Designer Forum: A VA clinic’s patient-centric design focuses on intuitive wayfinding – Dec 2023

By Ashleigh Savage

The VA Worcester Outpatient Clinic is located on the University of Massachusetts (UMass) Chan Medical School campus. Spearheaded by SmithGroup, the project was honored in the 2023 American Institute of Architects Healthcare Design Awards and the 2022 Boston Society of Architects Design Awards. The driving design concept was twofold: one, to seamlessly integrate the new building into the context of the UMass medical campus, and two, to honor the service and sacrifice of the nation’s veterans. This dual focus is seen in both the building’s grand design and the subtle details of materials graphics and patterning that support the overall architectural approach-with flooring selections from Mohawk Group, Interface and Tarkett playing an integral role.

BUILDING OVERVIEW
The VA leases the first two floors of the four-story medical office building in Worcester, Massachusetts for its community-based outpatient clinic, while the upper two floors are reserved for UMass outpatient and administrative programs. Clinic spaces are organized around the VA’s Patient-Aligned Care Teams (PACT) model, a patient-centered model of care in which a dedicated team of health professionals works collaboratively to provide for all of the patient’s healthcare needs. The building’s programs include radiology, cardiology, mental health, rehabilitation, audiology, podiatry, and pharmacy and laboratory services.

Exam rooms have two entrances, one for patients and one for healthcare professionals, the latter of which connect to off-stage PACT teaming areas. This next-generation design enables multidisciplinary care teams to provide care in one location, reducing the need for patients to move between clinics, while the off-stage workspaces allow care teams to work and collaborate without disruption to patients. 

An awareness of the unique veteran experience is at the core of the project’s design and layout. Military men and women undergo extensive training to be constantly vigilant and aware of their immediate surroundings. Many combat veterans, who may have PTSD and other sensitivities to environmental triggers, do not experience a building in the same way as the civilian population does.

To create a welcoming, calm and clearly defined environment, corridors and stairs are located on the perimeter of each floor so that patients always have a clear sense of egress as well as a connection to the outside and natural light. One prominent stairway adjacent to the lobby, located within glass walls, features a four-story American flag super-graphic, a tribute to all current and former servicemembers. Additionally, dedicated gathering spaces, including a courtyard patio, ensure the visiting veterans can connect with one another, reinforcing a sense of camaraderie.

The clinic wing is denoted by narrow window openings, while the lobby and waiting areas are grouped in the corner, a public zone, with a glass curtain-wall façade to take advantage of the beautiful campus setting. The overall building massing aligns with the established campus geometry, but there is one departure: a striking glass corner framed with crisp white lines-an architectural gesture of welcome and respect, as if the building is standing at attention and saluting.

Energy modeling informed the building massing and determined a strategic window-to-wall ratio design for effectively allowing natural light into the building. Extensive utility savings are achieved using an active chilled beam system with decoupled ventilation, high-efficiency heating and cooling equipment, and LED lighting fixtures. The project was designed to meet a Two Green Globes rating, required by the VA’s lease agreement, as well as Massachusetts’ LEED Plus green building standard, and the building is LEED Silver certified.

FLOORING SELECTIONS
The light-filled interior uses a combination of intuitive wayfinding, a mix of clean and organic lines, and a palette of warm wood and soft blues and greens to create a modern, peaceful environment that elevates the patient experience. All materials were selected to support the idea of honoring the veterans while providing a strong regional connection.

The public lobby greets guests with three different colors of terrazzo, creating a hierarchy of finish while respecting the durability needs of the campus and climate. Incorporating different sized zinc strips between the various colors to add depth and definition, the team designed an organic pattern representative of a waving flag. It was important to the design team that a patient’s first impression directly relate to the quality of care they are to receive, and using terrazzo in these zones helps support the patient’s experience.

Inside the clinic, the team incorporated Mohawk Group’s Hot and Heavy LVT in circulation paths and Tarkett’s Formation carpet tile in soft seating areas. The selections are based on a neutral palette and inspired by nature. The team created a custom gradient of blues, with darker blue indicating waiting areas and lighter blue indicating circulation paths. Mohawk’s Hot and Heavy collection was selected not only for its range of colors and styles, but also for its thickness-the 5mm resilient flooring product aligns seamlessly with the carpet tile from Tarkett. This was done for many reasons: first, to achieve a clean transition, eliminating a tripping hazard for the veterans, and, because of the thickness, the flooring has a high sound absorption property, which is important in highly populated and trafficked spaces.

Because this is an outpatient clinic, the team had more choice than they would have in an inpatient unit, allowing them to use more resilient tile. With an eye on each room’s function and level of cleanability necessary, Tarkett’s IQ Optima sheet flooring with applied base was used in procedure rooms, while Interface’s Studio Set LVT with applied base was used in patient exam rooms.

For the rehabilitation gym, the design team specified 3.5mm rubber flooring from Interface’s Nora, and the designers worked with the care providers to come up with floor patterns that could function as visual cues during physical therapy sessions. For example, the flooring patterns have a lot of linear line work that ranges in colors so the therapists can use them to guide patients.

Overall, however, the design team made sure the flooring selections were not overwhelming. It was important to create a sense of calm inside the clinic, so the flooring does not feature busy patterns with a lot going on. Additionally, it was important that the flooring indicate clear circulation paths to help lead patients to their destination. The resilient flooring selected for the clinical corridors has a defined linear language to it, and the team rotated the tile with the path of travel so that the linear lines are pointing in the direction of travel.

Copyright 2023 Floor Focus 

Related Topics:Interface, Mohawk Industries, Tarkett