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Designing Facilities for Wraparound Health Services

Wraparound healthcare services are exactly what they sound like—they encompass medical and non-medical services and resources that wrap around a person or family to best support their individual needs and improve their well-being in multiple areas of their life.

Wraparound healthcare programs are based on the idea of treating the whole person. There are many complex determinants of health and someone’s ability to seek or follow through with treatment, particularly for vulnerable populations. This can include financial, emotional, logistical, and other concerns. Wraparound services also account for the impact someone’s illness has on his or her mental health, family, or other chronic conditions.

For example, if your doctor prescribes a specific medication, do you have the ability to get to the pharmacy, pay for the prescription, understand and take it as prescribed, and return for a follow-up appointment to determine if the medication is working? Wraparound care aims to alleviate obstacles in the diagnosis and treatment process—like eliminating a trip to the pharmacy by including one right in the clinic—and providing multiple service and medical providers in one location. Comprehensive care like this has been shown to reduce ER visits and hospital readmissions and improve health outcomes.

One organization providing these types of services in Indianapolis is the Indiana University Student Outreach Clinic (IUSOC). The clinic is a partnership between several educational institutions and community organizations and operates out of the Neighborhood Fellowship Church on East 10th Street in Indianapolis. The clinic provides primary care-based services free of charge. IU School of Medicine, University of Indianapolis, and IUPUI students and other partners provide this care under the supervision of physicians and licensed providers. This includes medical, pharmacy, physical and occupational therapy, dental, social work, and legal services.

Clinic Renderings

Plan for Reception Area & Nurses’ Station at IUSOC

We worked with IUSOC to design a new space to better serve patients. Three primary principles guided our process:

1. Understand What Drives the Mission

Designing spaces that provide wraparound services is a unique challenge. Before you dive into the details of design, you must first understand the organization’s mission and vision. Why do they do this work?

The IUSOC, for example, “strives to close the healthcare gap in the community by coordinating a medical presence to address a wide variety of conditions.” Its focus is the uninsured and underserved, who historically are less likely to seek medical care for a host of reasons, including previous negative experiences with the healthcare system.

This mission drives how the clinic’s volunteers serve patients and the values the clinic space should embody. The team makes a concerted effort to create a welcoming environment where those who are nervous or skeptical to see a doctor feel comfortable. They also have an increased focus on education, helping patients understand their conditions, treatments, and how to navigate the healthcare system. This serves to empower patients to better manage their health.

2. Design for Full-Service Care

The idea of wraparound healthcare is to provide, essentially, a one-stop-shop for patients, making it more convenient and efficient for them to receive the different types of care they need.

To achieve this for IUSOC, we designed what we call “full-service” exam rooms. These rooms are large enough to accommodate a variety of medical equipment so that patients can get everything from an eye exam to a gynecological exam all in one place. If a patient comes in for one problem, and the practitioner finds another problem at the same time, this allows both to be addressed without the hassle of making a separate appointment or moving to a different wing of the clinic.

We were also cognizant of tangential services patients may require to achieve positive health outcomes, such as meeting with a social worker or getting legal support. These services are co-located in the clinic, allowing patients to address root causes and make long-term healthy lifestyle changes.

3. Focus on Access

Having a streamlined, efficient, full-service facility is fantastic. But if that facility isn’t easy to get to or isn’t welcoming to its patrons, it won’t be successful.

For IUSOC, we recommended a new space in Clifford Corners, a mixed-use building containing affordable house and retail we completed for another client, across the street from the church where it currently resides.

Clifford Corners

Clifford Corners

This location was a natural and convenient choice. It is right next to the existing clinic and in a neighborhood where many patients live. In addition, 10th Street is a major thoroughfare to and from downtown Indianapolis, with direct access to public transportation routes.

Overall, the space promises enhanced outcomes for the community—growing the foundational education of our young providers, creating community, and helping to build and maintain individuals and families—regardless of ability to pay.

 

The IUSOC is currently seeking funding to secure its new space and enhance its ability to care for patients. Learn how you can support this mission.

Designing for Generation Z

Generation Z, the 60-some million young people born between the late 1990s and early 2000s, are the most diverse group in our country’s history.

