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Pulse healthcare design
Halff Associates has completed the new
office of Dermatology Consultants, Inc.,
on the Texas Hospital for Advanced
Medicine campus.
P 2
Halff Associates has been interviewed by
Interior Design Magazine, New York.
P 3
Halff Associates has the answers to your
questions on new build-outs, expansions
or renovations to existing office space.
P 4
ISSUE 1 FALL 2009
Increasing concerns on hospital-acquired infectionsEvidence-based designs may be the best deterrent to rising healthcare crisis
thE growIng body oF EvIdEncE-bASEd dESIgn
knowLEdgE IS EnAbLIng hEALthcArE dESIgnErS to
crEAtE bEttEr hEALIng EnvIronmEntS wIth ProvEn
ImProvEmEntS In PAtIEnt oUtcomES.
Infection control ranks extremely high as a priority concern
for healthcare providers. Today, we find our nation fighting
the spread of flu epidemics such as H1N1, and we spend
billions annually treating two million patient cases of reported
nosocomial bacterial and fungal hospital-acquired infections.
As much as we want to control and eradicate disease, we
expect we will always be vulnerable.
As evidence-based medicine is the application of best
practices from scientific documentation for the best patient
outcomes, evidence-based design is the process of basing
design decisions about the built environment on credible
research to achieve the best possible outcomes. The way
we design healthcare facilities can have a profound impact
on human behavior including the care and outcome of
patients’ health.
For more than two decades, architects and designers
have tested and learned the important role design plays in
healthcare facilities. In 2000, the Center for Health Design
Research created the Pebble Project program. For the last
nine years we have learned through scientific protocol how
to better design for healthcare. In 2006, one of their research
contInUEd on PAgE 2
The body of design evidence has dramatically grown, and
it is believed that the ripples of the Pebble Project will soon
become a large wave. The US government is already requiring
architects to be capable of implementing evidence-based
design into their medical facilities. In 2009, the first evidence-
based design examination was prepared by the Evidence-
based Design Accreditation and Certification Board (EDAC).
dan Lee, AAhId, AIA, ASId, IIdA, and vice President
of Healthcare at Halff Associates, was among the first
100 healthcare design leaders to be certified to practice
evidence-based design in the United States. He will present
“An Introduction to Evidence-based Design” on September 22
at the UNT Health Science Center, Fort Worth, Texas. You
are invited. See “Keepers” section on Page 4 for details.
At right: Laboratory facility for Baylor Health Care System,
Dallas, TX
contInUEd From PAgE 1
A new design masterpiece:Dermatology Consultants, Inc.
halff Associates has completed the new office of dermatology consultants, Inc., a medical practice on the texas
hospital for Advanced medicine campus in Farmers branch, texas. this office and the practice of drs. michael
maris and rebecca Euwer are known for their advanced techniques in cosmetic surgery.
A recent fire damaged the doctors’ office, forcing them into a temporary space as all of their furnishings, equipment, and
accessories had been destroyed. For their celebrity practice, the physicians knew they needed an exceptional interior
design solution in the shortest time possible. Halff Associates was contracted to provide overall design and coordination
services including furniture specifications, procurement and move coordination.
Halff project manager, Dan Lee, recalls meeting the physicians the first time: “They understood their practice model
and their patients’ expectations. They worked well together and allowed themselves latitude for individual taste without
compromising the overall design intent. They understand the work habits of their staff and healthcare professionals and
were able to communicate specific programming requirements that allowed Halff to move quickly into the design phase.”
Team participation, along with a supportive landlord and hospital, made it possible for Halff to design a healing environment
reflective of the physicians’ brand and at a cost that was agreeable to everyone. p
“working with halff Associates has been a delight. they made great use of unusual materials and finishes but worked them into a style where every detail was coordinated.
my only regret was that the project got finished!” – dr. michael L. maris, m.d.
projects was referenced in “The Impact of Design on Infections
in Healthcare Facilities” by Anjali Joseph, Ph.D. This white
paper included research information about the placement of
hand washing sinks in hospital settings to improve frequency
of use and duration of use. By simply placing the sink on the
path to the patient bed and in a position where the caregiver
could face the patient, its usage was greatly increased, and
hospital-acquired infection decreased.
