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Enhancing the Patient Experience:
Design Drivers for Urban Hospital
Ambulatory Care
HEALTHCARE DESIGN 11
Nashville, TN
Tim Gramann
CEO, GHA
James Harrell, FAIA, FACHA
GBBN Architects, Inc
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TriHealth
Cincinnati, Ohio
 Two acute-care hospitals
with nearly 900 beds
 Good Samaritan (GSH) has
the highest market share in
TriHealth’s four-county care,
and Bethesda North (BNH) is
#3
 Over 10,500 births per year
 GSH is #1 in Ohio; BNH is #7
 One of the largest robotic
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surgery programs in the U.S.
Over 50 outpatient service
locations
Over 250 employed
physicians
Over 1,700 physicians on
medical staff
Over 10,000 employees
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MAP
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GROUP HEALTH ASSOCIATES (GHA)
 Founded 1974 with 3
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physicians
135 physician today
Medical Center Model vs.
MOB
Primary Care and 18
specialties working
collaboratively
Connected with the Epic EMR
Integrated ancillaries on site
Coordinated scheduling to
maximize convenience
Centralized practice
management
Acquired by TriHealth in 2005
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DRIVERS FOR A NEW FACILITY
 Flagship in shambles
 Emergence from hospital to healthcare
system
 Support growth of hospital based specialties
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DRIVERS FOR A NEW FACILITY
65,000 SF Flagship in Shambles
 50 years old
 Build as a concrete structure motel
 Extremely high operating costs
 No room for growth
 Inconsistent with group & system
aspirations
 Inadequate parking and vehicle drop-off
area
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1977 Lincoln Continental
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And Mom Wonders why I don’t Bring
my Friends Over…
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DRIVERS FOR A NEW FACILITY
Emergence from Hospital to Healthcare System
 Support programs of care that cross hospital &
practice settings
- Skin Cancer Center
- Sinus Center
- Weight Center
 Reduction in Duplicate Services
- mammography, dexascan
- outpatient pharmacy
- physical therapy
 Greater integration with hospital based
resources
- radiologists & PACs
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DRIVERS FOR A NEW FACILITY
Support Growth of Hospital based Specialties
 Dermatology
 Otolaryngologist
 Sinus surgeon
 GI General
 GI ESRP Fellow
 Minimally Invasive Bariatric Surgeon
 Colorectal Surgeon
 Oncology Surgeon
 Breast Surgeon
 Orthopedic Surgeon (x2)
 Procedural Physiatrist
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DESIGN CHALLENGES
Urban Hospital Campus Ambulatory Facility
 Separate yet Connected Building Identity
 Convenient interior vehicle drop-off, parking
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and seamless entry
Security & privacy
A ‘sense of arrival’
Intuitive patient flow
Branding entry points of complementary
specialties
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DESIGN CHALLENGES
Urban Hospital Campus Ambulatory Facility
 Planning for the immediate while
preparing for the future
 Balancing vision and reality
 Incorporation of a care team module suite
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DESIGNING THE PATIENT CARE SUITE
Standardization
 Exam Room Design
 Arrangement - permits flexibility in
practice patterns.
 Team Approach - afford patients a more
comprehensive care.
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DESIGNING THE PATIENT CARE SUITE
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PATIENTS / FAMILIES WANT QUICK AND
CONVENIENT SERVICE
CLARITY OF ORGANIZATION
PARK CLOSE TO DOOR
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URBAN CAMPUS
ACCESS TO COMPREHENSIVE DIAGNOSTICS
SAFETY NET OF HOSPITAL SERVICES
CONVENIENCE FOR PHYSICIANS
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URBAN CAMPUS
COMPLEXITY
MULTIPLE ACCESS POINTS
MULTIPLE TRANSPORTATION CHOICES
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DESIGN GOALS
 Optimizing Patient Convenience
 Clarify Entrance Choices
 Rapid Check-in
 Welcoming, Hospitality-type Environment
 Positive Distractions
 Coffee Shop
 Access to Nature
 Access to Artwork
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DESIGN GOALS
 Immediate Access to Ancillary Services
Imaging
 Laboratory
 Pharmacy
 Physical Therapy
 Optometry
 Hospital Services
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PLANNING MODULE
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STANDARDIZED MA
STATIONS
STANDARDIZED EXAM
ROOMS 105 sf
STANDARDIZED TWOPHYSICIAN OFFICES
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RECEPTION
WAITING
PLANNING
MODULES
RECEPTION
WAITING
PLANNING
MODULES
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PLANNING MODULE 12 EXAM ROOMS
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SEVENTH FLOOR
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EIGHTH FLOOR
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CLINIC RECEPTION
REGISTRATION KIOSKS
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CLINIC WAITING
HOSPITALITY SEATING
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SIXTH FLOOR
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SIXTH FLOOR
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SIXTH FLOOR
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MED-MALL
PHYSICAL THERAPY
OPTOMETRY
GALLERY
GARAGE
ELEVATORS
PHARMACY
CHECK -IN
CLINIC ELEVATORS
COFFEE SHOP
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MED-MALL
CLINIC ELEVATORS
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MED-MALL
REGISTRATION KIOSKS
GALLERY
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MED-MALL
COFFEE SHOP
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HOSPITAL
MAIN ENTRY
HOSPITAL
GARAGE
ENTRY & EXIT
GHA ENTRY
BUS STOP
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GARAGE ENTRY
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GHA GRADE ENTRY
PEDESTRIAN ENTRY
AUTOMOBILE ENTRY
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DESIGN GOALS
 Optimizing Patient Convenience
 Clarify Entrance Choices
 Rapid Check-in
 Welcoming, Hospitality-type Environment
 Positive Distractions
 Immediate Access to Ancillary Services
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THANK YOU
Tim Gramann
CEO, GHA
James Harrell, FAIA, FACHA
GBBN Architects, Inc
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