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Conceptualization and development of the Household/Ne ighborhood Model for skilled nursing facilities : A case study
David Arthur Green
Frontiers of Architectural Research. 2014, 3 (3): 228-237.
https://doi.org/10.1016/j.foar.2014.02.001
The conceptualization of the Household/Neighborhood Model for skilled nursing facilities began in 1987 at Evergreen Retirement Community in Oshkosh, WI, USA in the search for the “ perfect” nursing home. Being able to see perfection required being freed from the mental constraints of regulations, reimbursement systems, and existing staff training programs so that visionary thinking was possible. Conceptualization was followed by a pilot project to test various aspects of the vision. The result was (1) a management philosophy built on Continuous Quality Improvement, (2) a team-based organization structure, (3) cross-functional staff roles, (4) social-model activity programming, and (5) a residential style physical setting that won strong support from the State of Wisconsin. With this support, we had the opportunity to open in 1997 the first full-scale model of a Household/Neighborhood in the United States based upon providing “ resident and relationship centered services and care” . The model was validated through a year-long evaluative research study. In 2004 we opened a second full-scale model incorporating significant improvements identified through experience. The opportunity to further develop the model has been provided through its adoption in China by China Senior Care, which will open their fi rst facility in 2014. & 2014. Higher Education Press Limited Company. Production and hosting by Elsevier B.V. All rights reserved.
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The evolving role of evidence-based research in healthcare facility design competitions
Stephen Verderber,Shan Jiang,George Hughes,Yanwen Xiao
Frontiers of Architectural Research. 2014, 3 (3): 238-249.
https://doi.org/10.1016/j.foar.2013.12.001
The architectural design competition remains a widely accepted method to advance design innovation, creativity, theoretical discourse, and the profession. In the realm of healthcare facility design, by contrast, clients and their sponsoring organizations seldom utilize this method. The reasons for this are many, and continue to stand in stark contrast to a growing body of evidence-based research and design (EBR&D)that is potentially of value in improving performance-based dimensions—esthetic and otherwise—of healthcare facilities globally. A comparative analysis of the entrants to a recent U.S. completion was conducted. Based on the results of this analysis, a two-phased healthcare facility design competition paradigm is put forth that is premised on the assumption that the intuitive dimensions of design creativity can be further advanced by means of a well timed and thoughtful injection of quantitatively based knowledge pertaining to patient, family, staff, and organizational concerns and priorities. This proposal's limitations, and future opportunities, are discussed.
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Performance-driven design with the support of digital tools: Applying discrete event simulation and space syntax on the design of the emergency department
David Morgareidge,Hui CAI,Jun JIA
Frontiers of Architectural Research. 2014, 3 (3): 250-264.
https://doi.org/10.1016/j.foar.2014.04.006
Planning the design of the emergency department (ED) is a complex process. Hospital leaders and architects must consider many complex and interdependent factors, including evolving market demands, patient volume, care models, operational processes, staffing, and medical equipment. The application of digital tools, such as discrete event simulation (DES) and space syntax analysis (SSA), allows hospital administrators and designers to quantitatively and objectively optimize their facilities. This paper presents a case study that utilized both DES and SSA to optimize the care process and to design the space in an ED environment. DES was applied in three phases: master planning, process improvement in the existing ED, and designing the new ED. SSA was used to compare the new design with the existing layout to evaluate the effectiveness of the new design in supporting visual surveillance and care coordination. This case study demonstrates that DES and SSA are effective tools for facilitating decision-making related to design, reducing capital and operational costs, and improving organizational performance. DES focuses on operational processes and care flow. SSA complements DES with its strength in linking space to human behavior. Combining both tools can lead to high-performance ED design and can extend to broad applications in health care.
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Nearby outdoor environments and seniors physical activities
Zhe Wang
Frontiers of Architectural Research. 2014, 3 (3): 265-270.
https://doi.org/10.1016/j.foar.2014.04.002
More than 60% of older Americans have sedentary lifestyles1 and are recommended more physical activities for health benefit. Nearby outdoor environments on residential sites may impact older inhabitants' physical activities there (defined as walking, gardening, yard work, and other outdoor physical activities on residential sites). This study surveyed 110 assisted-living residents in Houston, Texas, regarding their previous residential sites before moving to a retirement community and physical activities there. Twelve environmental features were studied under four categories (typology, motivators, function, and safety). Based on data availability, a subset of 57 sample sites was analyzed in Geographic Information Systems. Hierarchical linear modeling was applied to estimate physical activities as a function of the environments. Higher levels of physical activity were found to be positively related with four environmental features (transitional-areas, connecting-paths, walk-ability, and less paving).
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Passive cooling techniques through reflective and radiative roofs in tropical houses in Southeast Asia: A literture review
Karam M. Al-Obaidi,Mazran Ismail,Abdul Malek Abdul Rahman
Frontiers of Architectural Research. 2014, 3 (3): 283-297.
https://doi.org/10.1016/j.foar.2014.06.002
Cooling is one of the major concerns in building tropical houses. This problem is exacerbated by the heat gain of the roof, which constitutes 70% of the total heat gain. The passive cooling technique is one of the innovative practices and technologies that provide buildings with comfortable conditions through natural means. Reflective and radiative processes are the methods used to decrease heat gain by facilitating the elimination of excess heat in a building's interior to maintain a comfortable environment. Given that the potential of these techniques vary from region to region, their application in the tropics should be examined. Exploring these approaches in detail allows us to rethink how to effectively adapt these techniques to overcome the build-up of heat in modern tropical houses in Southeast Asia. This study reviews the physical characteristics of these approaches to guide architects and building designers. Results indicate a great reduction in operational cost. However, the significant differences in the performance of colour and material properties should be considered, given that the selected approach strongly affects the required thermal conditions of a building.
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