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    Sustainability in flexibility: Manhattan hospital laid out for the future

    Geraldine Chua

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    A new ambulatory care centre in New York is hoping to change the game in healthcare, reimagining the patient experience and creating a one-stop destination for individualised, coordinated care in Manhattan’s Upper East Side. 

    Designed by HOK, Ballinger and Pei Cobb Freed & Partners, the almost 69,000sqm New York-Presbyterian David H. Koch Centre is home to a variety of services, from outpatient surgery and interventional radiology, to diagnostic imaging, as well as an Integrative Health and Wellbeing program.

    A multi-disciplinary team of physicians works collaboratively under one roof here, considering each patient holistically, no matter their needs. 

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    Image by Albert Vecerka/Esto, courtesy of HOK

    To cater for such an integrated patient experience, the project team had to focus on two key design elements: operational efficiency, and future flexibility and sustainability.

    OPERATIONAL EFFICIENCY

    Every element of the new facility, from the check-in process to recovery rooms, was designed to create a smooth and pleasant patient experience. Smart technology plays a huge role in the design.

    For example, patients can complete their paperwork remotely and securely before their visit, on their mobile phone or online. Upon arrival, they are offered a personalised "smartband" that provides access to the building, and receive information about their visit and step-by-step directions to their room through a NYP app.New-York-3.jpgPrivate infusion room

    Designing smart spaces was also important. Each patient's visit has a clear, planned flow that begins and ends in the same space—a private prep and recovery room that serves as "home base" for them and their companions throughout their visit.

    This home base replaces the large hospital waiting room most people are familiar with.

    Meanwhile, constant communication, including real-time text message updates and a digital smart board in the private prep/recovery area, keep loved ones apprised of a patient's progress.

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    Prep recovery room

    However, nailing this new patient experience paradigm was not without its challenges. Working with the geometry of the site and existing foundations, the team had to optimise navigation and siting.

    City streets and natural light are used as key orienting elements, while staff and patient hallways are separated to prevent patients from having to wander through corridors.

    The procedural areas are also designed as unobstructed spaces for clarity of zones.  

    “A lot of thought went into the choreography of movement so that patients are not faced with unnecessary decision making in a confusing setting,” Amy Beckman, principal and senior project manager at HOK, told ENR. “The building suggests where you move to next.”

    FUTURE FLEXIBILITY

    While catering to existing patient needs and experiences was a focal point of the design strategy, these had to be balanced with adaptability. Layouts and rooms are largely standardised, so new programs or equipment can be swapped or moved around easily in the future.

    At the same time, the team adopted a grid format for the layout, which allowed for just 19 columns throughout the building.

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    Operating room

    The David H. Koch Centre is designed to be sustainable in the long run. Its green roof doubles up as a ‘blue roof’, which can capture up to six inches of stormwater. Its distinctive skin consists of triple-paned insulated glazing with a slatted wood screen, which significantly reduces solar glare, building heat gain, and the need for solar and privacy shading.

    Meanwhile, the curtain wall on one side of the structure acts as a “zipper”, with removable panels that allow for the ease of delivery and installation of new equipment and systems.

    The building is also designed for resiliency in the case of an extreme weather event or disruption to city power, with heating equipment, air handling units, emergency generators and other key operational equipment located on higher floors above potential flood levels.

    “One of the challenges we face in health care design is that the way it’s delivered is changing at such a rapid pace,” Erin Nunes Cooper, associate principal and senior project manager at design firm Ballinger says.

    “No one has a perfect crystal ball. The structure really does give the hospital a lot of options to adapt the space.”

     Images by Albert Vecerka/Esto, courtesy of HOK

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