Ballinger Associate Principal and Director of Healthcare Planning Christina Grimes, AIA, LEED AP, ACHA, EDAC moderated a panel discussion organized by AIA Philadelphia and SMPS Philadelphia. Panelists Diana Henkel, Assistant Director of Infrastructure at NYU Langone Health; Kelly Miller, Architect and Project Manager at RWJBarnabas Health; and Suzanne Morris, Director of Construction Management at Nemours Children’s Health System discussed topics driving facilities decision-making.
Ballinger Senior Principal Louis A. Meilink, Jr., FAIA, FACHA, ACHE and Director of Healthcare Planning Christina Grimes, AIA, LEED AP, ACHA, EDAC, presented Design’s Ability to Transform + Deliver Population Health at this year’s European Healthcare Design Congress. The theme of the virtual event was “At the Tipping Point: Designing for Population and Planetary Health.” Ballinger’s poster and presentation explored how innovative technologies and thoughtful design can increase access to healthcare and promote healthier aging.
How can architects play a role in meeting the urgent demands of the COVID-19 pandemic? Ballinger Associate Principal and Director of Healthcare Planning, Christina Grimes, AIA, LEED BD+ C, EDAC, ACHA, was interviewed by PlanPhilly, a reporting project of the public media organization WHYY, about remaking spaces for our new socially distanced lives.
Ballinger’s Christina Grimes, AIA, LEED BD+ C, EDAC, ACHA,was recently accepted as a 2019 Board Certified member of the American College of Healthcare Architects (ACHA).
The ACHA is an organization dedicated to improving the quality of environments for healing by offering certification in the specialized field of healthcare architecture. The College’s rigorous certification process includes healthcare project experience, portfolio, completion of an approved educational program, and an exam assessing knowledge and skills requisite to high-quality performance in the practice of healthcare architecture.
Christina Grimes has led the healthcare planning of projects for Children’s Hospital of Philadelphia, Penn Medicine, Cooper University Health Care, and Tower Health in addition to work with other organizations. In 2017 she was also named to Healthcare Design Magazine’s HDC 10, which recognizes contributors to the healthcare design community who have made significant achievements and innovations in the field.
Penn Medicine Radnor, a 250,000 SF, four-story, outpatient ambulatory care center, reached a construction milestone Monday. IMC Construction held a “topping out” ceremony to mark the installation of the final piece of structure.
Designed for LEED Silver certification, the 4-story facility adheres to Penn Medicine’s commitment to sustainability. The building and its attached 1000-car garage form two sides of an inward focused campus. The building wraps around a courtyard, bringing natural light and calming views to patients, families, and staff inside. A circulation corridor around the interior garden enhances wayfinding and serves to orient patients. Within the garden are lawns and groves landscaped with native plants.
The building is scheduled to be completed in 2020.
Many of today’s workers are nomads – moving from one place to another within a building or campus, or working remotely with periodic visits to the office. How can workplace design enable flexibility, and how do the solutions compare in corporate, academic and healthcare environments?
Writer Patricia Washburn covered the topic in her Tradeline Report “Designing Space for Nomadic Workers,” based on presentations by members of Ballinger’s Research + Strategy team.
“More and more, workers aren’t going to an office and sitting at the same desk Monday through Friday….These nomadic workers are often mobile by choice, taking advantage of the flexibility that technology has enabled for academic staff, knowledge workers, and even healthcare employees,” Washburn writes.
Principal Keith C.H. Mock, AIA, associate principal Christina Grimes, AIA, LEED AP BD+C, EDAC, and senior associate Katherine Ahrens, LEED AP contributed to the research. They looked across a range of work environments to illustrate the continuity of workplace strategies.
The Research + Strategy team at Ballinger builds on experience gained through diverse project types to design evidence-based, high-performing environments. The team’s unique methodology combines a series of well-honed tools, critical thinking, and cross-market knowledge to better inform project design and outcomes. This takes the form of detailed pre- and post-occupancy analysis and evaluations, branding and change management communications.
