Omaha VA Ambulatory Care Center

Omaha, Nebraska

LEO A DALY designed a landmark Ambulatory Care Center on the campus of the Omaha VA Medical Center. The facility will provide much-needed services, greatly benefitting veterans in the Omaha area.

The project was partially funded by a first-of-its-kind public-private partnership. The 114th Congress passed the “CHIP IN for Vets Act” in 2016, which authorizes the Department of Veterans Affairs (VA) to carry out a pilot program under which it may accept donations from non-federal entities to construct a project on VA property.

We were selected by the private entity because of our long history of providing high-quality design and consulting services for the VA, dating to the 1950s.

Patient-focused layout

Our design features the VA’s Patient Aligned Care Team (PACT) prototype model and includes eight primary care PACT units, one specifically dedicated to women’s healthcare. There is also a specialty care unit and an ambulatory surgery suite, in addition to services such as radiology, pharmacy, lab, etc.

The building has 157,000 departmental gross square feet allocated in a three-level structure. A connector link to the existing hospital building will separate public-patient traffic patterns from the required service traffic for the new building.

The facility’s design promotes patient-centered environments throughout to focus on the relationship between the physical environment and the patients’ overall experience. The design creates a healing environment that integrates spaces of escape and refuge, positive distractions, access to views and nature and abundance of natural daylight.

Symbolic, reverent design

Our design of the Omaha VA Ambulatory Care Center draws on patriotic iconography to honor veterans:

Freedom and sacrifice: A folded glass curtain wall covers the main façade, expressing the form of an American flag rippling in the wind.

Honor: The western façade is lined with glass panes of different hues that evoke the ribbons awarded to service members.

Duty: A limestone wall separates public spaces from secure clinical areas. The wall’s physical strength represents security. Limestone’s sedimentary composition references foreign soil tracked home, with layers representing periods of conflict and peace through which veterans have served.

Client 

Veterans Ambulatory Center Development Corporation

At a glance

157,000 SF

First of its kind public-private partnership

Surgical suite

Women’s health center

Features

Evidence-based design principles

Patient Aligned Care Team (PACT) prototype model

Eight primary care PACT units

Sustainable design features

Services

Full architectural design services

Interior design

Mechanical, electrical and structural engineering

Marsha M. Whitt

Marsha M. Whitt

CHID, EDAC, NCIDQ, Lean Six Sigma – Healthcare
Vice President
Director of Operations
Dallas, TX
469.357.4240    CONTACT ME   
Expertise
Operations
https://www.linkedin.com/in/marshawhitt/
https://leoadaly.com/about-us/locations/dallas/

​Marsha’s deep understanding of all aspects of project design and delivery, combined with a “roll up her sleeves attitude” allows her to excel in managing teams through the dynamic process of planning, design and construction.

Her responsibilities include management of the design team and project consultants, monitoring projects for compliance with budget and project staff and resource allocation, as well as oversight of project team efforts, coordination of work across disciplines and review of the design documentation process. Marsha’s leaderships abilities and management skills ensure that the office runs smoothly and that our team can best serve our clients.

Array Dallas healthcare team joins LEO A DALY

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Five designers join our Dallas design studio to help expand our healthcare capabilities in the region

LEO A DALY is happy to announce the hire of the Dallas staff of Array Architects. The Array team brings a sizable portfolio of past and current healthcare projects that will further the growth and development of our Dallas studio and global health practice.

“Integrating an established healthcare design team into our Dallas studio adds significant value to our design capabilities in Texas, the surrounding states and worldwide. This is a team with an extensive work history together, who share LEO A DALY’s commitment to innovative, thoughtful and sustainable design,” said Steve Lichtenberger, AIA, president of LEO A DALY.

This new integration brings healthcare-focused architects, interior designers and planners to LEO A DALY’s existing Dallas team, including Marsha Whitt, CHID, EDAC, Lean Six Sigma Healthcare; Katelyn Nunn, RA; Christina Taylor, planning and design; Gregg Hicks, planning and design; and Adrian Negron, lean design practitioner.

“This is an exciting move for our studio,” said Ken Martin, AIA, managing principal in Dallas. “The world knows LEO A DALY’s Dallas team as one of the preeminent hospitality design studios in the industry. Integrating healthcare into that mix will elevate the creativity of both groups, infusing wellness expertise into our hospitality practice and a dose of hospitality style into our healthcare work.”

