What constitutes a healthful, vibrant, mixed-use and flexible healthcare campus? What will be the role and responsibility of healthcare and civic partnerships in the larger built environment for supporting human health, promoting healthy lifestyles, and improving equitable access to health-promoting activities and healthcare services?
These were just a couple of key questions explored at AIA South Atlantic Region’s recent “Healthcare Without Walls” conference, which focused on topics related to expanding the reach of healthcare organizations outside of traditional healthcare services.
One glance at the ever-changing healthcare landscape tells a story of tremendous change, with healthcare delivery expanding beyond the scopes of hospitals and healthcare campuses and into our communities. With this change comes a larger focus on prevention and a care model that moves beyond symptoms and sickness to wellness.
“Healthcare campuses are increasingly being reimagined and interwoven into communities as opposed to being isolated from them.”
Healthcare campuses are increasingly being reimagined and interwoven into communities as opposed to being isolated from them. The AIA conference reinforced to me just how much the design of healthcare campuses and districts is shifting, creating opportunities for them to serve as models of healthy and livable community design.
As a healthcare architect, I’m committed to designing spaces that promote community wellness and population health management. And, I personally don’t think it’s possible to discuss the subject of “community wellness at healthcare campus—and beyond” without asking one important question first: Why should we focus on community wellness? In this blog, I take a look at why.
Responding to Public Health
Focusing on community wellness is important because it addresses the interconnection between the built and socioeconomic environments, as well as access to healthcare, by listening to—and raising the voices of—marginalized populations. But where do we start?
Ultimately, healthcare design must respond to population health. One of the visual tools that helps identify infrastructure and organizational policy changes that need to be addressed in healthy community design is the Health Impact Pyramid, which includes both individual and community factors.
Health Impact Pyramid
At the base of the pyramid—indicating public health interventions with the greatest potential impact to a community overall—are efforts to address socioeconomic determinants of health, such as inequality, poverty, lack of housing and poor education. In ascending order, and yielding smaller impact, are clinical interventions that require ongoing, direct clinical care, as well as health education and counseling.
By integrating this framework for public health action into our designs, we encourage healthy communities with a focus on the development of walkable streets, bike paths, green spaces and preserving nature. Leading healthcare clients into partnerships for health also promotes the development of healthy communities and is an important step in helping to address underinvestment in public health and community resilience.
Community Wellness & Design
So, how can we design healthy communities? Some of the traits shared among successful community wellness projects include implementing a mixed-use approach (such as planning for residential, retail and healthcare services in the same area), providing access to nearby transit, emphasizing walkability, accommodating alternate modes of transportation such as cycling, and creating a vibrant, diverse architectural language.
Community wellness is a continuum with multiple scales of application, identified by the size of the typical project type and the size of the population served. These scales can be classified as:
- City scale: Large, citywide projects that aim to improve the public health of a large population.
- District scale: Wellness districts within a city that serve as a catalyst for health initiatives and improving quality of life in the area.
- Neighborhood scale: Smaller neighborhood clinics serving the distinct needs of neighborhoods, particularly those with a lack of access to healthcare or other services.
- Hospital scale: Urban hospitals that engage the community around them by providing open green space.
One of the driving factors in a successful community wellness project is an inclusive design process. This method consists of extensive user-group and community-stakeholder meetings throughout the duration of the project’s design and development. These sessions allow for voices from a wide spectrum of groups to be heard to account for the unique needs of a community.
When planning for larger projects, such as a wellness district or a hospital campus master plan, a Needs Assessment can be developed. This process includes understanding data specific to the populations and geographic area served, holding key informant interviews with stakeholders, conducting listening sessions with the hospital’s regional health board, organizing focus group meetings with residents, and oftentimes participating in a health summit with community and hospital leaders.
When a project team understands the needs of a community as seen through a “wide-angle lens,” the project has a far greater chance for success in terms of creating the greatest impact for community health and wellness improvement.
A New Community Health Model
These insights have been incorporated into several Gresham Smith community wellness projects, including UF Health Wildlight at the master-planned Wildlight community in Nassau County, Florida. The overarching goal of Wildlight was to create a health-centric development for residents in Yulee and its surrounding areas that focuses on disease prevention, improving quality of life through encouraging healthier lifestyles, and taking a more proactive approach to addressing the health and wellness of the community.
In support of this goal, Gresham Smith worked collaboratively with UF Health to design a new community health model in the form of UF Health Wildlight Ambulatory Care Center and the UF Health Rehabilitation Clinic, Healthy Living Center and YMCA. Our healthcare designers combined the insights from community health data and the confluence of consumerism and population health to design these forward-thinking facilities that are at the core of the Wildlight community.
The 43,000-square-foot, two-story ambulatory care center provides the clinical services most needed by the Wildlight community, including primary care, urgent care, pediatrics, obstetrics, labs, imaging, dentistry, and behavioral health. Extensive telehealth integration was adopted in the building to support the variety of programs offered, allowing the facility to easily adapt to changing technologies, extend its services to a wider scope of patients, and make available the full resources of the UF Health specialties.
The 37,000-square-foot Rehabilitation Clinic, Healthy Living Center and YMCA is comprised of a 10,000-square-foot rehabilitation center, a two-story, 25,000-square-foot YMCA, and a 2,000-square-foot concourse and Healthy Living Center—all providing critical programming for creating a healthy community.
The rehab clinic offers occupational therapy, physical therapy and speech-language pathology to adult and pediatric patients, directly responding to the community’s healthcare needs by providing the first full-service pediatric rehabilitation office in the region. The YMCA features cardio and strength-training equipment, a second-story running track, and dedicated workout studios that provide space for group exercise classes.
The Healthy Living Center is designed to host educational programming and health screenings, with a dedicated classroom for teaching community members about making healthier choices, reducing chronic disease, and reclaiming good health.
UF Health Wildlight also takes a proactive approach to health and wellness through features such as an on-site walking path that connects to miles of trails in the region, as well as on-site bicycle repair stations that encourage members of the community to ride their bikes.
Beyond the clinical and exercise facilities, other strategies include demonstration gardens, healthy food-truck stations, outdoor dining areas, an outdoor child play area, and a sheltered outdoor yoga exercise area—all bearing the depth and breadth of the University of Florida and UF Health’s expertise on community health.
More Than Just a Trend
Community wellness is clearly becoming a driving force in the planning, design and execution of healthcare projects. As healthcare facilities expand care beyond the confines of a building or campus, the population they serve can greatly benefit through improvements for health and overall quality of life—even when implemented at smaller scales.
To carry out a successful project with a community-driven mission, inclusive design, designing for mixed uses, accommodating multiple modes of transportation, and encouraging design elements for healthy activities and education should all be of the highest priority.