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PLANNING Modern

Psychiatric Care Facilities


Rusk State Hospital + Beyond
A TEXAS HOSPITAL
PLANNING Modern
Psychiatric Care Facilities
Rusk State Hospital + Beyond
2017

This study was PREPARED by THE:


Center for Sustainable Development
The University of Texas at Austin
School of Architecture

ON BEHALF OF THE:
TEXAS DEPARTMENT OF STATE HEALTH SERVICES

csd
Center for Sustainable Development
csd
Center for Sustainable Development

Principal Investigator

Dean Almy, RA, Associate Professor and Director of the


Graduate Program in Urban Design

Collaborating Investigators

Elizabeth Danze, FAIA, Professor and Acting Dean

Frances Gale, Conservation Scientist

Carmen Garufo, AIA, Research Consultant

Allyssa Hrynyk, Research Fellow, Center for Sustainable


Development

Allan W. Shearer, Ph.D., Associate Professor and Co-Director


of the Center for Sustainable Development

Stephen Sonneberg, M.D., Adjunct Professor

Sarah Wu, Program Manager, Center for Sustainable


Development

Graduate Research Assistants


Aparajita Bhatt, MSUD Candidate
Tian Bian, MLA Candidate
Kathleen Conti, MSHP Candidate
Zhun Jiaoz, M Arch II Candidate
Jason Melling, MLA Candidate
JinWon Lee, MSHP Candidate
CONTENTS
SUMMARY

1 Introduction 7

PART 1 _RESEARCH
2 Best Practices 15
3 Consultations 31
4 Programming 37
5 Idealized Model 67

PART 2 _RUSK STATE HOSPITAL


6 Existing Conditions 79
7 Design Process 103
8 Applied Model 109
9 Visualization 123
10 Implementation 133

Appendices
A Sources 148
B Photo References 151
C Exterior Building Conditions 152
D Letter from THC 160

Acknowledgements 168
The new model for Texas hospitals should
include outdoor therapeutic space for
patients and staff to circulate. This
naturally landscaped esplanade is a
central axis between the residential quads,
connecting them to the central services.

W_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


SUMMARY
The most current global trends in mental repairs and system improvements. As The research was conducted in two
health care and treatment focus on a one the largest inpatient mental health parts: Part 1 focused on research into
patient-centered model that supports hospitals, RSH has been providing the best qualitative practices, identifying
empowerment and recovery. Such comprehensive psychiatric treatment programming goals, and developing a
recovery-oriented models replace and care for the citizens of Texas since design for an “Idealized Model”. The
paternalistic, illness-oriented perspectives 1919. It has funding for 325 patients but research synthesizes the key principles and
with collaborative, autonomy enhancing currently only serves 245 patients due to critical spatial relationships into a flexible
approaches. These approaches have the deplorable state of its facilities. planning strategy that has applicability
proven successful at treating people around the state. Part 2 then applied the
suffering from mental illness and helping ASSIGNMENT principle components from Part 1 to a
them to cope with everyday life. Identified preliminary planning strategy for the RSH
To address a number of these concerns
as the patient-centered care model, this campus in order to establish a scenario
the Texas Department of State Health
approach understands that services for for the future campus. This final planning
Services (DSHS) retained The University
individuals with mental health issues scenario is referred to as the “Applied
of Texas at Austin’s Center for Sustainable
cannot be optimized without attention to Model”.
Development (CSD) to undertake a study
all aspects of their health and well-being.
to investigate how mental health facilities PART 1: RESEARCH
However, these programs are only effective
should be designed to support modern
if the physical environment of the mental
psychiatric care models so that physicians, Part 1 involved a lengthy review of literature
health facilities is mutually supportive. As
nurses, administrators, and staff can on best practices, successful precedents,
mental health care practices shift to a more
provide the best possible treatment and and current design trends for modern
patient-centered care model, the design of
care for the people of Texas. mental health facilities across the U.S.,
facilities for psychiatric care and treatment
Canada, and Europe, in the interest of
must change to support new treatment and The purpose of the study, to which this determining the state of knowledge on the
care approaches. report concludes, was to understand how relationship between mental health and the
architecture can—and should—support physical environment.
Recognizing that current mental health
the programs and care models for mental
care best practices are in conflict with its
health treatment. The study engaged in This research confirmed a fundamental
system of aging state hospital facilities, the
design-based research to explore and concept that therapeutic design principles
Texas Legislature approved a long-term
demonstrate a planning process and spatial must extend beyond traditional interior
plan addressing fundamental changes for
model that could be specifically applied and spaces to accommodate a more normalized
state and local hospitals in 2015 (DSHS,
then tested as a preliminary development physical environment with clear and
2015). A supplementary study to the
plan for RSH, but could also be applicable meaningful access to the outdoors and to
State Hospital System Long-Term Plan
to all DSHS mental health facilities. natural landscapes. Design approaches
concluded that a number of the state’s
that focus on the therapeutic properties
mental health facilities did not meet The UT Austin team was composed of a of landscape are paramount to a patient’s
current criteria for clinical best practices multi-disciplinary group of professionals well-being and recovery.
(Cannon et. al., 2014). with expertise in urban design,
architecture, landscape architecture, The research also pointed to design
Rusk State Hospital (RSH), which has
clinical psychology, and historic approaches that are more modular and
been providing comprehensive psychiatric
preservation. The disciplinary diversity are determined by a manageable (defined)
treatment and care in east Texas since
of the team created a collaborative number of patients and support staff per
1919, was identified as one of five facilities
environment thru which an integrated unit. Spaces should be appropriately zoned
assessed to be most in need of major
approach could be derived. for optimizing treatment opportunities and

SUMMARY_1
LEGEND
OUTDOOR SPACE

LANDSCAPE HARDSCAPE GREEN SPACE

PRIVATE SEMI-PRIVATE PUBLIC

PATIENT ROOM

UNIT UNIT
ACTIVITY SUPPORT FACILITIES
UNIT CENTRAL COMMUNITY
CONTROL POINT MEDICAL SERVICES SERVICES
UNIT CENTRAL
ADMISSION
STORAGE SUPPORT FACILITY
CENTRAL
ADMINISTRATION
ENVIRONMENTAL SERVICES

CENTRAL FOOD SERVICES

MAINTENANCE
ROAD
GROUNDKEEPING

WAREHOUSE VACANT

Diagram of the Idealized Model: The


Idealized Model explores optimal spatial
relationships needed to support best
practices for treatment and operations of
Texas state hospitals.

2_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


should focused on patient privacy, social Architecture that focuses on the program is organized into a “kit of parts”
activities, and physical health, all of which therapeutic properties of nature and the that can be adjusted to the context of a
should be arranged around a central, powers of choice for patients has been specific hospital site, scale, and program.
organizing outdoor space. proven to help reduce stress and incidents
of aggression, and to promote healing. The PART 2: RUSK STATE HOSPITAL
The elements of best practices were Idealized Model also incorporates elements
organized into a series of programmatic To verify the applicability of the Idealized
that may seem simple but are revolutionary
modules or planning diagrams at varying Model, Part 2 focused on its employment
in the design of mental health facilities;
scales in order to illustrate fundamental within the historically sensitive context
elements such as a window in every room,
design properties, differing levels of of the RSH campus. To appropriately
allowing for natural light and a direct visual
freedom, and the scalability of various apply the model to RSH, a compendium
connection to nature.
programming components. of the history of RSH and a chronology
Furthermore, new therapeutic care of its construction was investigated and
Through extensive consultation with DSHS models encourage patients to take an documented; existing site conditions were
and staff at RSH, this qualitative research active role in their treatment. Therefore, assessed, which included a survey of the
helps to identify best practices in the the architectural programming must exterior and interior conditions of the
Texas context and further defines Texas- support the therapeutic programs such existing buildings, and were then evaluated
specific programming goals, establishing that the buildings and outdoor spaces based on their physical capability for re-
a platform from which a new spatial and become recovery-focused tools in use, their adaptability to “best practice,”
functional model can be defined for modern themselves. In attempting to reflect the and how best to integrate them into a new
mental health care facilities in Texas. ranges of environments in which people development plan.
This work provides DSHS very specific typically conduct their daily lives, the
programming goals that will help to lay One of the most notable features of the
Idealized Model organizes four units into
the groundwork for all future facilities, set existing campus is the 1886 Administrative
a quad that provides shared space for
within the financing and staffing regimes Building (Building 501). Originally
therapeutic treatment, dining, recreation,
mandated by the Texas Legislature. constructed to house prisoners, it was
and staff operations: a neighborhood of
subsequently renovated from a two-story
sorts. Central support programs are
This research underpins the design of the structure to a three-story structure in 1919
organized into what best practices refer to
“Idealized Model”, which was created to to accommodate the growing psychiatric
as a “therapy mall” or “treatment mall,”
spatially establishe the goals and objectives population of the state. At about 600 feet
offering patients an opportunity to interact
for treatment and operations of state long, it is an iconic piece of architecture for
with amenities or functions they are likely
hospital systems as a whole. The Idealized the entire campus.
to utilize in their communities, such as
Model is an exercise in visualizing optimal
clothing stores, libraries, cafes, movie During the process, the components and
spatial relationships with no immediate
theaters, fitness rooms, and salons. The principles of the Idealized Model were
contextual influence.
Idealized Model centrally organizes these applied to the spatial, physical, and cultural
Fundamental to the Idealized Model is the uses around a series of outdoor social landscape of the RSH, and resulted in a
establishment of “home-like” therapeutic spaces, reestablishing patient opportunities series of spatial and functional tests that
units comprised of a small number of to occupy a hierarchy of outdoor spaces and quantified the spatial and operational
private bedrooms around a welcoming and providing patients with a sense of existing relationships among departments. In
directly accessible outdoor courtyard. This within a broader community. consultation with staff at RSH and DSHS,
is in contrast to traditional units, which test-fit scenarios were considered in
Finally, the Idealized Model has been
tend to be centered on the nurse’s stations, the contexts of best practices, legislated
designed and organized in order to provide
an unintentional focus which adversely staffing and funding, the historic identity
for a general planning process that can
hinders patient-centered care models. of the RSH, and the sites topographic and
be applied to other DSHS facilities. The
spatial constraints.

SUMMARY_3
The architectural form for the residential
units is determined by the therapeutic role
of nature. Visualization of a unit courtyard
in the Applied Model looking from the day
space towards the dining hall.