They grew up during times of recessions and financial crises, war and terror threats, and technology overload. Many of them knew how to operate a tablet or cellphone before they could put sentences together. They don’t remember a life without social media and spend up to nine hours a day consuming media. They have a rather short attention span and it can difficult to keep them engaged. In the next ten years, it is estimated that Gen Z will consist of 22% of the workforce and many will be working in jobs that don’t even exist yet.

Generation Z Workforce Percentage

According to the Wall Street Journal, “Gen Z workers are more competitive and pragmatic, but also more anxious and reserved, than millennials, the generation of 72 million born from 1981 to 1996, according to executives, managers, generational consultants and multidecade studies of young people.”

Learning how to design for Generation Z will be essential in the longevity of our communities, facilities, and workplaces. So what design features will help attract and retain this large cohort?

Choice and Input

It’s easy: let them be a part of the design process, ask them to give input on what they want and expect, and then simply listen to what they have to say. One of the easiest ways to connect with this generation is through making them feel like their voices are heard. Designers can bring them idea starters and guidelines to get conversation going but try to immerse yourself into their world if you want a truly successful project. You can do this through focus groups, community engagement events, social media polls, and project blogs/websites.

Of special note, long-term choice is essential. Design should allow for variation over the life of a building, allowing the space to be tailored to each user’s preferences:

  • Robust power – consider a raised floor
  • Expansive wi-fi
  • Furniture that is movable – think everything on wheels, closable pods, and sitting/standing desks
Technology-Rich Spaces

As the baby boomers are retiring and Gen Z starts to fill in the gaps, technology will follow them. The places they live, work, and play need to reflect a lifestyle they are accustomed to: attached to hand-held supercomputers which provide instant communication with others. This diverse and mobile group will crave a digital connection to the world. In terms of the workplace, an office setting should include technology that will seamlessly allow staff to work from home (or a coffee shop across the world) but also enhanced video conferencing from anywhere. With good lighting and acoustics along with the ability to easily share documents and control, the office can be anywhere.

As designers, we need to think of technology that will help the facilities operate longer yet efficiently. Because Gen Z is predicted to put in a lot of hours in the office, the building systems will need to run differently than the regular 8-5pm. Allowing small spaces to be controlled and operated as needed without requiring the entire facility to be in operation will result in lower energy costs.

Flexibility

This generation works really hard, but they want some playtime as well. If you are going to create a flexible work environment, including staff who work remotely, creating a gathering space is essential for retention and overall job satisfaction. One design idea is to create a comfortable commons area filled with homey furniture, a coffee bar, and plenty of natural light. This type of space will allow Gen Z workers to take a brain break and socialize before getting back to the grind. Filling a space with familiar furniture pieces will ease anxiety and gives everyone a space to feel connected to peers.

We don’t all work the same, and an office won’t likely be comprised solely of Gen Z’ers. Design a workplace that has multiple types of rooms with varying functionality and privacy. If you can handle working in an open concept area, great! If you also need to get away from the hustle and bustle to really concentrate, great! If you need that ability to meet with a couple team members for a quick collaboration session away from your desks, great! If you need to meet with several people from around the office and need a more formal setting with technology, that’s great too!

Genuine Feel

This is a big one to keep in mind when you are looking to put your roots down for a new project. This generation gravitates toward places, people, and things that feel real, predictable, and safe. If you are wanting to attract and retain the Generation Z population, start by looking for a location that has its own sense of culture. Your building or space should come from and build on its history and the community naturally. Furthermore, your space should promote general well-being for users. Historic areas and neighborhoods are a big hit with this generation, leaving a lot of good potential for adaptive reuse projects. Staying true to the story makes the work resonate – do not to cut out the charm of the old while designing the new. The pre-packaged, Instagram filter world has ended, and Generation Z is seeking a genuine experience.

Choosing a location that is walkable and bikeable with nearby restaurants and attractions, grocery stores, and hotels will draw in more people. This goes for any type of building in the urban mix, from office space to apartments to mixed-use developments.

Once you have a location, make sure to include biophilic design features that promote happiness and health. Generation Z is very conscious of their mental and physical health—promoting that connection back to nature within a building will relate well with those users.

