MMA Architects | Walmart Health - Calhoun, GA

Wa l m a r t

H e a l t h

Evidence Based Design Calhoun, GA VOLUME 2

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Introduction Exterior Lobby Acoustics Wellness Center Clinical Support Primary Care Dental Dental Distrobution System Vision Center Now Open

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“As architects, our daily goals are to create design problems, so we can solve them. That’s what we do. Designing what we want is easy. Designing what our clients need and want, that is our real purpose. If we can do that, we are good listeners!

When we listen, we learn.”

-Gabriel J. Massa, CEO

ABOUT US

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The Process

WALMART HEALTH INTRODUCTION

Evidence Based Design (EBD) is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes.

Challenges: There is a lack of primary care or family physicians in the United States: The problem appears to be getting worse. According to research released by the Association of American Medical Colleges in March 2017, the estimated shortage of primary care physicians will be between 8,700 and 43,100 physicians by 2030. Today we are facing a global pandemic that stretches across all continents. COVID-19 is testing the healthcare industry’s ability to deal with crises with providers, supplies and the ability to get care. This pandemic will change the landscape on how the healthcare industry will be providing care moving forward. What that will look like, is yet to be known!

Solution: So how do we begin to deal with the lack of primary physicians in this country. First, we need to acknowledge it and second, to provide options for patients.

Revitalizing the nation’s primary care system is critical to achieving safe, high-quality, accessible, equitable, and affordable health care for all Americans. The primary goal is to address what the patients really want. Patients are looking for a single source location for most of their health and wellness needs. Unlike many primary care facilities that take care of a handful of patient problems and chronic illnesses, developing a facility that can accommodate an array of services, that’s a Game Changer.

On January 29th, 2020 Walmart Health Launched its second Primary Care Clinic in Calhoun, Georgia. Dallas Georgia being the first which opened on September 13th, 2019. Walmart Health offerings include a very diverse set of services under one roof giving Walmart customers and their patients the opportunity to easily access what they need, whenever they need it. Services include cost effective and comprehensive primary care including behavioral health, telehealth, dental, phlebotomy, imaging services, audiology, community health (nutritional services, fitness), health insurance education, clinical and optical services and a newly designed state of the art vision sales and pharmacy.

Walmart continuous to learn. The Calhoun clinic is roughly

2,400 square feet smaller than Dallas, Georgia and no functions or offerings were removed or replaced. The feedback from the community has been extremely positive and continues to be.

We started the design and construction of the Calhoun facility 3 months prior to opening Dallas, Georgia. Our goal was to evaluate the Dallas footprint and look at ways to further reduce the footprint while simultaneously maintaining all the primary functions. We were able to collectively achieve that goal.

Walmart continues to engage in getting feedback from the community to help better understand community expectations, build trust and more importantly allow the community to engage in the process and improve the quality and delivery of our Health & Wellness Service offerings.

Accessing high-quality primary care is critically important for

health. Unfortunately, for low-income people, it often falls short of meeting needs. Many low-income patients avoid getting care or needed tests and because of costs. Many times, appointments are unavailable outside regular working hours. These individuals struggle to get paid for time off and can’t forgo the income.

Walmart has extended hours including weekends and providing digital solutions such as telehealth services to help overcome these types of issues for our customers. Walmart is also overcoming cost by allowing the uninsured and the insured choices that best fit their needs, including cash and financing options. Service offerings are about 30 to 50 percent less than what people are paying now. Just another way of reinforcing Walmart staples by being accessible to low-income households.

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Live Better

Reduce Time to Market

Live Better Program. The Health & Wellness Strategy Continues

Reduce Time to Market. Use of previously constructed full-

to Evolve. Walmart knows a well-trained and engaged workforce is critical to winning in the future. To prepare its associates for the next generation of healthcare jobs, Walmart in September 2019 began giving it’s 1.5 million associates in the U.S the opportunity to apply for one of seven bachelor’s degrees and two career diplomas in health-related fields for $1 a day through Live Better U, Walmart’s education benefit program. There is no other retailer in America that has a program that allows its associates the opportunity to achieve a degree in healthcare that can translate into a higher-paying job within the company or in the broader field.

Medical primary care physicians are continually facing

jam-packed schedules, unproductive work environments, and numerous minuscule tasks and as a result, the value of physician-patient relations are declining. Sixty-five million Americans live in what are officially deemed primary care shortage areas and adults throughout the United States face difficulty obtaining prompt access to primary care. Walmart Health with the array of services being provided, along with the design and development of state-of-the-art facilities, is helping the healthcare industries reduce the impact of these issues.

