Healthcare Studio Archives

Expanded access for behavioral health services to address shortages in treatment options

Margulies Perruzzi (MP), one of New England’s most innovative architectural and interior design firms, announced today that it has completed the expansion and repositioning of two behavioral healthcare units at the Sanford Medical Center (formerly the Goodall Hospital) for Southern Maine Health Care. The grand opening took place on October 20^th. Please click here to view a video courtesy of SMHC about the new behavioral healthcare units.

Southern Maine Health Care, in partnership with Maine Behavioral Healthcare, engaged Margulies Perruzzi and Array Architects to renovate a 24,000 SF unit, creating 40 new beds across two floors, and to design a five-bed Emergency Department Acute Psychiatric (EDAP) unit. This project triples the number of short stay behavioral healthcare beds available in York County, Maine.

“Behavioral health design requires a deep level of both experience and empathy. Margulies Perruzzi worked closely with our staff – both clinical and facilities – to ensure we were able to stay within our budget and yet deliver a high-quality space for our patients,” said Nathan Howell, president of Southern Maine Health Care.

Partnering with Array Architects, a leader in healthcare planning and design, Margulies Perruzzi focused on incorporating as much access to daylight and nature as possible to leverage its clinical benefits. The team collaborated to situate activity rooms and common areas along the exterior walls of the building to bring in natural light and views of the Maine landscape for both patient and staff areas. Windows were maintained at patient areas while safety glass and borrowed light concepts were used to bring daylight deeper into the building. Art highlighting nature is incorporated at various seating areas throughout the unit to bring nature inside the building.

“The design team did a great job of listening to how we care for our patients and how we would be using the space. The new units will allow us to deliver a higher level of care to behavioral health patients,” said Diane Mankus, RN, senior director of behavioral health services at Southern Maine Health Care.

The new inpatient unit is secured with access through an interlocking sally port and features 20 double occupancy rooms, each with its own bathroom. To ensure the safety of patients, each room is designed to minimize ligature risk to provide both privacy and safety. Anti-ligature fixtures were used in the bathrooms and bedrooms as well as vandal proof ceilings. The design team used institutional materials with a residential look and feel to help reduce stress by providing a home-like feel for patients on the unit.

Each floor has a clinical support area with rooms designated for common dining, noisy activity, quiet activity, group therapy/multi-purpose, and private consultations with clinicians. The program accommodated a calming room on each floor that allows agitated patients a quiet area to self-calm through tactile work surface, reduced lighting levels, and reduction in both audio and visual distractions. This de-escalation space helps reduce the need for restraints or a seclusion room.

A centralized staff area provides a variety of open and closed work areas for staff. An open nurse station on the inpatient floors removes barriers between patients and staff. An enclosed private staff area can be used for charting, phone calls, and private clinical discussions.

The design team leveraged new highly efficient and anti-ligature chilled beams to heat and cool the two floors, utilizing existing duct work to maintain existing ceiling heights, and removing the prior fan coil units at the perimeter windows to address patient safety concerns.

The Emergency Department Acute Psychiatric (EDAP) suite is a five-bed assessment area located off the Emergency Department (ED). Designed as the first step in the behavioral health admissions process once patients are medically cleared in the ED, the EDAP includes five patient rooms with a toilet and shower as well as a place to store their belongings while they are being evaluated. Designed around a small common area, the circular design allows clear visibility from the nursing station. The EDAP is located directly adjacent to the security office of the hospital for emergencies.

The project team includes:

Architect: Margulies Perruzzi
Behavioral Health Architect & Interior Designer: Array Architects
Construction Manager: PC Construction
Mechanical, Electrical, Plumbing, and Fire Protection (MEP/FP) Engineer: Fitzmeyer & Tocci
Structural Engineer: Simpson Gumpertz and Heger
Acoustical Consultant: Cavanaugh Tocci

As you may know, The AIA COVID-19 Task Force (including MP’s John Fowler) has published tools to assess and catalog the adaptive reuse of buildings as Alternative Care Sites. We are extremely grateful for all of the hard work and sacrifice healthcare professionals are putting in on the front lines of this pandemic and are looking for more ways to support them whenever we can.

The work of the TF was acknowledged, and AIA was highlighted by ASAE as one of the 100 Associations That Will Save the World (ASAE is the professional association for people who work in Association Management). Click the graphic below to see the entire article. AIA was recognized under the Coronavirus Response section. The rest of 99 associations are an amazing list of organizations that do great work around the country and the world. It is incredible that MP is represented on this TF alongside many others that contributed.

EndoPro Magazine cover story: If you are thinking about expanding, relocating or renovating your endoscopy center or department, there are several key space planning concepts, regulatory requirements, trends, options and features that should be considered before anyone puts pen to paper or sets a project budget.

Given the impact that the current pandemic has had on the ability for many endoscopists to see patients and the use of some endoscopy centers for surge capacity, pandemic resiliency should also be factored into the planning.

Click the cover image for the full article by John Fowler, AIA, EDAC, LEED AP, Healthcare Studio leader at Margulies Perruzzi.

As the stay-at-home mandates are lifted, corporate America is evaluating how to maintain safety measures within their current office space. From rearranging furniture to implementing one-way traffic flow patterns, and providing additional cleaning supplies, tenants and landlords are looking at office spaces and office cultures like never before. But are corporate offices equipped with the right infrastructure to support these changes? More specifically, do our office spaces and buildings have the means to store hazardous materials in abundance? Alcohol Based Hand Sanitizers are often a Class III flammable liquid and their use and storage are regulated by the Massachusetts building code.