Inclusivity

Generation Z is a beautiful ethnically-diverse population, which is important to keep in mind when designing communities and buildings for them. Not everyone experiences a space the same, in part due to their culture and all that comes along with their unique backgrounds. Connecting back to “choice and input”, you will get the information that you need to ensure a space is inclusive if Gen Z’ers are included in the process.

 

It is time to prepare and adapt for future generations, allowing their influences to permeate through the built environment to stay relevant and competitive in the world. We should admire and enhance their creativity, empathetic attitudes, desire to feel connection, and heads-down work mentality with the spaces we provide. With the help of Generation Z, we should create communities and spaces that harness that same energy and drive toward success. If you want to more specifics on how to design for Gen Z, give us a call!

Community Engagement

A building project is far more than pieces and parts that define spaces.

Projects reflect the goals and aspirations of the communities they serve.

Schmidt Associates views community engagement as an essential part of our strategic, data-based planning, giving Owners information to evaluate viable options and make good decisions. We take a proactive role in planning for public meetings that inform, gather feedback, and incorporate public input to achieve a relevant facility solution that the public can support.

In order to understand what is truly important in the eyes of the end user, we like to become part of the “fabric of the community” by gathering input directly from community members and project stakeholders throughout our process. Here are a handful of community engagement tactics we typically use:

Community Workshops

The target audience for these workshops are neighboring businesses, residents, the end users, students and parents, property and business owners, others who visit and work within the area, etc.

These workshops can range from presentations with Q&A, to an open-ended SWOT analysis, to interactive display boards where people can vote on the types of spaces, furniture, aesthetics, etc. they like the best. Depending on the scope of the project, these could be hour-long sessions, last a few hours, or be an open-house where attendees can interact and ask questions for as long as they need.

We want to hear from as many community members as possible, which can be hard to do. Some tactics we utilize to ensure these workshops are as convenient as possible are:

  • Setting up a variety of time slots, across several days, held in various locations—in the evening after the school day, Saturday morning with coffee and donuts, on a Sunday after church services, etc. It all depends on each unique community and type of project.
  • Providing childcare options, if children aren’t an integrated part of the workshop process. For example, we can meet with community members at a school with child-friendly activities held in the gym under the supervision of adults.
  • Offering a variety of input methods—like notecards, email, and limited access blogs—to ensure the quiet voices are heard and allow 24/7 access to the conversation.

Community Engagement - Community Workshops

Stakeholder Meetings

This is where we gather key targeted stakeholders and leadership in a casual environment to build interest and allow their influence on the project. We quickly share the community workshop findings and offer a brainstorming session to continue building ideas and support for the project. Our team then creates a deliverable that can be posted to a website and distributed to the community, stakeholders, and other interest groups.

The targeted attendees typically include property and business owners, developers, and neighborhood and city representatives. We take similar approaches to making these meetings as convenient for the stakeholders as we did with the community workshops. As the planning process moves forward, we often will reconnect with these stakeholders to communicate any findings, recommendations, and intent of the results.

Community Engagement - Stakeholders

Community Empowerment

The plan for any project must be intentional and community-driven so stakeholders will feel a sense of ownership. To create community empowerment, we have found that allowing physical, deliberate interaction with the space is essential. Together, we will visit the physical space and brainstorm ideas on-site, allowing the realities of the space to influence decision making.

Another approach we often take is to attend community, city council, or PTO meetings.

Community Engagement - Community Empowerment

Project Blogs

Along with our physical approach to community engagement, we also leverage technology to bring it all together. We have successfully used a blog on projects to have a way for the community, stakeholders, and Owners to see the progress and to offer input. This is a controlled way to manage feedback and disperse current information, as determined by the project’s leadership team. Each blog features a “Make a Comment” button which sends comments as emails to Schmidt Associates. This way, we can receive comments, review with the Owner, and post appropriate responses.

We have used a link to our website to post the ongoing status of the project—from planning through construction—to keep the public involved and informed throughout the process.

Community Engagement - Project Blogs

Ultimately, only community projects built on community input can maximize their influence and create shared ownership and investment. If you have questions about our community engagement process or want to learn more about how we can help you with your next project – reach out!