4_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


Through ongoing refinement, review, Passive versus active surveillance: One of the cornerstones of the patient-
and discussion with the project team and centered care model is caring for patients
The design-based research has been
steering committee, an “Applied Model” was in environments that simulate everyday
innovative in promoting a therapeutic
finalized into a preliminary development life in order to provide them with tools to
model that moves from one based on active
plan for RSH. The Applied Model provides be functioning members of society. The
surveillance to one that promotes a patient-
significant opportunity and gives campus-like arrangement of buildings
focused treatment programs using passive
meaningful consideration to the quality better replicates the home environment
surveillance. Models based on active
of critical landscape spaces between the through the design of discrete social
surveillance and security goals use direct
buildings, working with the noteworthy units, building up to a larger community
sightlines as the primary determinate
topography to provide opportunities for environment through programs like the
of architectural form. The result is an
stimulating outdoor therapeutic spaces. treatment mall. The facility not only
architectural form that always places the
becomes a place for healing, but a place for
nurse’s station at a central and prominent
CONCLUSIONS living as well.
location within the residential unit.
Designing spaces that support the care and
This research intends to highlight
treatment programs that are necessary Contrary to these previous designs, the
the active role architecture has in
for people with mental illness is a complex courtyard model is an architectural form
establishing the patient care regime, just
and multifaceted issue. This research that allows for degrees of freedom, choice,
as the programming has an active role
establishes significant insight into the and privacy, while still providing necessary
in organizing the architecture. There is
opportunities and constraints involved with surveillance to patient-occupied spaces,
a reciprocal relationship between the
designing a new, state-of-the-art Texas such as the day space or courtyard.
form and the therapy. The results of the
model for RSH and other DSHS facilities Rather than having the nurse’s station as
research will continue to deliver insight
that best supports current care models. the central focus, the outdoor courtyard
into all future investment in mental health
and access to nature are the foci and
There are three innovative themes facilities, for the state of Texas and beyond.
the nurse’s station is provided in a more
expressed through the Idealized Model and Through research, documentation and
discreet location, which results in the
its application to RSH in the Applied Model the application of this knowledge, the
improved mental state of patients and in
that are transformative to the way mental goal of this study is to raise the level of
better relationships between patients and
health care facilities should be designed: design-based knowledge on therapeutic
staff.
environments and to lay the groundwork for
A campus of healing and living: A campus of healing and living: the creation of better mental health care
The fundamental organization of “home- facilities in Texas.
A final fundamental approach that makes
like” therapeutic units around a directly this research and design innovative, is
accessible outdoor courtyard provides the based on strategically moving away from
much-needed access to the therapeutic a singular institutional building, towards a
properties and relief of stressors provided series of buildings that are organized into
by nature. This arrangement, coupled with compact, pedestrian-focused, campus-like
a hierarchy of other outdoor spaces and settings. This not only allows for greater
therapeutic programs, helps to support adaptability to a wide variety of sites
best practices in mental health care and and the flexibility to support a range of
treatment that are patient centered to demographic profiles, but it also provides
support empowerment and recovery. a better simulation of the social and
community dimensions of public life.

SUMMARY_5
1 INTRODUCTION
_Research Assignment
_Research Process
_Schedule
_Strategic Issues
_Performance Objectives
North Texas State Hospital
Vernon Campus
North Texas State Hospital
Wichita Falls Campus

Terrell State Hospital


Big Spring State Hospital
El Paso Psychiatric Center
Waco Center for Youth

Rusk
State
Hospital
Austin State Hospital
Kerrville State Hospital

San Antonio State Hospital


Texas Center for Infectious Disease

Rio Grande
State Center &
South Texas
Health Care system

LOCATION OF TEXAS STATE HOSPITALS

8_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Research Assignment
Recognizing that current mental health RSH was identified as one of five facilities
care best practices are in conflict with its
system of aging state hospital facilities, the
assessed to be most in need of major
repairs and system improvements. As
How CAN
Texas Legislature approved a long-term
plan addressing fundamental changes for
one of the largest inpatient mental
health hospitals, RSH has been providing
TEXAS State Hospitals
state and local hospitals in 2015 (DSHS, comprehensive psychiatric treatment and be DESIGNED to
2015). A supplementary study to the
State Hospital System Long-Term Plan
care for the citizens of Texas since 1919. It
currently has funding for 325 patients but support
concluded that a number of the state’s
mental health facilities did not meet
currently only serves 245 patients due to
the aging state of its facilities. According to the best possible
current criteria for clinical best practices
(Cannon et. al., 2014). Furthermore, the
the State Hospital System Long-Term Plan
(January 2015), RSH has been identified for
behavioral health
study forecasted that over the next ten
years demands on state hospitals will
on-site replacement as a 350 bed facility.
Treatment and care?
increase due to growing populations This work focused on more-precisely
across all age groups, increasing forensic identifying and testing strategic options
commitments and adding patients with related to the future redevelopment of the
medically complex or co-occurring physical facilities in a manner that would
conditions. support the best possible mental health
treatment at RSH and other state facilities.
To address a number of these concerns, It is anticipated that the outcome of this
the Texas Department of State Health study will have considerable influence on
Services (DSHS) retained The University future hospital redevelopment plans and
of Texas at Austin’s Center for Sustainable change the way Texas delivers mental
Development (CSD) to undertake a study health care.
to investigate how mental health facilities
should be designed to support modern
psychiatric care models so that physicians,
nurses, administrators, and staff can
provide the best possible treatment and
care for the people of Texas.

The purpose of this study is to understand


how architecture can—and should—support
the programs and care models for mental
health treatment. The study engaged in
design-based research to explore and
demonstrate a planning process and spatial
model that could be specifically applied and
then tested as a preliminary development
plan for Rusk State Hospital (RSH), but
could also be applicable to all DSHS
facilities.

SECTION 1 INTRODUCTION_9
_Research Process
PHASE 1 • Goals for treatment and care services PHASE 2
with respect to the expected operations
Phase 1 commenced in January 2016 and (Best Practices); Phase 2 expanded upon the work
was focused on the development of both an completed in Phase 1 by further developing
ideal model for patient care and alternative • The range of RSH’s expected hospital and testing the Applied Model for the RSH
physical planning options for RSH operations (Programming); property. Additional studies investigated in
buildings and grounds based on preferred more detail the particular characteristics
relationships between treatment options • Stakeholder ideas, expertise, and of a preferred scenario for RSH. Phase
and facilities configurations. concerns (Consultation); 2 concluded the study with a refined
development plan for RSH, visualizations,
The study began with a thorough review • Strategic plan questions related to
and a phasing strategy..
of all background documents, site visits the design of facilities (buildings,
to RSH, analysis of existing conditions at landscape, and infrastructure) that
RSH, and research on best practices for need to be addressed in pursuit of a
mental health care facilities. Consultations new model for treatment and care;
with state hospital physicians, nurses,
• Idealized and applied design options
administrators, and staff assisted in more
related to the strategic plan questions.
precisely defining:

“Hope, Resilience, and Recovery for Everyone.


vision statement of the Mental Health and Substance Abuse Division of
the Department of State Health Services
1

10_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Schedule

Phase 1 Phase 2

Review_Internal Report
DSHS

DSHS

Phase 2_Draft Report


Phase 1_Final Report
Documentation and Assessment
of Existing Facilities

HUNT

RUSK
RUSK

RUSK
Best Practices_
Research and Documentation
Diagramming
Documentation

2
DSHS
Programming_
Spatial and Functional Requirements
Diagramming

DSHS
Scenarios_
Development and Evaluation

RUSK
Test Fit Alternatives
Analysis

DSHS

DSHS

DSHS
Design Development Production of

Final Report
Final Report
Final Recommendations
and Deliverables
Renderings
Production

September

November

December
February

October
January

January
August
March

April

June
May

July

SECTION 1 INTRODUCTION_11
_Strategic Issues
Foremost, the team identified the following How can the hospital create an efficient, How can the facility establish an
strategic issues to inform the research comfortable, and desirable place for staff appropriate new identity while preserving
directives and design solutions: to work? the cultural importance of the historic
campus and buildings?
How do you create the most therapeutic A critical part of the care provided at RSH
environment focused on recovery and is dependent on providing the best work A number of buildings within the existing
rehabilitation? environment for staff so that the physical hospital campus are fifty or more years
environment supports the care they provide old and may have historical and cultural
RSH is focused on stabilizing psychiatric and their own personal needs are met. importance for the community and State.
symptomatology (recovery) and providing Any preservation, modernization and
education and treatment (rehabilitation) in How can quality of care be assured and adaptive re-use of significant buildings
order to successfully transition patients to supported through optimal operational needs to be done with regard to the
a less restrictive environment. To achieve efficiencies? suitability of achieving best practices and
this goal, the built environment has to the use of economic resources.
be designed and organized to support A new plan for RSH should maximize all
therapeutic programs and improve mental operational strategies in staff work flow, Can the hospital continue to be an
health. management, and movement of materials exemplary social and economic benefit to
and services; use advanced technology; the greater community of Rusk?
What are the most advanced models for support environmental sustainability;
psychiatric care and how do these models and provide long-term flexibility and The redevelopment of RSH provides a
inform the design of a world-class, state- adaptability. prime opportunity to create a new “face”
of-the-art hospital? for the town of Rusk and the greater
What is the most appropriate location for community. The new plan should continue
Research and review of the most current, a new hospital complex within the physical to support RSH as an exemplary neighbor
state-of-the-art hospitals identified and cultural landscape of Rusk? and help to further de-stigmatize mental
successful design elements and functions illness and its treatment.
necessary to deliver the most advanced With over 600 acres of property, a thorough
care and treatment for mental illness. site analysis is necessary to understand
appropriate location for the future hospital
within the RSH property.

12_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Performance Objectives
The following performance objectives
were identified based on discussion and Valuation of Establish an attractive
consideration of the strategic issues and Embodied Energy and welcoming
other current best practices for planning Respect presence in the
and design. Design solutions for the Rusk Historical Significance community
State Hospital should be evaluated and & Integrity
Consider
considered in the context of the defined
Financial
creiteria, all with equal importance.
Implications

Consider Building
Conditions
Achieve Best Practices in
Patient Care and Treatment
Design for
Adaptability
Use
Sustainable
Design
Principles
Create a desirable
and safe work
environment
Optimize Operating Plan for Phasing &
Efficiencies Sequencing

SECTION 1 INTRODUCTION_13
2 BEST PRACTICES
_Overview
_Precedents
_Patient Room Scale
_Unit Scale
_Quad Scale
_Institution Scale
_Landscape Scale
“architecture which aids healing for patients
is based on classic ingredients such as light and shade,
quietness, materials, colors, green landscape elements,…(and)
ingenious architectural solutions which result in a calming
layout and engaging spaces.”
Gideon Sykes
Psychiatric Hospital Demonstrates the Healing Power of Good Architecture
8
2

16_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Overview
In recent years, mental health care has patient management protocols, as this may trauma for patients and hospital caregivers.
evolved to include active treatment, be at the expense of patient well-being and Providing day rooms and other shared
integration with primary care, normalizing chances for recovery. spaces with movable seating, for example,
environments, community care, patient gives patients the ability to control their
empowerment, and a focus on the Although the process can be lengthy, and personal space and interactions with
overall continuum of care. Identified as the length of treatment varies from patient others.
the patient-centered care model, this to patient, admittance to a psychiatric
approach understands that services for hospital is not meant to be permanent. The therapeutic platform must extend
individuals with mental health issues Hospital environments must be designed to beyond traditional interior spaces to
cannot be optimized without attention to all be support recovery in a manner that helps include outdoor environments: that is,
aspects of their health and well-being. It patients recover from their illnesses and buildings and sites that offer a holistic
is a proactive model addressing wellness, prepares them to be functional in society or setting with access to natural landscape,
medical, mental, psychosocial, and in a less restrictive environment. views, and daylight. The positive influence
basic human needs in an integrated and nature has on a person’s state of mind
The quality of the physical environment has long been recognized. Physical
coordinated manner. This model places
and access to nature, is intrinsically environments that take advantage of the
emphasis on non-traditional services such
linked to a patient’s well-being and therapeutic properties of landscape are
as wellness and fitness, nutrition and
recovery, as well as the comfort, safety, paramount to a successfully-designed
access to healthy foods, development of
and performance of staff (Karlin, 2016). health care facility. The impact of the views
coping strategies, everyday living skills,
Research affirms that the environment from a patients’ room and day-spaces
educational and training programs for
influences mental health and illness in must be thoughtfully considered, as must
gainful employment, and housing support.
neither a passive or inconsequential way. be a patient’s ability to easily access the
As mental health care practices shift to The built environment has considerable outdoors.
a more patient-centered care model, the influence on the behaviors, relationships,
design of facilities for psychiatric care stress, health, and happiness of people An equally critical part of any modern
must change to support new treatment regardless of whether they have a mental mental health care and treatment strategy
and care approaches. Antiquated mental illness or not. “Psychiatric patients are is the quality of the work environment for
health facilities far from support patient much more reactive to the physical milieu staff and caregivers. Staff are only able
empowerment and recovery; in fact, than healthy controls – which suggests to provide the best client care when they
studies show they may actually exacerbate that the environment is a critical element are in the best possible work environment
mental illness. In these facilities, patients of psychiatric intervention” (Golembiewski, to support their programs and meet their
perceive treatment as an incomprehensible 2015). Mental illnesses can intensify when daily needs.
and unhelpful process that is out of their a patient is being confined in locked rooms
or wards. A facility that is noisy, lacks The exterior impression of the hospital is
control simply based on the aesthetics
privacy, and/or hinders communication even fundamental to the overall design as
and condition of the facility alone. When
with staff increases stress and agitation in it can work to de-stigmatize mental illness
treatment has no perceived positive effect,
patients. and convey an attractive and welcoming
patients feel that the effort needed to
presence to the community, patients,
control their illness is also meaningless
Best practices for mental health care and staff. Mental health facilities can
(Golembiewski, 2015).
facilities emphasize design that minimizes be exemplary neighbors for the larger
Current guidelines on the design of noise and crowding, decreases the sense community; therefore, the appearance
mental health facilities appear to reflect of confinement, increases a patient’s sense should reflect the importance of the work
only society’s main concerns with people of control, and offers a variety of home done there.
with mental illness: that of suicide risk and community-like activities. Features
and the threat of violence, crime, and like single-patient bedrooms with private
arson. (Golembiewki, 2015). Mental toilets may increase the building cost, but
health facilities cannot simply be designed research suggests that initial costs are
primarily to improve staff efficiencies and arguably offset by the reduced stress and