The Array team joins LEO A DALY with a portfolio of local projects that includes work for Parkland Health & Hospital System, UT Southwestern Medical Center and Baylor Scott & White Health.

“Strong client relationships have helped LEO A DALY become a globally recognized leader in the design of the built environment. It’s very important to us, throughout this transition, that Array’s Dallas clients experience no interruption. The only thing they should notice is how great their projects turn out,” said Rebecca Davis, AIA, ACHA, LEED AP, our healthcare market sector leader in Dallas.

The Dallas healthcare team will be supported by talent from across the firm’s global health practice. LEO A DALY, which has 11 architecture offices across the U.S. and the Middle East, is recognized as an international leader in medical planning and design. The firm is ranked 19th in healthcare by Building Design + Construction healthcare and 11th by Interior Design.

“LEO A DALY’s global health practice is dedicated to helping our clients elevate care delivery through design. That means leveraging a deep understanding of medical processes and bringing clarity to the whole system of systems that interact in a healthcare setting. The Array team brings a unique differentiator in their Lean Six Sigma methodology, which will be an asset to our clients not just in Dallas, but worldwide,” said Josh Theodore, ACHE, EDAC, LEO A DALY’s global health practice leader.

 

Rebecca A. Davis

Rebecca A. Davis

AIA, ACHA, LEED AP
Senior Associate
Principal Market Sector Leader - Healthcare
Dallas, TX
469.357.4237    CONTACT ME   
Expertise
Healthcare market strategy and business development
https://www.linkedin.com/in/rebecca-davis-aia-acha-leed-ap-6651219/
https://leoadaly.com/about-us/locations/dallas/

Rebecca Davis guides strategy and business development for our growing healthcare team in the Dallas studio.

During her 20 years of practice, Rebecca has been dedicated to the planning, design and management of healthcare projects, with a passion and expertise in behavioral health spaces, oncology and support services departments, such as labs and pharmacies. Her portfolio includes more than 6 million SF of facilities, from small renovations and community hospitals to specialty medical centers and research facilities.

The drone-powered hospital

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Drone distribution could enable a more resilient future for rural and hurricane-prone health systems.

LEO A DALY is dedicated to helping health systems respond to a changing environment through the planning and design of resilient facilities. Our Miami design studio is now working on a concept for a drone-powered hospital, which uses autonomous aerial vehicles to deliver food and medical supplies directly to patients. The idea was inspired by managing principal Eduardo Egea’s experience aiding relief efforts in Puerto Rico following Hurricane Maria. With roads out across the island, he thought, how could we provide better healthcare services to more people, more reliably.

We spoke with Eduardo Egea, AIA, NCARB, about the drone-powered hospital, how it can help rural and hurricane-prone health systems stay resilient, and how it suggests future opportunities in healthcare and beyond.

How did hospitals in Puerto Rico suffer during and after Hurricane Maria?

During Hurricane Maria, the entire island of Puerto Rico lost power. Some facilities had emergency power, but that only lasted until their diesel fuel ran out. Many of the roads were either destroyed or unusable because of fallen debris, so access to hospitals was limited for staff, family members and suppliers. Patients were pretty much stranded without access to food, medication, and air conditioning. Some of the staff was unable to get to the hospital to take care of the patients.

How did your personal experiences inspire the drone hospital?

I was involved in extracting family members out of the island, including my 78-year-old father and 79-year-old mother. One is a dementia patient and the other is a cancer patient in remission, so very limited in their ability to take care of themselves. Meanwhile, my brother was organizing a convoy of ships from a local yacht club to deliver generators, food, and other supplies to the neighboring British Virgin Islands. The experiences of my family are what ultimately inspired the drone hospital.

If any of my family members had fallen or had a stroke and needed medical care, there would have been no place to go. The hospitals were not able to be used at their full capacity due to lack of power, water, access to clinicians and medication. When barges finally began entering the port with supplies, there were still cases where they were unable to get those supplies to those who needed it, including the elderly and critical patients who can’t move from those facilities. There was also an issue finding people to clean roads and drive trucks with supplies.

I thought, why couldn’t we bypass all that and have whatever is in the barges taken directly to the hospitals, and directly to patients?

What is the drone-powered hospital? Big picture.