Officials broke ground today on a new outpatient facility in Radnor for Penn Medicine. Ballinger designed the 250,000 SF building, providing architectural and structural engineering services. Attendees at the groundbreaking included Ballinger design principal Eric Swanson, AIA, project manager Thomas J. Parr, Jr., AIA, senior project healthcare planner Christina Grimes, AIA, LEED AP BD+C, EDAC, lead project designer Jason Cole, LEED AP, and project architect Michael Euker, RA.
Designed for LEED Silver certification, the 4-story facility and attached 1000-car garage will form three sides of an inward-focused campus. The building will wrap around a courtyard, bringing natural light and calming views to patients, families, and staff inside. A circulation corridor around the interior garden enhances wayfinding and serves to orient patients. Within the garden are lawns and groves landscaped with native plants.
What is the optimal mix of spaces to improve workforce engagement, maximize capacity, and minimize footprint and expenses? Ballinger associate principal Christina Grimes, AIA, LEED AP BD+C, EDAC, senior associate Katherine Ahrens, LEED AP and senior designer Kate Lyons explored these topics at the Tradeline Space Strategies 2018 conference in Scottsdale, Arizona. Their session “Workspace strategies for balancing workstyles, work locations, and footprint” looked at examples across the healthcare, corporate and higher education sector to identify common themes and opportunities.
The research presented was developed by the Research + Strategy team at Ballinger, which builds on experience gained through diverse and technical project types to design evidence-based, high-performing environments. The team’s unique research methodology combines a series of well-honed tools, critical thinking, and cross-market knowledge to better inform project design and outcomes. This takes the form of detailed pre- and post-occupancy analysis and evaluations, branding and change management communications.
Healthcare Design magazine published a cover story about the Reading HealthPlex for Advanced Surgical + Patient Care. The article, titled “Shaped by Nature,” was written by Ballinger principal Louis Meilink, AIA, ACHA, ACHE and associate principal Christina Grimes, AIA, LEED AP BD+C, EDAC. It describes how a new surgical platform for Tower Health resulted in an 88,000 SF roof garden, one of the largest in the US.
Ballinger provided architecture, engineering and interior design services for the 476,000 SF hospital, which opened in 2017. The project is one of several Ballinger has designed for the hospital system, now called Tower Health, over the past 35 years.
Healthcare Design magazine is a monthly publication covering architecture, interior design, facility planning, healthcare engineering and construction, relevant research, and the most recent projects opening their doors.
How do design and research create change in health, technology, and the environment? Ballinger associate principal Christina Grimes, AIA, LEED AP BD+C, EDAC addressed this question at the 2018 Design Research Symposium hosted by the Drexel University Westphal College of Media Arts and Design. The event examined the process of change and design through presentations by researchers from IBM, Drexel University, and others.
Christina was on a panel exploring how we can change the health and human services system by addressing the whole community and utilizing technology and design. The discussion covered issues such as barriers to change, immunity to change, and opportunities to change health and healthcare.
On Thursday Ballinger presented two talks at AIA Philadelphia’s Forum on Architecture + Design.
Associate principal Erin Nunes Cooper, AIA, LEED AP, senior associate Don Semler, AIA, LEED AP, and associate Shawn Billiard, RA presented a case study of the David H. Koch Center at NewYork-Presbyterian. Opened in April, the 740,000 SF ambulatory care center includes surgery, interventional radiology, and endoscopy procedures in standardized rooms.
Principal Craig Spangler, AIA, and associate principals Christina Grimes, AIA, LEED AP BD+C, EDAC and Erin Nunes Cooper, AIA, LEED AP presented “How Does Architecture Impact Population Health?” The talk explored the complex relationships between cause and effect in healthcare environments and how we, as architects, can design environments that contribute to improving health in the larger community.
The Forum on Architecture + Design is a Philadelphia conference focused on curating multidisciplinary educational content for designers, civic leaders, product manufacturers, technology providers, and real estate developers – all the industries that contribute to shaping our built environment. Held at South Philadelphia’s Bok, the event included over 30 accredited continuing education programs and tours as well as keynotes by Pentagram’s Paula Scher and Michael Ford of Hip Hop Architecture.
