May 30, 2019

When an architect designs an emergency department, they are assisting their client in setting a stage in which the caregiver can render the best care possible—a stage where real-life drama and action will ultimately play out. Little did I know that a real-life drama of my own would unfold in a freestanding emergency department and ambulatory care center that my firm had designed when my autistic son took ill one evening and I rushed him to Baptist Emergency at Clay. Located in Fleming Island, Florida, and not far from our home, the facility is about 26 miles and 30 minutes from the “mothership” hospital, Baptist Medical Center Jacksonville.

After ordering on-site testing and imaging to rule out more urgent possibilities, the attending emergency room physician was able to consult with an off-site specialist at one of Baptist’s main hospital campuses via telemedicine to develop a treatment plan. This particular ER was one of the first freestanding ED facilities in Florida to incorporate the latest telecommunications technology and infrastructure—a visionary act on behalf of the client at that time—to make remote consultations possible. I am happy to report that we left the ER with a diagnosis, a treatment plan and a prescription for antibiotics, all without my son having to consult with a specialist in a follow-up referral visit.

This personal experience allowed me to develop a much deeper appreciation of the role of freestanding EDs in patient care, and how the initial healthcare delivery model has evolved to bring a diversity of point-of-care services to patients that weren’t previously available in their community. In this post, I take a closer look at this evolution through the lens of two Gresham-Smith designed freestanding EDs in Jacksonville, Florida.


A Design Realized

Since Baptist Emergency at Clay opened in 2013, bringing outside resources in via telemedicine has become an important feature of the freestanding ED. However, as I watched the attending physician serve as my son’s advocate that night, sizing up the situation and resourcing the system, I was reminded how utilizing telemedicine in a freestanding ED was a mere concept just a handful of years ago.



My mind went back to a request from the hospital administrator at Baptist for increased data infrastructure and the incorporation of flex space into the facility design to provide the flexibility they needed to fully realize their vision of bringing this type of care to the community’s doorstep. Now, I was getting to see both the design solution and the end user in action, and a methodology once highly theoretical was now very much in practice—and helping my son.


A Kid-Friendly Model

Along with offering telemedicine services, another way in which freestanding EDs are expanding their scope is by offering specialized care for pediatric cases. To bring emergency services for children closer to home for several communities in North Jacksonville, Baptist Health partnered with Wolfson Children’s Hospital, starting with Baptist Emergency at Clay. Tasked with designing a new kind of freestanding ED, we set about developing a prototype design that provided separate waiting and treatment zones for adult and pediatric populations.

Because of the design’s flexibility, the client was able to adapt the prototype into a series of freestanding EDs in North Jacksonville, including Baptist Emergency at Town Center and Baptist Emergency at North. Today, Baptist Health can offer the services of one of the nation’s top children’s hospitals via these freestanding EDs, providing families with easy access to emergency pediatric medical care, and perhaps most importantly, saving them a trek to Wolfson Children’s Hospital in downtown Jacksonville when every minute counts.


Serving as a Billboard

As freestanding EDs can extend a hospital’s outreach into communities, it stands to reason that these satellite centers also serve as a vehicle that promotes a hospital’s brand and services. In the case of Baptist/Wolfson Children’s Emergency Center at Baptist Emergency at Town Center, both Baptist Health and Wolfson Children’s Hospital wanted the facility to clearly broadcast to passersby that pediatric emergency services were provided within. To achieve this, we paired the Baptist Health logo with the Wolfson Children’s Hospital insignia and displayed them prominently on two different sides of the exterior. This allowed the facility to serve as its own billboard, which is clearly visible from the interstate via multiple directions of approach.

We also introduced a solid feature wall in the organization’s signature shade of blue as a nod to Baptist Health’s “blue wall” which has become an icon for the system. This not only strengthens Baptist’s brand message but also serves as a prominent backdrop to the building, which is also easily visible from the freeway.



Prototype Thinking

Whether it’s offering telemedicine, pediatric-care or other service lines, it’s clear that freestanding EDs are evolving in lockstep with the needs of hospitals, patients and communities. And while it’s important that healthcare designers stay on top of these types of trends, it’s also important for us to provide the kind of forward thinking that sets a few trends. And that sometimes means catching a client’s vision when it exists only in theory. My experience as a customer at Baptist Emergency at Clay served as an unexpected reminder of that.