The drone-powered hospital is a new type of acute-care facility that incorporates autonomous aircraft into its supply chain. Supplementing the existing network of terrestrial distribution channels, the drone-powered hospital takes advantage of a new network of fulfillment centers that utilize drones to provide for last-mile delivery. Food, medicine and other medical supplies are delivered directly to patients as needed via a drone port integrated into the exterior wall of each patient room.

The drone-powered hospital concept has several advantages for hurricane-prone healthcare systems, the most obvious of which is an added layer of resiliency in the case of a natural disaster. Additionally, by moving certain materials management, storage, food production, and pharmacy functions off-site, drone-powered hospitals would shrink their square-footage by 15 to 17 percent. The reduced footprint would change the economics of population health management, allowing more, smaller facilities to be built closer to the communities that need them.

How does the drone port work?

The drone port is essentially a valve at the outboard wall of the patient room. On the exterior, there is a net into which the drone drops its cargo. After drop-off, the cargo slides through the valve, where it is accessed by a cabinet on the patient end. The valve is designed to keep any moisture and dirt out.

Tell me about the design process that led to it.

Our design charrette was inspired by the news that Amazon had acquired Whole Foods. That news allowed our team to think big about the future of supply chains. We fell in love with the idea of Amazontopia, Amazon’s vision of a food distribution and fulfillment network using drones and blimps. One patent for their fulfillment center is inspired by a bee hive, from which Amazon will deploy drones with cargo to be delivered to customers.

We were curious why no one was talking about receiving end. If you live in a hi-rise condominium without a balcony, like many do here in Miami Beach or Puerto Rico, how would a drone approach someone at 31st floor? And how would that play out in that hospital that is a 5 to 20-story bed tower. We started sketching, beginning with a template for a universal patient room that is flexible to accommodate anything from acute to ICU. By simply sliding the exterior wall a foot and a half, we were able to provide a louver on the outside of the building for a placing a drone port. If you look at building from the outside it looks like a shark’s gills. Those gills are the drone ports.

It sounds like there are applications for this that go beyond healthcare.

Yes. Because of LEO A DALY’s strength in multiple markets, we have the ability to work with experts in different areas of design to build on our ideas. We look forward to seeing how this concept evolves as our workplace, mixed-use, hospitality, food distribution, manufacturing and residential groups get involved. At this point the applications are limitless.

What other kinds of applications do you see?

The concept of a drone-powered hospital touches many other industries, and involves many logistical, security, and technological questions that suggest business opportunities. On the healthcare side, there are opportunities to partners with pharma companies, food retailers, supermarkets, and others to help them access new markets. On the tech side, partnerships with existing online retailers will be helpful in in creating a fast, secure, pleasant customer experience. Logistically, there are just a whole range of opportunities to reinvent supply chains and rewrite the rules of population health management.

How will the future look if this idea is implemented?

I see more patients being treated, with better care, for less money, and with better reliability. The decentralization of healthcare services and minimizing the infrastructure would allow us to create more healthcare delivery settings embedded in places within communities that couldn’t be accommodated before. The healthcare industry is getting away from the idea of large, complex facilities, and moving toward more ambulatory care. A drone-powered micro-hospital could be easily assembled and introduced into any community, supported by the strength of drone-assisted last-mile fulfillment.

About the Author

Eduardo Egea, AIA, NCARB, is vice president and managing principal of LEO A DALY’s Miami design studio. In this role, Eduardo facilitates a collaborative and iterative design process, using simulation and prototyping, to research and test the effectiveness of promising design solutions that may impact patient safety in high-stress healthcare environments. He has focused his 25-year career on using a multidisciplinary approach to improve patient safety in healthcare through the development of tools and built-environment solutions. He can be reached at esegea@leoadaly.com.

Rebecca Davis, AIA, leads Dallas healthcare team

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The 20-year healthcare design veteran has expertise in behavioral health, oncology and support services

LEO A DALY is pleased to announce that Rebecca Davis, AIA, ACHA, LEED AP, NCARB, has been hired as principal, market sector leader – healthcare in the Dallas studio. In this role she leads our healthcare design practice in Texas, leveraging talent across the firm to deliver world-class design services to healthcare clients.

“Rebecca is a relationship builder with a singular dedication to client service. As we expand our healthcare services in Texas, our clients can expect the highest caliber of design, coupled with the reliability of a large firm and thought leaders who specialize in healthcare. Rebecca is the ideal person to lead this effort,” said Joshua Theodore, ACHE, EDAC, vice president and global health practice leader.

