HEALTHCARE MASTER PLANNING

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1 HEALTHCARE MASTER PLANNING

2 Kaiser Medical Campus Modesto Hospital Support Wing

3 MEDICAL MASTER PLANNING The future of healthcare is one of evolving programs, technology, and alternative deliveries. Facilities must be flexible and ready to meeting these challenges while never losing sight of the needs of the patient or care giver. To be truly effective, a master plan must be a dynamic and evolving document. Lionakis has developed a consensus building approach to medical master planning based on proven experience integrating various stakeholders around a common vision. The physical development of campus master plans requires a solid understanding and the balanced development of client goals, physical characteristics, and the community interests. Lionakis has a six step process to develop a successful medical master plan: Vision, Goals, and Objectives Data Collection and Analysis Operational Modeling and Patient Flow Planning, Entitlement, and Community Interface Site Planning Medical Planning

4 Exploring Campus expansion opportunities

5 Through Lionakis s collaborative process, Kaiser Permanente received a high quality, functional design. It was a pleasure to work with the medical planning staff and they consistently demonstrated expertise and customer focus. Bill Pickford, Planning Specialist NFS Planning and Design Services VISION, GOALS, AND OBJECTIVES Working with a core group or steering committee, Lionakis can help you develop a clear vision statement for a campus master plan. We can then facilitate the discussion, outlining goals and objectives for the master plan, resulting in a strategic master plan for future projects. Desired facility service lines are identified and branding opportunities discussed. The common project drivers of patient and physician appeal are explored. A clear relationship of the facility as part of a larger regional plan or organization is determined. Listening to the stakeholders in the facility, patients, and the community is key to the successful start of the master planning process. DATA COLLECTION AND ANALYSIS A comprehensive master plan begins with understanding the issues. To do this, our team collects and analyzes all relevant data such as existing facility plans, census history, catchment population demographics and projections, vehicular flow, and relevant site characteristics. Obtaining information on common features such as zoning requirements, parking, setbacks, means of public access, utilities, off site impacts, and sustainable strategies is an integral part of all Lionakis projects. Physical site elements specific to significant medical campuses such as aviation pathways, emergency medical response, community utility upgrades, and road widenings are assessed with the assistance of a consultant team with proven experience within the project context. This information is critical to properly evaluate new and existing project sites.

6 Emanuel Medical Center Space Allocation Model The level of service and expertise given to this project by Lionakis was essential to its success, and the project is considered by all to be a major success. On this project Lionakis took customer service to a new level. Our priorities were taken to heart and became Lionakis s priorities. Scott Dasko Project Manager Kaiser Permanente

7 OPERATIONAL MODELING AND PATIENT FLOW Lionakis facilitates the development of the ideal patient experience through mapping of each service line. The objective is to identify the components of the ideal patient experience with measurable metrics of success such as patient waiting time. Since each service line may share components with other departments, the process will inherently address the re-engineering of interconnections between most parts of the hospital. Once the patient experience has been identified, facility operational models are developed. The operational models need to be considered at a service line level and at a facility level to identify overlap and opportunities for efficiencies. These models can be tested against the patient experience metrics and facility operational efficiency. Specialized consultants with computer based tools, developed for this process, help map the operational model of your facility. An economist may be engaged to discuss the financial implications of operational models. This depth of analysis is an integral part of the Lionakis commitment to the long term relationship and the financial success of, our clients. SITE PLANNING Whether its optimizing building orientation and adjacencies, resolving conflicts in pedestrian and vehicular circulation or meeting required parking demands in the most cost effective way possible, Lionakis draws from our vast experience with projects of varying scales and context. We capitalize on opportunities for success by identifying potential constraints for strategic long term growth and the challenges to achieving local approvals. We value the human need for outdoor space and the benefits gained by interaction with gardens and natural spaces to bolster patient wellness and employee / visitor satisfaction. Early in the process we our specialists to transcend accepted design constraints and, if needed, a contractor for cost estimating and scheduling to bring an added depth to the ultimate Site master plan.