Appropriate Care

Appropriate Care is essential to a sustainable healthcare business

model. This new 7,600 square foot facility can now meet the needs of the patients as well as the needs of the healthcare staff.

Since its opening late January, there has been a tremendous amount of feedback from physicians, nurse practitioners, and others delivering healthcare services who are grateful for the clinical space they work in. Leveraging existing strengths in health and wellness and working with the right partners can ensure a value-based sustainable care model and beyond.

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scale mock-ups provided an opportunity to test future-state operational processes. While the configurations of the prior mock-ups were different, the room sizes and layouts remained the same. This testing led to many design decisions including, the placement of the various functions within the facility.

Ways in maximizing the footprint while offering the various services. Reduction in non-revenue generating spaces such as circulation. Everything from floor finishes, ceiling finishes, casework were continually being explored and tested within the mock-up. Unlike the Dallas facility design, Calhoun underwent a fast track approach. Foundations and steel being erected while we were still in production and getting long lead-time jurisdictional approvals.

Testing Multiple Options continues to improve the program.

Calhoun differs in size from Dallas as well as exterior and interior aesthetics and will continue to do so until we get it right. The branding team continues to refine the interior theme to ensure we eventually create a brand that our patients and customers recognize and trust. A brand, that represents the strength and quality of service offerings.

Walmart is and continues to be, a Forward-Thinking Company!

MMA is exceptionally proud of being selected as the Lead Healthcare Design Team for this project. We want to thank LB Johnson – Vice President of Health & Wellness, Michael Thomas – Senior Director of Health & Wellness and all the other internal Walmart contributors and the associated Walmart consultants, Berry Hutton Construction, Camp5, Anderson Retail, Regency Lighting, CPH, Fitch, Henry Schein, Del Medical, Imaging Physics, Sevan, Steelcase and Arbee Associates. Without them, the project would never have been as successful as it is. A special thanks to Katie Bricker Photography for all of the great shots.

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Walmart

Health

Innovation is Key

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To successfully implement EBD principles, the design team sought to create an environment of care that incorporates streamlined processes, new technology, and nurturing design elements.

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Lobby For All to Enjoy

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Digital Signage placed throughout our facility helps to provide support for our staff, create an engaging experience for our patients, enhance wellness initiatives, and create a safer and more productive work environment.

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Lobby Central Hub

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“The feel of the center is more

conducive for that “white glove experience” that everyone at Walmart Health is striving for.

As more and more patients come in with anxiety, the feel of the center greatly reduces any induced anxiety that a local environment could bring on. Gabe and his team has a keen eye on what we are needing and putting our wants/needs into reality.

Thank you so much for your hard work! ” -Jason Mann, DMD

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Hospitality MODULAR POSSIBILITIES

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How To Achieve Optimal Healthcare Acoustics Many sounds are present in clinical environments, including those from, individualized discussions, patient interaction, equipment, rolling carts, HVAC systems, and among other sources. These can be irritating and at times disruptive to patients depending on their current conditions (i.e., age, hearing ability, medication intake, cultural background, and preexisting fears and anxieties).

Acoustics in healthcare environments are complex and require a careful, strategic design. Specific acoustical considerations in healthcare settings include supporting patient well-being and privacy; supporting communication among staff; and meeting standards and regulations of Health Insurance Portability and Accountability Act of 1996 (HIPAA). Evidence Based Design acknowledges acoustical control as a key component in healthcare design. In this Calhoun facility, acoustical control was an essential necessity.

Numerous steps were taken to control sound levels and transmission.

Maintaining patient privacy was our highest concern. The following are some of the targeted mitigation measures implemented into our facility.

1. Vulcanized Composition Rubber Underlayment: Flooring is an especially important design element within the healthcare environment. Not only is it necessarily found in all spaces, but the type of flooring specified greatly influences the outcome of each space. ECO Silence Underlayment made from Vulcanized Composition Rubber (recycled tires) is an underlayment designed to exceed IIC requirements while maintaining a low profile. Our 2mm underlayment can achieve Delta IIC ratings up to 25dB and IIC ratings up to 72 dB. Rubber underlayment not only provides acoustical properties it adds additional cushion underfoot. Caregiver staff spends most of their workday on their feet and this reduces leg and back fatigue.

2. Interior solid core doors with high pressure laminate, HPL is considered to be one of the most durable decorative surface materials in the healthcare industry. All doors have acoustic sound seals to block sounds from entering or exiting the rooms.

3. The above-door transfer grille simply has two grilles located above the door between the room and common space, one on each wall, with offset baffles to limit sound transmission.