Vacant Big Box Store Finds New Life as a Preschool

Building Indiana

Features Anna Marie Burrell, Sarah Hempstead, Brandon Fox, and Shelbyville Central Schools

January 24, 2019

“In the small Indiana community of Shelbyville, Shelbyville Central Schools District will transform a nearly 63,000 square foot abandoned Marsh Food Store and the adjacent strip center – once housing other retail stores, a restaurant, movie rental store, and a bank – into a preschool, space for children with special needs, and the school district’s offices.”… read full article

WOYS #5

The middle of winter is hands down my least favorite time to live in the mid-west. While I love the changing of the seasons – the trudge post-holidays to mid-March takes twice as long as it should.  The only way to survive is with a glass of wine, a nice fire, and a few good books.

Try these to warm up from the inside out:

 

The Nightingale

The Nightingale

By Kristin Hannah

“In love we find out who we want to be. In war we find out who we are.”

In The Nightingale, two sisters find their way through occupied France in WW2. With full acknowledgment that I am a sucker for this type of fiction, this is a wonderful story of becoming who we really are. Kristin Hannah’s writing is compelling, and her process of robust research allows the reader to experience a far less documented side of war to see what it’s like for the women and children left behind. I particularly appreciated the relationship between the sisters – full of all the love, history, and hurt that come hand in hand with family.

 

Uncommon Type

By Tom Hanks

“It turns out that Tom Hanks is also a wise and hilarious writer with an endlessly surprising mind. Damn it.” – Steve Martin

It doesn’t seem fair, but it’s true. Tom Hanks can write too. Uncommon Type is a book of short stories, all just the right length to read a few as you wait for basketball practice to end or right before bed. The stories are quirky, funny, sad, and unexpected. The characters are both unique and fully developed – quite an accomplishment in a few short pages. Like pretty much every other thing Mr. Hanks does, Uncommon Type is worth your time.

 

Drawndown

By Paul Hawken

“If you are traveling down the wrong road, you are still on the wrong road if you slow down.”

When I tell you Drawdown is a book on how to reverse global warming, I understand the inclination to put down this review and reread the one about Tom Hanks. However, if you can resist the urge, Drawdown is a good read. It focuses on how we can overcome confusion, apathy, or just being overwhelmed by the idea of global warming. The book takes 80 strategies and solutions, organizes them by sector, describes them in easily understandable language and ranks their effectiveness using the total CO2 impact, and the long and short-term costs.  Each solution is only a page or two long, with lots of photos and illustrations, so you can digest each idea in small bites. Ultimately, I left Drawdown feeling hopeful and better equipped to make a difference through design.

 

Want more recommendations?

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Blog #2

Blog #3

Blog #4

How Can Architecture & Design Affect Higher Education?

Butler University College of Education

Butler University – College of Education at CTS

If you’ve spent any amount of time on a well-designed, beautifully constructed university campus, then you understand the importance of architecture when it comes to influencing higher education. Not only can architecture inspire imagination and creativity, but it can unite students, teachers, and the community to create a space that feels energized, organic, and magnetic.

There are several ways architects can influence the way a higher education building is interpreted by the people who will use it every day. Considering there are more than 21,000 universities across the globe (and hundreds more currently being constructed), this specific design niche makes a notable footprint in the world’s landscape.

Can a design help make students more successful? Can architecture unite people from diverse backgrounds and beliefs?

We think so.

Here are a few ways that architecture and design directly affect higher education:

Vertical Spaces. Because many higher education campuses and their buildings are so large, it’s easy for designs to focus on the outward, horizontal sprawl. And, while often beautiful to look at, there’s a feeling of being “lost in a crowd” that can make these types of buildings and spaces less than conducive to interaction and collaboration. Instead, higher education facilities can look to find ways to build up – not out. These vertical spaces, when designed for students and staff in particular, become a powerful magnet for interaction, allowing individuals on campus to feel less “lost” and more as part of the crowd.

Cross-Pollination. Traditionally, most higher education campuses were divided into “schools”, separating one group of students and its professors from another. However, new facilities or those undergoing renovation and restoration are re-thinking this concept. Rather than sectioning people away from each other, as if some sort of quarantine is in place, new buildings and spaces are being designed so that students and staff from different disciplines have an opportunity to interact. This can take shape in many ways, but some of the most interesting are a sort of tunnel-bridge concept that connect buildings on multiple levels.

