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Cirugía ambulatoria: arquitectura

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Ambulatory
ARRAY-ARCHITECTS.COM
Table of Contents
Firm Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Ambulatory Care Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Capital Health Hopewell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Cleveland Clinic Indian River Hospital . . . . . . . . . . . . . . . . . . . . . 20
Montefiore Medical Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Children’s Hospital of Philadelphia . . . . . . . . . . . . . . . . . . . . . . . . 32
Catskill Regional Medical Center . . . . . . . . . . . . . . . . . . . . . . . . . 38
Saint Elizabeth Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Mount Sinai Health System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
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Firm Profile
We are a team of architects and designers with
unique backgrounds, but we all have one thing in
common­—we share a strong desire to use our
expertise and knowledge to design solutions that will
help people in moments that matter most.
The complex, changing world of healthcare requires
a team of effective communicators and true
collaborators. Our 35+ year history of being dedicated
to healthcare holds countless stories of discovering
optimal solutions with our clients.
Our core mission is the same as that of our clients,
improve the quality of our work, increase our
efficiency and motivate our staff to reach for success.
PAGE 4
We are not architects, who do healthcare.
We are healthcare architects.
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“An Ambulatory Care Center should sit at
the heart of the community. The care should
be surrounded by contemporary services.”
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Ambulatory Care Centers
There has been a significant amount of change in healthcare that
particularly impacts Ambulatory Care Centers. Array’s planners
recognize the changing requirement of Ambulatory Care Centers
to serve more patients with more complex procedures in a more
efficient manner.
Ambulatory services are a critical lynch pin in the development
of comprehensive, integrated networks of care that can deliver
services cost-effectively and achieve high levels of patient
satisfaction. Architects must orchestrate a process that allows for
improvements and adjustments to operations while maximizing
space utilization and throughput. The current and future trends in
ambulatory care underscore the high-growth, high-change nature of
ambulatory care facilities and the need for flexible design—now and
into the future as they continue to serve more people in more ways.
Successful ambulatory care facilities are designed to
maximize flow. At Array, we develop distinct circulation areas
for both patients and staff, introduce intuitive wayfinding to
enhance and streamline the patient care process, and then
fine-tune our designs through simulation modeling.
Multispecialty clinics are becoming more popular where services
are rotated with a number of practices sharing the same space.
This arrangement allows for increased space utilization, increase
integration across specialties, and less capital cost. The
expectation is for improved patient outcomes, increased patient
satisfaction and greater market share through cross referrals.
PAGE 9
Healing Environments
“Environments have the power to set our
expectations, lift our spirits and inspire
hope. This is what motivates me to create
spaces that mitigate the challenges
faced by all who enter a healthcare facility.”
Patricia D. Malick, CHID, EDAC, IIDA, Lean Green Belt
Principal and Practice Leader, Interior Design
Capital Health Hopewell
MOB & Cancer Center
PENNINGTON, NJ
PAGE 12
As a companion building to a new state-of-the-art 237-bed
Replacement Hospital for Capital Health, Array in association
with HKS, designed a new 328,000 SF Cancer Center and
Medical Office Building. Joined to the new Hospital by a
two-level pedestrian mall, the building consists of five floors
with suites ranging from 1,000 SF to 10,000 SF. The building
houses a combination of hospital-based outpatient services
and physician practice suites.
First floor services include a comprehensive Cancer Center
with state-of-the-art linear accelerators and cyber knife
therapies to treat outpatients. Additional first floor functions
include an outpatient Imaging Suite programmed with
radiography, nuclear medicine, 3.0T MRI, CT and PET/CT
equipment. A Spa is situated with access to Oncology in
support of a holistic approach to patient needs. Services
tailored to patients include wig fittings and lymphatic
massages. The Spa is also open to staff and the public.
Infusion programs are vertically connected by the lobby atrium
and pedestrian mall. The infusion bays have access to and
views of a roof garden developed over the Cancer Center’s first
floor with a coffee bar adjacent to the roof garden. Second floor
functions accessed from the mall include a four-OR ambulatory
surgery suite. Floors three through five are dedicated physician
office space. Corridors overlooking the five story atrium
connect the MOB/Cancer Center with the Medical Center and
allow for easy access for physicians who have rounds to make.
