Healthcare Design - January/February 2016 - 40

The brand message developed
by SmithGroupJJR for the Golden
Gate Urgent Care clinics is
modern with a retail sensibility.
Placed in dense urban retail districts throughout San Francisco,
the bold design and use of color
is meant to attract attention, with
large storefront windows offering visual impact to the street
beyond, especially at night.
Pictured here is the Civic Center
location, completed in 2014.

includes a combined ED and urgent care. In
addition to combatting the safety issues that go
along with true emergency cases landing in an
urgent care that isn't equipped to properly care
for them, it's "a huge inefficiency and overuti40

HCDmagazine.com 02.16

lization of the ED to have all these patients
coming in with very minor things when we
may have more serious patients in the waiting
room," says Stephanie Hill, clinical manager of
Gundersen Emergency Services. But there can
be downfalls. For example, while the colocation at Gundersen solved several problems, it
doesn't allow the flexibility between room uses
that was originally envisioned due to reimbursement differences between the ED and
urgent care spaces. "We have to stay pretty
true to our rooms. That was something that
wasn't completely understood when this initial
model was designed, so we've had to adjust a
little bit," Hill says.
Creating an experience
No matter the facility type chosen, experts
agree that the look and feel of these spaces

The front lobbies of all the
Golden Gate Urgent Care clinics
feature a signature curved wall,
painted in a bold orange color
reminiscent of the Golden Gate
Bridge. While the branded design is similar across sites, each
clinic has distinctive pieces of
artwork used to connect with
local residents, as seen here
at Golden Gate Urgent Care
West Portal in San Francisco,
completed in 2014.
©2015 SHARON RISEDORPH

the day, you get a lot of benefit," Seely says.
However, expectations for flexing between
primary and urgent care could come with limitations, says Centra Care's Brady. "When you
get into complex disease management and a
medical home model that's really at the heart of
primary care, then you're describing a different
staffing model and a different business model
[than urgent care]," he says. "There's some
crossover, but it's not apples and apples. Could
you colocate those in the same box? Definitely."
Shannon Bambery, medical planner with
BWBR (Saint Paul, Minn.), says colocation is
gaining traction on the ED front, too, with larger
systems recognizing the benefit of combining
emergency and urgent care services on one
site. For starters, the move combats the 40 to
50 percent of patients presenting in the ED who
are classified as those who, basically, can wait.
"If all you do is turn them away or make them
sit six hours to get their broken arm set, you're
really missing an opportunity. You've got them
at your door, so how do you turn that into an
ongoing relationship?" he says. The solution in
some cases is a 24-hour freestanding ED with
urgent care, providing round-the-clock access
for patients and the ability to properly triage
them, making sure the chest pain patients
aren't presenting to urgent care and the earaches aren't presenting to the ED-not only for
better care delivery but to simply keep patients
out of the much more expensive ED environment when possible.
Gundersen Health System in LaCrosse, Wis.,
completed a new hospital tower in 2014 that

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Healthcare Design - January/February 2016

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