Healthcare Design - December 2017 - 32

The design of the
rehabilitation and therapy
gym uses an open plan
that allows users to
change the layout as
needed to accommodate
the right treatment for
each patient.

BALANCING ACT

As the team continued to develop the design solution for its new location,
final volume projections were being completed, which further informed
the planning. Analysis of demographics and patient origination studies
showed that there would be greater demand at the new site for active
sports rehab and allergy needs in the spring and summer months and
general medicine and orthopedic care in the winter. The design solution
was a system of four flexible pods, each comprising up to 10 exam rooms,
multiple procedure rooms, and a multidisciplinary team center for
providers and clinicians to touch down and collaborate during the day.

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Located on the first floor, the pods each have
direct access from a shared waiting area.
Furthermore, more than 90 percent of the
patient spaces can flex as volumes demand.
For example, when neurology volumes are
heavy during athletic seasons, that service line
will schedule a full pod for four days per week,
and transition to two days per week in the off
season when volumes are lower. Those same
rooms may be used by the cardiology or urology programs on days when they're not scheduled for neurology. Thanks to universal room
design, all the necessary assessment, exam,
and documentation activities of each specialty
are accommodated in the pods, and the exam
rooms are zoned with staff, patient, and family
areas.
The pod design also drove the wayfinding approach. Each of the four clinic entries is clearly
designated with a portal marked by patterned
glass derived from mixed media collages created
by the youth advisory council and a specific color, which is repeated in the architecture and furnishings to promote intuitive navigation. Exam
rooms are oriented on a clear path from each
portal entrance and bound by support spaces
between the exam rows. Staff can easily traverse
between the pod corridors, but patients never
need to leave the corridor they entered.
Through value-stream analysis of support
services, Array also focused on integrating optimal locations and workflows for supplies,
equipment, medication, and lab processing in
each pod to limit travel distances for staff and
increase time spent directly with patients and

HALKIN MASON PHOTOGRAPHY

services on the second floor and cross-training staff with similar skills,
the facility could share resources and space to meet the regulatory and
safety requirements.
To that end, surgical prep and recovery zones were designed as larger
universal rooms that could accomodate families and equipment to meet
infusion patients' needs, further improving the flexibility of the space to
adapt to changing volumes of each program over time. New Jersey regulatory authorities approved this strategy, allowing Nemours to offer infusion while remaining both operationally efficient and financially effective.
Additionally, the project team took advantage of the greenfield site in
New Jersey to refine and streamline existing operations and develop a new
solution for ambulatory practices that better achieve the organization's
goals for flexibility and empathy (most of Nemours' existing outpatient
sites had been developed within existing buildings). Using a Lean approach
and multidisciplinary process-mapping workshops, the team completed
site visits at several existing Nemours facilities to gain an understanding of
the current state and how spatial configurations were impacting it.
For example, a recently opened facility used a team room set-up that
was designed to promote collaboration among the staff; however, the
open space didn't provide an appropriate setting for clinicians to perform
telemedicine consults. In the Deptford building, team centers are designed to accommodate cross-functional care providers to ensure maximum flexibility and utilization across all the specialties, and also include
private rooms to support telemedicine and personal conversations.
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