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4. Rooftop HVAC units are high SEER units with lower fan speed to mitigate noise transmission 5. Sound Masking in Healthcare Clinics: It was essential to install a state-of-the-art Sound Masking System in our clinic. Our primary focus is to provide our patients’ right to speech privacy, as well as the physical and psychological effects of noise on patients and caregivers. Studies have shown that noise increases distractions affect health and mood decreases productivity, and increases error rates.

Sound masking is part of a proactive approach in providing patients with speech privacy and comfort and providing our caregivers with the productive “space” they need to excel.

6. Lay-in ceiling with sound attenuation providing a CAC value of 42. Typical throughout

6” metal stud walls t channels & 6” sound ding an STC rating o

6” metal stud walls t sound attenuation pr of 49

3 5/8” metal stud wa ceiling sytem with so proving an STC ratin

to deck with relilient d attenuation provinof 54

to deck with 6” roving an STC rating

alls to to 6” above ound attenuation ng of 49

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Wellness Center Classes by Tivity Health

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Improving Patient Safety: to reduce slips and falls injuries, slip resistant flooring was specified throughout.

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Nurses Station Personalized & Friendly

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Clinic Support

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Primary Care Exam Rooms

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Primary Care: Minor Illnesses & Injuries Acne Allergies Back pain Chickenpox Cold and canker sores Cough, cold, flu Dizziness & fatigue Ear infections & earaches Ear wax removal Eczema Fevers Gout Head lice Headaches/migraines Heartburn & indigestion Hives and rashes Minor burns, blisters, & cuts Mono Mouth pain Nausea, stomachache, vomiting & diarrhea Pink eye, styes, & corneal abrasions Poison ivy/oak Ring worm, athlete’s foot, jock itch Scabies Sexually transmitted infections Shingles Sinus infections & congestion Skin tag/wart removal Sore & strep throats Splinter removal Sprains, strains & joint pain Suture & staple removal Tick/bug bites & stings Upper respiratory infections Urinary tract & bladder infections

Ongoing Health Conditions Anxiety (mild) Asthma COPD (mild/moderate) Depression (mild) Diabetes (uncomplicated) GERD/heartburn Heart disease (uncomplicated) High blood pressure High cholesterol Obesity Osteoarthritis Osteoporosis Thyroid disorders (hyper and hypo)

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Tests & Screenings Diabetes (Blood glucose & HbA1c) Cholesterol Flu Mono Pregnancy Strep throat Tuberculosis/PPD Urinalysis Bacterial vaginosis Trichomoniasis Additional lab services available

Immunizations & Injections

Chickenpox Flu Hepatitis A & B Human papilloma virus (HPV) Measles, mumps, rubella Meningitis Pneumonia Shingles Tetanus, diphtheria, pertussis B12 injections Birth control injections Migraine treatment injections Vaccines subject to availability.

Age and health condition related restrictions may apply.

Wellness Services Adult wellness exam Annual physicals (school, camp, work) Birth control DOT physicals* Nutrition counseling Pre-employment physicals Prescription refills Screening - obesity, high BP, high cholesterol, diabetes Smoking cessation Weight loss Well woman exam *By appointment only

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Behavioral Room

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Behavioral Health Counseling for adults Diagnostic screening and assessment Individual and couple’s therapy Wellness, recovery, and resiliency education Grief counseling Healing from trauma and abuse Stress and anxiety management

Can help to address: Stress and anxiety Feelings of sadness and loneliness Relationship issues Life Changes Psychiatric illnesses Trauma Substance use disorders and other addictive behaviors Gender identity concerns Depression and mood disorders

Behavioral health setting was designed to be noninstitutional and calming for patients. As part of the calming measures, natural daylight coupled with an incandescent table lamp helps set a more comfortable environment for the patent. Dimmable LED ceiling lighting further enhances the calming measures by being able to completely dim or turn off the overhead lighting fixtures. These measures provide solutions that will meet the needs of a diverse patient mix while providing a sense of comfort.

The room has been designed for one on one counselling sessions, marriage and couple counseling sessions and or family and group counselling sessions.