SECTION 2 BEST PRACTICES_17


3
Air PHoto of OREGON STATE HOSPITAL

collective space

view on gardens

view on courtyards

focus on daylight and


view to gardens

efficent grouping
around gardens
compact
focus on efficiency, short walking distances and
ideal treatment conditions

extending terraced gardens towards the south:


a subtle addition to the historic image

extending terraced gardens in between the new


winter gardens, providing a comfortable ward buildings: garden hospital
climate while connecting the inner patios,
restaurants, shops, and foyer

new axes, interweaving the old and new


hospital while connecting with the city
4
Diagramming the LANDSCAPE of the Bispebjerg Hospital, Copenhagen, DENMARK

18_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Precedents
Global trends in mental health care and Southwest Centre for Forensic Mental Rigorous review and research of the
treatment strategies focus on patient care, Health Care, St. Thomas, Canada (2013), physical design qualities and spatial
empowerment and recovery. These care requirements of these hospitals and other
and treatment strategies need to be housed Broadmoor Hospital, United Kingdom research on best practices was a key
in well-designed, state-of-the-art facilities (2017), component of the study. Through gathering
that support therapeutic programs which and sharing of information, the goal is to
St Bernard’s Hospital, Thames Lodge
promote these patient care strategies. raise the level of design of therapeutic
Medium Secure Unit, United Kingdom
environments and lay the groundwork for
A key component on this study was to (2016),
the creation of better mental health care
review and document a number of current facilities.
Our Lady of Lourdes Hospital: Acute
state-of-the-art public mental health
Psychiatric Facility, Drogheda, Ireland
facilities in the United States, Canada, The following provides a target of the best
(2015),
United Kingdom, Scandinavia, and beyond practice elements at the various scales of
that reflect current best practices in patient Danish psychiatric regional hospital in a hospital – patient bedroom, unit, quad,
care and treatment. The facilities identified Slagelse, Demark (2014), institution and landscape – as identified
included: through the research, precedents, and
Kronstad Psychiatric Hospital / Origo consultation with staff from DSHS, RSH,
Worcester Recovery Center and Hospital, Arkitektgruppe, Bergen, Norway (2013), and other state hospitals.
Worcester, Massachusetts (2012),
Helsingor Psychiatric Hospital, Helsingor,
Oregon State Hospital, Salem, Oregon Denmark (2005),
(2013) and Junction City, Oregon (2015),
Helix, Forensic Psychiatric Clinic of
Vermont Psychiatric Care Hospital, Berlin, Stockholm, Sweden (2012), and
Vermont (2014),
Psychiatric Building, Östra Hospital,
VA Palo Alto Mental Health Center, Palo Gothenburg, Sweden (2007).
Alto, California (2012),

Centre for Addiction and Mental Health,


Toronto, Canada (2014),

SECTION 2 BEST PRACTICES_19


15 8

2’-7”
Storage Low Shelving Desk

Sitting
3’-6”

Storage
zone Patient zone
12’
5’-11”

Bed

Corridor

24’-0”
minimum 7 feet wide
Bathroom
Nature

1’-6”
3’-6”
3’-6”

11’-9”
12’

6’-6”

Storage
3’-6”

zone Patient zone


2’-1”

Duplex bedroom DIAGRAM


4’-10” 4’-2” 4’-6” 1’-8”
15 8
2’-7”

Storage
zone
3’-6”

Patient zone
12’
5’-11”

Bathroom
24’-0”

Corridor Nature
1’-6”

minimum 7 feet wide

Bathroom
3’-6”
3’-6”

11’-9”
12’

6’-6”
3’-6”

Patient zone
Storage
zone
Single-person
2’-1”

bedroom DIAGRAM
4’-10” 4’-2” 4’-6” 1’-8”

20_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Patient Room Scale

• Patient accommodations have • Multi-functional, with focus away


shifted to single-occupancy from the bed by providing “living”
or duplex bedrooms. Double- spaces and amenities, such as a
occupancy bedrooms are also desk and window seat.
feasible where risk management
and safety allow and patient care • Rooms should provide
may be optimized. opportunities and choices in
• All bedrooms are equipped with personalizing.
attached bathrooms that provide • Increased degree (as
appropriate levels of privacy and appropriate) of choice, privacy,
autonomy. and autonomy.
• Ample natural light and views to •
nature through sufficiently sized
windows.
• Room should be comfortable
and “home-like” equipped with
a typical looking bed, desk, and
fixture that create a residential
feel.

5 6 7

SECTION 2 BEST PRACTICES_21


Flexible Maximum Rooms
support+ Shade 6 beds in a with ample,
treatment row natural

View of nature

View of nature
spaces light

Short Corridors
Easy + free access to
passive, therapuetic landscaping

Nursing
station with
Open, centralized, sightlines
home-like day space to rooms,
dayspaces,
and
courtyard
Short Corridors Unit Entrance

Comfortable, residential-like rooms

View of nature

UNIT SCALE DIAGRAM


Courtyard
Patient Rooms
Unit Activities
Unit Control Point
Unit Support Facility
Landscape

22_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Unit Scale

• Appropriate zoning of resident • Located at grade for free and • Ample natural light and access to
units is essential for providing easy access to outdoor spaces nature.
optimized care and treatment that can act as an extension of
opportunities. Zones, such dayroom. • Separate staff breakrooms and
as privacy, social activity, staff work rooms from the patient
control, and support areas, • Meaningful, appropriately activities.
should be organized around a secured outdoor spaces without
the sense of confinement. • Clear separation between patient
central identifying space. areas and food / environmental
• A unit is defined as a small • Open nurse desk with increased services.
grouping of approximately 6-15 communication and maximum
visibility of patient areas. • Minimize the sense of
patients. confinement, noise, and
• Shared centralized living room, • Intimate, home-like setting using crowding; create a calming
reading room, exercise room, furnishings, textiles, color, art, environment and access to a
kitchen facilities, and laundry to and design. variety of activities.
support daily living functions. • Replace long, monotonous
• A greater variety of activity and corridors with short corridors
social spaces that provide more that are no longer than six
choice and control for patients. patient rooms.

8 9 10

SECTION 2 BEST PRACTICES_23


Direct access for delivery of food and environmental services

Shared
Shared staff communal Shared indoor recreation
breakroom dinning

Safe, secure,
semi-private,
shared outdoor
space
Multi-purpose and shared support spaces

Support choice of activities


Unit 1 Unit entrance Unit 2

Access to
basketball
court

Unit 3 Unit entrance Unit 4

Visual screening through Visual screening through


appropriate landscaping appropriate landscaping

Quad Entrance
Easy access to central activities and support

QUAD SCALE DIAGRAM


Courtyard
Patient Rooms
Unit Activities
Unit Control Point
Unit Support Facility
Semi-private landscape
Semi-public landscape

24_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Quad Scale

• Grouping units to allow for • Safe and secure outdoor


shared and multi-purpose activities and therapies (such as
spaces and operational basketball, gardening, walking,
efficiencies. etc).
• Informal, easy, and patient- • The degree of normalization and
appropriate access to therapeutic social spaces should increase as
activities. patients move from the initial,
more acute, treatment setting to
• Standardized and modular, with a a transitional, more residential-
focus on the flexibility to adapt to like setting as their illness
shifts in patient demographics. becomes more stabilized.
• Promote staff efficiencies by • Consider products, fixtures and
minimizing distance between furnishings new to the market
frequently used spaces. that are specifically designed for
• Ample natural light and views of the mental health environment
nature. and offer an improved balance
among safety and security
• Easy visual supervision of features, durability, privacy, and
patients for effective use of staff. clinical functionality.

11 12 13

SECTION 2 BEST PRACTICES_25


Seperate secure admission entry
Direct delivery for
food services and environmental services

Centralized
support and
treatments
programs and
services

Semi-public outdoor space Minimized distances Semi-public outdoor space


between frequently used
Plenty access to fresh air outdoors spaces Plenty access to fresh air outdoors

INSTITUTION SCALE DIAGRAM


Courtyard
Hospital Entrance
Patient Rooms (Distinct, welcoming entrance)
Unit Activities
Unit Control Point
Unit Support Facility
Central Support and Services
Semi-private landscape
Semi-public landscape
Public landscape

26_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Institution Scale

• Create an overall environment • Expanded use of peer support


that promotes wellness and services to complement clinical
rehabilitation. care by licensed staff.
• Contribute to “place-making” • Active patient-focused treatment
through design excellance. offered in “therapy malls” which
offer amenities that consumers
• Overall building design focused are likely to utilize in their
on access to nature, fresh air, communities, including clothing
outdoor, views, and daylight. stores, libraries, cafes, movie
• Distinct, welcoming main lobby theaters, fitness rooms, and
and admissions area, both of salons.
which are filled with natural light • Share support rooms to create
and clear wayfinding. multi-purpose/flexible spaces.
• Separate patient admission • Incorporate space and functions
processing area from main public for community access to help
entrance. reduce stigma associated with
• Integration of research and on- behavioral health issues.
site education.

14 15 16

SECTION 2 BEST PRACTICES_27


Semi-private,
Active
GARDENS
Private
Secure,
COURTYARDS

Semi-public, Public,
Passive Active
COMMONS CENTRAL
GREEN

LANDSCAPE HEIRARCHY DIAGRAM


Courtyard
Semi-private landscape
Semi-public landscape
Public landscape

28_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Landscape Scale

• Use a variety of landscape • Security fences should have a


scales and functions as a “soft” and friendly quality.
key therapeutic treatment
component. • Comfortable yet durable
seating should be provided
• Provide direct and open access to to accommodate a variety of
controlled outdoor spaces. activities and uses.
• Include areas for outdoor sports • Use low-impact design
and other activities. for parking and vehicular
infrastructure.
• Highlight culturally important
landscapes and structures.
• Outdoor spaces should have
provision for shading from sun.
• Create the ambience of a
domestic garden.