Natural Light. The more light you let in, the more successful you will be. Or, at least, that’s what many studies are confirming. In addition to more success, natural light is said to make people happier, reduce stress, and combat illness as well. By finding ways to allow more natural light in, higher education facilities can improve the environment for everyone working and learning on campus. In addition to natural light, which can be let in by windows and skylights, creating spaces that are truly light-filled, such as a wall of windows or clear walls, can help make studying and meetings more enjoyable.

Student-Centric. Students want to feel like they belong at their university or college – and that’s something that great design can accomplish. When creating a space, architects should look at developing areas that are convenient for students to enjoy. Places to safely store laptops and personal items in between lectures, attractive lobbies with comfortable and adaptable furniture, as well as large seating areas where bigger study or friend groups can meet will help to bolster the attitude and loyalty of students on campus.

Skip-Stop Strategy. In order to create healthy, vibrant spaces on higher ed campuses, architects should look for ways to incorporate the “skip-stop” strategy. The idea behind this concept is to help students and staff circulate easily, offering more opportunities for exercise as well as those chance encounters with friends and acquaintances. A notable innovation are skip-stop elevators, which only stop on certain floors, encouraging individuals to use the stairs. In cases where the stairs are designed in conjunction with this strategy, you can develop staircases that are grand, wide, filled with light, and a natural place to stop and chat. In order to be ADA compliant and for employee convenience, there must be a secondary elevator option which does stop on each floor.

Outdoor Strips. Acting as gateways to campus, large outdoor strips can be an inviting way to welcome students and visitors. They’re also the perfect place to host sports activities and large gatherings. Beautiful to walk through, these strips are also another way to bring the campus community together on a daily basis.

When designed and built with the intention to inspire the next generation, there’s no limit to how beneficial architecture can be on higher education campuses.

Multipurpose Facilities (MPF’s)

Multipurpose Facilities (MPF’s) exist in many forms. As we consider the transformation of existing facilities into part-time athletic venues – ad hoc “field houses” – a plethora of sports can reasonably be considered. Indoor track and field, cheerleading, dance, and gymnastics, indoor soccer, baseball batting cages, tennis, and competition court activities (e.g. volleyball, basketball, and handball) should all be considered.

While each sport has its own unique requirements, there are 4 critical considerations shared by all:

1. Dimensions

  • Column Grid
  • Structural Height

2. Materials

  • Flooring

3. Lighting

  • Natural
  • Artificial

4. Amenities/Support

  • Restrooms/Locker Rooms
  • Food/Vending/Ticketing
  • Spectator Viewing
  • Parking

Multipurpose Facilities graphic

 

Dimensions

The structural grid, both layout and height, is the primary driver of sport appropriateness in existing facilities. Strictly governed court sizes, including overrun areas and required clearances, will likely determine both how many and what kind of courts can fit into any given building efficiently.

Material

Most purpose-built Multipurpose Facilities have multiple courts with a mix of both wood and synthetic floors. Wood floors are more preferred for sports like basketball and volleyball while synthetic floors are best for activities such as baseball, tennis, or even flag core. Soccer players, on the other hand, prefer natural grass, with turf as a distant second best. In an existing facility that will be a “sometimes” sporting venue, the selected sport will determine the surface. Whatever surface(s) is(are) selected, each appropriate surface needs to be easy to install in a foolproof fashion – so athletes are not injured. In addition, storage for each surface must be accommodated.

Light

Competitive sports all require consistent high-quality lighting, ideally with no glare, shadow, or hot spots. To that end, while natural light makes things nicer for spectators, it is often highly problematic to athletes. Solar studies of existing buildings can help discover lighting trouble spots.

Amenities/Support

Storage and some form of changing space or locker rooms is a necessary component of a successful MPF for the athletes. In addition, accommodations for spectators and the public is critical. This starts with parking, a ticketed entry, and some form of lobby space. Easy access to restrooms and concessions becomes almost as important as spectator viewing areas.

 

Ultimately, most large event facilities are capable of supporting athletics. Evaluation using the critical considerations above, can help determine what fits easily and what may require more extensive and expensive modifications. Of note, considerations for new facilities are very similar to those above, however they have the benefit of preplanning. With a new facility, flexibility can be enhanced by being purpose-built to accommodate the desired athletic functions from day one.

