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Designing For Medical And Behavioral Health Comorbidity

In the United States, an estimated 68 percent of adults with a mental health affliction have at least one concurrent medical condition and 29 percent of people with medical conditions have a behavioral mental health disorder, according to a 2011 health policy brief by the Robert Wood Johnson Foundation. With the general population’s access to services often limited by availability, financial constraint, or stigma, these totals may be understated.

This medical and behavioral health comorbidity, which is the simultaneous presence of two or more diseases that encompass both mental health and medical conditions, can be due to causality, environmental risks factors, or even to chance. A 2008 report in the American Journal of Medicine by Dr. Wayne Katon addressed comorbidity of type 2 diabetes and depression, indicating that each condition can influence the other.

For example, depression has a direct negative effect on glucose metabolism and may increase insulin resistance … Read the rest

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Face Time: Nicholas Watkins

Healthcare research was front and center throughout Nicholas Watkins’ undergraduate and PhD studies at the University of Illinois at Urbana-Champaign, but it was during his Psychology 101 class that he was first exposed to environmental psychology and Roger Ulrich’s pioneering study on how the built environment could influence healthcare outcomes. Watkins says the realization of how the field could advance fundamental physical and psychological needs gave architecture “a higher purpose.” After graduation, he continued to sharpen his skills at several firms, including Cannon Design and HOK, before joining Gensler in 2017. These days, he’s also “testing” new running strategies when taking a break from professional research.

What drew you to a career in research?

The University of Illinois at Urbana-Champaign is a large pool to wade around in and cobble together a lifelong passion before you even realize that’s what’s happening. Several faculty members from the anthropology, architecture, educational psychology, … Read the rest

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Dignified Design

Inside the new Omaha VA Ambulatory Care Center (Omaha, Neb.), colored light streams down a long corridor connecting the new facility to the existing Omaha VA Medical Center. Running the length of the 157,000-square-foot addition’s western façade, the corridor’s long curtain wall of colored glass symbolizes the “honor bars” earned by veterans and placed on their lapels. “Everyone, whether you’re a patient, a visitor, or even a provider, is reminded daily of the veteran and the honor and respect that they’re due,” says Jonathan Fliege, senior associate and director of design at Leo A Daly (Omaha), which provided architectural, engineering, and interior design services for the project. “You ‘breathe’ the color almost as you pass through this space.”

The project not only represents a new outpatient facility for the VA but also marks the first public-private partnership-funded VA healthcare facility in the nation to be delivered since Congress passed the … Read the rest

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Using Telemedicine To Increase Access to Healthcare

With the onset of COVID-19 in early 2020, many people were unable to leave their homes or feared going to see a doctor in person due to the potential risk of exposure. One solution that allowed patients and healthcare providers to connect was telehealth (generally defined in broad terms to encompass technology and health-related services provided via telecommunications and digital communication). Wider adoption of this practice was coupled with changes in reimbursement models as part of the 2020 U.S. Coronavirus Aid, Relief, and Economic Security (CARES) Act, which included emergency polices that improved provider payments for telehealth and allowed for providers to deliver care across state lines.

As a result, telehealth grew significantly last year. In the analysis, “Medicare Beneficiary Use of Telehealth Visits: Early Data From the Start of the COVID-19 Pandemic,” the U.S. Department of Health and Human Services found that in April 2020 nearly half (43.5 percent) … Read the rest

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PHOTO TOUR: Providence Newberg Medical Plaza

In 2006, after Providence Health & Services (Newberg, Ore.) opened Providence Newberg Medical Center in Newberg, patient volume surged, creating the need to provide additional on-campus outpatient services. As a result, the three-story, 64,000-square-foot Providence Newberg Medical Plaza was opened in January 2020.

Led by architecture firm JRJ Architects (Portland, Ore.), the project team had two key design objectives. First, leadership wished to retain but update the health system’s “brick brand identifier,” which was achieved by incorporating metal curtain walls and generous windows for a fresher, more modern aesthetic. To architecturally connect the new facility to the existing hospital and any future buildings, the team also incorporated the brick branding to the back side of the structure. Second, the team worked to preserve the sweeping views of the Willamette Valley that hospital patients and staff enjoy. Additionally, a generous use of wood, glass, and steel design features helped bring natural … Read the rest

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FIRST LOOK: Veterans Affairs Community-Based Outpatient Clinic

To meet the growing needs of the more than 23,000 veterans living in the Lakeland, Fla., area, the U.S. Department of Veterans Affairs is consolidating multiple local facilities into one expanded outpatient clinic. At 132,000 square feet—five times bigger than the existing clinic spaces together—the facility will be better suited to meet patients’ needs, now and into the future.