17 18 19

SECTION 2 BEST PRACTICES_29


3 CONSULTATION
_Engagement Overview
_What Was Learned
20
TEXAS DEPARTMENT OF STATE HEALTH SERVICES

32_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Engagement Overview
SUMMARY OF MEETINGS DSHS RUSK COMMUNITY

2016: Consultation with RSH clinical staff and Consultation with Rusk community
physicians, as well as with staff from other stakeholders provided useful feedback
February 8_Project Kick Off Meeting
DSHS operated hospitals within the State regarding strategic issues and was
March 4_Austin State Hospital Visit of Texas, proved invaluable in confirming characterized by innovation and an
March 11_Rusk State Hospital Visit and best practices for a mental health care overwhelming desire to construct a first-
Stakeholder Meeting facility and defining a usable program for class facility that supports patient care and
March 30_Huntsville Prison Site Visit the hospital. The Hospital Superintendent, recovery and continues to benefit the local
Assistant Superintendent, and their community and those who work there.
April 6_Steering Committee Meeting
staff of administrators, physicians, and
May 16_Steering Committee Meeting clinical staff were critical participants
May 20 + 25_RSH Site Visit and Stakeholder in the stakeholder process and provided
Meeting vital information regarding hospital
June 7_RSH Site Visit programming, needs, and deficiencies.

June 29_Steering Committee Meeting


RSH
July 7_Meeting at State Capitol
Consultation with both clinical and
July 21_Stakeholder Consultation at Rusk community stakeholders was a critical
State Hospital component to the overall process for
August 8_Steering Committee Meeting identifying strategic issues within Rusk
State Hospital. While the project team’s
September 20_Steering Committee Meeting
intentions were to conduct stakeholder
September 27_Comissioner’s Briefing meetings at key points in the project
October 25_Steering Committee schedule, it became quickly apparent that
in order to identify realistic options and
November 16_UT Systems Meeting
specify intended goals for treatment and
December 6_Meeting at State Capitol care for the hospital, the team needed to
December 13_Steering Committee speak with the clinical and community
stakeholders frequently, who best know the
December 16_UT Systems Meeting
hospital itself.
2017:

January 19_Steering Committee

SECTION 3 CONSULTATIONS_33
21

22 23
STAKEHOLDERS CONSULTATION AT RUSK STATE HOSPITAL

34_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_What Was Learned
STAKEHOLDER CONSULTATION JULY 21 CLINICAL STAKEHOLDERS GROUP COMMUNITY STAKEHOLDERS GROUP
While many meetings and conversations Feedback from this group upheld the Members of this stakeholder group
took place prior, the primary stakeholder consistent theme of a desire for patient repeatedly conveyed that the Rusk State
consultation took place on-site at the Rusk well-being and for a facility that reduces Hospital is seen as a thriving part of the
State Hospital on July 21, 2016. In the the stress on both patients and staff. local community and employment base.
morning, the project team and members Staff provided feedback on project team’s This group was asked to provide feedback
of the DSHS staff met with the clinical and programmatic diagrams of best practices regarding the exterior influences of the
staff stakeholder group. In the afternoon, and hospital usages through a variety of hospital campus and the role, or lack
the team met with members of the greater group exercises. A desire for the hospital thereof, of the older buildings on the
Rusk community. A summary of findings site to allow for better movement and hospital site. Many stakeholders from
from each meeting follows. access for patients and staff was heard this group shared that they believed state
repeatedly, through improvements to hospitals like Rusk have old buildings
central therapy, location of maintenance that are not designed for the mental
and storage facilities, and designing spaces health treatment of today. The group does
that are both therapeutic and functional for understand there are some historical
both patients and clinical staff. buildings on the site that may not be able
to be removed, and thus time was spent
discussing what is the most cost-effective
way to achieve the desired facility and the
best possible configuration to achieve the
ideal hospital.

SECTION 3 CONSULTATIONS_35
4 PROGRAMMING
_Overview
_Programmatic Components
_Patient Unit
_Patient Quad
_Maximum Security Unit
_Maximum Security Quad
_Adminstration
_Admissions
_Central Medical Clinic +Pharmacy
_Central Support + Treatment
_Central Kitchen +
Environmental Services
_Maintenance + Groundskeeping
_Community Services
_Outdoor Recreation
24
_Overview
In order to create design options for how • Residential Units that are composed • Pharmacy prepares and dispenses
the buildings and grounds of the RSH might of no more then 18 – 22 patients with medicine to Units, maintains drug
be composed and support best practices, similar illnesses and/or treatment inventory, and provides consultation to
it was necessary to understand and define requirements. They provide secured, clinicians.
the expected functional and operational unrestricted access to communal day
requirements of RSH and of their care and spaces and that are serviced/surveyed • Central Food and Nutrition Services
treatment programs. A new programmatic by a nurse’s station. prepares and serves food to patients;
model was prepared through a review and provides consultation to clinicians, and
analysis of: • 45 maximum security beds in three ensures patient therapeutic dietary
Maximum Security Units to receive requirements are met.
• The existing programs and floor areas male patients who are admitted on
at RSH today; criminal commitments because • Environmental Services and Laundry
of used a deadly weapon, causing/ provides a safe, clean, and pleasant
• State-of-the-art hospital precedents; threating serious bodily injury or environment.
other offenses, therefore requiring
• Best practices in mental health care; • Community Services includes a Court
heightened security.
of Law, the Tyler Junior College of
• Consultation with both clinical and Nursing, and Family visitation facilities.
• Administration which is the
community stakeholders; and
overarching bodies responsible for
• Maintenance and Groundskeeping
• Legislative funding for beds and running all facets of the hospital.
provides a safe and therapeutic
staffing. environment by managing the physical
• A separate Admissions area where
patients are admitted to the hospital plant, mechanical systems, and
Operational efficiencies and space
and undergo an initial psychiatric outdoors.
optimization were also reviewed in light of
the spatial and programmatic requirements evaluation .
• Outdoor recreation and gardens could
in order to be as efficient as possible. include a number of sports fields,
• Central Support Programs to provide
a centralized system of therauptic passive outdoor gardens, mediation
The following sections provide more detail
spaces and programs which are gardens, greenhouses and vegetable
regarding each of the components of the
accessed by the general population. gardens, walking trails, cookout space,
hospital and their spatial requirements.
The desire is to create a community- therapy animals, and the lake.
The floor areas identified should be read
as general estimates. They are based like setting to promote patient recovery
on the understanding of the program by providing functions patients would
requirements in order to understand the find in everyday life, such as a cafe,
general size of the overall hospital and salon, library, gymnasium, medical
the necessary spatial and operational clinics, classrooms, central park, etc.
requirements of the institution.
• Central Medical Clinic which
In summary, the ideal plan for the RSH completes the admissions evaluation,
would accommodate: annual physical assessments,
provides service calls to patients, and
• 320 residential beds of which, 40 beds coordinates services with outside
are reserved for “swing”. Swing units medical providers (i.e. Optometry and
are additional units and bed in addition Dental).
to the funded capacity that are only
used in the event that a populated Unit
needs to be temporarily relocated.

SECTION 4 PROGRAMMING_39
_Programmatic Components

NATURE

MAIN ENTRY
PATIENT ENTRY

ADMISSIONS ADMINISTRATION
COURT
1700 sq ft
7,000 34,000
sq ft sq ft

NATURE

60,000
CENTRAL 60,000
QUAD 1 sq ft MEDICAL QUAD 2 sq ft

10,500
sq ft
UNIT 1 UNIT 2 UNIT 1 UNIT 2

NATURE
15,000 15,000 15,000 15,000
sq ft sq ft sq ft sq ft

SWING SPACE SWING SPACE UNIT 3 UNIT 4


A B

15,000 15,000 15,000 15,000


sq ft sq ft sq ft sq ft

60,000 60,000
QUAD 3 sq ft CENTRAL QUAD 4 sq ft
SUPPORT
UNIT 1 UNIT 2 UNIT 1 UNIT 2

15,000 15,000 15,000 15,000


sq ft sq ft sq ft sq ft

UNIT 3 UNIT 4 UNIT 3 UNIT 4

15,000 15,000 15,000 15,000


31,000 sq ft sq ft
sq ft sq ft sq ft

SCALE

1,000 VEHICULAR ACCESS AROUND PERIMETER FOR EMT, SERVICES, AND MAINTENANCE
sq ft

40_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


The entire program for the hospital combines all the
components previously described in an orderly and
logical arrangement. The illustrated arrangements
NATURE
includes 4 separate quads (320 beds) and a
separatment maximum security quad (45 beds) for a
total of 365 beds.
NURSING FAMILY
SUITES
STAFF
RESIDENCE
COLLEGE
1,600
sq ft

5,000 3,200
sq ft sq ft Bedrooms 280
Swing Bedrooms 40
NATURE
Maximum Security Bedrooms 45

TOTAL BEDROOMS: 365

MAX SECURITY
60,000 sq ft

UNIT 1 UNIT 2

15,000 15,000
sq ft sq ft

UNIT 3 SUPPORT
15,000 15,000
sq ft sq ft

MAINTENANCE AND
GROUNDSKEEPING
20,000
sq ft
Square Feet

Residential Units 240,000


CENTRAL FOOD
SERVICES AND Maximum Security Units 60,000
ENVIRONMENTAL
SERVICES LARGE TRUCK Administration 34,000
LOADING BAYS
Admissions 7,000
25,000
sq ft Central Medical Clinic and Pharmacy 10,500
Central Support Programs 31,000

CLOTHING WAREHOUSE Central Food and Environmental Services 25,000


STORAGE
15,000 Maintenance and Groundskeeping 20,000
3,000
sq ft sq ft
Community Services 2,000
Warehousing 18,000
TOTAL ESTIMATED FLOOR AREA 447,500

SECTION 4 PROGRAMMING_41
_Residential Unit

FACILITIES SHARED WITH ANOTHER UNIT

PATIENT ENTRY

SIZED TO FIT UNIT (18-22 BEDS)


ONE UNIT AT A TIME,
BUT SHARED WITH UP
TO 3 OTHER UNITS

DE-ESCLATION ROOM
COMMUNAL DINING /
300 sq ft UNIT
MED. STO-
ROOM RAGE
SECLUSION
MULTI-PURPOSE
OFFICE ROOM
MEETING ROOM 200 200 200
FOOD
SERVICES 300 sq ft sq ft sq ft sq ft

900 TREATMENT ROOM 600 NURSE’S NATURE


sq ft 300 sq ft sq ft STATION

CLEANING
STORAGE /
ENVIRONMENTAL REFUSE /
SERVICES LINEN
900
sq ft

PATIENT PATIENT PATIENT


LAUNDRY DAY SPACE READING EXCERCISE

300 1500 300 300


sq ft sq ft sq ft sq ft

1 6 11 16

2 7 12 17

3 8 13 18

4 9 14 19
NATURE NATURE NATURE
5 10 15 20
HALLWAYS SHOULD BE HALLWAYS SHOULD BE
NO LONGER THAN 6 ROOMS NO LONGER THAN 6 ROOMS