On display at this year’s European Healthcare Design Congress & Exhibition, Ballinger presented an infographic poster analyzing the current state of population health in the United States and a case study of the Ballinger-designed 88,000 SF green roof at Tower Health System as a solution to space limitations and strategy to improve the patient experience.
Well-trained and effective clinical staff are in high demand around the world. In the United States, primary care physicians are out-numbered 3:1 by specialists, leaving the neediest populations in remote areas without physicians to address chronic and primary care. Staff at large institutions are increasingly asked to see patients in multiple locations across a number of campuses, stretching their time and resources.
Telemedicine presents an unprecedented opportunity to extend the reach of existing staff into rural and remote locations and prolong the careers of experienced nurses and physicians by reducing the physical demands of providing care. In their presentation to the European Healthcare Design Congress & Exhibition on June 11, “Telemedicine and the Future of Disruption”, Ballinger Principal Louis A. Meilink Jr., AIA, ACHA, ACHE and Senior Project Healthcare Planner, Christina Grimes, AIA, LEED AP BD+C, EDAC explored the increasing implementation of telehealth technologies and ways in which space planning can evolve to support these changes.
The topic was in keeping with the theme of the 4th annual conference, “Utopia or dystopia? Visioning the future for health” focused on the effects of environmental changes and technological advancement on modern healthcare systems and how institutions and designers can adjust to take advantage of advances such as AI, remote and algorithmic diagnosis, nanotechnology, and virtual reality. Held in London, this year’s event was organized by Architects for Health and SALUS Global Knowledge Exchange and hosted by the Royal College of Physicians.
Nomadic workers are mobile across buildings, campuses, and the globe. As the primary workplace evolves, how can the design of work spaces foster innovation and support these changes in the workforce? Ballinger principal Keith Mock, AIA, senior associate Christina Grimes, AIA, LEED AP BD+C, and associate Katherine Lyons presented their findings at the Tradeline University Facilities 2018 Conference in Austin. Their talk demonstrated how to incorporate individual work styles and cultural attributes into efficient, holistic team environments. By examining the nomadic journey of a typical researcher across multiple work environments, they identified work space design improvements.
Ballinger participated in this year’s PDC Summit, an international conference and exhibition on health facility planning, design and construction. Ballinger principal Louis A. Meilink, Jr., AIA, ACHA, ACHE, and senior project healthcare planners Christina Grimes, AIA, LEED AP BD+C, EDAC and Debbie Phillips, AIA, ACHA, EDAC presented “Population Health and the Quadruple Aim,” in which they explored how we as the design community contribute to population health. They illustrated the key factors that link design and population health through case studies of Puentes de Salud, Penn Medicine: Lancaster General Health Urgent Care, Reading HealthPlex for Advanced Surgical and Patient Care, and the New Jersey Institute for Food, Nutrition and Health.
A digital poll of the audience, conducted during the presentation, revealed that 69% of respondents view individuals (rather than healthcare providers or policy makers) as having the most impact on population health. The presenters issued a call to action for the design community to employ humanistic design and “the right place” to contribute to population health.
On March 19, at this year’s Population Health Colloquium in Philadelphia, Ballinger Associate Principal, Erin Cooper, AIA, LEED AP and Senior Project Healthcare Planner, Christina Grimes, AIA, LEED AP BD+C, EDAC presented their talk entitled “Beyond Green: Design of the Built Environment and Its Impact on Healthy Communities”. Their session explored the significance of design in improving overall wellness for communities and patient care spaces. They illustrated the role design can play within population health using examples from recent Ballinger projects, Penn Medicine, Lancaster General Health, Ann B. Barshinger Cancer Institute; Tower Health, Reading HealthPlex for Advanced Surgical and Patient Care; and Rutgers University, New Jersey Institute for Food, Nutrition + Health.