570,000 SF New Hospital
330,000 SF Medical Office Building
Left: Atrium
Photography: Blake Marvin/HKS, Inc.
PAGE 13
Capital Health Hopewell
MOB & Cancer Center
PENNINGTON, NJ
PAGE 14
“Wow I can’t believe this is a hospital.”
Al Maghazehe, PhD, FACHE
Chief Executive Officer & President, Capital Health
Patient safety, family-focused care and operational
efficiency were the focal points for the design.
The design team segregated inpatient and
outpatient flow to support an exceptional patient
experience. Additional dining options are available
on the first floor – adjacent to the Main Entrance
reception desk as well as on the second floor of
the outpatient side of the facility, providing a place
for a quick meal and respite while waiting for an
outpatient surgical or infusion patient.
The inclusion of multiple gardens surrounding
the Hospital and their integration into the natural
landscape allows the building to be an extension
of the environment. The result: a new hospital that
reflects the history of Capital Health, offers patients
and their families an enhanced experience and
supports the technology of modern medical care.
Collaborators:
AKF Engineers
Anchor Health Properties
HKS, Inc.
O’Donnell & Naccarato
Skanska
Target Building Construction
The Lighting Practice
Wells Appel
Top Left: Waiting and Reception
Top Middle: Infusion
Top Right: Waiting
Bottom Left: Emergency Family Waiting
Bottom Right: Water Feature within Healing
Garden
Photography: Blake Marvin/HKS, Inc.
PAGE 15
Capital Health Hopewell
MOB & Cancer Center
PENNINGTON, NJ
PAGE 16
Because patient and family engagement was so critical to
the overall vision, the design team was tasked with not only
designing hospital functions but also gift shops, a spa, public
resource library, business center, coffee shop and bistro. The
Oasis Spa was designed to offer full spa services to the public,
visitors and patients, with a particular focus on cancer support.
Top Left: Waiting
Top Right: Oasis Spa
Bottom Left: Bistro Dining Area
Bottom Right: Gift Shop
Photography: Blake Marvin/HKS, Inc.
PAGE 17
Wellness
“As a father, I am even more focused on
the value of wellness and prevention
and setting a good example for my
children. As an architect, I want to
empower others to do the same.”
Jonathan M. Bykowski, AIA, Lean Six Sigma Black Belt
Principal and Practice Leader, Continuous Improvement
Cleveland Clinic Indian River Hospital
Health and Wellness
VERO BEACH, FLORIDA
In conjunction with Anchor Health Properties
a universal exam room for all specialties and
and Indian River Medical Center, Array designed
primary care. Using this universal room in a
a 72,000 SF integrated medical home model
standardized pod configuration allows Indian
health and wellness campus. This phase
River to flex the boundaries of each individual
features a multi-specialty physician practice
service line on a moment’s notice without the
center with integrated diagnostics and health
need for renovation or cost.
education. The building shares a healing garden
with our recently completed cancer center and
is designed to allow provider synergy between
the programs.
The full project is designed to promote
prevention, education and healthy living
in addition to providing chronic disease
management and interventions. The project
Built for optimal flexibility, a series of early
features cross discipline care coordination
process and design prototyping work sessions
and a unified patient experience while being a
with stakeholders from each practice yielded
market differentiator for Indian River.
Top: Exterior
Bottom Right: Waiting Area
Bottom Center: Work Space
Bottom Right: Exterior
Photography: Halkin Mason Photography
PAGE 20
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Emblem Health
Medical Office Building
BROOKLYN, NY
PAGE 22
A new 160,000 SF seven-story Medical Office Building with
elevated parking, is designed to provide outpatient medical
services at a bustling Brooklyn intersection. Serving the
community in this urban setting, the building was strategically
located near major mass transportation to attract patients to
the health system’s expanding services. The project is one of the
largest and newest buildings in the neighborhood and will act as
a catalyst for community growth.
Urgent Care and Imaging, which have high walk-in patient
volumes, were placed at the ground floor, setback and
surrounded in highly visible storefront, under a continuous
marquee, to help connect to the urban fabric. Vehicular traffic is
directed discretely off the street, up a ramp into three levels of
parking, cloaked in a back-lit veil of custom perforated soft white
metal panel. Physician practices are located on the top three
floors of the building with a draped in articulated glass wall. The
folding glass wall was parametrically designed to respond to
mitigate late afternoon solar gain, as well as provide stunning
views of the city from the waiting areas.