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Blood Lab

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Phlebotomy

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Imaging Room

RADIOGRAPHY EXAMINATION CONTENT SPECIFICATIONS

Anteroposterior Projection

ARRT® BOARD APPROVED: JANUARY 2016 IMPLEMENTATION DATE: JANUARY 2017

Anteroposterior Projection

Posteroanterior Projection

Right Lateral Position

Left Lateral Position

Right Lateral Position

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“The entire Walmart Calhoun Left Posterior Oblique Position

Right Posterior Oblique Position

Left Anterior Oblique Position

Right Anterior Oblique Position

Left Posterior Oblique Position

Left Anterior Oblique Position

ARRT® BOARD APPROVED: JANUARY 2016 IMPLEMENTATION DATE: JANUARY 2017

RADIOGRAPHY EXAMINATION CONTENT SPECIFICATIONS

Posteroanterior Projection

Anteroposterior Projection

Posteroanterior Projection

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installation was a smooth and successful process. The reason for the Calhoun project being a huge success was the MMA staff effectively communicated with the Del Medical Technical Team early on and throughout the entire process. Their expertise allowed for efficient planning of the numerous details involved with the installation of a state-of-the art Del Medical Digital Radiographic System. Del Medical gives the entire MMA team an outstanding score for the entire planning and site preparation process.”

Right Lateral Position

Left Lateral Position

Left Posterior Oblique Position

Right Posterior Oblique Position

Left Anterior Oblique Position

Right Anterior Oblique Position

Left Lateral Position

Right Posterior Oblique Position

Right Anterior Oblique Position

-Ron Cronin, VP of Sales at Del Medical

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Dental Care Suite Treatment Rooms

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Preventive Services Exams Periodic limited Comprehensive X-rays Intraoral individual Intraoral bitewings Intraoral FMX Panoramic CBCT (Cone Beam CT) Prophylaxis Adult Child Fluoride Sealants

Direct Restorations Resin based composite restorations (1,2,3,4,5 surfaces) Therapeutic restorations

Indirect Restorations (CAD/CAM Technology to deliver same day restoration when applicable) Inlays (composite and porcelain) Onlays (porcelain) Full coverage crowns (porcelain) Temporary acrylic crown (transitional purposes only) Recement/Rebond restorations Bridges (porcelain) Implant crown and bridges (porcelain) Endodontics Anterior root canals Bicuspid root canals Molar root canals

Adjunctive Services

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Removable Prosthodontics Complete dentures (upper and lower) Immediate dentures (upper and lower) Partial dentures (upper and lower) Immediate partial dentures (upper and lower) Adjust complete/partial dentures Repair complete/partial dentures Reline complete/partial dentures Rebase complete/partial dentures Interim complete/partial dentures Tissue conditioning complete/ partial dentures Overdentures complete/partial (over implants)

Oral Surgery Simple extractions Surgical extractions (no impacted wisdom teeth or no IV sedations) Socket preservations following extractions Orthodontics Limited orthodontics

Periodontics Gingivectomy Provisional splinting Scaling and root planing (limited and full) Full mouth debridement Periodontal maintenance Gingival irrigation

Teeth bleaching Occlusal guards (Night guards) Sport guards Nitrous Oxide

Providing a functional balance dental suite incorporating the principles of architectural design, clinical function, technology integration, and ergonomic design. These elements work together to produce a balanced, functional, well-designed practice that expresses Walmart’s personal vision while effectively meeting the needs of their patients.

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Dental Exam Room

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“The current design allows our Dental team to work

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more efficiently with greater privacy during more invasive dental procedures.�

-Jason Mann, DMD

Four-Handed Dentistry A technique in which a dentist works together with a dental assistant or another dentist on the procedures being done in the mouth of a patient.

This technique reduces fatigue and improves the effectiveness of the dental procedure.

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“It was with great pleasure to

work with MMA on the designs of the center in Calhoun, Ga. We were able to learn from the first center in Dallas for MMA to redesign some of the layout to create a more unified experience. ” -Jason Mann, DMD

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Panoramic

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Sterilization Lab

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Vision Center Sales

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The Vision Center undergoes a total transformation. With upgraded and branded eyewear, to casework, new state of the art equipment and colors that deliver the WOW!

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Vision Center Sales L o v e Yo u r E y e s L o v e O u r L o o k

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Optometry Medical eye exams (red eyes, infection) Basic eye exams Contact lens exam Trauma to the eye

Sales Floor: Shopping for Frames & Contact Lenses Select & Discuss Lenses Repairs Advise on Insurance Benefits Fitting & Adjustments Pupillary measurements Seg height measurements for progressives

Pre-Test Services: Color Blind Test Air puff- Tonometer- screens for Glaucoma Auto refraction- how the eye processes light Visual Fields Screening- peripheral vision Auto Lensometer- read the prescription on the patient’s’ current glasses Retinal Digital Camera (Some locations) takes a photo of the back of the eye providing a view into overall health Pupil dilation (If Retinol Camera is not used)