250 RESTROOMS
sq ft

300 STORAGE
sq ft

3,000 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

42_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


A residential Unit consists of a small grouping
of twenty (20) patients in single or duplex type
bedrooms. Within each secure Unit, patients should
have unrestricted access to communal day spaces
(social, TV, laundry, exercise, quiet room, etc.) and a
secure courtyard. The Unit is secured, serviced, and
surveyed by a nurse’s station which includes an open
desk, offices, medication control, and storage. The
Unit entry should be adjacent to the nurse’s station
for ease of surveillance. A Unit has controlled and
direct access to support program space, which is
STAFF ENTRY VISITOR
ENTRY shared with another Unit(s). This includes communal
dining space, a group therapy/multi-purpose room, a
recreation room, and outdoor basketball court.
STAFF MEETING
LOCKERS, ROOMS / FLEX
BREAKROOM, OFFICES
VISITATION Square Feet
& RESTROOM
(RECOVERY
400
sq ft
Patient Bedrooms (20 beds x 200 sq ft/each) 4,000
TEAM &
SUPPORT
STAFF)
Unit Activity
Communal / Day Room 1,500
Quiet / Reading Room 300
1000 1000
sq ft sq ft
Excerise Room 300
Patient Laundry 300
Unit Support
Interview / Meeting Room 300
Treatment / Medical Exam 300
De-escalation Room 300
Seclusion Room 200
Group Therapy / Multi-purpose Room* 400
Activity Room* 400
GROUP THERAPY / HALF Communal Dining Room and Service Kitchen* 450
MULTI-PURPOSE BASKETBALL
800
sq ft COURT Visitation* 200
Recovery Plan Meeting / Team Offices* 500
INDOOR ACTIVITY
800 1600
Staff Breakroom, Lockers, and Restrooms* 500
sq ft sq ft
Unit Control
Unit Office and Nurse’s Station 600
Medication Room 200
Storage 200
Other
Environmental Services: Storage/Refuse/Linen* 500
Additional Restrooms 250
Additional Storage 300
Circulation and Mechanical / OPS 3,000
TOTAL ESTIMATED FLOOR AREA 15,000
*Shared with another unit, therefore 1/2 of floor area only included

SECTION 4 PROGRAMMING_43
_Residential Quads
QUAD ENTRY
EASY CONNECTION TO CENTRAL
SUPPORT AND MEDICAL

UNIT ENTRY
STAFF ENTRY

UNIT 1

STAFF LOCKERS,
BREAKROOM & RESTROOMS
1000 sq ft

MEETING ROOMS / FLEX OFFICES


(RECOVERY TEAM & SUPPORT STAFF)

1000 sq ft

NATURE

GROUP THERAPY / MULTI-PURPOSE ACTIVITY


800 sq ft

COMMUNAL DINING / VISITATION INDOOR


MULTI-PURPOSE ACTIVITY
FOOD SERVICE & 900 sq ft
ENVIRONMENTAL
SERVICES
STORAGE / REFUSE / HALF
LINEN BASKETBALL
1000 sq ft
400
sq ft
800
sq ft
COURT

NATURE
UNIT 3

GROUP THERAPY / MULTI-PURPOSE ACTIVITY


800 sq ft

MEETING ROOMS / FLEX OFFICES


NATURE (RECOVERY TEAM & SUPPORT STAFF)
1000 sq ft

STAFF LOCKERS,
BREAKROOM & RESTROOMS
1000 sq ft

UNIT ENTRY

SCALE

100
sq ft

44_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


A Residential Quad is a grouping of four (4) Units,
which share program, therapy, and service spaces. A
Residential Quad services eighty (80) patients.
UNIT ENTRY

UNIT 2

# of rooms
NATURE
Patient Bedrooms (20x4) 80
Communal / Social / Day Room 4
Quiet / Reading Room 4
Excerise Room 4
Patient Laundry 4
Interview / Meeting Room 4
INDOOR VISITATION COMMUNAL DINING / Treatment / Medical Exam 4
ACTIVITY MULTI-PURPOSE
900 sq ft FOOD SERVICE & De-escalation Room 4
ENVIRONMENTAL
SERVICES
STORAGE / REFUSE / Seclusion Room 4
LINEN
800 400 Group Therapy / Multi-purpose Room 2
sq ft sq ft 1000 sq ft
Activity Room 2
Communal Dining Room and Service Kitchen 2
UNIT 4
Visitation 2
Recovery Plan Meeting / Team Offices 2
Staff Breakroom, Lockers, and Restrooms 2
Unit Office and Nurse’s Station 4
Medication Room 4

NATURE

Square
Feet
UNIT ENTRY
1 Quad (4 Units / 80 Beds) 60,000
3.5 Quads (14 Units / 280 Beds) 210,000
2 Swing Units (40 Beds) 30,000
FOUR QUADS FLOOR AREA 240,000

SECTION 4 PROGRAMMING_45
_Maximum Security Unit

FACILITIES SHARED WITH ANOTHER MAXIMUM SECURITY UNIT

PATIENT ENTRY

MAXIMUM SECURITY UNIT


SIZED TO FIT (MAX 15 BEDS)
ONE UNIT AT A TIME,
BUT SHARED WITH UP
TO 3 OTHER UNITS

DE-ESCLATION ROOM MED. STO-


COMMUNAL DINING /
MULTI-PURPOSE 300 sq ft UNIT ROOM RAGE SECLUSION
OFFICE ROOM
MEETING ROOM 200 200 200
FOOD
SERVICES 300 sq ft sq ft sq ft sq ft

900 TREATMENT ROOM 600 NURSE’S NATURE


sq ft 300 sq ft sq ft STATION

CLEANING
STORAGE /
ENVIRONMENTAL REFUSE /
SERVICES LINEN
900
sq ft

PATIENT PATIENT PATIENT


LAUNDRY DAY SPACE READING EXCERCISE

300 1500 300 300


sq ft sq ft sq ft sq ft

200 200 200 200


1 sq ft 5 sq ft 9 sq ft 13 sq ft

200 200 200 200


2 sq ft 6 sq ft 10 sq ft 14 sq ft

200 200 200 200


3 sq ft 7 sq ft 11 sq ft 15 sq ft

4 200
sq ft 8 200
sq ft 12 200
sq ft
NATURE NATURE NATURE
HALLWAYS SHOULD BE HALLWAYS SHOULD BE
NO LONGER THAN 6 ROOMS NO LONGER THAN 6 ROOMS

250 RESTROOMS
sq ft

500 STORAGE
sq ft

3,000 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

46_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


The Maximum Security Units are spatially the same as
residential units except that they require heightened
levels of security, less patients per Unit, and separate
support program space. MSU should contain no then
fifteen 15 beds.

STAFF ENTRY

STAFF MEETING
LOCKERS, ROOMS / FLEX *Shared with another unit therefore 1/2 of area only Square Feet
BREAKROOM, OFFICES
& RESTROOM
(RECOVERY
Patient Bedrooms (15 beds x 200 sq ft) 3,000
TEAM &
SUPPORT Unit Activity
STAFF)

Communal / Day Room 1,500


Quiet / Reading Room 300
1000 1000
sq ft sq ft
Excerise Room 300
Patient Laundry 300
Unit Support
Interview / Meeting Room 300
Treatment / Medical Exam 300
De-escalation Room 300
Seclusion Room 200
Group Therapy / Multi-purpose Room* 400
Activity Room* 400
GROUP THERAPY / HALF Communal Dining Room and Service Kitchen* 450
MULTI-PURPOSE BASKETBALL
800
sq ft
COURT Recovery Plan Meeting / Team Offices* 500
Staff Breakroom, Lockers and Restrooms* 500
INDOOR ACTIVITY
800 1600
Unit Control
sq ft sq ft
Unit Office and Nurse’s Station 600
Medication Room 200
Storage 200
Security / Sallyport Entrance 200
Other
Environmental Services: Storage/Refuse/Linen 1,500
Additional Restrooms 250
Additional Storage 300
Circulation / Mechanical and OPS 3,000
TOTAL ESTIMATED FLOOR AREA 15,000
*Shared with another unit, therefore 1/2 of area only included

SECTION 4 PROGRAMMING_47
_Maximum Security Quad
QUAD ENTRY

SECURE SALLY PORT

UNIT ENTRY STAFF ENTRY

UNIT 1
STAFF LOCKERS,
BREAKROOM & RESTROOMS
1000 sq ft

NATURE MEETING ROOMS / FLEX OFFICES


(RECOVERY TEAM & SUPPORT STAFF)
1000 sq ft

GROUP THERAPY / MULTI-PURPOSE ACTIVITY


800 sq ft

NATURE

COMMUNAL DINING / VISITATION INDOOR HALF


MULTI-PURPOSE ACTIVITY BASKETBALL
900 sq ft
COURT
FOOD SERVICE &
ENVIRONMENTAL
SERVICES
STORAGE / REFUSE /
LINEN
400 800 1600
1000 sq ft sq ft sq ft sq ft

SECURE
SALLY PORT

UNIT 3

GROUP THERAPY / MULTI-PURPOSE ACTIVITY


800 sq ft
NATURE

MEETING ROOMS / FLEX OFFICES


(RECOVERY TEAM & SUPPORT STAFF)
1000 sq ft

STAFF LOCKERS,
BREAKROOM & RESTROOMS
1000 sq ft

SCALE UNIT ENTRY


100
sq ft

48_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


A Maximum Security Quad contains three (3)
Maximum Security Units instead of four like in a
standard Quad. The remaining space is occupied by
uses found in the central support within the confines
of the maximum security environment. Having most
UNIT ENTRY services within the maximum security quad reduces
risk of elopement.
UNIT 2

NATURE

INDOOR VISITATION COMMUNAL DINING /


ACTIVITY MULTI-PURPOSE
900 sq ft FOOD SERVICE &
ENVIRONMENTAL
SERVICES
STORAGE / REFUSE /
LINEN Square Feet
800 400
sq ft sq ft 1000 sq ft
Security 500
SECURE
SALLY PORT Visitation 1,000
Tele-conference Room 1,000
ARTS &
EXERCISE MEDICAL CRAFTS / Gymnasium 3,500
MUSIC
1000
sq ft 700 sq ft 400 sq ft Indoor Recreation 1,000
Excerise 1,000
RECREATION
1000 BARBER Barber 400
sq ft TELE- / SALON
CONFERENCE Library and Reading 400
400
ROOM sq ft
Arts and Crafts / Music 400
SECURITY / SURVEILLANCE
500 sq ft Computer Room 400
VISITATION LIBRARY Medical Exam / Treatment Rooms 400
1000
sq ft
1000
sq ft
400
sq ft
Staff Breakroom, Lockers, and Restrooms 1,000
Additional Restrooms 250
Additional Storage 250
Circulation / Mechanical and OPS 2,500
Three (3) Units (45 Beds) 45,000
TOTAL ESTIMATED FLOOR AREA 60,000

SECTION 4 PROGRAMMING_49
_Administration

MAIN HOSPITAL
ENTRY

CENTRAL
SECURITY MEETING ROOMS LOBBY &
WELCOME
400 400 400
sq ft sq ft sq ft CENTER
LOCATED NEAR 1200
ADMISSIONS CONFERENCE sq ft
ROOM
800 RECEPTION
sq ft 200 sq ft

NURSING CHIEF ACCOUNTING CHIEF ASST. SUPER- ADMIN. CLINICAL DIREC-


SUPPORT FINANCIAL INTENDENT SUPPORT TOR
OFFICER
600 200 600 200 200 400 400 400 200
BUSINESS OFFICE sq ft sq ft sq ft sq ft sq ft sq ft sq ft sq ft sq ft
STORAGE
800 sq ft

HOSPITAL JOB CENTER & SAFETY AND REIM- PATIENT RIGHTS CENTRAL
RECORDS FILES WORKERS BURSEMENT I.T.
COMPENSATION
900 900 1200 900
sq ft sq ft sq ft sq ft

1600 1600
sq ft sq ft

REIMBURSEMENT
STORAGES
STAFF TRAINING FLEX ADMIN. STAFF
MEETING SPACE BREAKROOM
1200
sq ft 400 sq ft 400 sq ft 800 sq ft

1200
sq ft CONFERENCE
ROOM
FLEX
800 sq ft
OFFICE SPACE
200 200 200 200
LECTURE ROOM sq ft sq ft sq ft sq ft

800
sq ft

300 RESTROOMS
sq ft

300 STORAGE
sq ft
convenient ACCESS TO CENTRAL SUPPORT AND CENTRAL MEDICAL
800 CIRCULATION & MECHANICAL OPS
sq ft

SCALE

100
sq ft

50_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


The Administration body is a multifaceted department
which houses the leadership offices associated
with the Superintendent, Chief Financial Officer,
Chief Nurse Executive, Clinical Director, Director of
Psychology, Community Relations Director, as well
as a number of support functions. Administration
should be located near the main entrance to the
hospital and provide a welcoming presence for
visitors, staff, and patients alike. Administration
benefits from a strong but separate connection to
Admissions and Central Support Services.

