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A Medical Center Relocation 

To support Cayuga Medical Center in developing a four-department medical space that promotes flexible space, sensory comfort, and effective circulation to increase patient satisfaction and staff productivity.

Cayuga Medical

Type

Healthcare Programming

 

Role

Design Strategist

Software

Adobe Suite, PowerPoint

Outcome

Complete programming document

Discovery

Context

The Cayuga Medical Center plans to relocate four departments (dermatology, endocrinology, gastroenterology, and rheumatology) into one shared site, creating a multispecialty clinic. Through in-depth user research, this project examines the current interior orientation at the existing sites of Cayuga Medical Associates, delivering a list of detailed and elaborate design recommendations.

Summary of Developments

The overall progression of the programming for the multispecialty clinic is as follows:

  1.  Developing interview questions

  2.  Site visits, observations, and group interviews

  3.  Literature Review

  4.  In-depth interviews with staff and patients

  5.  Analysis and Synthesis

  6.  Initial development of recommendations, with goal statements, performance requirement (PR) statements, concept diagrams, and adjacency diagrams.

Programming Approach

We programmed the Cayuga Medical Associates Building through two approaches, the user profile and the behavior circuit.


The user profile approach provided detailed information on what each user (patients and staff members) required, accompanied by their desires, helping our designers and us better understand the users to create the most optimal environments. The behavior circuit approach helped us understand the recurring sequences of behaviors for each user profile we identified, providing a more comprehensive understanding of their design requirements.

 

Combining the two approaches allowed us to have a more comprehensive understanding by
understanding both the user and their relationship to their environment.

User Profile Approach

  1. Identify user types (staff & patients).

  2. Construct user profiles

  3. Generate design recommendations for each

Behavioral Circuit Approach

  1. Identify predominant and recurring behaviors

  2. Determine discrete behavioral units in each flow

  3. Specify a level to support or discourage the behavior

  4. Determine design requirements

Interview & Persona

We conducted 5 interviews with a program manager, medical assistant, registered nurse, nurse practitioner, and patient from different departments to understand user needs, employee workflows, and their relationship with the physical environment. From the findings, we developed four main user personas.

Screenshot 2023-03-01 at 2.20.35 AM.png

Selena

  • Age: 32

  • Position: Program Manager

  • Habits: Needs to go home to her kids - leave work on time

 

Wants

  1. A private space to discipline her team members 

  2. A personal space with photos and decorations

  3. To boost team productivity while taking care of the team members

Quote Highlights

"I want my own office. Currently, I share an office with my provider and PA"

"Our exam room needs to support better flow to boost efficiency"

"I like that the department "pods" are color coded. It helps patients with wayfinding"

Screenshot 2023-03-01 at 2.20.35 AM.png

Helen

  • Age: 27

  • Position: Registered Nurse

  • Habits: Lacks exercise; likes meeting new people

Wants

  1. To take short walks around the building or outside during break 

  2. Less noise when talking to people in the hallway or the reception area

  3. More privacy (have space away) from patients when working

Quote Highlights

"I like the sliding doors. They give us control of the area, but they are heavy. And we have a lot of older patients"

"Circulation is important. For instance, when patients can only leave one way, they won't wander into the staff area."

Screenshot 2023-03-01 at 2.20.35 AM.png

Connor

  • Age: 43

  • Position: Provider

  • Habits: Busy lifestyle, drinks at least 2 cups of coffee per day

Wants

  1. To have an office near the exam rooms

  2. A bigger office where he doesn’t feel congested with other providers

  3. Natural light in the office

Quote Highlights

"I wish I could have individual rooms, so we don't interrupt each other."

"Since most of the exams don't have windows, ventilation became a big issue during Covid"

"I like the double doors in these exam rooms, they make it easy to get patients in and out"

Screenshot 2023-03-01 at 2.20.35 AM.png

Carolyn

  • Age: 36

  • Position: Patient

  • Habits: Feels uncomfortable in the dark, fears unfamiliar environments

Wants

  1. A comfortable healthcare space where she feels welcomed

  2. The choice of actions (sense of control) within her experience

  3. Access to a bright space, ideally lit with natural light

Quote Highlights

"Many places have closed waiting for rooms, but this isn't. It's niceI feel very secure and welcomed here."