The annual Population Health Colloquium brings together healthcare providers, payers, pharmaceutical executives, leading technology and solutions companies, academia, and government to highlight advances in population health. The conference is an opportunity for leaders within the industry to share best practices, case studies, expert insights, and industry trends.
Senior Project Healthcare Planner Christina Grimes, AIA, LEED AP BD+C, EDAC was named a winner of the HDC 10, an annual awards program organized by Healthcare Design magazine honoring contributions to the healthcare industry. She received the “Team MVP” Award for her work with Tower Health System and her role on the Reading HealthPlex for Advanced Surgical and Patient Care. The “Team MVP” category recognizes individuals whose contribution to team projects proved invaluable. Christina accepted the award during the Healthcare Design Forum and is recognized in a special feature article in the September 2017 issue of Healthcare Design.
Ballinger recently published a Post-Occupancy Evaluation (POE) of the Ann B. Barshinger Cancer Institute at Penn Medicine’s Lancaster General Health. Ballinger conducts POE’s to assess and monitor how buildings are being used. This data informs how future designs can best foster healing and optimize the healthcare experience for patients, families, and caregivers. The research team was led by Ballinger Principal, Louis A. Meilink, Jr., AIA, ACHA, ACHE; Senior Associate, Amy Floresta, AIA, LEED AP; and Healthcare Planner, Christina Grimes, AIA, LEED AP BD+C, EDAC.
The objective of the POE was to understand which planning and design intentions have been most successfully realized, where user adaptations have been made, and the reasons for change. The team began by gathering both qualitative and quantitative data through an on-line survey to patients and staff, on-site interviews with staff, and on-site observation. These varied collection points allowed the evaluation team to triangulate issues that permeate all groups. The data was then evaluated using three categories: the overall building design and the perception of its spaces, how shifts in operations and procedure have affected staff culture, and patient experience.
The results suggest that the design was successful in fulfilling Lancaster General Health’s vision of providing an extraordinary experience every time. The iconic and integrated nature of the building has increased the hospital’s ability to attract and retain talented physicians and caregivers. Patients reported spending a significant amount of time utilizing the building amenities, which can be attributed, in part, to the presence of nature throughout these areas. The clinical layout was designed to provide a quiet and calming atmosphere. By separating the “on-stage” clinical environment from “off-stage” staff circulation, noise, traffic, and disruption were reduced. Decentralization supply stations reduced walking distances for staff and increased their time with patients. Overall, respondents found these planning strategies effective in improving the healthcare experience.
As part of Ballinger’s commitment to designing facilities that optimize the healthcare experience for patients, families, and staff, our teams conduct post-occupancy evaluations (POE) on completed projects to assess and monitor how they are used. Particularly illuminating was a recent POE conducted on the new Lasko Tower at Penn Medicine Chester County Hospital (PMCCH).
The research team, led by Ballinger Principal Louis Meilink, Jr., AIA, ACHA, ACHE and Senior Project Healthcare Planner Christina Grimes, AIA, LEED AP BD+C, EDAC, assessed how effective the inclusion of decentralized caregiver stations are toward improving staff and patient experience in the medical/surgical inpatient environment. By comparing four new floors of the tower, each with a unique layout featuring decentralized caregiver stations, to the hospital’s existing units which previously accommodated the same patient populations and were built with a single caregiver station, they were able to control for patient populations and consistent staff. The result was a study focused solely ¬on the physical environment.
The POE findings were strongly indicative of the benefits of decentralized caregiver stations. Patient and staff overall satisfaction scores increased by 113% in the new Lasko Tower units as compared to the pre-existing hospital units featuring central nursing cores. Sixty-six percent of staff felt that decentralized stations improved their ability to deliver quality patient care, and ninety-one percent of patients said that the stations improved the way they felt cared for in the new building. The decentralized stations resulted in reduced walking distances and increased patient time for staff, as well as improved fall rates and noise levels for patients. These results suggest an improved patient care environment.
The study was displayed at the 2017 European Healthcare Design Congress held at the Royal College of Physicians in London, UK, and published by SALUS Global Knowledge Exchange, a global media, publishing and research organization whose mission is improving human and planetary health.
