Citation
Denver Department of Health and Hospitals

Material Information

Title:
Denver Department of Health and Hospitals intermediate care psychiatric facility
Creator:
Friedman, David B
Publication Date:
Language:
English
Physical Description:
193 unnumbered leaves : illustrations, plans ; 22 x 28 cm

Subjects

Subjects / Keywords:
Psychiatric hospitals -- Design and construction -- Colorado -- Denver ( lcsh )
Psychiatric hospitals -- Design and construction ( fast )
Colorado -- Denver ( fast )
Genre:
bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

Notes

Bibliography:
Includes bibliographical references (leaves 191-193).
General Note:
Submitted in partial fulfillment of the requirements for a Master's degree in Architecture, College of Design and Planning.
Statement of Responsibility:
David B. Friedman.

Record Information

Source Institution:
University of Colorado Denver
Holding Location:
Auraria Library
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
08643298 ( OCLC )
ocm08643298
Classification:
LD1190.A72 1981 .F74 ( lcc )

Full Text
DENVER DEPARTMENT OF HEALTH AND HOSPITALS
INTERMEDIATE CARE PSYCHIATRIC FACILITY
THESIS 1981 DAVID B. FRIEDMAN
ARCHITECTURE DIVISION
COLLEGE OF ENVIRONMENTAL DESIGN
UNIVERSITY OF COLORADO AT DENVER


CONTENTS
a
SOLUTION


I
INTRODUCTION


I
background
The treatment of the mentally ill in the United States and Europe has gone through three phases and is now moving into a fourth phase.Prior to the 1880's the mentally ill were considered to he evil beings or weak people inhabited by evil spirits.These people were hidden in their familys' homes or in miserable prison-like mental institutions.
Between 18^0 and 1880 faith in science and strong moral convictions combined to evolve the second era of treatment. Scientific and humanistic principles were discovered, codified, and practiced extensively.One pioneer of this era, Dr. Thomas
Kirkbride, was highly involved in the design of an ideal prototype for the mental hospital facility.The 'Kirkbride Plan' called for large, institutional buildings yet each building had socially functional subdivisions of patient numbers.
The third era of psychiatric treatment was the result of scientific and technological discoveries in the field of psychotrophic medicine.This was the custodial era of the the 1950's,Patients were always kept on lots of drugs.Shock therapy and brain surgery were done with too much enthusiasm. Hospital staffs saw little reason to involve patients in challenging activities, The patient's dignity was traded for rational efficiency.
In the 1960's and 1970's, with sympathetic public opinion and federal economic support, the emphasis was placed upon community mental health treatment centers. This was the era of total deinstitutionalization. It was believed that no one could get better while living in an institution. Communities were given opportunities to help the patients cure their social problems .Patients living in communities would be safe, assuming that they went to ther-


background
apy sessions and took their medications regularly; unfortunately they didn't always do these things due to a lack of supervision.
What we are now entering is perhaps best described as an era of responsible options treatments.This approach will require a coordinated functioning of institutional, semi-institutional, and de-institutional-ized facilities.The type and intensity of the individual patient's illness will be
emphasized as the primary determinant of what kind of facility he or she is sent to.
The city of Denver's mental health care problem of the 1980's is twofold: first, the diminishing number of community based apartments, nursing homes, and hotels for patients to live in; and second, the general public's growing fears of violence by psychiatric patients 'on the loose';
In September of 1979 mental patient David DelaCruz, 21, stabbed an RTD bus driver for no apparent reason.
Mental patient Andrew McCoy Jr. stabbed a sailor to death at Stapleton Airport in 1980 because he believed that the stranger was out to destroy him.
Larry Evans, a 36 year old patient, was killed by a policeman after he shot and wounded another Denver policeman in March of 1980.
All of these patients were acting out their psychotic problems in the real world and were each declared not guilty by reason of insanity.The only facilities now availiable for psychiatric inpatient care


THESIG PRGPGGaL g
Project Description
an inpatient psychiatric care facility for 64 patients in a semi-residential neighborhood of Denver (City Park West); since the place will not be as open as an outpatient clinic or a daycare center and since it will not be as closed as a traditional psychiatric hospital, it will be called an "intermediate care" facility;
Issues Addressed
-integration of this relatively large building into the existing neighborhood -integration of this sensitive urban function into the existing fabric of medical, residential, and business activities -provision of many levels of restriction for various types of patient conditions -provision of many levels of privacy for various types of patient moods -balancing of patient privileges with general public's safety
-coordination of this facility with other Denver psychiatric facilities
Goals and Objectives
-to make environments for helping psychotic patients grow and adjust so that they can live with maximum independence after being discharged
-to partially relieve the Denver Health and Hospitals northwest catchment area of a severe shortage of psychiatric beds
Scope and Limits
The site is formed by eight residential lots on or near the comer of 20th Ave. and Gaylord St.The rectilinear property lines enclose 25,000 sq.ft., measuring 200 feet by 125 feet.The building setback lines enclose 17,437.5 sq.ft., measuring 187.5 feet by 93 feet.The program calls for the enclosure of approximately 45,925 sq.ft, thus requiring a multi-story building.
Personal Goals
-improvement in quality of conceptual seeing, thinking, and drawing -improvement in quality and speed of presentation drawing -application of behavioral theory to architectural design
Approach Proposed
produce design alternatives from the therapeutic program concepts, de facto activities, and systems requirements
Products of Thesis
-drawings of the project in plan, eleva-
tion, section, paraline, and perspective