Evidence-based healthcare designs are used to create
environments that are therapeutic, supportive of family
involvement, efficient for staff performance, and restorative
for workers under stress. An evidence-based practitioner
makes decisions based on the best information available
from research and project evaluations. The result is a higher-
quality healthcare experience for patients, families, healthcare
professionals and staff members. p
Typical room layout Better room layout
yoU woULd not conSIdEr hIrIng A SUrgEon
to oPErAtE who hAd not PErFormEd
thE ProcEdUrE mAny tImES bEForE. thIS
common SEnSE rULE APPLIES to SELEctIon
oF A dESIgn tEAm. nothIng SUbStItUtES For
ExPErIEncE. At hALFF, oUr bESt PrActIcES
mAtUrE wIth EvEry ProjEct. wE LEArn
From EvEry SUccESS And EvEn morE From
oUr chALLEngES.
Halff Associates was selected as a subconsultant to the HKS/
Wingler and Sharp JV to enter into negotiations to provide
architectural engineering services to support the Department
of Defense Medical (DoDM) Program. The contract will be
administered by the Huntsville Center. The center is the
U.S. Army Corps of Engineers’ Medical Facilities Mandatory
Center of Expertise and Standardization (MX), which is
charged with delivering medical expertise and the highest
quality medical care and medical research facility life cycle
support to the Department of Defense (DoD), other federal
agencies and foreign governments. Under the contract, the
team will have the opportunity to provide planning, survey,
energy conservation and analyses; comprehensive interior
design; and Requests for Proposals (RFPs) development.
Services will also include design and planning related to new
construction, upgrades, maintenance, and repair of various
medical facilities. Halff Associates is tasked with supporting
the team in the areas of civil and structural engineering,
interior design, landscape architecture, and Antiterrorism
Force Protection.
Halff Associates was selected as a subconsultant to WestEast
Design Group of San Antonio, Texas, to enter into negotiations
to provide architectural engineering services to support the
DoDM. The small-business contract will be administered
by the Huntsville Center. Under the contract, the team will
have the opportunity to provide planning, survey, energy
conservation and analyses; comprehensive interior design;
and RFP development. Services will also include design and
planning related to new construction, upgrades, maintenance,
and repair of various medical facilities.
market watchA sluggish economy often calls for hard decisions on where to decrease spending and how
to prioritize new facility and remodel plans. on the other hand it can be an excellent time to
re-evaluate standards and policies that impact life cycle, workplace injury, energy consumption,
and time management, to mention a few.
The Obama Administration is providing stimulus money to move America’s healthcare system from
paper to paperless. Early participation in 2010 will yield the greatest refunds, and if nothing has
changed by 2017, your facility will find it very difficult to get reimbursement from Medicare or Medicaid.
Only a handful of information technology companies exist that can manage this opportunity. On a
recent trip to the Hill-Rom headquarters, Halff learned that they are positioned to help you integrate
your technology with your facility, including your equipment assets. Hill-Rom has earned the largest
percentage of hospital equipment market share, so it is a good place to start your exploration.
While talking with Hill-Rom you might also ask about several of their new innovations such as
their patient lift machines. Nearly 30% of all nurses suffer back injuries during the course of a year
of employment. Spending money on a lift may be a wise investment when insurance is high and
nurse retention is low. Investigate Hill-Rom’s new “bed-as-a-hub”, which demonstrates state-of-the-art
technology while improving patient outcomes. p
hALFF ASSocIAtES IntErvIEwEd by IntErIor dESIgn mAgAzInE, nEw york
Halff Associates has been interviewed by Interior Design Magazine,
New York. The November 2009 issue will focus on healthcare design
and the trends of this industry. Halff provided trend information for the
article and surveys are being developed based on this information.
These relevant surveys will go to the 100 healthcare design giants
including Halff Associates.
