Independent Financial, a community bank based in Texas and Colorado, has developed a number of community initiatives over the years, focusing on building healthier, stronger, and more resilient neighborhoods. More than seven years ago, the financial institution began participating in meetings with local organizations, including government agencies, healthcare providers, and nonprofits, about the specific needs of McKinney, Texas, where it is based. One of the topics that kept resurfacing was healthcare. “There was a lot of talk about the need for primary care at McKinney, especially for those who are underserved and who are underserved,” says Kate Perry, senior director of healthy communities at McKinney Financial.
While the North Texas area where McKinney is located has grown significantly over the past two decades, there have been disparities across the region, with the average resident income in East McKinney half of what it is in West McKinney. Moreover, Perry notes that lack of health insurance, high rates of chronic diseases, and limited access to health and dental services have also affected the population. “People were driving 15 miles or more to get emergency care because they had no option to get immediate care in their area,” she says.
Building on these findings, Perry says she has begun working with James Tibbett, Head of Corporate Responsibility at Independent Financial, to launch a project to bring a new healthcare clinic to the area. While the bank was leading the project, providing $ 2.5 million in funding, Perry says his “catalytic work” was forming partnerships with community organizations, such as McKinney City, Baylor Scott, White Health, and the Texas Community Foundation, to build support through financial and in-kind donations. .
Meanwhile, Berry and Tibet have begun searching for a location for the clinic. “The site was important in terms of who we served,” says Berry. Specifically, the bank wanted the clinic to be located in East McKinney and be easily accessible because the area lacks robust public transportation. A vacant location between a major highway and downtown McKinney fits those needs. In 2016, the North Texas Family Health Foundation was formed as a non-profit entity to own the site and clinic building of 25,000 square feet that would be built there.
In keeping with the popular nature of the project, the Community Health Care Center (Wichita Falls, TX), a mission-oriented organization that runs 14 clinics in North Central Texas, has agreed to operate as an operator, bringing its expertise in the patient-centered center to the medical home model of the project (hires provider The building from the ground up).
Design-wise, Perry communicated with his Boston headquarters Model Architecture Service Association (MASS) Design Kit, Which was on her radar after reading about the company’s healthcare business in Haiti. Although MASS has contributed to more than a dozen medical facilities and labs around the world, the McKinney project will be his first in the US We have spent the past decade working with government health ministries and nonprofits, trying to expand access to care High quality by leveraging the built environment and the design to do so, ”says David Saladik, Senior Director and Design Director at MASS (Kigali, Rwanda). “This seemed like a really natural transition from our global business to the United States.”
Initially recruited to undertake the immersion process, the company’s role evolved to act as a design engineer for the community clinic, while Smith Group (Dallas) helped with architecture and supervised interior design. As part of its year-long research, MASS spoke to patients as well as service providers and community groups to begin identifying the needs the clinic could serve. Additionally, the company visited Wichita Community Health Care Center facilities to meet with employees and understand their operations, what works, and what they hope to improve in the new clinic, such as implementing a capsule model to support caregivers who work in a team – the existing setup. “We learned a lot about their ambitions in terms of how they want the space to look,” says Sladek.
By 2018, the project team is ready to move to design. The primary goal was to “live in” the neighborhood as much as possible and create a design that looked more like a home than a clinic, says Saladik. To break down the size of the facility, the project team took architectural cues from the area, including Texas Dogtrot-style homes, which feature multiple buildings connected by a breeze and a common roof. The result is a two-story structure divided into two buildings, with clinical services in one and community and staff services in the other.
The new Virginia Family Health Center, named after its Virginia Street location, will offer primary care, family medicine, obstetrics, gynecology, behavioral health and dental services. In addition to improving access to care, Perry says the partners also wanted to incorporate comprehensive services that would help address other key social determinants of health such as stable housing and nutritional resources.
Berry says early research with MASS helped the project team understand the kind of synergies that could exist, such as a clinic serving as a head start provider.
During the interiors, the project team sought to transform the healthcare experience by rethinking waiting areas as “different experiences of the home,” says Saladik, such as one focused on dining, one for work, and one with a game theater for younger patients and their family members. .
Saladik says the furnishings and large windows help support the family atmosphere and support the goal of creating a welcoming and gracious experience. “We didn’t want you to walk into a small, crowded waiting room. We wanted you to walk in something that feels roomy, comfortable and naturally lights up.”
To support the clinic’s team-based care model, areas for primary care, dentistry, staff and education are organized into incubators by specialty and located on the first and second floors, as well as team-based staff areas. Using a steel frame construction, capsules are placed on a grid to allow for future expansion and flexibility. Saladik says similar design and layout is used on both floors, so if there is incredible demand for a single service, such as dental health or behavioral health, clinical staff can relocate to adjacent areas without the need for major renovations to the spaces.
Two sizes of examination rooms are provided, including a standard room and a family room to accommodate patients who visit the clinic with family members. To support collaboration between patients and caregivers, examination rooms are designed so that patients can sit down with the doctor and view the same computer screen. Other features include daylight entry windows and a flexible examination bed that supports patient seating during conversations with a provider. “All of these things are important because they really change the perception of your care,” says Saladik.
To increase interdisciplinary cross-referrals and fighting concerns regarding stigma, behavioral health services in the medical field are included. “That way, no one knows if you’re in a particular clinical area to get vaccinated or to receive psychotherapy,” says Berry. “These types of design moves have been very important in supporting improved health outcomes and access to care in subtle ways.” The clinic also houses a space for group programs to support the management of chronic diseases, such as diabetes, as well as group counseling. “The intention was to provide some space for this purpose to facilitate these types of sponsorship activities,” says Berry.
For more unconventional services in the clinic, the design team has incorporated a variety of flexible spaces. On the ground floor, a large communal room opens to the outside and can be used for a variety of activities, including nutrition lessons or a food bank. There is also a built-in space within the waiting and reception areas where services such as tax preparation or benefit assistance can be supported, while the classroom on the second floor provides a training space for medical students and staff.
The bigger picture
The Virginia Family Health Center, designated as a federally qualified health center, was completed in December 2020. Dental services began in January, and the facility is expected to welcome medical and behavioral health patients in May after completion of state and federal requirements. While the COVID-19 pandemic has had limited community and team activities at the facility for now, Perry says it has conducted tours with several project partners. “One of our partners said,” This building will help people feel loved, “and she has taken possession of it. This is a community place and it’s for everyone.
Saladik agrees and says he would like to see the project as a model for future community health projects. “I hope that when this building starts to open, it exceeds everyone’s expectations of what they think a community health center can look like and feel.”
Project name: Family Health Center on Virginia
Project completion date: December 2020
Owner: North Texas Family Health Foundation
Total Building Area: 25,000 sq. Ft.
Total project cost: $ 10 million
Principal design engineer: MASS
Design Help: SmithGroup, Corgan
Recording Engineer: SmithGroup
Interior designer: SmithGroup
General Contractor: Rogers O’Brien
Engineers: LA Fuess (Structural), Cross Engineering (Civil), SmithGroup (MEP)
Furniture designer: WRG
Furniture: Herman Miller
Lighting designer: SmithGroup
Anne Denardo is Executive Editor for Healthcare Design magazine. It can be accessed at [email protected].