CITY AREA MAP [J



CITY AREA MAP KEY [J
IffllfRiiP jfflj
I'IIP r^l1
1 Washington Park
2 Colorado Boulevard
3 St. Luke's Hospital
4 Children's Hospital
5 Congress Park
6 Sixth Avenue
7 University of Colorado Health Sciences
Center
8 National Jewish Hospital and Research
Center
9 Presbyterian Medical Center
10 Cheesman Park and Denver Botanic
Gardens
11 Denver Civic Center
12 East High School
13 Mercy Hospital
1^4- Denver General Hospital


GITE DESCRIPTION [J
Denver, Colorado is a metropolitan center which had a daytime population of over
680.000 people in 1978.By the year 2000 it is expected to have a daytime population of over 2,000,000.The large daytime population is now achieved by people commuting from surrounding cities and suburbs.The resident population of the city went from
515.000 in 1970 to about ^55,000 in 1980. Denver is situated just east of the Rocky Mountains foothills and has flat to mildly rolling contours.
Roughly one fourth of Denver's area is given city medical and psychiatric care by the Health and Hospitals catchment area.
Within this catchment area is a neighborhood known as City Park West.The project site is in this area on the comer of 20th Avenue and Gaylord Street.lt is virtually flat and is surrounded on two sides by sidewalks and large trees.The property lines enclose 25,000 square feet.
Surrounding the site on all sides are turn of the century Victorian and bungalo brick veneer homes, ranging from one to three stories.Three homes once occupied the site but were cleared for construction of a geriatric care facility.The recent trend of the neighborhood has been towards renovation of older homes for residential, commercial, and professional office uses. For the purpose of this hypothetical problem, the site and ^5,000 square feet of adjacent sites will be assumed successfully rezoned R-5 (institutional district) from the existing R-A- status (high density apartments and office district).


SITE DESCRIPTION [J
The City Park West neighborhood overlaps some of the Midtown Hospitals complex and is only a few blocks from Mercy Hospital. Denver General Hospital is only 3.25 miles away from the site by automobile.
The Denver Department of Health and Hospitals Division of Psychiatric Services finds this site desirable because it is in a relaxed semi-residential setting and is close to the Denver City Park which offers open spaces, paths, trees, plants, people, lakes, a zoo, and a golf course.The prox-
imity of the park will allow the staff to take small groups of patients out for exercise, learning, recreation, and therapeutic activities.Patients will be in familiar urban territory which makes their transitions into and out of inpatients easier.The patients also benefit from living in the city by being able to take advantage of self-improvement programs within Denver.


I
ITE DESCRIPTION
CITY AND COUNTY OF DENVER
3 Park East Mental Health Catchment Area k- Health and Hospitals Mental Health Program Catchment Area
5 Fort Logan Mental Health Center
6 University of Colorado Health Sciences
Center
LEGEND
1 Southwest Denver Mental Health Catchment
Area
2 Bethesda Mental Health Center Catchment
Area


catchment area j_J
The Northwest Denver Catchment Area is the largest of Denvers four catchment areas with a population of 181,000.Its people have severe economic, occupational, and educational handicaps.lt has high psychiatric casualty rates.Many people in this area are living in non-family settings or in environments of broken families.Suicide attempts are more common here than in the other catchment areas.Thirty per cent of the population is Chicano and ten per cent is Black.The Chicano population is in a child raising stage with many more intact family structures than the Black population.
Community cohesion is difficult to achieve in this area due to a high transience rate (thirty-six per cent).This catchment area also has a large number of teenagers out of school, disabled persons, and impoverished aged.Psychotic illnesses tend to prevail as the most common mental problems here which reinforces research indicating a high correlation of psychotic cases and low socio-economic income groups of people.
NORTHWEST DENVER

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TL.
.5
v-v ... :/
.8
2 NORTH
3 MILES

LEGEND
1 Westside Counseling Service
2 Capitol Hill Counseling Service
3 Northwest Counseling Service k Eastside Counseling Service
5 Rehabilitation Services
6 Capitol Hill Activity and Outreach
Program
7 Consultation and Education
8 Denver CARES (alcoholism treatment)
9 Drug Abuse Treatment Program (west)
10 Drug Abuse Treatment Program (east)
11 Research and Evaluation


CITY PARK AREA MAP
SITE
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YORK*
ST
20th



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LEGEND
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NORTH
750 FEET
26 th AVE
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I
LEGAL DATA
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1899 GAYLORD STREET
SITE PLAN
5 20
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NORTH
EAST 20th AVENUE


I
LAND FEATURES
SITE PLAN
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30 FEET


UTILITIES
SITE PLAN
0
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30 FEET
STORM SEWER GRADE 0.43%


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SITE PLAN
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AERIAL PHOTO


CLIMaTE ANALYSIS
Denver is located at 39 4-5' north latitude at an elevation of 5,280 feet above sea level.Due to its distance from any sizeable water source, it enjoys a semi-arid climate.In the summer, clouds and afternoon showers moderate otherwise high temperatures, and in the winter, winds are moderated by the position of the city in relation to the Rocky Mountains.Fall is the best season with little precipitation and much sunshine.Spring is the worst season with rain, heavy snows, and severe storms from the northeast.
Annual precipitation is 15.5 inches, the greatest part of which occurs in the spring.The normal annual snowfall totals fifty-nine inches (one inch of precipitation equals ten inches of snow).The average frost penetration is thirty inches.Summer prevailing winds are from the west.Occasional summer winds come in from the southwest and the southeast. Winter cold winds are predominantly from the north.The average windspeed throughout the year is ten miles per hour.Occasional winter Chinooks have been known to hit Denver with unseasonably warm seventy-five mile per hour winds.
The average number of heating degree days is 6106; average number of cooling degree days is 625.Annual means and extremes are as follows:
January
average high = hi F
average low = 15 F
record high = 76 F
record low = -29 F
July
average high = 88 F
average low = 57 P
record high = 104- F


CLIMATE
ANALYSIS
record low = ^2 F
Average humidity in January is 5^%
Average humidity in July is 50%,
Denver gets 70% of maximum annual possible sunshine with 278 average rainfree days. This makes passive or limited active solar energy utilization feasible (see solar angles diagrams).Automobile smog often collects over the Denver area and deposits particulate matter onto buildings, plants, and people's lungs.