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Emblem Health
Medical Office Building
BROOKLYN, NY
The spatial organization supports each patient’s
clinical, emotional and physical needs and provides
a safe and efficient facility allowing caregivers to
deliver healthcare in a compassionate environment.
Activity rooms and dining areas feature partial height
partitions and glass walls to provide visibility from
the support zones and also allows natural light to
flow through the central areas. Large scale, impactful
art serves as a wayfinding device at key entry portals,
complemented by soothing colors and materials.
Previous Page: Exterior
Top Left: Infusion
Top RIght: Waiting
Bottom Left: Exterior (side view)
Bottom Center: Waiting
Bottom Right: Exam Room
Photography: Halkin|Mason
Collaborators:
Cauldwell Wingate
Cerami Asscoites
Cosentini
Dewberry
FNA Associates
HDLC
Metropolis
Reuther + Bowen
Thornton Tomasetti
Timothy Haahs
VD Associates
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Ambulatory
“Except for the beds, ASCs have all the
elements of a hospital. Programming
one can be like solving a complex,
three-dimensional jigsaw puzzle. I
enjoy figuring out the most efficient
way to put all the elements together
to achieve throughput goals.”
Jeffrey P. Drucker, AIA
Vice President, Northeast & New England Regions
Montefiore Medical Center
Ambulatory Surgery Center
BRONX, NY
PAGE 28
Montefiore Medical Center selected Array to consolidate
ambulatory services from three campuses and outpatient
clinics into a new state-of-the-art Ambulatory Tower
that would become the benchmark for their expanding
Ambulatory Care services. Array provided planning and
design services for a new 12-story Ambulatory Surgical
Center on a site that received prior zoning approval for a
hotel. To avoid obtaining a variance, which would result
in significant cost and delays, the footprint and setbacks
could not be altered.
Array developed a unique design solution incorporating
dedicated elevators for staff and materials within the
operating suites and support areas. Although the 12 ORs
and four procedure rooms (sized to become additional
ORs if needed) are split between three floors, simulation
modeling showed that the dedicated elevators facilitated
patient flow and reduced room turnaround time.
Opposite: Exterior Canopy
Rendering: Array Architects
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Montefiore Medical Center
Ambulatory Care Center
BRONX, NY
PAGE 30
Left: Waiting Area
Middle: Prep/Recovery Bay
Right: Operating Suite
Above Center: Main Lobby & Waiting
Rendering: Array Architects
Collaborators:
BR+A Engineers
Reuther & Bowen
Cauldwell Wingate
Jones Lang LaSalle
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Montefiore Medical Center
Ambulatory Care Center
BRONX, NY
PAGE 32
“State-of-the-a
art ambulatory tower that would become the
benchmark for ambulatory care services.”
- Client
Left: Exam Room
Right: Pre-Op / PACU
Bottom: Elevator Lobby & MRI room
Middle: Team Center
Photography: Halkin Mason Photography
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Oncology
“After having the privilege of working
with heroes who cure, treat and receive
care in our cancer environments, I will
never underestimate the importance of
creating uplifting, inspiring spaces.”
Lisa N. Lipschutz, RA, ACHA, EDAC, Lean Green Belt
Principal and Senior Planner
Children’s Hospital of Philadelphia
Child Care Physician Practice
FLOURTOWN, PA
PAGE 36
The Children’s Hospital of Philadelphia (CHOP) engaged
Array Architects to fitout their new physician practice in
suburban Philadelphia. The physicians currently lease
space in a one-story medical complex surrounded by
specialists and small businesses.
By expanding their primary care practice in Flourtown,
they can maintain their current patient base while
attracting new patients to a stand-alone facility with
ample parking.
Array has recently completed, or is currently working on,
similar physician suite expansion projects in Haverford,
Newtown and Springfield, PA
Opposite: Exterior Canopy
Rendering: Array Architects
PAGE 37
Children’s Hospital of Philadelphia
Child Care Physician Practice
FLOURTOWN, PA
PAGE 38
Top Left: Exam Room Corridor
Middle Left: Exam Room
Bottom Left: Staff Workroom
Opposite: Reception/Waiting
Photography: Jeffrey Totaro
PAGE 39
Engagement Management
“As an architect, I live for fulfilling and
evolving challenges of healthcare
design, and as engagement manager,
I am dedicated to creating team
enviroments that ensure the shared
success of each project and its team
members.”