Square Feet

Lobby, Welcome Center, and Reception 1,400


RESIDENTIAL PSY- COMMUNITY DIREC- PATIENT Superintendent and Support 1,000
SERVICES CHOLOGY RELATIONS TOR TRANSPORTATION

400 200 400 200


Chief Nurse Executive and Nursing Support 800
sq ft sq ft sq ft sq ft 300 sq ft
Chief Financial Officer and Accounting 800
Clincial Director and Clincial Support 600
Director of Psychology and Res. Services 600
UTILIZATION QUALITY
MANAGEMENT MANAGEMENT HEALTH INFO. Director of Community Relations and Support 600
MANAGEMENT
Central Security 400
600 600 1200 Information Technology 900
sq ft sq ft sq ft
Utilization Management 600
Quality Management 600
HEALTH INFO.
MANAGEMENT Health Information Management and Storage 4,200
STORAGE
Patient Rights 1,200
Patient Transportation 300
Safety and Worker’s Compensation 900
3000 Job Center 1,600
sq ft
Reimbursement and Storage 2,100
Administration Storage and Hospital Records 2,400
Facility Training 1,200
Conference / Lecture / Training Rooms (3) 2,400
Meeting / Multi-purpose Rooms (4) 1,600
Flex Staff Offices (8) 800
Staff Breakroom, Lockers, and Restrooms 800
Additional Restrooms 800
Additional Storage 900
Circulation / Mechanical and OPS 4,500
TOTAL ESTIMATED FLOOR AREA 34,000

SECTION 4 PROGRAMMING_51
_Admissions
PATIENT ENTRY
SECURE CONNECTION TO CENTRAL MEDICAL AND PATIENT UNIT

VAN ENTRY
(SALLY PORT)
400
sq ft

LOBBY /
WAITING
ROOM

VISITOR ENTRY 800


sq ft

RECEPTION
PATIENT SNACK OFFICE SECURITY OFFICE MEDICAL
(KITCHEN) (SWITCH BOARD)
OPTIONAL 200 sq ft OFFICER ON
DUTY
CENTRAL 200 PHOTO & ID 200
VISITATION sq ft 200 sq ft sq ft 400 sq ft

INTERVIEW OBSERVATION

3000 ROOM1 ROOM1


sq ft 200 sq ft 200 sq ft

NEAR ADMISSION + CENTRAL SECURITY ROOM2 OFFICE


200 sq ft 200 sq ft

ROOM3 ROOM2
200 sq ft 200 sq ft

STAFF FLEX (SHARED) OFFICES HOUSE STAFF BREAKROOM / LOCKERS


100 100 100 SUPERVISOR (MULTI-PURPOSE ROOM)
sq ft sq ft sq ft
STAFF ENTRY
100 100 100 800
sq ft sq ft sq ft sq ft

600
sq ft

300 RESTROOMS
sq ft

300 STORAGE
sq ft

800 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

52_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


Admissions operates 24 hours a day, 365 days a year,
and requires a close connection to the Central Medical
Clinic and Central Security. A Sally Port is needed for
secure transfer of patients from transportation into
the hospital.

Visitation may be centralized to Admissions and


removed from each Quad.

Square Feet

Sallyport / Van Entrance 400


Lobby / Waiting Room 800
Reception 200
Photo ID Preparation 200
Snacks and Beverages 200
Security / Switchboard 200
Interview Rooms (3) 600
Observation Rooms (2) and Attached Office 600
Admissions Supervisor 600
Flex Staff Offices (6) 600
Medical Officer on Duty (MOD) 400
Staff Breakroom, Lockers, and Restrooms 800
Additional Restrooms 300
Additional Storage 300
Circulation / Mechanical and OPS 800
TOTAL ESTIMATED FLOOR AREA 7,000

SECTION 4 PROGRAMMING_53
_Central Medical Clinic + Pharmacy

PATIENT ENTRY
SECURE CONNECTION TO ADMISSIONS AND CENTRAL SUPPORT

WAITING
AREA
600 PHYSICAL & OCCUPATIONAL
sq ft
THERAPY
PODIATRY &
OPTOMETRY DENTAL MEDICAL
TREATMENT
SPACE
FLEX EXAM ROOMS DENTAL EXAM ROOMS MD EXAM ROOMS 800
150 sq ft 150 sq ft 150 sq ft 150 sq ft 150 sq ft 150 sq ft sq ft

FLEX OFFICES DENTAL OFFICES MD OFFICES OFFICES


150 sq ft 150 sq ft 150 sq ft 150 sq ft 150 sq ft 150 sq ft 150 sq ft 150 sq ft

EKG & ISOLATION


EMPLOYEE HEALTH INFECTION CONTROL LAB IMAGING
400 400
200 sq ft 200 sq ft 200 sq ft sq ft sq ft

ISOLATION ENTRY

250 RESTROOMS
sq ft

250 STORAGE
sq ft

1,500 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

54_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


The Central Medical Clinic provides annual
physical health assessments and service calls to
patients within Residential Units, completes health
assessments during the admissions process, and
coordinates outside medical professionals. It requires
a close and secure connection to Admissions and
benefits from a nearby relationship with Pharmacy
and Central Support Services, which is easily
accessible to all Units.

STAFF ENTRY
RECEIVING
DELIVERY

STAFF
PHARMACY LOCKERS,
BREAKROOM,
& RESTROOM

Square Feet

Pharmacy 2,400
800 sq ft
Lobby, Waiting Room, and Reception 600
2000 sq ft Medical Professional Offices (6) 900
MEETING ROOMS
200 sq ft Medical Exam / Treatment Rooms (2) 300
OFFICES
200 sq ft 200 sq ft 200 sq ft
Medical Lab and EKG / Imaging 600
Dental Exam / Treatment / Imaging (2) 300
Flex Exam / Treatment Rooms (Opt., Pod., etc) (2) 300
Physical and Occupational Therapy 1,100
Infection Control Office 200
Isolation Room / Negative Air 400
Employee Health Offices 200
Multi-purpose Meeting Rooms (2) 400
Staff Breakroom, Lockers, and Restrooms 800
Additional Restrooms 250
Additional Storage 250
Circulation / Mechanical and OPS 1,500
TOTAL ESTIMATED FLOOR AREA 10,500

SECTION 4 PROGRAMMING_55
_Central Support + Treatment

STAFF ENTRY

STAFF
LOCKERS, FLEX
BREAKROOM,
& RESTROOM STAFF OFFICES

AUDITORIUM /
CHURCH & PLACE OF
WORSHIP 800 1200 SERVICE KITCHEN
sq ft sq ft 500 sq ft

CAFE CANTEEN &


SOCIAL SPACE
CASHIER / POST OFFICE /
CLOTHING FLEX TRUST PATIENT MAIL ROOM
PROPERTY
CENTER SPACE FUNDS 1500 900
400 400 400 400 400 sq ft sq ft
sq ft sq ft sq ft sq ft sq ft

CENTRAL GREEN SPACE

3000~5000
sq ft

CHAPEL
600
sq ft PROGRAM ROOMS BARBER / READING LIBRARY COMPUTER PEER
SALON ROOM ROOM SUPPORT
400 400 400 400 800 400 400
sq ft sq ft sq ft sq ft sq ft sq ft sq ft

400 400
sq ft sq ft
FLEX SPACE

SECURE, convenient CONNECTIONS TO CENTRAL MEDICAL, ADMINISTRATION, AND PATIENT UNITS

500 RESTROOMS
sq ft

800 STORAGE
sq ft

3,000 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

56_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


Central Support Services comprise all programs,
services, and therapy in a central location to service
all patients. Central Support Services benefit from
a central location which is easily accessible from
the Units. The identified spaces should generally
be located near each other. In a number of the best
practice hospitals these uses have been described
as being a “therapy mall” or “downtown”. A central
common outdoor space/square/green helps to define
an important social and functional space for the
GYMNASIUM
(BASKETBALL, VOLLEYBALL, ETC) community. A number of rooms/spaces should be
provided that can serve multiple purposes and adapt
to a variety of functions.

Square Feet

Gymnasium 5,000
Central Recreation 2,000
Auditorium / Stage / Church 5,000
ART & MUSIC TEACHING
CRAFT ROOM KITCHEN Chapel / Spiritual Center 600
400 400 400
sq ft sq ft sq ft
Cafe with Service Kitchen 2,000
Canteen & Social Space 900
5000
sq ft Library 800
Reading Room 400

INDOOR RECREATION Computer Room 400


(TABLE GAMES, POOL, ETC)
Post Office and Mail Room 400
Barber / Salon / Cosmetics 400
Arts and Crafts 400
2000
PATIENT PROGRAM ROOMS sq ft
Music 400
EDUCATION
400 400 400
sq ft sq ft sq ft Patient Education 400
Teaching Kitchen 400

400 400 Peer Support 400


sq ft sq ft

FLEX SPACE
Trust Funds 400
Cashier and Patient Property 400
Clothing Center (Distribution) 400
Flex Room 400
Flex Program / Meeting Rooms (8) 3,200
Staff Offices / Computers (~8) 1,200
Staff Breakroom, Lockers, and Restrooms 800
Additional Restrooms 500
Additional Storage 800
Circulation / Mechanical and OPS 3,000
TOTAL ESTIMATED FLOOR AREA 31,000

SECTION 4 PROGRAMMING_57
_Central Kitchen + Environmental Services

SERVICE CONNECTION TO UNITS

EQUIPMENT FOOD SERVICE RETURN &


STORAGE DELIVERY DISH CLEAN

600 400 600


sq ft sq ft sq ft

CENTRAL KITCHEN
(PREPARATION & COOKING)

STAFF ENTRY

4000
sq ft OFFICES
PANTRY/ STAFF
FOOD STORAGE WALK-IN FOOD STORAGE OFFICES LOCKERS, 200
sq ft
200
sq ft
REFRIGERATOR FREEZER BREAKROOM,
& RESTROOM
600 400 200 200 200 200
sq ft sq ft sq ft sq ft sq ft sq ft FLEX
SPACE
400
FOOD WAREHOUSE FLEX COMPUTER sq ft
REFRIGERATOR FREEZER SPACE STATIONS
400 400 400 800
sq ft sq ft sq ft sq ft COMPUTER
STATION
1000 400
sq ft sq ft

1200
sq ft

LOADING BAYS

400 RESTROOMS
sq ft

400 STORAGE
sq ft

2,400 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

58_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


Central Food and Nutrition Services prepare meals in
a central kitchen and serves them to patients within
their communal dining rooms located in each pair of
Units. Easy and direct access from the central kitchen
is required by van/trolly to deliver food directly into the
service kitchens within the communal dining facilities
in the Unit. Loading Bays are required to support
sixteen-wheel trucks that deliver food directly into
refrigerators, freezers, or pantries.

Environmental Services is responsible for cleaning all


facets of the hospital. They require a central location
for supplies and assembly. A central refuse location
is also needed to collect waste and recyclables from
Units and other areas of the hospital to eventually be
picked up by large trucks. Laundry requires space
to collect, sort, and send out dirty linens and then
receive, sort, and deliver clean linens to the Units.
SERVICE CONNECTION TO UNITS SERVICE CONNECTION TO UNITS Like Food Services, they require easy and direct
access to the service areas of each Unit by a van/
trolley.