CLIMATE ANALYSIS
a


I
CLIMATE ANALYSIS
a


CLIMaTE ANALYSIS 3
PRECIPITATION
2- 1-

in. J F M A M J J A S 0 N D
SNOWFALL
10- 5-
in. J F M A M J J A S 0 N D


CLIMATE ANALYSIS
a


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WINDS
WINTER
SITE PLAN
5 20
K)
30 FEET
NORTH
ST 20th AVENUE


WINDS
SPRING & FALL
SITE PLAN
20th AVENUE


SoLAR aNoLES


SvjLaR aNoLES
UJ
-
239 4:30 PM
/ /

233 4:00PM
N'^ 121
- 7:30AM
W 40-7
127 8:00AM
6
180
12:00AM
WINTER
AZIMUTH
0.
ZD

26
jQ 12:00AM
5
8:00AM
4:00PM
0
7:30 AM 4:30PM
WINTER
ALTITUDE


SuLaR ANGLES


SOIL DESCRIPTION
Denver's soils tend to be expansive-contractive and its water tables often fluctuate.There is a water table at the site about 1^ feet below ground level. Drain tiles and a sump pump to the storm sewer are recommended to keep water away from the building.
It is 17 feet down to solid bedrock. Steel reinforced concrete caissons are recommended for vertical and horizontal support.


PROBLEM CS-: RIPTIvN |_J
Denver Department of Health and Hospitals Division of Psychiatric Services wants to put together an intermediate care psychiatric facility, primarily for inpatient us use.The facility must he reasonably self-sufficient, giving therapy, shelter, food, and other supports for the sixty-four inpatients.The center will also need to give care to outpatients who have previously been in the facility and are in the process of adjusting to more independent living conditions.
John Zook, Administrator of Psychiatric Services at DGH, has suggested that there be a gradient distribution of patients from higher to lower floors for more dependent and less dependent patients, respectively.Therefore, the program calls for some wards to function more restric-tively than others.Occupational and group therapies will play important roles in preparing patients for productive lives in the outside world.
Standards of the American Psychiatric Association and guidelines of the Joint Commission on Accreditation of Hospitals must be followed as well as the local City and County of Denver Building Codes and Zoning Ordinances.


CLIENT DESCRIPTION [J
The Denver Department of Health and Hospitals Mental Health Program has for two decades been in the forefront of the movement to give complete mental health care to all of its clients.lt has kept this status by maintaining a program which offers treatment for people who suffer from:
1.Social problems
2. Mental problems
3. Emotional problems
^.Alcohol problems
5. Drug abuse problems
6. Vocational problems
In the early 1960's Denver was divided into four quadrants to allow each area of the city to deal with its own health care problems on a more local basis. The Denver Department of Health and Hospitals is one of those four quadrants and covers most of northwest Denver.
The Mental Health Program in this quadrant is a network of eighteen facilities scattered throughout the catchment area (see description of the H&H catchment area).The administrative center of this area is located in the Nicholson Building on the Denver General Hospital grounds and is directed by Edmund Casper, M.D.There is a board of twenty-one citizens which gives grassroots representation for neighborhoods and communities within the catchment area.All of the eighteen community based services are operated for outpatients only.The DGH Acute Care Psychiatric Ward for adults does take inpatients although it has been severely overloaded since Ft. Logan cut back on its capacity.
The Department of Health and Hospitals has received sixty per cent of its funds from the city of Denver while the remainder has come from state and federal sources.


UCERS DESCRIPTION g
The most important users of this facility-must be the psychiatric inpatients.They are the ones who must do the most difficult work of moving from despair to greater ability to cope with problems. Serving the inpatients are other users such as professional staff, administrators, and plant service staff.
Nearly all of the patients in this hospital will have psychotic disturbances with accompanying social and emotional problems, A psychotic patient is a person with fundamental mental derangement characterized by defective or lost contact with
reality.Psychotic symptoms include hallucinations, delusions, disorientation, paranoia, hostility, and mania.Psychosis is not usually a curable disease.The goals of the professional staff for the patients will be to help them cope with their physical and social environments and to rehabilitate the patients from mental and emotional side effects accompanying the disease.
There will be a total of sixty-four inpatients and an average of ten outpatients being served at any one time (see projected statistics for patients).Patients will be divided into sixteen person 'community teams' to allow limited self government and meaningful social relationships in each ward.
The facility will have a professional staff of psychiatrists, psychiatric interns, psychologists, psychiatric nurses, psychiatric nurse aides, occupational therapists, and a psychiatric social social worker.
The administrators will overlap the pro-
fessional staff for some positions so as
to minimize personnel and to keep the ad-


USERS DESCRIPTION
ministration in touch with staff problems. There will be a director, a co-director, secretaries, and an accountant.
Other users will provide service functions by maintaining the patients' rooms, their food, their clothing, the building, and the grounds.


patient ctatisticc
Sexes
Males = 57%
Females = 43$
Ages
Adult(18-64) = 95$
Elderly(over 65) = 5%
Ethnicities
White = 55%
Mexican American = 26%
Black = 14%
Native American = 4$
Asian = 1%
Lengths of Stay
1-3 days = 2%
4-7 days = 5%
8-11 days = 5%
12-15 days = 30%
16-21 days = 43$
22 or more days = 15#
Admissions Types
Voluntary = 37%
72 Hr. Eval. = 10%
Involuntary = 2%
Other = 1%
Admissions Rates
Admissions/day = 4
Admiss./Client = 1.3
a


