Independent Financial, a community bank based in Texas and Colorado, has developed a number of community initiatives over the years, with a focus on building healthier, stronger and more resilient neighborhoods. More than seven years ago, the financial institution began engaging in meetings with local organizations, including government agencies, healthcare providers and nonprofits, about McKinney’s specific needs. , Texas, where she is based. A topic that came up constantly was health. “There has been a lot of conversation about the need for primary care at McKinney, especially for those who are unserved and underserved,” says Kate Perry, senior director of healthy communities for Independent Financial (McKinney).
While the North Texas area where McKinney is located has grown significantly over the past two decades, disparities existed across the region, with the median incomes of residents in East McKinney being half of what they are in west of McKinney. Additionally, Perry notes, the lack of health insurance, higher rates of chronic disease, and limited accessibility to health and dental services have also impacted residents. “People were traveling 15 miles or more to get emergency care because they didn’t have an option for immediate care in their neighborhood,” she says.
Spurred on by these findings, Perry says she began working with James Tippit, head of corporate responsibility at Independent Financial, to launch a project to bring a new healthcare clinic to the area. While the bank led the project, providing $2.5 million in funding, Perry said its “catalytic work” was forming partnerships with community organizations, such as the City of McKinney, Baylor Scott & White Health and the Communities Foundation of Texas, to build support through financial and in-kind donations.
Meanwhile, Perry and Tippit began looking for a site for the clinic. “Location was important in terms of who we serve,” Perry says. Specifically, the bank wanted the clinic to be located in east McKinney and be easily accessible as the area lacks solid public transportation. A vacant site located between a major highway and downtown McKinney met these needs. In 2016, the North Texas Family Health Foundation was established as a nonprofit entity that owns the site and the 25,000 square foot clinic building that would be built there.
In keeping with the local nature of the project, the Community Health Care Center (Wichita Falls, Texas), a mission-driven organization that operates 14 clinics in North Central Texas, agreed to serve as the operator, contributing its experience in the patient-centered domain. medical house model to the project (the supplier rents the building from the foundation).
On the design side, Perry contacted Boston Design Group for the Model of Architecture at the Service of Society (MASS), which she had on her radar after reading about the company’s healthcare work in Haiti. Although MASS has contributed to more than a dozen medical facilities and laboratories around the world, the McKinney project would be its first in the United States. high-quality care by leveraging the built environment and design to achieve this,” says David Saladik, Principal and Design Director at MASS (Kigali, Rwanda). “It felt like a really natural transition from our global work to the United States”
Initially engaged to lead an immersion process, the company’s role evolved to serve as the design architect for the community clinic, while Smith Group (Dallas) assisted with the architecture and oversaw the interior design. As part of its year-long research, MASS spoke to patients as well as providers and community groups to begin to define the needs that the clinic could meet. Additionally, the company visited the facilities at the Community Health Care Center in Wichita to meet staff and understand their operations, what was working and what they hoped to improve in the new clinic, such as implementing a model to support care providers working as a team. -based setting. “We learned a lot about their ambitions for the look and feel they wanted for the space,” says Saladik.
In 2018, the project team was ready to move into design. The main goal was to “nestle” into the neighborhood as much as possible and create a design that felt more like a house than a clinic, says Saladik. To break down the scale of the installation, the project team took architectural cues from the area, including Texas-style Dogtrot houses, which feature multiple buildings connected by a common breezeway and roof. The result is a two-story structure divided into two buildings, with clinical services in one and community services and staff in the other.
The new Virginia Family Health Center, named after its location on Virginia Street, would offer primary care, family medicine, obstetrics and gynecology, behavioral health, and dental services. In addition to improving access to care, Perry says the partners also wanted to integrate holistic services that would help address other key social determinants of health, such as stable housing and food resources.
Perry says early research with MASS helped the project team understand what kind of synergies might exist, such as the clinic serving as a supplier for Head Start.
Throughout the interiors, the project team sought to transform the healthcare experience by reimagining waiting areas as “different experiences of a home,” says Saladik, as one centered on dining, one for work and one with a playscape for young patients and family. members.
Furnishings and large windows contribute to the warm ambience and support the goal of creating a welcoming and dignified experience, says Saladik. “We didn’t want you to walk into a stuffy little waiting room. We wanted you to walk into something spacious, comfortable and naturally lit by daylight.
To support the clinic’s team-based care model, areas dedicated to primary care, dental care, staff and education are organized into modules by specialty and located on the first and second floors, as are the staff areas. as a team. Using steel frame construction, the modules are laid out on a grid to allow for future expansion and flexibility. Saladik says a similar design and layout is used on both floors, so if there’s an incredible demand for a service, like dental or behavioral health, clinical staff can fit into adjacent areas without requiring major space renovations.
Two sizes of exam rooms are provided, including a standard room and a family room to accommodate patients visiting the clinic with family members. To promote collaboration between patients and caregivers, exam rooms are set up so that patients can sit with their doctor and view the same computer screen. Other features include windows to bring in daylight and a flexible exam bed that helps patients sit up during conversations with a provider. “All of these things are important because they really change the perception of your care,” says Saladik.
To increase cross-referencing between disciplines and combat concerns about stigma, behavioral health services are being integrated into the medical field. “That way no one knows if you’re in a particular clinical area to get vaccinated or to advise treatment,” Perry says. “These kinds of design moves have been very important in supporting improved health outcomes and access to care in subtle ways.” The clinic also includes space for group programs to support the management of chronic conditions, such as diabetes, as well as group counselling. “The intention was to provide a purpose-built space to facilitate these types of caregiving activities,” says Perry.
For more non-traditional clinic-housed services, the design team incorporated a variety of flexible spaces. On the ground floor, a large community room opens onto the outside and can be used for various activities, including nutrition classes or a food bank. There is also space built into the waiting and reception areas where services such as tax preparation or benefit assistance can be supported, while a classroom on the second floor provides a training space for medical students and staff.
The Virginia Family Health Center, which is a designated Federally Registered Health Center, was completed in December 2020. Dental services began in January and the facility is expected to see medical and behavioral health patients in May after completion of state and federal requirements. . And while the COVID-19 pandemic has limited community and group activities at the facility so far, Perry says she has arranged visits with several project partners. “One of our partners said, ‘This building is going to help people feel loved’, and for me, that captured him. It’s a community place and it’s for everyone,” she says.
Saladik agrees and says he would like to see the project serve as a model for future community health projects. “I hope when this building starts to open, it will exceed everyone’s expectations of what they thought a community health center might look and feel like.
Project name: Family Health Center on Virginia
Project completion date: December 2020
Owner: North Texas Family Health Foundation
Total building area: 25,000 square feet
Total project cost: $10 million
Principal design architect: MASS
Design assistance: SmithGroup, Corgan
Official architect: 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
Landscape architect: Kimley-Horn (McKinney)
Artistic Consultant: Janet McDougal
Artist: Jim Wilson (main artwork in the lobby)
Anne DiNardo is editor-in-chief of Healthcare Design magazine. She can be contacted at [email protected]