Exam Room/Lane: Visual Acuity test Ocular motility Test- eye movement Slit lamp Exam- view the eye structure Pupil dilation (If Retinol Camera is not used)

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OD Lane

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Pre Test

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Audiology

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Audiology Testing, fitting and selling hearing aids Hearing screenings and tests Adults only – 19 years and up

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Colors help assess the Level of Care: Walls painted with lighter shades have proven to make people feel accepted, while that of medium shades help create trust. The different color vinyl graphics also contribute greatly to the environments. Blue is soothing, symbolizing the sky and sea. It lowers the heart rate, therefore allowing the body quiet time to heal itself. Green creates balance and harmony within the body. It is especially good for heart and blood-pressure problems. Yellow is thought to have decongestant and antibacterial properties, acting as a cleanser for the body. Orange gives vitality to the body and is associated with the kidneys, urinary tract, and reproductive organs. It is a proven fact that colors can influence a person’s perception of their surroundings.

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Employee Break Room

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OUR 3rd LOCATION

Loganville, GA G ra n d O p e n e d - 6 .1 7. 2 0

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OUR 4th LOCATION

Springdale, AR Grand Opened - 6.24.20

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Our fourth location is better, faster and smarter.

This is MMA’s first design-build collaboration approach with Walmart. Walmart’s GC constructed from the ceiling grid up and MMA with the various sub-contractors and venders built from the ceiling grid down including all FFE for the most part. From pencil to opening, including all entitlements, permitting, physicist, shielding to Certificate of Occupancy, 2 months 27 days. Remarkably fast. Unprecedented!

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Looking to the Future

Creating Lasting Impressions Through Design

Your site or company’s Branding

In our modern world, most traffic is brought by web at the conveni-

and Marketing aspects are going

ence of some one’s tablet or phone. Whether they need a place to stay,

to be how clients and custom-

hangout, eat or drop off their dog, your branding message is what

ers identify your product. It is the

makes you stand out among the rest when customers are looking.

public image and message that your company stands behind and influences future reputation and customer base.

Let us Market your Project MMA’s professional Web Design and Marketing Team has a vast portfolio of full-scale architectural sites, marketed through web, print and social mediums. We offer full marketing, imaging and web design services

OUR SERVICES ARCHITECTURAL DESIGN

We create sketches of your project which give form to the qualities and functions described and respond to the unique features of your site.

INTERIOR DESIGN

We shape the experience of interior space, through the manipulation of spatial volume as well as surface treatment for the betterment of human functionality.

MASTER PLANNING

High-quality designs that create a strong identity and enhance the long-term value of a new development project are both key to the success of any master planning assignment.

PROJECT ENTITLEMENT

Applicable zoning regulations, municipal codes, General Plan, and neighborhood council requirements – resulting in project approval from a Planning Commission or City Council.

DOCUMENTATION

We prepare dimensioned architectural drawings and detailed specifications for construction which describe the materials, sizes, and relationships of built components.

CONSTRUCTION ADMIN

During construction, we serve as your advocate to interpret the construction drawings, answer questions and work out details as necessary.

GET IN TOUCH

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RENDERING

Bring your project to life at any stage of development with the creation of diagramatic, romantic or photorealistic renderings

ANIMATION

Working closely with our clients we shape the way a project is presented and showcased using the latest technology available.

SUSTAINABLE DESIGN

Designing physical objects, the built environment, and services to comply with the principles of social, economic, and ecological sustainability.

WEB DEVELOPMENT

Websites that adapt to each unique visitor. We work to ensure your website is effective and easy to use on any device.

VIRTUAL REALITY

A new offering from Studio B. You can now experience a 360 view of your project renderings on a dedicated webpage.

MARKETING

Get your message heard with our marketing services. Email marketing, Search Engine Optimization & social media marketing.

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MMA LOCATIONS FOUNDED 1996

HEADQUARTERS

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

DC OFFICE

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 OFFICE

TALLAHASSEE, FLORIDA 2757 West Hannon Hill Dr. Tallahassee, FL 32309 732.898.7856

SATELLITE OFFICE

TAMPA, FLORIDA 8524 Tidal Bay Ln. Tampa, FL 33635 732.898.7863

WE KNOW HEALTHCARE

NEPTUNE, NJ 3297 Route 66 Neptune, NJ 07753 732.918.2300

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

GREENVILLE, SC 1002 East Washington St. Greenville, SC 29601 864.467.9871

TAMPA, FL 8524 Tidal Bay Ln. Tampa, FL 33635 732.898.7863

TALLAHASSEE, FL 2757 West Hannon Hill Dr. Tallahassee, FL 32309 732.898.7856