Healthcare design hinges on patient needs and a cohesive look: Designer Forum - March 2017

By Michael Burke

Sacramento, California has grown into a healthcare hub, with no fewer than four major healthcare providers serving the Sacramento metro area. Following the lead of other local and regional healthcare providers, UC Davis Health made the decision to expand access to services within the city’s downtown and midtown core-known by locals as the Grid-combining primary and specialty care services into a centralized location. Creating a cohesive design, while paying particular attention to the unique requirements presented by departments such as pediatrics and neurology, played into Lionakis’ design of the facility, especially in the selection of finishes and flooring.

Upon leasing a 100,000 square foot, three-story building originally designed for outpatient clinical use, UC Davis set about renovating the space not only to bring it up to current code and medical practices but also to infuse it with a new look. With minor improvements to the lobby area, such as paint and the installation of Shaw’s Color Play carpet tile, already completed by the building owner, UC Davis’ desire was to develop a modern and contemporary design to complement the lobby improvements while evoking hospitality and warmth. Heading into the design process, the health system had a clear idea of what it was looking for in its newly renovated clinic, and the design team worked closely with it to select products and materials that would bring its vision to reality.

HEALING MEETS HIGH PERFORMANCE
The interior design of healthcare facilities requires that we seek a unique balance between adhering to the institutional requirements of a medical facility and providing a tranquil and welcoming environment. People arrive at medical facilities for different reasons-for work, a happy occasion, a routine visit or, perhaps, for one of the most difficult days of their lives. Designing healthcare spaces that are warm and welcoming is key to providing a healing environment that supports the patient while providing an environment in which staff and family members can thrive as well. This trend in the design of healthcare facilities takes its cues from the hospitality industry, designing healthcare spaces that feel more like a luxury hotel or resort than a medical office building or hospital. The fun part of designing these hospitality-inspired healthcare facilities comes in part from the vast array of flooring materials and options available today. The plethora of options allows designers to embrace this trend in creative ways that are still cost effective, durable, sanitary and easily maintained, such as laser-cutting resilient flooring to play with patterns or installing wood-like flooring in an exam room or back-of-house support area to add warmth while enhancing aesthetics.

The existing building’s main feature is an open, airy three-story lobby that connects all the floors, daylit by a large skylight. The design streamlines wayfinding for patients, as all departments are visible from the ground floor. The openness provides a strong connection between the central lobby and each provider space, while the palette and flooring enhance the wayfinding process and differentiation between spaces, such as waiting areas, patient reception desks, exam rooms and support areas. Lionakis provided a furniture package to enhance the minor lobby improvements already made by the owner, offering a variety of open seating arrangements. The client’s ultimate goal was to continue improving the lobby-as the central focal point of the building-infusing the space with more seating options to provide variety and more intimate seating options to meet each visitor’s unique needs. Off the lobby, Lionakis utilized a mostly neutral palette with a range of materials and textures to provide visual interest, while the neutral tones provide a timeless look.

Maintenance, durability and lifecycle costs are always key concerns when designing a public space, and the neutral palette was selected in part due to the anticipated lifespan of the flooring. While pops of accent colors through fabric, paint and artwork can be easily changed out and updated to refresh a space, flooring is not as easily or frequently changed out. In a busy medical facility like this one, which serves a diverse population ranging from children and families to the elderly, a durable and neutral flooring that can truly stand the test of time in both wear and appearance is extremely valuable. A variety of materials, including carpet, faux wood and vinyl, were leveraged throughout the space to enhance wayfinding, manage acoustics and create natural separations between functional areas.

In the design of all public facilities, and especially in healthcare, privacy is of the utmost concern, and the decision to go hard versus soft in any given area is often influenced by acoustics and privacy. At the Midtown Clinic, the design team utilized different flooring types to define areas of separation while enhancing patient privacy. For example, by using a combination of carpet tiles and faux wood flooring in the waiting room areas-with Milliken’s Remix 2.0 Freestyle carpet tile in Snare with Azul and Mannington Commercial’s Spacia resilient flooring in Dusky Walnut, an innate privacy divider was created between the reception desk and the rest of the waiting area. Rather than posting a large sign asking patients to stand back, the differentiation in flooring encourages them to wait back on the carpeting until their turn is called. In addition to managing acoustics and privacy through the decision to use soft flooring in the busy waiting area, acoustical features located above each reception desk provide another layer of sound management.

Combining multiple existing providers and facilities into a centralized location also required a balance to ensure that the design would be generalized enough to weather any changes down the road, but specialized enough to address the unique concerns presented by some of the specialty providers moving into the space.

PATIENT-FOCUSED DESIGN
For a child, even a routine visit to the doctor can be a scary thing. Recognizing this, the team was intentional in selecting a bright, patterned carpet tile-Milliken Fixate Velvet in Compound-and child-sized furniture for this space. The design of the pediatrics department provides bright colors, liveliness and playfulness, resulting in an environment that is not only welcoming and friendly, but also designed with some of the health system’s youngest patients in mind. The bright color palette of saturated blues and greens in the pediatrics department is echoed in less saturated hues throughout the rest of the building via artwork, accent walls and furniture, resulting in a cohesive design.

The wide range of patients served by this facility also includes older patients, some of whom have neurological and balance issues and dementia. Particularly busy or patterned flooring can present a challenge for patients with these types of conditions. Ensuring the safety and comfort of patients is always the most important consideration when developing a design and selecting flooring and finishes. At the Midtown Clinic, the use of Shaw’s Color Play carpet tiles in the hallways and Milliken’s Remix 2.0 Freestyle carpet tiles in all waiting and select back-of-house areas achieved a neutral look while meeting all safety requirements. Areas featuring resilient tile, such as the sleep lab and exam rooms, were installed with Mannington’s Spacia in Dusky Walnut, while the Lab and Triage departments feature Armstrong Striations composition tile in Haze. These wood-like options provide warmth and reinforce the hospitality inspiration but are also easily maintainable.

Staff safety and comfort also play an important role in flooring and finish selection. Shaw’s Feeling Plush Glitz carpet tile in Seaside Elegance was chosen for the conference rooms and select back-of-house areas for ease of installation and management of acoustics. Installing the carpet tiles with a quarter turn subtly adds visual interest and movement to these spaces.

By adhering to California’s Green Building Code, many projects in the state are already well on their way to LEED status, regardless of a client’s sustainability goals. While some clients choose to forgo LEED certification, many others are building upon this sustainable baseline by establishing LEED goals for all projects. UC Davis Health has established a goal of LEED Silver for all projects, and the UC Davis Midtown Clinic was no exception. Eco-friendly and PVC-free flooring, such as the Milliken carpet tile and Armstrong resilient tile, were used wherever possible. By leveraging LEED points accrued simply by designing to the code and making smart decisions on materials and finishes, the project was able to exceed the client’s goal and recently achieved LEED Gold for Commercial Interiors.

It is one thing to simply design a functional and usable space; it is another to design a soothing and welcoming environment. Blending a hospitality-inspired design with sustainable principles allowed the Lionakis team to deliver a successful project to UC Davis, which promotes health and healing while minimizing the clinical feel of the facility.

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