PROXIMITY MATRIX g 4 5 6
INPATIENT SLEEPING SPACES
Dayrooms
Activity Rooms \P?\ X>X /\ v^\
Nurse Station Areas
Mini Kitchens /OjVZi X
Double Bedrooms
Single Bedrooms /oV/
Large Hallways for Inpatients
Charting, Filing, and Break Rooms
Quiet Rooms
Medical Preparation Rooms
Laundry- Linen Rooms M
Physical Exam Rooms
Men's Bathrooms A ks/t/X
Women's Bathrooms
Men's Restrooms A \S4 P\
Women's Restroom's
Bathtub Rooms S&ne
Nursing Staff Restrooms
Exam Room Restrooms """X/x*/
Quiet Room Restrooms / 1
LEGEND
1 united Z closely connected
4 distantly connected
5 no connection necessary
6 no connection allowed a' restricted passage to some people b1 adjacency desirable regardless of connection 'c' remoteness desirable regardless of connection


MATRIX
PROXIMITY
PUBLIC ACCESS SPACES
Entry Lobby
Receptionist's Space
Family Therapy Rooms
Psychiatric Social Worker's Office
Patient Representitive's Office
Display Gallery
Mini Library
Automobile Areas
Public Restrooms
Janitorial Closet
LEGEND
1 united
2 closely connected 3 can be connected via other space k distantly connected 5 no connection necessary 6 no connection allowed 'a' restricted passage to some people 'b' adjacency desirable regardless of connection 'c' remoteness desirable regardless of connection


I
PROXIMITY MATRIX g
SHARED BUILDING SPACES
Dining, Meeting, Assembly Space___________
Occupational Therapy Grafts Shop__________
Occupational Therapy Wood and Metal Shop
Occupational Therapy Kitchen______________
Conference/Group Meeting Room_____________
Exercise Dance Room_______________________
All Faiths Mini Chapel____________________
Occupational Therapy Greenhouse Vocational Education Classroom
Beauty Barber Shop________________________
Occupational Therapist's Office
Occupational Therapist Assistants1 Office
Recreational Therapist's Office
Vocational Counselor's Office
Part Time Religious Counselors' Office
Kitchen Serving Area
Main Kitchen
Men's Restroom
Women's Restroom
Staff Bath and Restrooms__________________
Central Medical Supply Room_______________
Central Laundry___________________________
Central General Supply Room Inpatients' Remote Storage Room Janitorial Closet
LEGEND
1 united
2 olosely connected 3 can be connected via other i 4 distantly connected 5 no connection necessary 6 no connection allowed 'a' restricted passage to some people 'b' adjacency desirable regardless of c< 'c' remoteness desirable regardless of coi


PR/I'M IT Y pIaTRKES a
SHARED FLOOR SPACES
Conference- Group Meeting Rooms Psychiatrist's Offices Psychiatric Nurses' Offices Staff Secretarial Spaces Open Use Offices Staff Restrooms Janitorial Closet
ADMINISTRATIVE SPACES
Director's Office_____________
Associate Director's Office
Accountant's Office___________
Administrative Waiting Area
Secretarial Space_____________
Administrative Restrooms 1 2 3 4 5 6
LEGEND
1 united
2 closely connected
3 can be connected via other space
4 distantly connected
5 no connection necessary
6 no connection allowed 'a' restricted passage to some people 'b' adjacency desirable regardless of connection 'c' remoteness desirable regardless of connection


I
PFKvIMITY MaTRK ES g
PRIVATE ACCESS SPACES
Central Security Office Admissions Secretary's Office Receiving Physical Exam Room Receiving Quiet Room Physical Exam Restroom Quiet Room Restroom
ALL SPACE GROUPS
2 closely connected
3 can be connected via other space
k distantly connected
5 no connection necessary
6 no connection allowed 'a' restricted passage to some people b' adjacency desirable regardless of connection 'c' remoteness desirable regardless of connection


SPaCE aNaLYSIS
Quantity, Identity and Square Feet
1 Intermediate Care Psychiatric Facility ^5,925 sq.ft, gross
Furnishings and Services
complete hvac system artificial lighting natural lighting sprinkler system elevators
People and Activities Involved
psychotic mental patients learning to overcome moderate or extreme problems with living in a community therapeutic staff helping patients improve through activities and talking
Location
on the eastern edge of the H.& H. catchment area
one block west of Denver's City Park in City Park West neighborhood
Spatial Concepts
a place of mental healing and learning a miniturized, more controlled, reproduction of the pattern of life that patients live before and after being admitted
finishes and furniture strong enough to take abuse yet not so durable looking as to become a challenge
visitors giving inpatients support and involvement with significant others administrators directing and managing neighborhood people accepting the building and its occupants
a relatively large building which
responds to the scale of surrounding houses and to the scale of its own residential functions


I
SPaCE aNaL/SIS
Quantity, Identity and Square Feet
^ Inpatient Sleeping Spaces Groups
^,062 sq.ft, each + 50$ services = 6,093 sq.ft
Furnishings and Services
lots of natural lighting lots of fresh air
safety controlled hot water faucets views outside; controlled views from outside to inside
People and Activities Involved
inpatients sleeping, eating, using bathrooms and restrooms
inpatients attempting to regain familylike social skills in a casual residential atmosphere
Location
on an upper level of the building more restricted inpatients should be on highest floors
away from spaces below which might need skylighting
Spatial Concepts
inpatients are divided into groups of 16 to form ^ wards
each ward should serve a slightly different level of inpatient dependence many privacy levels in each ward
3
gross
various levels of flexibility for furnishings
flexible and controllable openings to the rest of the building
therapeutic staff working to get
through to and to help inpatients
critical care wards give patients fewer privileges
intermediate care wards give patients more privileges and more stimulation