8 Site Planning Study For Campus Expansion Options

9 MEDICAL PLANNING Through multi-group user meetings, the functional and space programs are developed. From data and descriptive narratives, physical form takes shape into departmental block diagrams. We collaborate with users to comment, clarify, and confirm with this feedback. Validation of the operational models, the patient experience, and the project vision is completed through core group meetings. Through specialized consultant computer modeling, the effectiveness of the patient experience, operational efficiency, and target cost model is tested and refined. Once planning is complete, design execution begins in concert with the entire project team in preparation for permitting and construction. LAND USE, ENTITLEMENTS AND COMMUNITY ENGAGEMENT Project costs and critical timelines can be greatly impacted by what happens during the entitlement and environmental review process. Effectively navigating this process is critical to project success. This is why Lionakis offers integral planning and entitlement services and brings a broad knowledge of community and jurisdictional issues to advocate client interests and facilitate the successful shift from concept to approved project. The planners at Lionakis are well versed in all aspects of land use development, including the California Environmental Quality Act (CEQA) and have extensive experience in securing a broad array of local, state and federal discretionary entitlement approvals for an extensive array of planning and land use matters. Development or expansion of a medical facility can be a very public process; usually of great interest to the surrounding community it serves. As well, community stakeholders are an important consideration in any project subject to discretionary review. Lionakis works collaboratively with our clients to develop effective strategies which meet project needs and increase understanding and acceptance in the community. In short, we help turn controversy into consensus. Lionakis also routinely investigates the development potential, entitlement status and code compliance for properties being considered for development.

10 SIMPLIFIED WAYFINDING SOUTH SACRAMENTO MEDICAL CAMPUS HOSPITAL & OSC EXPANSION client: Kaiser Permanente location: Sacramento, CA square footage: 200,000

11 This project consists of a new bed tower and outpatient surgery center expansion to an existing hospital and medical office campus. The site is constrained leading to a key driver: make wayfinding as clear as possible, from the patient s arrival on the campus to the hospital or MOB destination. CASE STUDY An existing circular ring road was realigned to be more legible, and a new parking garage was built to enable the expansions to take place. Pedestrian pathways and entry points were enhanced, a primary circulation spine was reinforced with the placement of the new bed tower, and patient and staff routes were separated. The existing architectural vocabulary was dominated by a dark brick veneer. While respecting the initial design, the response was to move to a slightly lighter brick which was used more sparingly and juxtaposed with pre-cast concrete surfaces. The interior circulation spine is enhanced with natural light as landmarks. The introduction of an internal courtyard increases patient room density and functions as a focal landscaped element and healing garden for patients. Sustainable design features include: cool roofs, improved indoor air quality, materials using recycled content, low VOC material, daylighting strategies, healing garden and elimination of vinyl products where feasible.

12 PROMOTING WELLNESS & NATURE MODESTO MEDICAL CAMPUS client: Kaiser Permanente location: Modesto, CA square footage: 680,000

13 This campus design blends the architecture of three unique buildings into one cohesive concept. The buildings are organized around an outdoor room a plaza that creates a public space for contemplation, a healing garden, outdoor conferencing, and open-air markets. CASE STUDY The goal was to create a facility that promotes wellness an oasis for healing. In this regard, our site planning and architectural concepts focus on outdoor spaces for areas to sit, contemplate, and heal through the use of semi-private outdoor spaces and a healing garden. Interior views are also directed to these landscaped spaces. Sustainable design elements include: the largest permeably paved parking lot west of the Mississippi, bio-swales for offsite drainage, storm water management, solar shading from trees, sun shading devices, native and drought-tolerant trees, shrubs, and ground covers; solar collection though photovoltaic panels; and a green roof above the entry rotunda. The energy-efficient exterior skin coupled with lighting and HVAC design provides an environment of low energy consumption without compromising any healthcare activities. During design, it was noted that the required detention basin would occupy up to 20% of the 50-acre site. Considering the environmental and long-term site development goals, the team recognized that a detention basin would require regular maintenance and significant site grading for underground storm drains. Pervious paving became the innovative choice to address seasonal stormwater. Part of the site development approval included detaining stormwater from the campus buildings and hardscape, and runoff from off-site surface streets. This choice freed up valuable land to be used for walking paths through and around the site, a bike path connecting to the regional bike path system, and increased landscaped open spaces.