As part of Ballinger’s commitment to designing facilities that optimize the healthcare experience for patients, families and staff, our teams conduct post-occupancy evaluations (POE) on completed projects to assess and monitor how the buildings are being used. Ballinger recently published a POE on their design for the Lasko Tower at Penn Medicine Chester County Hospital, completed in 2015. The research team, led by Ballinger Principal Louis A. Meilink, Jr., AIA, ACHA, ACHE and healthcare planners Christina Grimes, AIA, LEED AP BD+C, EDAC and Debbie Phillips, AIA, ACHA, EDAC, assessed which planning and design interventions were most successful and what effect the unit design had on staff and patients.
Although the primary goal was to gather insights for an additional bed tower (currently under construction), it also offered an opportunity to compare patient satisfaction and operational performance against an existing 20-bed unit, the West Building (built in 1962 and renovated in 1998). Significant differences between the West unit and the Lasko Tower unit include a larger floor area with a racetrack organization of patient beds rather than a single-corridor layout, the inclusion of decentralized care stations between every two patient rooms, and more locations for staff charting.
The analysis assessed patient satisfaction with rooms and amenities, staff operations relative to charting and patient care, and housekeeping operations relative to material selection and ongoing maintenance. Because both of the units studied have private patient rooms, the evaluation enabled direct comparison between fall rates, HCAHPS scores (noise and cleanliness), and rates of hospital acquired infections (HAI). The study included a proximity index charting the travel distances between staff care stations, patient rooms and supplies, and assigned a cost/benefit metric to key design considerations.
The POE results suggest Lasko Tower is an improved patient care environment, and since moving in, the hospital has noted significant improvements in all categories. The insights gained through this study directly informed planning of the 96-room patient bed tower currently under construction.
A Japanese delegation of 35 architects and healthcare administrators traveled to Pennsylvania today to tour the Ballinger-designed Lasko Tower at Penn Medicine Chester County Hospital and to visit Ballinger’s office in downtown Philadelphia.
The delegation became familiar with Lasko Tower and Ballinger’s design role when Principal Louis Meilink and Senior Healthcare Planners Christina Grimes and Debbie Phillips presented a Post-Occupancy Evaluation of Lasko Tower at the 2016 PDC Summit in San Diego. The presentation piqued the Japanese delegation’s interest and inspired their trip to Philadelphia around this year’s PDC Summit.
The delegation explored the three floors of Lasko Tower with Louis Meilink and his Ballinger colleague’s Associate Principal Tom Parr and Junko Huang serving as tour guides.
Following the Lasko Tower tour, the delegation arrived at Ballinger’s office in Philadelphia where they gave a compelling presentation on the latest design trends and healthcare facilities in Japan.
Office-wide tours and four thought-provoking healthcare topics were then presented by Ballinger healthcare team members. The topics, conceived by the delegation, explored improving patient safety, increasing staff motivation in the workplace, ensuring flexibility for the future, and the importance of codes and guidelines when designing hospitals. The topics were presented by Ballinger healthcare team members: Erin Cooper, Amy Floresta, Rob Goss, Christina Grimes, Debbie Phillips, and Eric Swanson.
For decades architects, engineers and contractors have speculated about how the healthcare building process can be improved. Pre-fabrication offers dramatic opportunities for construction process improvement and quality control. What are the right applications for pre-fabrication in healthcare and what factors should be considered at the start of design?
Ballinger Principals Louis Meilink, Jr., AIA, ACHA, ACHE and Barry Finkelstein, PE and Healthcare Planner Christina Grimes, AIA, LEED AP BD+C, EDAC, along with Richard Lanzarone, a Project Executive at Turner Construction Co., explored these questions at the 2017 PDC Summit in Orlando, an annual international conference on health facility planning, design and construction. Their presentation “The Whole Box: Beyond Pre-Fabrication,” illustrated the spectrum of pre-fabrication possibilities, from components to structural modules, and outlined a process to help clients determine if a project, or part of a project, is right for pre-fabrication.