"Designers should consider people's differences. I have arthritis, so it would be helpful if they have handicap accommodations."

Summary of Findings

Through interviews, site visits, and on-site observations, we identified three main challenges.

Screenshot 2023-03-01 at 2.46_edited.jpg

None of the departments has sufficient space to maintain the general workflow.

Insufficient space in exam rooms for multi-staff operations 

Screenshot 2023-03-01 at 2.46_edited.jpg

Space Allocation

  • Lack of multi-functional, private spaces to support Zoom meetings, telehealth appointments, and informal patient-doctor conversations.

Screenshot 2023-03-01 at 3.00_edited.jpg

Many of the exam rooms do not have a window, causing ventilation issues and lackof daylight.

Sensory Comfort

  • Staff wants accessible exterior spaces for short breaks and “walkaways.”

  • Patients mentioned the need for natural elements as a source of “sensory relief."

Acoustical privacy, though particularly important, is lacking at reception areas

Screenshot 2023-03-01 at 3.08_edited.jpg
Screenshot 2023-03-01 at 3.08_edited.jpg

Offices are located along the patient’s journey, invading staff’s privacy 

Circulation

  • The current layout lacks privacy.

  • The lack of acoustic barriers reduces the sense of security, and low wayfinding performance could lower therapeutic outcomes.

Recommendations

i. Adjacency diagram: provide an overview of the spatial relationships between each department

ii. Recommendations for further detail on resolving the challenges

a. Problem statements

b. Goal statements

c. Performance requirement (PR) statements

iii. Line-by-line diagram

Adjacency Diagram

Screenshot 2023-03-01 at 3.21.28 AM.png

Problem, Goal, & Performance Statements

Challenge 1: Overall

Problem Statement 1: There is insufficient space to maintain the general workflow.

Goal Statement 1: The facility would provide flexible spaces to accommodate patient flow, internal management events, and patient-doctor communication.

Screenshot 2023-03-01 at 3.36.38 AM.png

PR.1.1: There should be extra rooms that are multifunctional and can serve as backup exam rooms or rooms for nurse visits.

Screenshot 2023-03-01 at 3.36.46 AM.png

PR.1.2: Provide separate space for the staff to have private conversations with patients (i.e., telehealth) that ensures acoustic privacy (no more than 50dB).

Screenshot 2023-03-01 at 3.36.53 AM.png

PR.1.3: The waiting room should have seatings in a variety of sizes and arrangements to support different needs and desired sociability of patients (and their company).

Challenge 2: Dermatology

Problem Statement: Many offices are located along the patient’s journey, invading the staff’s privacy.

Goal StatementStaff offices should be private to promote worker productivity.

Screenshot 2023-03-01 at 4.06.14 AM.png

PR.2.1: Have centralized staff space with visual accessibility and easy access to patient space, minimizing travel distance from the staff space to the patient space.

Screenshot 2023-03-01 at 4.06.07 AM.png

PR.2.2: The patient circulation paths should not cross any
staff work areas (i.e., staff offices and break rooms) by having separate entrances for staff and patients.

Screenshot 2023-03-01 at 4.05.42 AM.png

PR.2.3: The space should provide clear visual distinctions
between staff offices and patient-treatment areas (i.e., signage, wall colors, interior design elements, etc.).

Challenge 3: Gastroenterology

Problem Statement: The storage area conflicts with the office area; with insufficient temperature-controlled storage for samples.

Goal Statement: The space should have sufficient, appropriate, and accessible storage areas.

Screenshot 2023-03-01 at 4.03.13 AM.png

PR.3.1: The equipment storage (shared across departments) should be located near exam rooms without intruding on patient circulation. 

Screenshot 2023-03-01 at 4.22.42 AM.png

PR.3.2: There should be a distinct area in the staff area to store samples that require a controlled temperature. 

Screenshot 2023-03-01 at 4.02.49 AM.png

PR.3.3: Shared exam rooms should have flexible/wheeled storage furniture for different departments.

Line-by-Line Program

Total space that we are renovating (Suite A + C): 5010 + 4518 = 9528 sq ft

Total space planned: 4200 + 1265 + 1185 + 1525 + Corridors = 8175 + Corridors sq ft

Screenshot 2023-03-01 at 9.04.37 PM.png

Credits

Persona icons were created by Freepik

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