Case Study: Planning a Prototype Health Center
By Cynthia Hayward
Originally printed in the
SpaceMed Newsletter
Fall 2013
www.spacemed.com
BACKGROUND
The Northwest Territories one of three federal territories of Canada delivers
healthcare to its residents through eight Health and Social Services Authorities.
While half of the 42,000 residents of the Northwest Territories live in the city of Yellowknife, the rest of the population is spread throughout 32 different communities
that are a mix of settlements, towns, hamlets, and villages. With many of the existing remote health centers in need of replacement, the Department of Health and
Social Services decided to develop a prototype health center that could be replicated to serve communities of less than 1,500 people many of which are accessible
only by air.
THE CHALLENGE
The challenge was to develop a community-oriented, culturally-sensitive facility
focused on wellness to reflect the new "Integrated Service Delivery Model." This
client-centered approach to providing health and social services focuses on health
prevention and promotion using a multidisciplinary team of nurses, social workers,
mental health and addictions counselors, and other community-based and visiting
staff. At the same time, there was a need to provide operational flexibility with
generic, multi-use and technically adaptable spaces to allow visiting and rotating
staff to function efficiently regardless of which facility they are assigned.
Operational plans were initially prepared for small, medium, and large health
centers based on a demand analysis and site visits to the remote communities of
Jean Marie River, Fort Providence, and Normal Wells. A space planning
methodology and facility configuration concept were developed that could be
scaled-up or scaled-down based on the assigned staff and availability of local and
regional services. This would allow a functional and space program to be easily
prepared for each new health center as it is replaced.
A structured planning process was undertaken that included identifying generic
spaces to be located within the health center, determining the factors that drive
the size and number of individual spaces required, and aggregating space by its
function to optimize the work flow and circulation and minimize construction costs.
FACILITY PLANNING PRINCIPLES
After review of the planned scope of services, hours of operation, projected staffing,
and support service assumptions documented in the operational plan, key facility
planning principles were established and
include:
2013.6.3
The health center should be communityoriented, culturally sensitive, and focus on
wellness.
The health center environment should be safe and secure.
Advanced technology should be embraced to the extent possible.
Spaces should be multi-functional, flexible, and adaptable as programs,
services, and technology evolve over time.
All health centers should be configured similarly to allow staff to easily work in
any facility with minimal orientation.
Copyright SpaceMed
www.spacemed.com
Page 1 of 4
Case Study:
Planning a Prototype
Health Center
Continued
IDENTIFYING GENERIC SPACES
All potential spaces were identified and room data sheets were developed for generic spaces that accommodate similar functions and can be replicated in each
health care center. This provides future flexibility as well as cost savings as rooms
are similarly sized and finished instead of tailored to the occupants at a particular
site.
DETERMINING KEY SPACE DRIVERS
A specific space driver was determined for each individual room or area to be located in the prototype health center (illustrated in the diagram below):
Staffing dependant spaces. The number of exam/treatment rooms, offices,
consult rooms, and administrative workstations are based on the expected daily
head count including nurses, social workers, and mental health/addictions
counselors, and support staff.
Variable. The total number of exam/treatment rooms and office/consult rooms
in which clients will be routinely scheduled during the day will impact the
number of waiting room seats and client toilet rooms. At the same time, the size
of the mechanical room depends on the overall size of the facility.
Fixed. All other spaces will generally not vary in either number or size,
regardless of the overall scope of activities and projected staffing at a specific
health center.
Optional. In addition, the decision to include on-site provider apartments
versus a single staff sleep room within the health center will depend on housing
availability within a specific community.
Staffing
Dependant
Client Care
Space
Variable
Waiting seats
Client toilet rooms
Mechanical room
Fixed
Exam/treatment rooms
Office/consult rooms
Dental treatment room
Optional
Administrative
Space
On-site provider
apartments
Staff sleep room
2013.6.3
Reception office
Private offices
Workstations/cubicles
Copyright SpaceMed
www.spacemed.com
Entry vestibules
Group meeting room
Emergency treatment
room
Multipurpose
screening room
Medication room
Laboratory
Clean/soiled utility
rooms
Kitchen/dining room
Laundry room
General storage room
Housekeeping room
Other
Page 2 of 4
Case Study:
Planning a Prototype
Health Center
Continued
ORGANIZING SPACE INTO FUNCTIONAL CATEGORIES
The functional program and space planning guidelines for the prototype health
center were organized into five major categories of space which relate to specific
activity zones within the prototype facility as follows:
Public reception zone includes the main entrance to the health center and
associated public spaces and amenities.
Client care zone includes spaces for client assessment, treatment, and
counseling along with associated support space.
Staff administrative zone is for the exclusive use of the staff assigned to the
health center.
Building support
zone includes
housekeeping,
storage, mechanical,
and other spaces that
support the facility but
are not routinely
occupied by staff.
Provider housing will
be located on-site and
include four onebedroom apartments
with a shared entrance
and laundry room.
Provider
Housing
Staff and Service
Vehicle Parking
Service
Entrance
Building
Support
Zone
Client Care
Zone
Staff
Entrance
Staff
Administrative
Zone
Public
Reception
Zone
Clients and visitors arrive
at the health center, park
as necessary, and enter
Main
Entrance
the building via the main
Client and Visitor
Parking
entrance leading directly
into the public reception
zone. From this area, clients will be escorted to the client care zone when the provider is ready. Access to
the staff administrative and building support zones will be for the exclusive use of
the staff and secured from public access. Dedicated service and staff entrances
should not be visible from the main entrance (e.g., at the rear of the facility) to avoid
confusion.
FUTURE EXPANSION
The health center was designed to accommodate future expansion if required. The
organization of the facility into distinct zones will facilitate the expansion of one or
more specific zones independent of the others as shown in the diagram on
the next page. It should be noted that demand for additional client care and staff
administrative space will be greatest.
2013.6.3
Copyright SpaceMed
www.spacemed.com
Page 3 of 4
Case Study:
Planning a Prototype
Health Center
Continued
Provider
Housing
Service
Entrance
Building
Support
Zone
Staff
Entrance
Staff
Administrative
Zone
Client Care
Zone
Public
Reception
Zone
Main
Entrance
Due to the economies of scale, the planned
building support spaces have the capacity
to accommodate a significant amount of
future growth in client activity volume. Likewise, the public reception zone does not
necessary need to expand proportional to
the client care zone depending on whether
throughput is improved, hours of operation
are extended, and other factors. The provider housing can also be expanded independent of the health center itself.
SUMMARY
By developing a space planning methodology and a generic space programming
template and a conceptual facility layout the process of preparing a functional
and space program and schematic design for any new health center in the Northwest Territories can be expedited. In addition, this approach will result in short-tem
operational efficiencies and long-term operational flexibility while minimizing construction and renovation costs.
See the room-by-room space planning template for the prototype health center at
www.spacemed.com/newsletter/news63.html.
The Government of the Northwest Territories contracted with Hayward &
Associates LLC in Ann Arbor, Michigan to develop the prototype health center. The
replacement of facilities in Jean Marie River, Fort Providence, and Norman Wells is
in process and functional and space programs have been prepared for facilities in
Tulita and Lutsel Ke based on the prototype.
Cynthia Hayward, AIA, is founder and principal of Hayward & Associates LLC.
2013.6.3
Copyright SpaceMed
www.spacemed.com
Page 4 of 4
