Ambulatory clinic provides framework for flexibility
Form doesn’t follow function anymore
Like the rest of the national market place, the military is seeking new ways to provide cost-effective health care by not only shifting its emphasis to outpatient treatment but also building flexibility into its new designs.
Take, for example, the concept of a "flexible clinic fabric" used in the design of a 160,000 square foot ambulatory care center at McGuire Air Force Base in Wrightstown, NJ.
The center one of the military’s largest will house a full-service outpatient operation, including ambulatory surgery, radiology, physical therapy, pharmacy, and clinics for family practice, pediatrics, gynecology, orthopedics, ophthalmology, optometry, emergency medicine, flight medicine, and mental health.
But in this case, form won’t necessarily follow function. "Rather than designing individual departments first and then imposing structural elements on top of them, this approach creates a standard, flexible building grid and then fits each department’s need within the framework," explains Laura Poltronieri, AIA, director of health care architecture at Ewing Cole Cherry Brott, the Philadelphia-based architectural firm that is designing the project. "To meet the challenges of changing health care, it’s not always advisable to get as departmentally specific as in the past."
For example, the plan follows conventional building concepts featuring multiple entrances and separate waiting areas for each clinic but breaks with tradition by designing a core of universal exam rooms off each clinic corridor.
"The flexibility of this concept allows for scheduling of clinics according to peak demand times because patients can simply be moved over to the next corridor."
What about cost?
Examination rooms and offices also will be configured alike so that, if needed in the future, one could be easily converted to the other. Building for flexibility is no more expensive than building a conventionally planned facility, Poltronieri notes. "In fact, it can be less expensive because you need fewer square feet since you’re gaining efficiency through the shared exam rooms," she explains.
An additional potential cost saver is installing plumbing outlets behind the walls in the physicians’ offices so that conversion to exam rooms will be much less expensive, she says.
The building will also feature a "simple and direct circulation pattern," points out the architect. After parking in a 350-car lot immediately adjacent to the center, patients enter under a covered canopy at either of two main entrances at the east and the west end and walk into a multi-storied atrium. Each department, marked by a kiosk staffed by a receptionist inside, will have a different seating arrangement."
The structure is warm and filled with light and fountains," says Poltronieri. "It’s not an institutional setting at all."
Scheduled for completion in 2000, the center will serve as a regional hub of outpatient care for servicemen and women and their families as well as retirees.
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