Quadruple Aim and the Importance of Place, an article by Ballinger’s Louis Meilink, Jr., AIA, ACHA, ACHE and Christina Grimes, AIA, LEED AP BD+C, EDAC, was published in the March/April 2017 issue of Medical Construction and Design Magazine. The article suggests that health networks and architects must act together to put forth a diversity of healthcare facility solutions, thereby delivering the right care, at the right time, with the right price, in the right place.
Read the full article.
Ballinger recently conducted a post-occupancy evaluation to assess how effective the inclusion of decentralized caregiver stations are toward improving staff and patient experience in the medical/surgical inpatient environment.
The research team focused on the Ballinger-designed Lasko Tower at Penn Medicine Chester County Hospital that was completed in 2015 and utilized data and survey results to compare the new floors, each featuring decentralized caregiver stations to existing units which previously accommodated the same patient populations and were built with a single caregiver station and no decentralized stations. By controlling for patient populations and consistent staff, the study focused on the physical environment. Its results support a strong case for the use of decentralized stations with benefits extending beyond patient visibility.
This research was published by the AIA AAH Academy Journal in an article written by Ballinger principal Louis A. Meilink, Jr. AIA, ACHA, ACHE and senior associate Christina Grimes, AIA, LEED BD+C, EDAC entitled “The decentralized station: More than just patient visibility”.
At the PDC Summit 2016 in San Diego, CA, Ballinger’s Principal Louis A. Meilink, Jr., along with healthcare planners’ Christina Grimes & Debbie Phillips, and Chester County Hospital’s Director of Medical Services Cathy Weidman presented a Post Occupancy Evaluation (POE) of Penn Medicine Chester County Hospital’s new 24-bed Lasko Tower. Although the primary goal was to gather insights for another bed tower in design, it also offered an opportunity to compare patient satisfaction and operational performance against an existing 20 bed unit, the West Building (built in 1962 and renovated in 1998).
The most significant changes between the existing unit and the new unit included a much larger floor area and a racetrack organization of patient beds rather than a single corridor. In addition, the new Lasko Tower’s design includes decentralized care stations between every 2 patient rooms and more locations for staff charting. The analysis reviewed multiple items including:
- Patient satisfaction with the new room and other amenities,
- Staff operations relative to charting and patient care, and
- Housekeeping operations relative to material selection and ongoing maintenance.
Because both units had private patient rooms, there was a more direct comparison between fall rates, HCAHPS scores (noise & cleanliness), and rates of hospital acquired infections (HAI). Since the move, the hospital has seen significant improvements in all categories.
The study assigned a cost/benefit metric to key design considerations including private rooms, decentralized care stations, supply locations, and family amenities. The study also included a Proximity Index charting the travel distances between staff care stations, patient rooms and supplies. Insights gained will directly inform plans for the future 96-room patient bed tower design scheduled to be built in 2018.
Data collection method: 117 staff and 50 patient survey responses, onsite observation and onsite interviews with staff (December 2015).
The Ballinger presentation at the PDC Summit 2016 utilized live polling software to gauge the audience’s perspectives on several healthcare design topics. When asked the question “Which intervention had the Highest Impact for the Least Cost?” the audience made up of architects /engineers and healthcare staff responded: 70% Decentralized Station; 18% Noise Reducing Measures; 9% Décor + Material; 3% Size of the Patient Room.
Ballinger Principal Louis Meilink Jr., AIA, ACHA, ACHE and Senior Associate Christina Grimes, AIA, LEED AP, EDAC shared their analysis of multigenerational healthcare workers’ preferences in an article in Health Facilities Management.
In an effort to plan and design healthcare workplaces better, Ballinger used post-occupancy evaluation surveys to gather data on generational preferences for different kinds of working environments.
A key finding of their research is the importance of an inclusionary design process. Facilities that are designed to comprehensively address multiple generations result in a more efficient and fulfilled workforce.
Health Facilities Management is a publication of the American Hospital Association, providing comprehensive coverage of health facility design, construction and operations.