SPaCE ANALYSIS
Quantity, Identity and Square Feet
4 Dayrooms ^00 sq.ft, each
Furnishings and Services
soft chairs couch lamps plants
views to outside
People and Activities Involved
patients sitting and thinking patients reading/writing/drawing patients casually talking patients and therapists holding meetings patients playing relatively quiet games
Location
not on north side of the building unless supplemented by east and/or west sides near to nurses station fairly close to activity room on an outside wall
Spatial Concepts
more than any of the other spaces, encourages meaningful and casual conversation between the patients
bookshelves magazine rack card table and chairs bulletin board wall pay telephones
patients eating breakfast or lunch within the ward at leisure patients eating meals within the ward due to restricted priviledges small parties for patients within the ward
near the mini-kitchen
not open to patient circulation
network within the ward many levels of privacy and semiprivacy


Quantity, Identity, and Square Feet
k Activity Rooms 250 sq.ft, each
Furnishings and Services
television set
People and Activities Involved
patients playing relatively noisy and active games with other patients patients watching others play patients talking loudly patients watching television
Location
semi near the dayroom can he next to bedrooms on an outside wall
same open space as the nurse station
1 ping pong table or 1 bumper pool table vending machines
light chairs light end tables plant grow lights
Spatial Concepts
a space where patients are encouraged to be less passive
total withdrawl into television is discouraged
a space which tolerates abuse but with minimal institutionality
lively social interaction is encouraged
open to circulation network in ward


I
SPaCE ANALYSIS
Quantity, Identity and Square Feet
4 Nurse Station Areas 100 sq.ft, each
Furnishings and Services
counters with drawers and kneespace below for nurses to work on higher counters for interaction with patients
views to all patient gathering areas
People and Activities Involved
nurses watching patients nurses interacting with patients nurses talking with other therapists in semi privacy-
nurses giving patients medications
Location
in same space as activity room
next to medical preparation room
next to charting, filing and break room
a boundary to define nurses territory
emergency call locator panel
bulletin board wall
telephone-intercom
view to main entrance of the ward
nurses maintaining the ward's functions 2h hours a day in three shifts
Spatial Concepts
a space which offers closeness between patients and staff yet which also separates them to better maintain the therapeutic relationship
the central control point of each ward


Quantity, Identity, and Square Feet
^ Mini Kitchens 160 sq.ft, each
Furnishings and Services
small sink small refrigerator two burner stove dishes storage
People and Activities Involved
patients making between meal snacks for themselves
occupational therapist or nurse aide showing patient how to safely and effectively use the kitchen
Spatial Concepts
a scaled down residential kitchen which options for locking up some items
doesn't encourage big cooking projects indlvidual concentration emphasized
safety promoted by openness to staff and other patients
food storage pantry
emergency call switch
Location
towards center of the ward
near dayroom
near nurses station


SPaCE aNaLYSIS
a
Feet
Quantity, Identity and Square
28 Double Bedrooms 2^0 sq.ft, each
Furnishings and Services
2 beds 2 desks
2 wardrobe closets 2 soft chairs 2 bookcases
People and Activities Involved
patients sleeping at night patients getting dressed patients reading/writing patients sitting and thinking patients talking to one another
Location
next to other bedrooms off of patient circulation artery with a buffer zone
on an outside wall of the building not on south side of the building
Spatial Concepts
a place where the patient feels ok at night and yet feels bored during the day
an expression of the patient's interests
1 full length mirror views to outside
pairs of patients are separated enough to sense personal territory yet are not so divided that a personal relationship doesn't form


a
Quantity, Identity and Square Feet
8 Single Bedrooms 110 sq.ft, each
Furnishings and Services
1 wardrobe closet 1 soft chair bookshelves
People and Activities Involved
patient sleeping at night patient reading/ writing
patient sitting and thinking
Location
off of patient circulation artery on an outside wall not on south wall of building next to other bedrooms
1 bed 1 desk
1 full length mirror view to outside
Spatial Concepts
patient placed in this space will be one who is most difficult to match with anyone else (two per ward)
a place where the patient feels secure at night and is bored during the day
allows expression of the patient's interests


SPaOE ANALYSIS [j
Quantity, Identity and Square Feet
Large Hallways for Inpatients 8 ft. wide
Furnishings and Services
wall graphics
plant grow lights 1
light chairs light end tables
People and Activities Involved
patients, therapists and general staff circulating through the building patients who sit alone or with others to talk, play games or watch people go by
Location
between spaces being served by it towards the center of the building
Spatial Concepts
create a point of interest at each end or minimalize institutionality turn or jog in the hallway plan utilize the excessive width required by the life safety codes for other purposes without risking patient safety
people moving across or out of the building in an emergency situation some movement of patient beds although much less often than in a medical care hospital


I
SPaCE aNaLySIS
Quantity, Identity, and Square Feet
^ Charting, Filing, and Break Rooms 120 sq.ft, each
Furnishings and Services
1 desk and chair
1 horizontal patient data file, 36,lxl8,, pigeon holes for messages and mail
2 soft chairs bookshelves
People and Activities Involved
nurses relaying information during work shift changes nurses, doctors, or aides refering to and writing in patients' files nurses and aides taking coffee breaks
Location
on an outside wall
next to nurse station area
Spatial Concepts
the center of the staff's private territory within the ward a place for the staff to repair morale
views to outside telephone-intercom
nurses, aides, and doctor casually talking about events which have occured in the ward nurses or aides reading professional books or journals
casual social interaction encouraged


