINEN

B125

FOYER

B105

B106 203 SF

CLOSET

227 SF

230 SF

110 SF

KITCHEN CLOSET B124

B107 255 SF

37 SF

FAMILY ROOM B104 233 SF

Freedom House Ground Floor Plan (below) Selected Interiors (right)

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12 SF

FRONT PORCH

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ST. MARY’S DEMENTIA & ALZHEIMERS CARE ATHENS, GA

MMA’s clients and other experts say it best: “It has been a week since our CEO – Stan Anderson and I visited St. Mary’s Center for Alzheimer’s and Dementia Care. Both of us felt the design and the construction set a new standard for memory care units. We hope to showcase the St Mary’s facility as a center of excellence which will bring attention to your design work and our technology”.

Howard Bradley , SimpleC, LLC

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MICHAEL GRAVES FOR STRYKER PRIME TC TRANSPORT CHAIR &PATIENT ROOM FURNITURE Hospitals are constantly evolving to improve patient outcomes, yet a key piece of equipment that is ubiquitous has gone unaltered since it was patented in 1933. And it was never designed for use in the hospital. We’re talking about the wheelchair! Prime TC is the result of a thorough product development process undertaken to transform seated patient transport in the hospital. Discoveries have turned into real solutions to problems that go beyond the patient experience.

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The “X- Frame” Wheelchair from 1933-2013

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B

A

C

A Bed Side Cabinet B Detail of Height Adjustment C Overbed Table

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UNIVERSITY OF GEORGIA UNIVERSITY HEALTH CENTER ATHENS, GA

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PRAISE “The first project we retained Graves office to participate in was a commingling with one of our seasoned stabled architectural firms, who had already begun design development. The project was a delicate integration, where Graves’ office acted as the lead conceptual design entity while melding their concepts to the architectural firm who was already involved in the project.

Graves office innate creative problem solving skills, coupled with their graphic and oratory presentation acumen exceed any presentation I have seen at my tenure at YNHH. The Center For Elder Care Graves offices designed for us continues to be the rave of our clinical staff.”

-Susan F. Chamberland Yale New Haven Hospital “The facility is absolutely stunning. I was overtaken by it.

We are very proud.”

– Cindy Fox Miller, Baptist Easley Foundation Chair “Our architect, solved what we thought was an unsolvable problem.”

– Dr. Jean Chin, CEO, MD, MBA, Diplomate ABIM, UGA Health Services Director “His collaborative approach with our medical staff and employees has resulted in a highly functional and very well accepted facility.

Patient and community response has been overwhelmingly positive.”

– Tom Fitz, President and former CEO of St. Mary’s Healthcare System “MMA are schematic geniuses.”

– Kenn Flynn, Project Manager “The renovations are functionally perfect.”

– UGA Women’s Health Services Director “I’ve participated in hundreds of architect presentations to hospital boards, MMA’s presentation is the only one I can recall where the Committee and Physicians applauded upon conclusion.”

– Judy Smith, National Birthing Consultant with Smith Hager Bajo, Boston “My spirit is uplifted when I come into this space.”

– Dr. Middendorf, Intensivist “Tom Fitz, President and former CEO of St. Mary’s asked MMA to create something ‘uplifting, comfortable, and really inspiring.’ Mr. Fitz asked the 200 visitors their opinion; guests responded with rousing applause.”

– Athens Banner Herald “I can think of no way to improve the design.”

– Fremont P. Wirth, MD, Past President of American Association of Neurological Surgeons, Director of American Board of Neurosurgery

“Fantastic facility. Great attention to detail.”

– St. Mary’s Health System Anesthesiologist “The ICU at St. Mary’s ranks in the top 10th percentile.”

– NCR Picker “The design is unbelievable. This is a great day for the Athens community.”

– St. Mary’s Healthcare System Board Member “The layout is perfect from the patient care workflow perspective.”

– Ronald Forehand, MD, FAAFP, UGA DIrector of Medical Services “I have agreement that your latest design was brilliant.”

– Dr. Jean Chin, CEO, MD, MBA, Diplomate ABIM, UGA Health Services Director “None of our four ophthalmic surgeons could find anything wrong with the design – and that’s scary.”

– Bonnie Butler, Surgery Center Manager “After a year of operations, I can not think of one thing we would change. I am very very pleased with how things turned out.”

– Diane Hinely, MSN, RN, Neurosciences Manager with St. Joseph’s / Candler Health System “We are super, super pleased with the design. Everything is so impressive that even after a year of operation we continue to receive compliments. The process is evidenced in the design. You can see it.”

– Neurosciences Director “I’ve completed over 110 surgery centers and Athens Eye Surgery Center was the best project to date.”

– Jennie Simmons, President of Surgery Center Consultants “It was a blessing working with these guys.”

– Will Gaither, PM with Brasfield and Gorrie Contractors “The architect really captured what I was after. I could not be more pleased.”

– President and CEO of St. Mary’s Healthcare System “This is a great place to work. It is really fantastic. We are very lucky.”

– Dr. Gary Persons, MD, Obstetrician “This is the most amazing thing I’ve seen.”

– Dr. Dicks, Neurosurgeon Chief of Staff “Their team’s professionalism was unmatched! Attention and commitment to detail, nothing was left to chance, or unchecked.”