The Veterans Affairs Community-Based Outpatient Clinic will be centrally located within the Lakeland community and just 4.5 miles from Lakeland Regional Medical Center. Patient parking at the front of the site, along with a covered drop-off area on the front of the building, will enable easy access for visitors, while dedicated staff parking and entry on the rear of the building will increase efficiencies.

Outdoor seating areas will offer veterans and visitors a space to enjoy the fresh air and Florida sunshine. The site will include an exterior canteen area and … Read the rest

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Living Color

Main Line Health (MLH), a not-for-profit health system serving portions of Philadelphia and its western suburbs, was looking to expand beyond its traditional patient base, says JoAnn Magnatta, senior vice president of planning and design at MLH (Philadelphia). The opportunity to do so took shape when MLH evaluated its women’s offerings, which included comprehensive services but not much convenience. “We looked at our women’s service lines scattered throughout the system and realized it would be a positive move for us and for our patients to have those services aggregated in one location,” she says.

Through a joint venture with physician group Axia Women’s Health, MLH wanted to provide a holistic solution, serving women’s physical, mental, and emotional health and emphasizing wellness and prevention, with a variety of specialty services including breast health, digestive health, heart and vascular care, integrative medicine, obstetrics and gynecology, pelvic floor care, rheumatology and autoimmune treatment, … Read the rest

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PHOTO TOUR: Northwest Health – La Porte

After joining Community Health Systems’ (CHS; Franklin, Tenn.) regional Northwest Health network, La Porte Hospital received funding to replace their outdated, undersized, and operationally inefficient facility. CHS wanted the new facility to align stylistically with the color palette, materials, and form of other facilities within its network and while also setting an updated, modern tone. The new hospital’s exterior and interior palettes will serve as the basis of design for the health system’s future projects.

The four-story Northwest Health – La Porte’s clean, modern façade does just that by marrying traditional brick with modern metal panels and large expanses of glass.

Inside, the two-story lobby features decorative stained-glass panels that the design team relocated from the former [ok? yes] facility for an accent wall behind the monumental stair, which leads to a shared waiting room on the second floor and registration areas. Large windows stacked in the corner of the … Read the rest

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Crucial Balance

When Wellstar Kennestone Hospital in Marietta, Ga., began planning a replacement for its dated and undersized 1970s-era emergency department (ED), the Ebola epidemic was still top of mind. It was 2016, and issues like how to screen potentially infectious patients before entering a facility and the need for isolation rooms were important topics in conversations about healthcare design. That reality influenced the 263,000-square-foot, 166-bed replacement ED, which opened in July 2020 and includes an outdoor decontamination area, 14 negative pressure rooms, and spaces to serve as de-escalation/isolation/decontamination for patients presenting with infectious disease, behavioral health, or chemical contamination issues. “I give [Wellstar] credit for thinking ahead,” says Matthew Manning, principal at ESa who served as design manager on the project, a collaboration between ESa (Nashville, Tenn.) and Huddy HealthCare Solutions (Fort Mill, S.C.).

Those strategies have now served the ED during the current COVID-19 pandemic. “We’ve actually managed quite well … Read the rest

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Difficulties For Diabetic Patients In Dental Implant

Physical therapists (PT’s) are professionals in medical scrubs who diagnose and treat patients of all ages, from infants to old people, who have illnesses or injuries which limit their ability to move or to function normally in everyday life. Dental Prosthetists will find employment opportunities in the public and private health sectors through government health department clinics and private practice as independent clinicians. The PA training require students to study for such subjects as biochemistry, pathology, human anatomy, physiology, microbiology, clinical pharmacology, clinical medicine, disease prevention and medical ethics. Theoretical study aside, students are also required to undergo practical trainings. They may obtain training in areas such as family medicine, psychiatry, internal medicine, surgery, emergency medicine and pediatrics. With distance learning or online format for a nursing degree, there is a lack of courses offered for science laboratory. Applicants may need to enquire more on the availability of such courses. … Read the rest

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