SPaCE ANALYSIS
Quantity, Identity, and Square Feet
8 Quiet Rooms 100 sq.ft, each
Furnishings and Services
hospital bed on wheels with restraints acoustically isolating walls, ceiling, floor, door, and ducts natural lighting tamper resistant hardware
People and Activities Involved
security guards, doctors, nurses, or aides securing an agitated patient to a bed, giving medications, and then isolating the patient for a specific duration
Location
on an outside wall of the building
can be on north side
near exam room
semi near nurses station
Spatial Concepts
minimal uncontrolled sensory stimulation calming and reassuring to occupant offers fewest opportunities for patient's self destruction
small view window from hall into room
emergency call switch inside light switch outside the room 2 hour elec, timer outside the room
staff putting a dangerously agitated into the room as a first measure

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similar in appearance to other rooms individual concentration emphasized


I
SPaCE aNaLYSIS
Quantity, Identity, and Square Feet
^ Medical Preparation Rooms 50 sq.ft, each
Furnishings and Services
1 small refrigerator 1 refrigerated storage cabinet small sink
base and wall cabinets good security, many locks
People and Activities Involved
routine preparation of patients' medications by nurse or doctor emergency preparation of medications for patient
Location
away from zones of patient access next to nurse station area
Spatial Concepts
by removing all unnecessary distractions, the staff worker will be more effective at preparing medications vital to the well being of patients and the ward


SPaCE aNaL/SIS
Quantity, Identity, and Square Feet
^ Laundry- Linen Rooms 100 sq.ft, each
Furnishings and Services
1 dryer linen storage closet
1 washer emergency call switch
1 sink with clothes layout counter clothes hanging rack general storage cabinets
People and Activities Involved
patients doing their own laundry chores patients picking up towels and other
articles cleaned by the central laundry
Location
near center of the ward near bath and restrooms near bedrooms
Spatial Concepts
to encourage the patient to be proud when he/she does this chore without help social interaction while working encouraged


I
SPaCE aNaL/SIS
Quantity, Identity and Square
4 Physical Exam Rooms 100 sq.ft, each
Furnishings and Services
1 examination bed 1 sink
base cabinets and countertop wall cabinets
emergency medical equipment storage
People and Activities Involved
doctor or nurse giving inpatient a routine physical exam doctor, nurse, or nurse aides giving inpatients emergency medical treatment within exam room or on that floor
Location
towards center of the ward near the quiet rooms
Spatial Concepts
calming and not frightening the patients
Feet
emergency call switch


a
Quantity, Identity and Square Feet
4 Men's Bathrooms 128 sq,ft, each
Furnishings and Services
2 private showers and dressing stalls controlled hot water supply 2 mirrors
radiant heat ceiling handicap accessibility
People and Activities Involved
patients showering themselves patients undressing and dressing patients casually talking
Location
towards center of the ward near men's bedrooms next to men's restrooms
Spatial Concepts
give the patient privacy when bathing yet allow indirect monitoring by other patients and staff
continuity elements which tie this space to more social spaces
noticably different to the patient from the women's bathrooms


Quantity, Identity and Square Feet
^ Women's Bathrooms 128 sq.ft, each
Furnishings and Services
2 private showers and dressing stalls controlled hot water supply 2 mirrors
radiant heat ceiling handicap accessibility
People and Activities Involved
patients showering themselves patients dressing and undressing patients casually talking
patients and staff
noticeably different to the patient from the men's bathrooms
Location
towards the center of the ward near women's bedrooms next to women's restrooms
Spatial Concepts
give the patient privacy when bathing yet allow indirect monitoring by other
continuity elements which tie this space to more social spaces


SPaCE ANALYSIS
Quantity, Identity and Square Feet
^ Men's Restrooms 126 sq.ft, each
Furnishings and Services
2 toilets 2 toilet stalls 1 urinal
1 stall for urinal
2 lavatories with counterspaces
People and Activities Involved
patients using toilets and urinal patients washing hands and face patients shaving patients brushing teeth patients grooming themselves
Location
towards center of the ward near men's bedrooms near men's bathrooms
2 paper towel dispensers 2 mirrors
handicap accessibility
patients casually talking
Spatial Concepts
minimally institutional to the patient noticeably different to the patient from the women's restrooms continuity elements which tie this space to more social spaces
give the patient privacy when using sink and toilet and urinal yet allow indirect monitoring by other patients and staff


Quantity, Identity and Square Feet
^ Women's Restrooms 126 sq.ft, each
Furnishings and Services
2 toilets 2 toilet stalls
2 lavatories with counterspaces handicap accessibility
People and Activities Involved
patients using toilets patients casually talking
patients washing hands and face
patients shaving
patients brushing teeth
patients grooming themselves
Location
next to women's bathrooms near women's bedrooms near women's bathrooms
Spatial Concepts
minimally institutional to the patient noticeably different to the patient from
give the patient privacy when using sink and toilet yet allow indirect monitoring by other patients and staff
the men's restrooms
continuity elements which tie this space
to more social spaces


SPaCE aNaL/SIS
Quantity, Identity and Square Feet
^ Bathtub Rooms 5^ sq.ft* each
Furnishings and Services
dressing space space for assistance radiant heat ceiling controlled hot water supply
People and Activities Involved
patient unable to use showers to bathe patient being assisted by aide to bathe patient undressing and dressing
Location
near bathrooms and restrooms towards center of the ward
1 bathtub with shower option
handicap accessibility
Spatial Concepts
a space patients will tend to like less
or the same as the group shower bath-
a space which doesn't encourage bizzare behavior (especially self-destructive) when the patient is alone
rooms