14 EXPANDING A MEDICAL CAMPUS MODESTO MEMORIAL HOSPITAL Lionakis has enjoyed an on-going relationship with Sutter Memorial, Modesto that spans decades. Their most recent master planning work will serve as the guide for immediate and future growth of our facility. John Del Re, Facilities Manager Sutter Memorial Hospital client: Sutter Health location: Modesto, CA square footage: 150,000

15 Expanding on an existing campus can be very challenging, especially if the campus is already fully builtout. Existing operations and circulation patterns must be fully understood and respected. The master planning process must explore the opportunities and challenges of each possible option, both now and in the future. This proposed five story 15,000 square foot bed tower expansion reinforces the strong interior circulation spline running north/south through the campus. Placement of the new ED provided a clean separation of ambulance and visitor vehicular circulation. The roof top helicopter pad provides direct express elevator access to the ED while conserving valuable site area. Parking was also preserved by placing the expanded Central Utility Plant underground. CASE STUDY

16 NATURE INSPIRED DESIGN & HEALING MOANALUA MEDICAL CENTER client: Kaiser Permanente location: Hawaii square footage: 140,000

17 THE DESIGN The campus design provides a welcoming environment that speaks to the community and the islands. It will promote health and healing to its members, staff, and guests. CASE STUDY The goals of the design were set by the Interior Core team (made up of representatives from the Campus) and the Lionakis design team. These goals are as follows: Create The BIG PICTURE Develop a stronger palette in association with the floor concepts Enlarge floor patterns to enhance way finding and provide a visual from a distance Develop the design both vertically and horizontally. Develop clear standards for casework, paint, flooring, cubicle curtains, wall protection, tile and base. THE PALETTE The palette was developed with materials and colors used throughout the Bed Tower. The team added accent colors from the and new materials to enhance elements and create a strong color palette for each floor. The colors and patterns are used to enhance way finding as a visual relief for patients, staff and guests as they make their way through the campus. CAMPUS STANDARDS The design process reflects a strong Master Palette that will guide each design team for all future projects. When developing these standards, lessons learned from previous projects and concerns in regards to products maintenance and performance were reviewed.

18 OPERATION DURING EXPANSION EMANUEL MEDICAL CENTER MASTER PLAN client: Emanuel Medical Center location: Modesto, CA square footage: N/A

19 THE DESIGN The campus design provides a welcoming environment that speaks to the community and the islands. It will promote health and healing to its members, staff, and guests. CASE STUDY The goals of the design were set by the Interior Core team (made up of representatives from the Campus) and the Lionakis design team. These goals are as follows: Create The BIG PICTURE Develop a stronger palette in association with the floor concepts Enlarge floor patterns to enhance way finding and provide a visual from a distance Develop the design both vertically and horizontally. Develop clear standards for casework, paint, flooring, cubicle curtains, wall protection, tile and base. THE PALETTE The palette was developed with materials and colors used throughout the Bed Tower. The team added accent colors from the and new materials to enhance elements and create a strong color palette for each floor. The colors and patterns are used to enhance way finding as a visual relief for patients, staff and guests as they make their way through the campus. CAMPUS STANDARDS The design process reflects a strong Master Palette that will guide each design team for all future projects. When developing these standards, lessons learned from previous projects and concerns in regards to products maintenance and performance were reviewed.

20 MASTER PLANNING EXPERIENCE HEALTHCARE Kaiser Permanente South Sacramento Medical Center Expansion Modesto Medical Center Campus Master Plan San Rafael Medical Center Expansion Moanaloa Medical Center Master Plan Sutter Health Sutter Memorial Medical Center New Hospital Tower Novato Community Hospital Tracy Community Hospital Emanuel Medical Center Tenet Healthcare Corporation Doctors Medical Center CIVIC State of California, Department of General Services Department of Motor Vehicles Headquarters State Office Building at Butterfield Way Department of General Services Central Plant DMV/CHP Headquarters Facilities Sacramento County Youth Detention Facility Stanislaus County Juvenile Commitment Shasta County Juvenile Justice Sutter County Long-Range Facilities Master Plan Jail Feasibility Study and Master Plan Yuba Yolo County Solano County Government Campus ADA Compliance Project City of Davis Public Facilities EDUCATION West Valley Mission Community College District California State University, Chico Chabot-Las Positas Community College District Las Positas College Merced Community College District Merced College Campus Master Plan Merced, CA Los Banos College Campus Master Plan Los Banos, CA Sierra Joint Community College District Truckee Campus Master Plan Napa Valley College San Joaquin Delta Community College District Delta College South Campus at Mountain House Mountain House, CA Delta College Stockton Campus Stockton, CA San Mateo Community College Distric Canada College Yuba Community College District Woodland College Turlock Unified School District Roseville Joint Union School District San Dieguito Union High School District Stockton Unified School District Franklin High School COMMERCIAL Ronald Malik The Bridges Business Park

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22 ARCHITECTURE ENGINEERING PLANNING INTERIORS GRAPHICS SUSTAINABILITY