Square Feet

LAUNDRY Central Kitchen 4,000


DIRTY LINEN
DROP CLEANING CENTRAL Food Delivery 400
OUT TO SUPPLIES & REFUSE
DISTRIBUTE ASSEMBLY Food / Dish Return and Clean 600
TO UNITS
DIRTY LINEN Food Storage / Pantry 1,000
SORT

CLEAN LINEN Equipment Storage 600


SORT
Walk-in Refrigerator 600
OUT TO
LAUNDRY
Walk-in Freezer 400
CLEAN LINEN 1800 1800
sq ft sq ft Warehouse Refrigerator 1,200

5000 sq ft Warehouse Freezer 400


Central Kitchen Offices (4) 800
Computer Rooms 800

LOADING BAYS LOADING BAYS Flex Meeting Rooms 800


Staff Breakroom, Lockers, and Restrooms 800
Environmental Services Offices (2) 400
Central Laundry 5,400
Laundry Supply and Storage 1,000
Clean Supply and Storage 1,800
Refuse Collection 1,800
Additional Restrooms 400
Additional Storage 400
Circulation / Mechanical and OPS 2,400
TOTAL ESTIMATED FLOOR AREA 25,000

SECTION 4 PROGRAMMING_59
_Maintenance + Groundskeeping

METAL SHOP

LOADING BAY

3200
sq ft

CARPENTRY

STAFF ENTRY
LOADING BAY

3200 RECEPTION ASST.


sq ft DIRECTOR DIRECTOR

200 400 200


sq ft sq ft sq ft

MOTOR POOL

FLEX MEETING ARCHIVES


LOADING BAY ROOM
800 400
sq ft sq ft

3200
sq ft

STAFF BREAKROOM & COMPUTER


LOCKER ROOM
STATIONS
800 400
LANDSCAPE AND GROUNDSKEEPING sq ft sq ft

LOADING BAY

3200
sq ft

EQUIPMENT PARTS & STORAGE

LOADING BAY

3200
sq ft

150 RESTROOMS
sq ft

150 STORAGE
sq ft

500 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

60_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


With a new facility, maintenance staff will be able
to focus on supporting the mechanical and systems
components of new buildings and equipment, in
addition to keeping the important landscape features
and outdoor spaces beautiful and functional.


Square Feet

Equipment and Parts Storage 3,200


Carpentry Shop 3,200
Metal Shop 3,200
Motor Pool 3,200
Groundskeeping 3,200
Reception 200
Staff Offices (2-3) 600
Staff Computers 400
Flex Meeting Room(s) 800
Archives 400
Staff Breakroom, Lockers, and Restrooms 800
Additional Restrooms 150
Additional Storage 150
Circulation / Mechanical and OPS 500
TOTAL ESTIMATED FLOOR AREA 20,000

SECTION 4 PROGRAMMING_61
_Community Services

COURT OF LAW TYLER JR. FAMILY RESOURCE CENTER


(BOARDING ROOMS)
COLLEGE OF
WITHIN
ADMINISTRATION NURSING 400
sq ft
400
sq ft
POSSIBLE CONNECTION TO
ADMINISTRATION , AUDITORIUM,
AND UNITS FOR LECTURE/
TRAINING ROOMS, RESIDENCY
1700 PROGRAM 400 400
sq ft sq ft sq ft
INCLUSIVE TO 1600
ALL DSHS HOSPITALS sq ft

5000
sq ft

USES EXCLUSIVE TO RUSK STATE HOSPITAL

SCALE

100
sq ft

62_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


Community Services includes those uses within the
Hospital that liaison with the greater community
beyond the hospital, such as the Court of Law. The
Court of Law requires a close and connected spatial
relationship within or near Administration.

Specific to RSH, the Tyler Junior College of Nursing


and the Family Resource Center and Lodging (guest
lodging for families visiting patients) are identified
under the umbrella of Community Services. These
uses can be near the greater complex, but must
not be embedded within it for security and access
reasons. The floor area for the Tyler Junior College
of Nursing and Family House are not included in the
total floor area estimate for all the programmatic
components.


Square Feet

Court of Law 2,000


Tyler Junior College of Nursing 5,000
Family House 1,600
TOTAL ESTIMATED FLOOR AREA 8,600

SECTION 4 PROGRAMMING_63
_Outdoor Recreation

SPORTS FIELD GARDENS / GREENHOUSE

32,000
sq ft

COOKOUT
SPACE

96,000
sq ft

* SHARED : 1 SOCCER FIELD + 1 BASEBALL FIELD

WALKING TRAILS

SCALE

500
sq ft

64_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


Physical wellness plays an important role in mental
health recovery. Outdoor recreation and gardens
could include a number of sports fields, passive
outdoor gardens, mediation gardens, greenhouses
and vegetable gardens, walking trails, cookout space,
therapy animals, and the lake.

BASKETBALL COMMON /
COURT CENTRAL
COURTYARD

5,000
sq ft

8,000
sq ft

ANIMALS / LAKESIDE
FARM ACTIVITIES

Square
Feet

Multi-Sport Field (Soccer, Baseball, etc.) 96,000


Unit Courtyards 9,000
Greenhouse and Vegetable Gardens 32,000
Central Courtyard and Entry 8,000
Basketball 5,000
Walking Trails -
Cook-out / Picnic -
Therapy / Farm Animals -
Lake Activities -
TOTAL ESTIMATED FLOOR AREA 150,000

SECTION 4 PROGRAMMING_65
5 IDEALIZED MODEL
_Overview
_Plan
_Axonometric Model
_Total Floor Area
_Control + Security
_Landscape Structure + Function
_Pedestrian Circulation
_Vehicular Circulation + Parking
_Medical Access + Medication Delivery
_Food + Environmental Services Access
_Overview
The Idealized Model has been developed are approximately 80 x 80 feet in size or The Idealized Model also provides a general
based upon the need to establish the 6,000 square feet. Four units are organized planning paradigm that can be applied
critical design parameters for a psychiatric into a quad to allow for efficiencies with to other DSHS facilities. Components of
hospital. These principle components space sharing, security, and operations. the plan are intended to be utilized as a
are scalable and can be applied anywhere “kit of parts”, that can be reorganized in
in the state. Codifying the critical Focused around a central treatment mall, the context of a specific hospital site and
programming requirements and their each quad has the ability to be self- program. It is important to note that this
relationships, best practice principles, and contained and flexible in its arrangement. exact model would be difficult to replicate
RSH’s staffing parameters, this Idealized Central administration and associated identically on an existing site, which will
Model is a demonstration of the optimum medical functions are located within a have a number of contextual influences,
spatial relationships necessary to establish two-story main building that provides a such as topography, servicing, access,
best practices in mental health care. public face and identity for the hospital. vegetation, historical structures, etc.
Service roads and deliveries are organized
Fundamental to the Idealized Model is peripherally in order to maintain a The Idealized Model equals approximately
the organization of individual therapeutic walkable, campus-like setting. Appropriate 451,000 square feet of floor area.
units. Each unit contains twenty (20) single provisions for service and emergency
bedrooms along with shared support access is provided through easements
spaces, organized around a controlled designed to be “shared spaces.”
outdoor courtyard space. The courtyards

“(Gardens) have the capacity to


restore the body, mind, and spirit.”
D Winterbottom and A WagenFeld
Therapeutic Gardens: Design for healing spaces
25

68_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Plan

LEGEND
OUTDOOR SPACE

LANDSCAPE HARDSCAPE GREEN SPACE

WAREHOUSE SPORTS FIELD PRIVATE SEMI-PRIVATE PUBLIC

LOADING ZONE
ALLOTMENT GARDENS GREENHOUSE
PATIENT ROOM

UNIT UNIT
LOADING ZONE

ACTIVITY SUPPORT FACILITIES


VISITATION THERAPY SECLUSION THERAPY SHOWER THERAPY SECLUSION THERAPY SHOWER SHOWER THERAPY SECLUSION THERAPY SHOWER THERAPY SECLUSION THERAPY VISITATION

COMMUNITY
REFUSE
UNIT CENTRAL
ROOMS ROOMS ROOMS ROOMS

STAFF BREAKROOM,
LOCKER ROOM &
MULTI-PURPOSE ROOM
PATIENT LAUNDRY PATIENT LAUNDRY PATIENT
LAUNDRY
PATIENT
LAUNDRY
STAFF BREAKROOM,
LOCKER ROOM &
MULTI-PURPOSE ROOM
CONTROL POINT MEDICAL SERVICES SERVICES
SERVICE MEETING ROOMS /
UNIT CENTRAL
ADMISSION
FLEX OFFICE

READING
READING

READING

READING
STORAGE SUPPORT FACILITY

ROOM
ROOM

ROOM

ROOM
MEETING ROOMS /
DAY DAY DAY ROOM DAY ROOM
FLEX OFFICE
ROOM ROOM

ARCHIVE DINING HALL

CENTRAL

EXERCISE
EXERCISE

EXERCISE

EXERCISE

PATIENT
PATIENT

PATIENT

PATIENT
DINING HALL

ADMINISTRATION

PATIENT ROOMS

PATIENT ROOMS
MULTI-
PURPOSE LANDSCAPE METALS 20 BEDS NURSE’S
MR
20 BEDS NURSE’S
MR NURSE’S 20 BEDS NURSE’S 20 BEDS
ENVIRONMENTAL SERVICES

STORAGE
STORAGE

STORAGE

STORAGE
STATION STATION STATION STATION
ROOM:
PATIENT ROOMS PATIENT ROOMS PATIENT ROOMS PATIENT ROOMS
LOADING ZONE

STAFF MEDICATION MEETING MEDICATION MEETING MEDICATION MEDICATION


ROOM ROOM
PARTS

LOADING ZONE STORAGE DE-ESCALATION TREATMENT DE-ESCALATION TREATMENT DE-ESCALATION DE-ESCALATION STORAGE
CENTRAL FOOD SERVICES
CONFERENCE FOOD FOOD ROOM ROOM ROOM ROOM ROOM ROOM

ROOM WAREHOUSE WAREHOUSE FLEX


DIRECTOR’S REFRIGERATOR FREEZER SPACE MAINTENANCE
OFFICE OFFICE ROAD
GROUNDKEEPING
INDOOR BASKETBALL COURT INDOOR
RECREATION RECREATION
ASST. DIRECTOR
REFRIGERATOR FREEZER
SERVICE

OFFICE
FOOD

MULTI-PURPOSE

WAREHOUSE VACANT
DISH CLEAN

STORAGE DE-ESCALATION DE-ESCALATION


DE-ESCALATION DE-ESCALATION STORAGE
RECEPTION
RETURN &

CARPENTRY VEHICULAR REPAIR TREATMENT TREATMENT ROOM ROOM


SERVICE

ROOM ROOM
STAFF

ROOM ROOM
LOADING ZONE

KITCHEN
MEDICAL MEDICAL MEDICATION MEDICATION
ROOM MEETING ROOM MEETING
PATIENT ROOMS PATIENT ROOMS PATIENT ROOMS PATIENT ROOMS
O