SPaCE aNaL/SIS
\
Quantity, Identity, and Square Feet
4 Nursing Staff Restrooms
40 sq.ft, each
Furnishings and Services
1 toilet
1 lavatory
1 mirror
paper towel dispenser
People and Activities Involved
nurse aides, nurse, or doctor using the toilet while in the ward
nurse or aides changing clothes while in the ward
Location
adjacent to charting, filing, and break room
within the staff's private territory within the ward
Spatial Concepts
a place protected from patients but less comfortable than the charting, filing, and break room
a


I
SPaCE anal/sis
Quantity, Identity, and Square Feet
4 Exam Room Restrooms ^0 sq.ft, each
Furnishings and Services
1 toilet 1 lavatory
1 paper towel dispenser 1 mirror
People and Activities Involved
patient using toilet during a physical examination
patients undressing or dressing for examination
Location
directly connected to exam room
Spatial Concepts
clean and comfortable yet not tempting for patient to withdraw into


SPaCE aNaLYSIS g
Quantity, Identity, and Square Feet
b Quiet Room Restrooms ^0 sq.ft, each
Furnishings and Services
1 toilet 1 lavatory
1 paper towel dispenser
small view window from hall into room
People and Activities Involved
security guard, doctor, nurse, or aide taking patient being isolated to use the toilet
Location
next to quiet rooms
towards center of the building
Spatial Concepts
minimal uncontrolled sensory stimulation not intended for use by other people
calming and reassuring to occupant at other times
offers fewest opportunities for patient's self destruction



SPaCE aNaL/SIS g
Quantity, Identity and Square Feet
1 Public Access Spaces Group
2,9^2 sq.ft. + 30# services = 3,825 sq.ft.
Furnishings and Services
views to outside; views from outside to inside
lots of natural light
lots of plants
skylighting
People and Activities Involved
peaceful new inpatients being brought into the hospital
inpatients with privileges interacting with others
staff entering and leaving the building
Location
on the ground level
near the comer of Gaylord St. and 20th Avenue
gross
space dividing furniture
visitors for inpatients entering and visiting or participating in family therapy
outpatients entering and leaving the building
Spatial Concepts
inviting to public and visitors offers opportunities for visiting at many levels of privacy


Quantity, Identity, and Square Feet
1 Entry Lobby
1,000 sq.ft.
Furnishings and Services
coffee tables and end tables textiles or plants for space dividers coffee service table views to outside
People and Activities Involved
family or friend visitors talking to a patient in a semi public environment non-restricted patients sitting and watching people come and go casual, small meetings of patients/public
ground level or one half level above ground
away from alley
near front entrance doors
a spatially condensed statement about the entire building
sub areas of greater and lesser publicness
a family room type of communal space
soft chairs and couches
pay telephones
Location
Spatial Concepts


I
SPaCE aNaL/SIS
Quantity, Identity, and Square Feet
1 Receptionist's Space 100 sq.ft.
Furnishings and Services
1 switchboard telephone-intercom low counter and chair bookshelves
People and Activities Involved
receptionist receiving and orienting disoriented people
receptionist checking patients in and out of the building
receptionist channeling incomming calls
Location
facing front public entry door not in center of the lobby
Spatial Concepts
a point of orientation and social interaction
not overbearingly authoritative


I
SPaCE aNaLYSIS
Quantity, Identity,
2 Family Therapy Rooms 150 sq.ft, each
and Square Feet
Furnishings and Services
soft chairs end tables natural light emergency call switch
People and Activities Involved
therapist, patient, and family members doing group therapy patient and family or friends visiting privately
Location
near psychiatric social worker's office hidden, yet not difficult to reach from the entry lobby
Spatial Concepts
individual concentration with others as well as personal interactions with others encouraged confrontation encouraged


SPaCE aNaLYSIS g
Quantity, Identity and Square
1 Psychiatric Social Worker's Office 110 sq.ft.
Furnishings and Services
desk and chair file cabinets
2 soft chairs bookshelves natural light
People and Activities Involved
social worker doing desk work social worker talking with patients social worker meeting with family or friends of patients
Feet
emergency call switch telephone-intercom
social worker meeting with represen titives of other agencies
Location
near family therapy rooms near other offices on this floor hidden, yet not difficult to reach from the entry lobby
Spatial Concepts
interaction is facilitated by a cheerful environment
a place where the individual social worker is able to feel a sense of territory


SPaCE analysis
Quantity, Identity, and Square Feet
1 Patient Represent!tive's Office 100 sq.ft.
Furnishings and Services
1 desk and chair bookshelves file cabinets
2 soft chairs natural light
People and Activities Involved
patients visiting the part time represen-titive to make sure that they know their rights and responsibilities meetings between the representitive and people from outside the hospital
Location
near other offices on an outside wall
easy for patients and visitors to find not too close to administrative offices
telephone-intercom emergency call switch
patients using the representative to express grievances about their treatment in the hospital meetings between the representitive and other staff members
Spatial Concepts
a place where problems of patients are heard and are dealt with justly confrontation encouraged


SPaCE aNaL/SIS g
Quantity, Identity and Square Feet
1 Display Gallery 300 sq.ft.
Furnishings and Services
storage for display equipment picture hanging tracks
controlled lighting for pictures or three dimensional objects capability of closing off this space
People and Activities Involved
local artists setting up exhibitions patients, visitors, and neighborhood
patients displaying work from occupational residents browsing through the
therapy and personal endeavors exhibitions and displays
institutions setting up displays to be more visible or to generally educate
Location
near mini library connected to entry lobby
Spatial Concepts
social interaction encouraged a casual, inviting space a neutral environment for the display of interesting objects