Local building and fire codes regulate the maximum quantity of hazardous materials allowed in a building. We’ve taken a closer look at the code implications of increasing hand sanitizer and cleaning supplies in office spaces and recommend developing a Hazardous Materials Management Plan (HMMP) (or update the existing plan) to incorporate any additional hand sanitizer and ensure compliance with these provisions. These plans are also critical to the local fire department and other emergency response teams as the plans will provide the necessary information for fire-fighting and emergency response operations. A chemical inventory including type and quantity of hazardous materials should be maintained by each tenant. We recommend landlords revisit lease agreements and consider adding language to address storage of hazardous materials and to define allowed quantities for each tenant space. Communication between tenants and landlords is critical to maintain compliance and life safety requirements for the building occupants.

Click the image below for the whitepaper by Caitlyn Angelini, P.E. of AKF and Jason Costello, AIA, EDAC, LEED AP of Margulies Perruzzi that breaks down requirements per the Massachusetts State Building Code, 9th edition 780 CMR (based on the 2015 International Building Code).

Jason B. Costello AIA, EDAC, is a Partner | Associate Principal and leads the Healthcare design practice at Margulies Perruzzi.

More information and articles published from the MP Healthcare studio posted regularly.

MP recently published “VOLUME 1: COVID-19 AND THE FUTURE OF THE WORKPLACE
WHERE DO WE GO FROM HERE?” Download by clicking here.

Bob Humenn, Director of Healthcare Strategy at Margulies Perruzzi, has spent more time at hospitals over the past few weeks than he’s spent at home. He is helping them increase the number of beds, create “pop-up” clinics, and set up testing sites. According to Bob, “it is humbling to see the dedication of healthcare workers putting their health and lives at risk every day. While you’re there, it makes you wish that you could do more.”

According to Bob, the Department of Public Health (DPH) and Centers for Medicare & Medicaid Services (CMS) have been very accommodating, issuing blanket waivers to allow hospitals to create testing sites and pop-up clinics in non-clinical areas and to add beds in alternative locations such as recovery areas instead of private rooms. Bob has worked with Milford Regional Medical Center for twenty years and is one of the hospitals that Bob has assisted in addressing COVID-19 through the following strategic initiatives.

Emergency Department Patients
To handle an influx in emergency department patients with COVID-19 symptoms, Margulies Perruzzi worked with Hospital staff to create an Alternate Treatment Area (ATA) in the parking area directly below the Emergency Department (ED). Walk-in ED patients will be triaged at the entry vestibule for Covid-19 symptoms and if appropriate, they will be sent down to the ATA for testing and treatment. The ATA has twenty bays for treatment and space for portable x-ray. The goal is rapid assessment, testing, and discharge within an hour of arrival. Margulies Perruzzi provided guidance on patient flow, regulatory guidelines and design and the ATA was constructed by Consigli Construction using a modular wall system. Cubicle curtains are free-standing and created from electrical conduit for the frame and curtain.

Inpatient Beds
Guided by the directives issued by The Department of Public Health and CMS, Margulies Perruzzi worked with Milford Regional to develop a strategic plan for the anticipated surge of hospital patients. COVID-19 patients will be grouped in existing medical/surgical, progressive care and intensive care nursing units. If needed, non-COVID-19 ICU patients will be cared for in the PACU, using two bays to provide needed clearance between patients, while other non-COVID-19 patients will be cared for in alternate areas such as Infusion and Endoscopy.

Patients Requiring Post-Acute Rehabilitation
There may be patients that are recovering from COVID-19 and would normally be discharged to a Skilled Nursing Facility (SNF). If the SNF is not able to admit a COVID-19 patient, MRMC is prepared to rehabilitate these patients. The Hospitalists, Nursing and Rehabilitation Services collaborated to develop a plan to manage patients requiring physical, occupational and speech therapies in order to maximize the patient’s abilities to move from hospital to home. Margulies Perruzzi worked with MRMC staff to develop options for temporary transitional care units for these patients. The main goal will be ensuring the patients continue to regain their strength in order to return to their baseline before discharge home.

COVID-19 has had a significant impact on the design of health care facilities. The dynamic nature of the pandemic has required our teams to be flexible and highly creative in addressing the needs of our clients in support of those healthcare providers on the front lines. As we ride the flattened curve of infection our focus is shifting to the safe re-activation of the healthcare system to begin seeing non-emergency cases, primary care visits and elective procedures to a broad range of healthcare facilities that until recently have been prepared for COVID-19 patient over flow. Margulies Perruzzi is working to develop strategies utilizing infection control measures and design flexibility to address the complexities of reactivating the hospital in the coming weeks and to better position our community for future pandemics .

COVID-19 Pop-Ups — This space was designed for maximum flexibility to accommodate the changing needs of the COVID-19 pandemic.

More information and articles published from the MP Healthcare studio posted regularly.

Additionally, The AIA COVID-19 Task Force (including MP’s John Fowler) has published tools to assess and catalog the adaptive reuse of buildings as Alternative Care Sites. We are extremely grateful for all of the hard work and sacrifice healthcare professionals are putting in on the front lines of this pandemic and are looking for more ways to support them whenever we can.

MP recently published a report with survey results, “COVID-19 AND THE FUTURE OF THE WORKPLACE WHERE DO WE GO FROM HERE?” Download by clicking here.