During her 20 years as an architect, Davis has dedicated herself to the planning, design and management of healthcare projects, with a passion and expertise in behavioral health spaces, oncology, and support services departments, such as labs and pharmacies. Her portfolio includes more than 6 million SF of facilities located domestically and internationally, ranging from small renovations and community hospitals to specialty medical centers and research facilities.

Davis’ professional experience spans the spectrum of architectural practice, ranging from planning and design to project management, onsite construction administration and quality assurance, business development and client management.

Davis has a M. Arch degree and a bachelor of environmental design from Texas A&M. She is a registered architect in Texas with certifications from the American College of Healthcare Architects, Leadership in Energy and Environmental Design and the National Council of Architectural Registration Boards. She is a member of the American Institute of Architects and the AIA Academy of Architecture for Health.

 

A first for the VA and a gift to our veterans

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by Jeffrey S. Monzu, AIA, NCARB, Vice President, Senior Project Manager

In an op-ed published by the Omaha World-Herald Feb. 16, U.S. Sen. Deb Fischer praises the United States Veterans Affairs’ first use of public-private partnership funding to deliver the new Omaha VA Ambulatory Care Center. As the project’s lead designer, LEO A DALY has collaborated with the VA to deliver innovations throughout the project, contributing to its being “under budget, ahead of schedule.” 

“Although a complete economic analysis has not yet been completed,” Fischer wrote, “VA estimated that the clinic would cost about $120 million if it were built as a standard federal construction project. Under the Omaha-devised public-private partnership program, the estimated cost has dropped to $86 million. That means potential savings as high as $34 million.”

As of March 1, 2019, construction approaches 30 percent complete, and the 160,000-square-foot facility is anticipated to open in summer 2020. Our integrated approach to architecture and engineering continues to forge innovations, while making gains in schedule and cost. For example, by specifying the use of a soil-nail wall rather than traditional excavation, we shaved weeks off of site preparation. At the same time, this innovation allowed traffic to the existing hospital to flow normally, without the additional costs associated with a second entrance or temporary detours.

The Omaha VA Ambulatory Care Center will be a first in the nation. As Sen. Fischer explains, Congress passed legislation specifically to support this project. A $30 million private donation to fund more than a third of the cost compelled what came to be called the “Communities Helping Invest through Property and Improvements Needed for Veterans Act of 2016,” better known as the C.H.I.P.I.N. for Vets Act.

By prescribing P3 delivery, the donor, Heritage Services, also prescribed opportunities for design innovation. For example, a blast-hardened curtain wall resembling a fluttering American flag will flank the hospital’s north side, blending thoughtful architectural detail with practical engineering.

“It is beautiful,” Heritage Services President Sue Morris said about the facility in an Omaha World-Herald article published March 4. “It’ll be a phenomenal space. It’s a tremendous gift to our veterans.”

Additionally, surgery staff collaborated with our designers to specify operating room temperature range. We met temperature and humidity requirements while lowering the supply-air dew point using desiccant dehumidification equipment, an innovation that reduces energy consumption.

We also deployed innovative methods such as virtual reality to “virtually tour” electrical and mechanical infrastructure for more precise design specifications. These are just a few of the innovations informing this revolutionary project’s success.

“I am proud of Nebraskans,” Fischer concluded, “for rising to this occasion and for coming up with an innovative and resourceful idea to keep our promises to those who have served our country.”

Jeff Monzu About the Author

Jeff Monzu’s primary focus is leading the planning, programming, design and project management of healthcare facilities. Over the past few years, he simultaneously managed a $34 million critical care hospital project requiring multiple trips to the client’s rural location, while completing design on a $100 million project that consolidated a healthcare provider and a medical school into a hospital campus.

For his dedication to helping smaller communities and populations with unique needs improve access to healthcare, Jeff was honored by Healthcare Design Magazine as a 2018 HCD 10 Winner. Jeff can be contacted at 402.390.4217 or jsmonzu@leoadaly.com.

Video: veteran symbolism infuses LEO A DALY’s Omaha VA clinic design

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LEO A DALY’s design for the new outpatient clinic at the VA Omaha campus celebrates the men and women who have served. In this video, designer Jonathan Fliege, AIA, discusses the veteran symbolism infused throughout the architecture.

The new Omaha VA clinic is designed to celebrate the men and women who serve our country. The main thought was to incorporate veteran symbolism throughout the experience.