- Christus St. Michael Staff

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SELECT PROJECT LIST

St. Mary’s 200 Building Tenant Upfit for Oconee Heart and Vascular 300 Building Tenant Upfit including MRI/CT 2002 Masterplan 2005 Masterplan Arrhythmia Broad Street Renovations Cath Lab Central Scheduling Chapel Colony Square Renovation C- Section CT Scan Doc Lounge Emergency Department Toilet Emergency Pediatrics Emergency Department Triage Endoscopy Addition Endoscopy Renovations EP Lab Executive Board Room Extended Recovery Gift Shop Health Information Services Highland Hills Dementia Addition ICU Core Renovation Rooftop Infrastructure Infusion Therapy Mammography NCCU Neuro Lab Neuro Diagnostics Operating Room 9 Palliative Care Rehab Addition Rehab Gym Respiratory Therapy Women’s Center Addition Private Dining Emergency Department Canopy Emergency Department EMS Lounge COO Office Board Room OB Sleep 7th Floor Nurse Station 1st Floor Hall Finishes Foundation Project

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Doc Lounge Extended Recovery Lab Draw Area Kitchen Sewer Emergency Department Masterplan 200 Building Renovations Financial Counselling Beltran Office Renovations Hospice House Signage Emergency Department Exam Dining Med School 6th Floor Patient Room Improvements Cath Lab Renovations Respiratory Therapy Sterile Processing Addition Colony Square Suite 229 Xray Dressing Room Flower Suite Industrial Medicine 200 Building Renovations OR Expansion – Threshold Capital 7th Floor ICU Dementia Fire Safety Plan Highland Hills Masterplan 1st Floor GME Renovations Classic City OBGYN Cashiers Mission Services – Computer Training Lab 7th Floor Patient Shower Renovation SMH Hospice House Addition CEP Expansion and Renovation 2nd Floor OR and Support Spaces Renovation 4th Floor ICU Waiting and Staff Areas Renovation 7th Floor Patient Bathroom Renovation Good Samaritan Life Safety Plans Sacred Heart Life Safety Plans Good Samaritan Workflow Analysis Good Samaritan Emergency Department Renovation Sacred Heart Emergency Department Renovation 3rd Floor EP Lab Equipment Upgrade Existing Conditions Plans

University of Georgia

Caremore

University Health Center UHC Vision Clinic Renovation Gold Clinic Renovation Lab Interior Upgrades

Primary Care Facility Temporary Care Facility

St. Joseph’s / Candler Candler Emergency Department Renovations Neurosciences ICU Addition Keller Crymes and Demarco Athens Eye Surgery Center Barrow Regional Medical Center Hyperbaric Wound Care Mary Black Health System MRI Addition

Greenville Health System USC Pharmacy Renovation Bed Scheduling Renovation LDR 6 East Renovations Peace Hospital 2nd and 3rd Floor Nurse Station Renovations Medical Center Powdersville Marshall I. Pickens Classrooms / DE Pharmacy Renovation Au Bon Pain Oakwood Orthopedics Renovation HSAB Renovations 3rd Floor Offices ICU Renovations HYPERPOD North Greenville Campus MRI Canopy Addition Pediatric Neurology – Patewood ‘A’ Heart Education Center Compounding Pharmacy 1st Floor Admin Offices and Medical Library Renovation 5th Floor Dialysis Unit Renovation Echo-EKG Unit Renovation Roger C. Peace 2nd Floor Sub-Acute unit patient room shower renovation Kidnetics Renovation Kitchen Floor Structure Remediation below Proposed MRI Telemetry Surveillance Room Chapel Renovation Vascular Access Relocation Door Hardware Standards Development

King Manor Care & Rehabilitation Center Redesigning a new entry for the facility Renovating the 2 main nurses stations Physical therapy suite Introduction of a robust ADL (advanced daily living suite)

New York School Construction Authority IS 174X School Based Health Center 456 White Plains Road, Bronx, NY 10474

IS 145 School Based Health Center 1000 Teller Avenue, Bronx, NY 10456

MS/HS 272 School Based Health Center 3710 Barnes Avenue, Bronx, NY 10467

PS 391 School Based Health Center 2225 Webster Avenue, Bronx, NY 10458

Susan E. Wagner HS School Based Health Center 1200 Manor Road, Staten Island, NY 10314

IS229 School Based Health Center Roland Patterson School 275 Harlem River Park Bridge, Bronx, NY 10453

Christus St Michael Hospital Madonna Rehabilitation Hospitals Steadman Clinic Shore Orthopedic Novacare Complex Wounded Warriors Home Project Stryker Transport Chair & Patient Room Furniture

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OFFICE LOCATIONS

HEADQUARTERS

NEPTUNE, NEW JERSEY 3297 Route 66 - Neptune, NJ 07753 732.918.2300

DC OFFICE HEADQUARTERS

PRINCETON, NEW JERSEY 341 Nassau St. Princeton, NJ 08540 609.924.6409

NYC OFFICE

NEW YORK, NEW YORK 18 West 21st Street Suite 902 New York, NY 10010 212.941.5890

DC OFFICE

WASHINGTON D.C. 1015 15th Street NW #600 Washington, DC 20005 202.450.5895

James Wisniewski, AIA, NCARB, LEED AP Principal jwisniewski@michaelgraves.com 609 924 6409 x283

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WASHINGTON D.C. 1054 31st St. NW - Suite 138 Washington DC 20007 202.450.5895

SOUTH CAROLINA OFFICE GREENVILLE, SOUTH CAROLINA 1002 East Washington St. Greenville, SC 29601 864.467.9871

SATELLITE OFFICES TALLAHASSEE, FLORIDA 2757 West Hannon Hill Dr. Tallahassee, FL 32309 TAMPA, FLORIDA 8524 Tidal Bay Ln. Tampa, FL 33635

GREENSBORO HOSPITAL SURGICAL & TRAUMA ICU GREENSBORO, NC

GRAVES + MASSA MEDICAL ARCHITECTURE