WOYS #4

Summer is almost here!

Time to pour a tall glass of lemonade, find a shady spot, and start a great book! We are back with another edition of “WOYS” – What’s On Your Shelf to help you out.

I have listed three books that are worth reading while soaking up some good Vitamin D:

 

 

children of blood and bone - summer reading

Children of Blood and Bone

By Tomi Adeymi
This New York Times Best Seller, has everything I love in a novel – magic, love, friendship, adventure, and memorable characters in a familiar yet totally unique world. The West African roots of the story weave texture through the narrative, and the heroines’ struggles with power (her own and others), personal responsibility, the pull of family, and the meaning of loyalty are infinitely relatable. This “young adult” book is worth reading in one delicious, big gulp. You can thank me later.

 

dreamland - summer reading

Dreamland – The True Tale of America’s Opiate Epidemic

By Sam Quinones
When a book is recommended to me multiple times, by people in totally different corners of my life, I tend to see it as a sign that I have a new reading assignment. That’s how Dreamland ended up on my list and I’m so glad that it did. This is a well-researched, infinitely readable, story of addition in America. From Mexican villages, to Appalachian pill mills, from pharmaceutical company board rooms to suburban home, Sam explains how we got here – to an addiction epidemic. While it isn’t a fun story, you owe it to yourself to dive in and come out enraged and enlightened.

 

frankenstein - summer reading

Frankenstein

By Mary Shelley
Feel like you need a reading buddy? Frankenstein turns 200 this year, and it is the focus of the One State/One Story program (a statewide read sponsored by the Indiana Humanities and the Indiana State Library). Shelley’s themes, specifically the role of science and our own humanity, still ring true today and are a great jumping off point for a full slate of discussions, podcasts, and the first-ever Indiana Sci-Fi & Horror Writers Festival – coming this October. Your high school teacher will be proud of you.

 

Get to your nearest library, and get reading this summer!

Want more recommendations?

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Blog #3

Brain-Based Design

Your brain is a vastly complex system with billions of neurons and interneurons constantly firing. And with billions of people in the world, with their own unique neural pathways to process daily experiences, it is safe to say we all think, interact, work, and learn differently than the next.

That said, our brains are similar in many ways. When we understand the patterns in how our brains work, we can design environments to help us learn better.

Our team is passionate about learning. In our roles as architects and engineers, we tailor our designs to optimize educational attainment through engaging the best in brain-based design research. This research includes findings with direct ramifications for environmental factors including, but not limited to:

    • Immersive Environments
    • Active / Passive Spaces
    • Natural Light
    • Stimulating / Enriching Spaces
    • Comfort and Security
    • Flexible Environments
    • Social Spaces

Our Brain-Based Design magazine covers each concept in-depth, and shows why it works. Click the link below to read in full screen:

 

What to learn more about how we tailor to brain-based design in our projects? Reach out!

There Is No Box

Milton, red stapler guy in the classic scene from the movie “Office Space”, whines on the telephone from his cluttered cubicle “if they move my desk one more time…” Milton wouldn’t last at Schmidt Associates. He probably wouldn’t have met our employment predictive analytics criteria at the outset.

As the CEO, I often remind staff and clients we don’t believe in out-of-the-box thinking, which is a really tired cliché, because Schmidt doesn’t believe in boxes. We don’t allow preconceived ideas, concepts, or notions to impact our thinking or finding solutions. That means we are responsive and nimble, proactive or reacting quickly to constantly changing conditions. If you don’t have a box holding you in, you don’t have to worry about thinking outside of it!

This summer an Inside Indiana Business Television’s Culture Matters segment reviewed the productive and unique Schmidt culture and environment. Our staff shifts from one team to another as a long-term project requires. Collaborative space is available to all teams. This builds teamwork and communication as each person is present with the entire team to make spot-on and on-the-spot collaborative decisions, eliminating meetings, endless e-mail chains, and deadly conference calls.

Our culture breeds creative, productive, cool projects for our clients on budget and on time. We’re flexible because we don’t have boxes… or set-in-stone spaces.

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Want to be a part of our team?  We are hiring for several positions – check them out on our careers page or our LinkedIn page to see if you could be a good fit.

Read Part 1 here