SPaCE aNaL/SIS g
Quantity, Identity, and Square Feet
1 Mini Library-900 sq.ft.
Furnishings and Services
study carrel desks and chairs tables for two book shelving
librarian desk with telephone-intercom natural light
People and Activities Involved
patients withdrawing to read or think or write
visitor or neighborhood resident browsing through books and magazines
Location
directly off of entry lobby north or east sides of the building near display gallery
emergency call switch
volunteer librarian maintaining flow of people and books magazines and books being rotated through wards and back to the mini library
Spatial Concepts
a warm academic environment a public place where individual concentration is encouraged


SPacE aNaL/i>IS
Quantity, Identity and Square Feet
Automobile Areas
19,000 sq.ft.
Furnishings and Services
fresh air natural light night lighting
68 regular car parking spaces 2 handicap spaces
People and Activities Involved
patients, outpatients, visitors, doctors, nurses, therapists, administration, and general staff arriving and departing the site by car
delivery of food and supplies by truck
Location
one level below ground, one half level below ground, or at ground level veiled from view of nearby sidewalks and residences
automobile, delivery truck, and emergency vehicle circulation food and supplies delivery dock emergency patient delivery dock
delivery of difficult or acute patients by ambulance
Spatial Concepts
a balanced response to the needs of people with cars and of neighborhood residents to have an optimally peaceful environment


Quantity, Identity and Square Feet
2 Public Restrooms (men's and women's) 126 sq.ft, each
1 urinal for men's only
2 lavatories with counter areas 1 paper towel dispenser
People and Activities Involved
visitors or general public or patients using toilets
people washing hands and face people grooming themselves people casually talking
Location
off of entry lobby area with buffer space towards center of the building
Spatial Concepts
minimally institutional continuity elements which tie this space to more social spaces
Furnishings and Services
2 toilets 2 toilet stalls
2 mirrors
handicap accessibility


SPACE ANALYSIS [J
Quantity, Identity and Square Feet
1 Janitorial Closet 30 sq.ft.
Furnishings and Services
1 janitorial service sink storage of janitorial cart storage of janitorial tools and supplies
People and Activities Involved
janitor cleaning up spaces in this area patients cleaning up spaces in this area for pay
cleaning of mops in sink
Location
near elevators or service core off of a main circulation artery
Spatial Concepts
easy to remove and replace items which fit compactly into the space


SPaCE aNaLYSIS
Quantity, Identity and Square Feet
1 Shared Building Spaces Group
9,692 sq.ft. + 30# services = 12,600 sq.ft
Furnishings and Services
views to outside; views from outside to inside although not as open as public access spaces group
natural lighting
durable finishes
People and Activities Involved
inpatients learning hobbies, skills, and self-support
outpatients participating in some of the programs
part-time staff helping patients
Location
ground level
near the shared floor spaces and the public access spaces
gross
durable furniture
restricted access from public spaces
therapists teaching and guiding patients
non-therapy staff providing patients with food and clean spaces
1
Spatial Concepts
a miniturized form of many of the activities and services that the inpatient may find in the community


Quantity, Identity, and Square Feet
1 Dining, Meeting, Assembly Space 1,100 sq.ft.
Furnishings and Services
tray return carts
People and Activities Involved
patients and staff eating meals patients and staff seeing old movies large dances for patients public meetings held by or for neighborhood residents
Location
south side of the building next to kitchen serving area near vertical circulation arteries up to the wards
moveable seating for 72 people 18 tables, k places each bulletin board wall views to outside
storage for tables projection screen control of natural lighting future patient activities display
Spatial Concepts
a large flexible space social interaction encouraged


I
SPaCE aNaL/SIS
Feet
Quantity, Identity and Square
1 Occupational Therapy CraftsShop 850 sq.ft.
Furnishings and Services
woodblock top tables with lockers below
clay kiln
potter's wheels
sink with sludge trap
base cabinets and counter
People and Activities Involved
inpatients making things as a means of analysis, therapy, or pleasure occupational therapists being near patients to evaluate or guide them
Location
adjacent to occupational therapists' offices
near vocational education spaces on an outside wall of the building
Spatial Concepts
emphasis on primitive creativity social interaction encouraged
wall cabinets weaving loom painting materials
storage cabinets for materials/tools storage for projects in progress
occupational therapists conducting patient groups to build upon their crafts experiences
to be used by maximum of one ward at a time
organized only enough to keep track of items and not to confuse the patients


SPaCE aNaL/SIS
a
Quantity, Identity, and Square Feet
1 Occupational Therapy Wood and Metal Shop 500 sq.ft, each
Furnishings and Services
power saw fire extinguishers
power drill exhaust fan to outside
power lathe emergency call switch
tool storage pegboard industrial size vacuum
People and Activities Involved
inpatients using dangerous machine tools under supervision of occupational therapist
storage of potentially dangerous hand and machine tools
Location
directly connected to the occupational therapy crafts shop away from quieter spaces, horizontally and vertically
Spatial Concepts
a space more organized than the crafts shop
individual concentration promoted
minimal unnecessary visual agitation


SPaCE aNaLYSIS
a
Quantity, Identity and Square
1 Occupational Therapy Kitchen 150 sq.ft.
Furnishings and Services
refrigerator stove and oven
2 basin sink base cabinets wall cabinets
People and Activities Involved
inpatients and occupational therapists simulating home and family living experiences for analysis and improvement of the patients1 skills
Location
connected to occupational therapy crafts shop
Spatial Concepts
a space which deliberately creates an illusion of being another space yet which offers reality checks for the disoriented patient
Feet
table and chairs for six natural light emergency call switch
a place of social activity