Alex Berman, AIA, LEED AP BD+C
Studio Director, National Capital Region
Catskill Regional Medical Center
Medical Office Building
HARRIS, NY
PAGE 42
Catskills Regional Medical Center’s new Montreign medical
office building is a highly adaptable clinical platform
designed to adapt to the needs of its community over time.
The 12 exam room space is designed to support a range of
general and specialty medicine along with the opportunity
for urgent care services supported by an imaging suite
comprised of X-Ray and CT capability.
Exam rooms are designed to maximize flexibility with a
cart system for storage of supplies based on the use of
the room for the day. A central team work area is designed
with a mix of space types for “heads down” focused work
and face-to-face or digital collaboration. Care was taken to
shield the work space from the corridor to preserve visual
and auditory privacy.
Exterior Photography: Halkin Mason Photography
PAGE 43
Catskill Regional Medical Center
Medical Office Building
HARRIS, NY
PAGE 44
Process-led design employs a rigorous and engaging approach
to quickly define goals and obstacles. Process-before-design
encourages the integrated team to focus on experience, quality,
outcomes, and work flow before specific spatial configurations begin
to limit innovation. Process mapping, visual programming, virtual
and physical mock ups and rapid prototyping were used in parallel
during the early design phases to ensure the optimal solution.
Top Left: Waiting
Top Right: Exterior
Bottom Center: Exterior
Photography: Halkin Mason Photography
PAGE 45
Patient Experience
“As Director of Design and Construction
for a top-10-ranked Medical School for
15 years, I had the opportunity to sit in
the client’s seat and work with many
architectural firms. I strive to bring that
perspective to all of our projects.”
George Shmidheiser, RA
Principal and Practice Leader, Project Operations
St. Elizabeth Healthcare
Ambulatory Care Center
COVINGTON, KENTUCKY
PAGE 48
Following a merger/acquisition of two hospitals located in
the Cincinnati metropolitan area, St. Elizabeth Healthcare
recognized a need for a new Ambulatory Care Center to
serve as a ‘Gateway for Health’ to increase its profile in the
Cincinnati metropolitan area’s growing market.
Array sited this new, three-story, 120,000 SF Ambulatory
Care Center facing a major interstate to increase public
awareness. A “Main Street” circulation design provides
convenient access to all services including a central
registration and reception desk, community conference
space, bistro, gift shop and patient education center. This
spine follows the length of the building with access to
Imaging and Lab Services and the 10,000 SF Urgent Care
Center. The Urgent Care Center establishes an optimal
patient experience with a focus on convenience.
Patients are warmly greeted, then invited to use the
latest technology for registration. Retail amenities ensure
patients and visitors have an engaging, positive experience.
Exterior landscaped views and an intimate reflection
garden, beautiful artwork and rich colors and textures
serve as orienting devices for both patients and staff.
Exterior Photography: J. Miles Wolf
PAGE 49
St. Elizabeth Healthcare
Ambulatory Care Center
COVINGTON, KENTUCKY
The Ambulatory Care and Urgent Care Center
provides many necessary services to this growing
area of northern Kentucky. The facility establishes
an outpatient experience where the patient can be
scheduled more conveniently and treated more
quickly in a less clinical environment. The building was
strategically located on a major interstate that fronts
the site and has a direct exit to the facility. Ambulatory
Care services are located on the first floor for public
access and cross utilization of staff. Easy access to
services was accomplished by the creation of a “Main
Street” circulation design that fronts all services.
Collaborators:
Anchor Health Properties
Champlin Architects
Health Strategies & Solutions
KLH Engineers
Messer Construction
THP Limited
Top Left: Private Gowning
Bottom Left: Main Street Corridor
Middle Right: Patient Registration
Bottom Right: Physical Therapy
Photography: J. Miles Wolf
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Mount Sinai Health System
Center for Health and Healing
NEW YORK, NY
PAGE 52
The Center for Health & Healing’s primary focus is on wellness
and offers an integrated, preventive approach to medicine.