The north façade of this clinic metaphorically represents the American flag rippling in the wind, reflecting the freedom and sacrifice of our veterans. The main entry façade is about the natural light filtering through those colored panes of glass that represent the honor ribbons that veterans have received through their service.

Similar to the way limestone is laid down in nature, we’ve designed this wall that separates the public and private spaces. It utilizes limestone panels, and that represents the sand that’s tracked home by veterans from foreign lands. In addition to creating a state-of-the-art healthcare environment, our intent was to incorporate these design ideas to honor our veterans.

How to be an effective healthcare designer

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Eduardo Egea, managing principal of our Miami design studio, is passionate about healthcare design. In this blog, he unpacks his 2019 CODDI keynote address, given this March in Puerto Rico, sharing insights about the mindset of a successful healthcare designer.

How to be an effective healthcare designer

Insights from my 2019 CODDI keynote address in Puerto Rico

by Eduardo Egea, AIA, NCARB

Last week I had the honor of addressing an audience of designers in Puerto Rico as the keynote speaker at the annual convention of Colegio de Disenadores – Decoradores de Interiores (CODDI). It was fascinating and energizing to return to the West Indies to share lessons learned over a career in healthcare design. As someone who has been involved in relief efforts in the wake of Hurricane Maria, it’s clear that the West Indies needs great design now more than ever. After getting to know many of the CODDI members during my trip, it was great to see that the talent is there to make a difference in the health, resiliency, and future of the region.

In this blog I will briefly lay out some of the main points of my CODDI keynote address. These are ideas that inspire everything I do as the leader of LEO A DALY’s Miami design studio.

Be an adviser

The main message I wanted to convey at CODDI is that we should think of ourselves as advisers to our clients. Some architects merely provide a drafting service, but that’s not enough. We need to embrace our role as leaders in the healthcare industry, and work with our clients to develop new methodologies of delivering care. To do that effectively, we must be researchers in addition to designers, capable of questioning assumptions and participating in a meaningful dialogue with our clients. Every decision we make must be in service of the triple aim: delivering better care to more patients for less money.  

Be a problem-seeker

People often view architecture as a problem-solving profession, but that’s only half-right. We must provide the right solutions to the right problems. Problem seeking begins in strategic planning, where we use data analytics and LEAN process-improvement exercises to uncover the hidden inefficiencies in the system. With these identified, we can consider which problems to solve. For example, is the Emergency Department running out of beds because of an undersized ED, or because of a backlog somewhere else in the hospital? Problem-seeking helps us focus our client’s capital resources in the right places, avoiding unnecessary construction, and improving the overall operation of the health system.

Be a disruptor

The profession of architecture has never been more ripe for disruption. Technologies such as Augmented Intelligence (AI), Augmented Reality (AR), and prefabrication offer opportunities for future-focused designers to automate and improve design and construction processes in ways that weren’t imaginable a decade ago. Smart architects will not wait for Silicon Valley to actualize the potential of these technologies. We should be harnessing big data today to make our designs more efficient, more universal, and more adaptable for a future that promises to change even more.

Be responsible

Climate change is here, and no one knows this more acutely than Puerto Rico. As designers, we have the responsibility to fight it, both in terms of reducing the carbon footprint of the buildings we design, and in helping our clients remain resilient to the increasing natural disasters we all face. Buildings are responsible for 39 percent of annual global greenhouse gas emissions, and hospitals are one of the most energy-intensive building types. Reducing their energy consumption and decreasing their reliance on fossil fuels is a no-brainer. Designers also have a responsibility to help health systems cope with rising sea levels, increasingly powerful storms, worsening wild fires and other threats. That’s as true for buildings as it is for the municipal infrastructure that keeps them running.

Healthcare design is more than just creating beautiful and functional facilities – it’s an overall point of view that seeks to improve the human experience by keeping communities healthier. By knowing our craft and applying it responsibly, we can help health systems improve access to care, quality of care and cost of care, now and in the future.

About the Author

Eduardo Egea, AIA, NCARB, is vice president and managing principal of LEO A DALY’s Miami design studio. In this role, Eduardo facilitates a collaborative and iterative design process, using simulation and prototyping, to research and test the effectiveness of promising design solutions that may impact patient safety in high-stress healthcare environments. He has focused his 25-year career on using a multidisciplinary approach to improve patient safety in healthcare through the development of tools and built-environment solutions. He can be reached at esegea@leoadaly.com.

 

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