Dominic Martino

Class: Elective Architectural Design Studio: Clinical Mix

Professor: Ulysses Sean Vance

Semester: Fall 2019

Program: Healthcare Facility

Location: 1700 N Broad Street, Philadelphia, PA

What is healthful design? What makes an environment beneficial to the well-being of those who inhabit it? What makes an environment detrimental to those who inhabit it? Through this inquiry, several architectural precedents were investigated with the goal and intention of responding to these questions. My project proposal for 1700 North Broad Street takes into consideration the conditions that are understood to promote patient health and well-being of which I have learned through this preliminary research. Four health clinics are proposed for the project program, the reasoning for which are based on the needs of the surrounding communities. In addition to addressing and solving existing health issues through appropriate program and through environmental conditions that support recovery, the proposal promotes healthful conditions to prevent future health issues in occupants and to induce positive, beneficial effects on their health and well-being. Furthermore, it simultaneously aims to reduce carbon emissions and to support the local ecosystem. Each of these goals are achieved through a biophilic approach and the proposal stands as a testament to support the utilization of that approach throughout healthcare design.

The four clinics my proposal features are an urgent care clinic, a physical therapy clinic, a mental health clinic, and a sleep therapy clinic. Firstly, I chose an urgent care center because of the lack of acute care facilities in the area. It would provide an option for the community and the University that is closer than the closest emergency departments - Temple University Hospital at about 2 miles away from the site location and Jefferson University Hospital at about 2.5 miles away. Only one urgent care center exists about two blocks south of the site and no others exist within a one mile distance to the site. One study estimated that between 13.7 and 27.1 percent of all emergency room visits could be handled by urgent care facilities. Secondly, I chose a physical therapy clinic primarily to serve college students doing physical activity, whether through athletics or through routine exercise. The demand for physical therapy services is also expected to grow by 22% between 2018 and 2028, in large-part due to an aging population of baby boomers. Furthermore, I chose a mental health clinic due to the high prevalence of mental health issues amongst college students. A 2012 survey done by the Association for University and College Counseling Center Directors found that on average, anxiety is a top presenting concern among college students at 41.6%, depression a presenting concern among 36.4%, and relationship problems a presenting concern among 35.8%. Lastly, I chose a sleep therapy clinic as many college students suffer from sleeping issues. The American Sleep Association reports that 37% of 20-39 year-olds report short sleep duration. Another study reported that 60% of college students suffer from poor sleep quality and 7.7% meet all the criteria of an insomnia disorder.

In line with the project brief, my proposal is comprised of a network of alternating interior and exterior spaces as well as public and private spaces within its massing volume. These spaces are created through a series of voids which have been carved into the volume, interweaving through the four clinic programs. Through these voids I intend to achieve several things. The first is continuous and porous thresholds, those of which being welcoming to the surrounding urban neighborhood and campus as well as being an extension of the natural aspects of the surrounding environment. As can be found in the Caboolture GP Super Clinic, Sendai Mediatheque as well as Westlake Dermatology, boundaries are blurred between the public spaces of the proposals and their surroundings. I intended to apply this principle to my proposal through the creation of a public plaza which creates a transition between the street and the interior public space as well as through the creation of elevated terraces intertwined with waiting rooms for each clinic. Through these voids I intend to create social interaction between patient groups and through the courtyard I intend to create social interaction between patients and the people within the surrounding community. In addition, these voids are intended to create visual connections between the spaces in and around the volume to improve navigation. Furthermore, these voids provide shared gardens which give patients as well as staff access to nature and fresh air even while not at ground level. Rather than feeling like they are in a typical institutional clinic environment, patients and staff have access to natural environments, which are connected as continuums of the interior environments.

Through the materiality of the proposal, a balance was sought between transparency and opaqueness, public and private, the interaction of the voids with the solidity of the massing, maintaining the essence of the form that was produced in the design of the massing. In addition, cross laminated timber was chosen for its beneficial effects on occupants in terms of stress and anxiety reduction as well as for its sustainability, a holistic approach in line with biophilic design.