Their clinic was recognized as one of the first healthcare
spaces in the US to incorporate sustainable materials as well
as Feng Shui principles. Demand for The Center’s services
drove the need to expand their practice. Array designed an
expansion plan which doubled their practice space onto
another floor of the same building, allowing the original
practice to operate during design and construction.
Array recently completed the renovation of The Center for
Health and Healing incorporating design tenets based in the
Feng Shui design methodology in conjunction with evidencebased design concepts. The new 10,000 SF floor includes
a gym with physical therapy services and treatment rooms;
reception and waiting areas; clinical space with consultation
and exam rooms; massage room; and, support areas. Feng
Shui findings were based on an energy profile which consisted
of an analysis of compass orientation, astrological influences,
building footprint and floor plan analysis. Using these findings,
space layout was adjusted to promote harmony with nature,
culture and community.
Reception Photography: Jeffrey Totaro
PAGE 53
Capital Health Hopewell
MOB & Cancer Center
PENNINGTON, NJ
PAGE 54
Using Feng Shui principles,
space layout was refined to
promote harmony and balance.
Feng Shui tenets:
• Enhanced healing potential throughout the
floor was capitalized by adding mineral quality
crystals in wall cavities and ceilings requiring
positive energies.
• Enhanced brand recognition and client loyalty
by designing bold dramatic graphics at entry of
elevator lobby.
• Natural daylight brought into formerly dark
areas.
• Enhanced income generation and business
growth by incorporating red, orange and green
accents and special textured materials.
The project accomplished Mount Sinai’s Center
for Health & Healing’s goal to transform the quality
of healthcare and its delivery toward a more
holistic model conscious of the role played by
the environment in the healing process. Demand
for the Center’s services grows and is expected
to increase as healthcare in the United States
continues to shift from one focused on illness and
reaction to one of wellness and prevention.
Collaborators:
Alex Stark
Kallen & Lemelson
Wexler Associates
Linmar Construction
Top Left: Exam Room Corridor
Top Right: Waiting
Bottom Left: Staff Room
Bottom Right: Physical Therapy
Photography: Jeffrey Totaro
PAGE 55
Interiors
“Knowing that the environment can
affect the healing process, I strive
to create comfortable, inspiring
and supportive spaces for patient,
family and staff.”
Stephanie Story, LEED AP BD+C, NCIDQ
Senior Interior Designer
Mount Sinai Health System
Beth Israel Medical Group
NEW YORK, NY
PAGE 58
Beth Israel Medical Center, part of Continuum Health
Partners, offers a broad-based fully integrated health
services network throughout the New York City metropolitan
region. After their lower Manhattan family practice patient
base increased beyond the capacity of their offices,
Continuum committed to quickly expand the services offered
at the medical facility. Continuum selected a building at
the corner of 8th Avenue and 23rd Street for the expanded
practice. The project included the renovation of a three-story
building adjacent to a popular restaurant
The design features a new curtain wall and façade that
incorporates the client’s brand with LED-illuminated panels
and signage. The exterior now draws patients to the space
and defines the entrance with a matte silver façade that is
lit blue in the evening. The entry canopy defines the practice
entrance and leads to an inviting building lobby and concierge
desk that speaks to Beth Israel’s patient and physicianfriendly environment.
Continuum’s new facility provides a multitude of resources
for their patients. The new walk-in, primary care medical
practice is located on the 2nd floor, while the 3rd floor serves
the specialty practices such as dermatology, radiology,
ophthalmology, orthopedics, GI, cardiology and pain
management.
Reception Photography: Jeffrey Totaro
PAGE 59
Mount Sinai Health System
Beth Israel Medical Group
NEW YORK, NY
This 16,500 SF renovation is now a benchmark
facility for Continuum and is considered a ‘Center of
Excellence’ for ambulatory care. The architecture
promotes Beth Israel’s brand, announces the
presence in the neighborhood and helps attract
new patients. The interior design promotes better
workflow and clinical efficiencies for the staff. The
warm, light and airy design lends an overall positive
feel which heightens staff morale and patient
satisfaction.
Top Left: Reception and Waiting
Top Middle: Reception
Top Right: Exterior
Bottom Left: Nurse Sub Station
Bottom Right: Nurse Station
Photography: Jeffrey Totaro
Collaborators:
Kallen & Lemelson
Wexler Associates
Linmar Construction
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