This key issue will reach the audience attending Healthcare 09 in
Orlando, Florida. Comments include a focus on how a new national
healthcare program will impact all aspects of this industry and a focus
on the number, size, and types of military healthcare projects. Lastly,
the new EDAC exam will have profound influence, much as LEED,
in forming opinions on usefulness of design data that is important
for clients and designers to consider when planning change for a
healthcare facility. p
dESIgnotes:halff’s Senior Interior designer,
jim marstiller, FASId, has been
awarded the Annual AAHID/Nurture
by Steelcase Scholarship for the
Advance of Healthcare Design
Education. Jim was selected from a
national pool of candidates, and this
scholarship will further his completion
of his PhD in Healthcare Interior
Design. Jim’s research will be focused
on dementia care within the senior
population. p
experiencematters
contInUEd on PAgE 4
Change can be a stressor — draining time and money or it can be a strategic decision that empowers, enables and refreshes your business.
Most medical providers care most about their patients. If a move will disrupt the care and service they provide their patients, the change
will be avoided until there is a crisis. Sometimes a fire or the landlord’s sale of the property forces change. Other times, it is required to
accommodate a new partner or service line. Whatever the reason, every project values change. When I started my design career I was
told to always oversize the business center of the
office as that was usually the first place to feel the
pain of a growing practice. But then again, I started
my design career when huge copy machines, long
rows of file cabinets, and spare typewriters were
stationed around the room. Technology changed the
programming of space dramatically, and it was the
patient area that ended up needing more space.
Any good design should plan for and forecast some
degree of change. While none of us has a crystal
ball and most of us designer-types lack the foresight
to appreciate what science will do next, we know to
design modularity that accommodates some degree of flexibility. Working with the structural language of the building, appreciating the cost
of plumbing installations, and keeping in mind that patient flow will always be important are but a few of the basic guidelines for planning
a new medical office.
The healthcare delivery system is in constant flux, too. Unexpected reimbursement changes may alter the procedures you offer and
thus change your office layout requirements. Integrating space for patient interviews near the front business office is vital to maintain the
privacy of patients who have payment concerns. Finding a way to welcome and accommodate all patient types can be very important to
your financial success. For example, planning for bariatric seating in the waiting and interview rooms is as important as providing second-
language assistance throughout your medical office.
In a tight economy where landlords cannot afford high-dollar finish-out allowances and tenants want to look like a million dollars for a
few bucks, the designer brings value to the relocation experience by carefully learning the project constraints and creatively designing
affordable solutions that fit within the budget and aesthetic framework. It is paramount that designers be hired who understand the specific
uniqueness of various medical practice types as well as the ergonomic requirements of that practice’s patient population. Simply creating
a beautiful “spa-like” environment is not enough. In today’s healthcare office, adherence to code compliance, personal privacy, infection
control, security, and employee retention can be key issues that differentiate healthcare-certified architects and designers from the rest of
the design profession. p
halff Associates, Inc.1201 north bowser roadrichardson, tx 75081-2275
214-346-6200 214-739-0095 fax
www.halff.com
Expanding your practice or moving into a “new” space? Here is some sage advice...
FAcILIty SUrvEyS | IntErIor dESIgn | PLAnnIng | grEEn dESIgn | wAyFIndIng dESIgn
EngInEErIng SErvIcES | LAndScAPE ArchItEctUrE | ArchItEctUrE | EvIdEncE-bASEd dESIgn “Hosp i ta l - i t y ”
COLUMN by Dan Lee. . . . . . . . .
Halff Associates is tasked with supporting the team in the areas of interior design, hazardous materials investigation, civil and structural
engineering, landscape architecture, and Antiterrorism Force Protection.
The collective experience of this expert team will bring real value to any project that may come from this contract. p
contInUEd From PAgE 3
“keepers”The Health Industry Council Integrated Project Delivery
Irving, TexasSeptember 10, 2009
Halff Associates presents: An Introduction to Evidence-based Design
Alcon AuditoriumThe Center for BioHealth
University of North Texas Health Science Center3400 Camp Bowie Blvd.
Fort Worth, Texas
September 22, 20095:30 - 6:15 p.m. (Registration & Reception)
6:15 - 7:00 p.m. (Presentation)
rSvP to [email protected]
The Health Industry Council North Texas Health and Technology Forum
Arlington, Texas September 24, 2009
Healthcare and Facilities Symposium Exposition
Chicago, IllinoisSeptember 30-October 2, 2009
World WorkplaceOrlando, Florida
October 7-9, 2009
Healthcare 09Orlando, Florida
October 29-November 3, 2009