OFFICE ROOM ROOM

EQUIPMENT NURSE’S NURSE’S NURSE’S NURSE’S

STORAGE
STORAGE
STORAGE

STORAGE
LAUNDRY STORAGE 20 BEDS STATION 20 BEDS STATION STATION 20 BEDS STATION 20 BEDS
O

PANTRY STORAGE OFFICE


DINING HALL

DINING HALL

READING
READING
READING

READING

ROOM
ROOM
ROOM

ROOM
FLEX MEETING ROOMS /
DAY ROOM DAY ROOM DAY ROOM DAY ROOM
FLEX OFFICE
SPACE MEETING ROOMS /

CLEANING FLEX OFFICE

EXERCISE
EXERCISE
EXERCISE

EXERCISE

PATIENT
LAUNDRY SUPPLIES

PATIENT
PATIENT

PATIENT
LOADING ZONE STAFF BREAKROOM, STAFF BREAKROOM,
PATIENT LAUNDRY PATIENT LAUNDRY PATIENT PATIENT
LOCKER ROOM & LOCKER ROOM &
LAUNDRY LAUNDRY
MULTI-PURPOSE ROOM MULTI-PURPOSE ROOM

SHOWER THERAPY THERAPY SHOWER THERAPY THERAPY VISITATION

SECLUSION SECLUSION SECLUSION SECLUSION


SHOWER ROOMS SHOWER THERAPY SECLUSION THERAPY FLEX STAFF BREAKROOM,

SECLUSION
VISITATION THERAPY ROOMS THERAPY SHOWER THERAPY ROOMS THERAPY ROOMS
ROOMS
OFFICE

ROOMS
LOCKER ROOM &

SHOWERS

THERAPY

THERAPY
MULTI-PURPOSE ROOM
FLEX
OFFICE
CONFERENCE ROOM

LAUNDRY
PATIENT ROOMS

PATIENT
FLEX
OFFICE
FLEX

READING ROOM / LIBRARY


OFFICE
FLEX STAFF TRAINING
CAFE FOR PATIENTS PROGRAM PROGRAM PROGRAM OFFICE

READING
ROOM
STORE SALON MUSIC ROOM ROOM ROOM DAY ROOM FLEX

DAY ROOM
OFFICE
PEER COMPUTER PROGRAM FLEX

RESTAURANT
OFFICE MEETING ROOM MEETING ROOM

PATIENT EXERCISE
SUPPORT ROOM ROOM
KITCHEN

EXERCISE
PATIENT
PATIENT READING PROGRAM
LIBRARY WAITING ATRIUM

20 BEDS
CHAPEL EDUCATION ROOM ROOM
NURSE’S AREA

NURSE’S

STORAGE
AUDITORIUM / CHURCH PROGRAM PROGRAM PROGRAM

STATION
TEACHING

STORAGE
STATION
CLOTHING STORAGE RESTROOMS CAFE FOR STAFF GYMNASIUM KITCHEN ART ROOM ROOM ROOM PATIENT ROOMS
MEDICATION CONFERENCE ROOM BUSINESS OFFICE STORAGE

MEDICAL
ROOM
SUPERINTEN-
DENT’S OFFICE
ASST.SUPERIN-
TENDENT’S

GROUP THERAPY/
MULTI-PURPOSE
SALLY PORT OFFICE

STORAGE
ROOM DE-ESCALATION STENOGRAPHY COPY CENTER CHIEF

MEDICAL
RESTROOMS RESTROOMS

ACTIVITY
DE-ESCALATION ROOM FINANCIAL
OFFICER
SAFETY CHIEF
MANAGEMENT NURSE
VISITATION THERAPY SECLUSION THERAPY SHOWER THERAPY SECLUSION THERAPY SHOWER SHOWER THERAPY SECLUSION THERAPY VISITATION WORKER’S EXECUTIVE
SHOWERS PATIENT ROOMS PATIENT ROOMS SHOWERS
ROOMS ROOMS ROOMS COMPENSA- REIMBURSEMENT STORAGE
TION CLINICAL
POST DIRECTOR
PATIENT
OFFICE RIGHTS
DIRECTOR OF
RESIDENTIAL
MEETING ROOM PATIENT EXERCISE READING ROOM / LIBRARY EXERCISE PATIENT MEETING ROOM
STAFF BREAKROOM,
PATIENT LAUNDRY PATIENT LAUNDRY PATIENT
STAFF BREAKROOM,
PATIENT FILES / RECORDS / SERVICES
DE-ESCALATION

DE-ESCALATION

STORAGE VISITATION SECURITY VISITATION READING ROOM / LIBRARY LOCKER ROOM & LOCKER ROOM &
STORAGE TRANSPORTA- DIRECTOR OF
LAUNDRY LAUNDRY
MULTI-PURPOSE ROOM
LAUNDRY
MULTI-PURPOSE ROOM CLOTHING STORAGE PSYCHIATRIC
TION
ROOM

ROOM

TREATMENT TREATMENT SERVICES


DAY ROOM
DAY ROOM CENTER REIMBURSEMENT DE-ESCALATION HEALTH INFORMATION DIRECTOR OF HEALTH INFO MANAGEMENT
NURSE’S MEDICATION MEDICATION NURSE’S MEETING ROOMS /
ROOM
NURSING SOCIAL
STORAGE STORAGE
ROOM MANAGEMENT M.E.P. STORAGE
STATION STATION SUPPORT

STORAGE
SERVICES
SOCIAL
DE-ESCALATION
FLEX OFFICE

EXERCISE
BARBER /
SALON
ARTS/ LIBRARY

READING
SECURITY
READING

READING

CRAFTS

ROOM
ROOM

ROOM

DAY DAY DAY ROOM

STORAGE

STORAGE
20 BEDS 20 BEDS MEETING ROOMS /
FLEX OFFICE
ROOM ROOM MEDICATION
UTILIZATION DIRECTOR OF
ADDITIONAL
TRUST MANAGEMENT MAINTENANCE STORAGE
SECLUSION SECLUSION DINING HALL PATIENT ROOMS
ROOMS ROOMS
EXERCISE
FUNDS COURT
EXERCISE

EXERCISE

NURSE’S
PATIENT
PATIENT

PATIENT

STORAGE
NURSE’S
MEDIC

STATION
BASKETBALL COURT DINING HALL

STORAGE
PATIENT ROOMS
CASHIER/ STATION
PATIENT ROOMS

PATIENT ROOMS

ADMIN

20 BEDS
TEL-

ENTRY
GROUP THERAPY/
PATIENT ON DUTY SUPPORT
CONFERENCE MULTI-PURPOSE
20 BEDS NURSE’S 20 BEDS NURSE’S NURSE’S 20 BEDS
STORAGE
STORAGE

STORAGE

ACTIVITY
PROPERTY ACCOUNT-

READING ROOM / LIBRARY


THERAPY THERAPY STATION STATION STATION
ING
PATIENT ROOMS

PATIENT ROOMS

OFFICE OFFICE
PATIENT ROOMS PATIENT ROOMS PATIENT ROOMS CENTRAL

READING
MEETING MEDICATION MEETING MEDICATION

ROOM
MEDICATION
ROOM ROOM CENTRAL IT SECURITY OFFICE OFFICE JOB CENTER
DAY ROOM

DAY ROOM
STAFF MEETING ROOMS / DINING HALL DINING HALL MEETING ROOMS / STAFF
BREAK FLEX OFFICE BREAK OFFICE OFFICE
FLEX OFFICE INDOOR

PATIENT EXERCISE
STORAGE /
ROOM/ RECREATION ROOM/ STORAGE / WAITING AREA QUALITY

EXERCISE
STORAGE

PATIENT
MAINT LOCKER MAINT DE-ESCALATION TREATMENT DE-ESCALATION TREATMENT DE-ESCALATION STORAGE MANAGE-
LOCKER OFFICE OFFICE

OFFICE
ROOM ROOM ROOM ROOM ROOM MENT
RESTROOMS STORAGE
OFFICE PATIENT
HOUSE STAFF BREAKROOM, LOCKER

LAUNDRY
PATIENT
LAUNDRY

OFFICE
OFFICE SUPERVISOR ROOM & MULTI-PURPOSE ROOM
INDOOR BASKETBALL COURT INDOOR TREATMENT SPACE
SECOND FLOOR DETAIL RECREATION OFFICE SHOWER THERAPY THERAPY

INFECTION EMPLOYEE
RECREATION

SECLUSION
CONTROL HEALTH
SECLUSION

ROOMS
SHOWERS
OFFICE ISOLATION

THERAPY

THERAPY
ROOMS
SALLY PORT
ECG +
STORAGE DE-ESCALATION
IMAGING MEDICAL

MAXIMUM SECURITY 2ND FLOOR PLAN QUAD 2ND FLOOR PLAN MAIN BUILDING 2ND FLOOR PLAN BASEMENT FLOOR PLAN
DE-ESCALATION DE-ESCALATION STORAGE EXAM MEDICAL
ROOM TREATMENT ROOM TREATMENT ROOM ROOM OFFICE
ROOM ROOM LAB MEDICAL
EXAM MEDICAL
ROOM OFFICE
DENTAL
EXAM DENTAL
MEDICAL MEDICAL MEDICATION AFTER ROOM OFFICE
ROOM MEETING ROOM MEETING HOURS
CART
PHARMACY FLEX
EXAM FLEX
PATIENT ROOMS PATIENT ROOMS PATIENT ROOMS

UPPER LEVEL PLANS


ROOM ROOM ROOM OFFICE
FLEX
NURSE’S NURSE’S NURSE’S FLEX
STORAGE

EXAM
STORAGE

STORAGE

20 BEDS STATION 20 BEDS STATION STATION 20 BEDS STAFF MEETING MEETING


ROOM
FLEX
OFFICE

EXAM FLEX
LOCKERS ROOM ROOM ROOM OFFICE
DINING HALL
BREAKROOM
& SECURITY
DINING HALL
RESTROOMS STORAGE OFFICE
READING
READING

READING

ROOM
ROOM

ROOM

MEETING ROOMS /
DAY ROOM DAY ROOM DAY ROOM OBSERVATION
FLEX OFFICE ROOM 1
MEETING ROOMS /
FLEX OFFICE
OFFICE
EXERCISE
EXERCISE

EXERCISE

PATIENT
PATIENT

PATIENT

OBSERVATION
ROOM 2 LOBBY
STAFF BREAKROOM, STAFF BREAKROOM,
PATIENT LAUNDRY
PHOTO & ID

PATIENT LAUNDRY PATIENT


LOCKER ROOM &
INTERVIEW

INTERVIEW

INTERVIEW

LOCKER ROOM &


KITCHEN

LAUNDRY
OFFICE
ROOM 1

ROOM 2

ROOM 3

MULTI-PURPOSE ROOM MULTI-PURPOSE ROOM

SHOWER THERAPY THERAPY VISITATION

SECLUSION SECLUSION SECLUSION


VISITATION ROOMS SHOWER THERAPY ROOMS THERAPY SHOWER ROOMS
THERAPY THERAPY

SECOND FLOOR DETAIL

GUARD
STATION

1 ACRE
FIRST FLOOR PLAN

OVERALL PLAN OF THE IDEALIZED MODEL 50 200

0 100 FT.

SECTION 5 IDEALIZED MODEL _69


_Axonometric Model
LEGEND
OUTDOOR SPACE

LANDSCAPE HARDSCAPE GREEN SPACE

PRIVATE SEMI-PRIVATE PUBLIC

PATIENT ROOM

UNIT UNIT
ACTIVITY SUPPORT FACILITIES
UNIT CENTRAL COMMUNITY
CONTROL POINT MEDICAL SERVICES SERVICES
UNIT CENTRAL
ADMISSION
STORAGE SUPPORT FACILITY
CENTRAL
ADMINISTRATION
ENVIRONMENTAL SERVICES

CENTRAL FOOD SERVICES

MAINTENANCE
ROAD
GROUNDKEEPING

WAREHOUSE VACANT

AXONOMETRIC OF THE IDEALIZED MODEL

70_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL


_Total Floor Area
Square Feet

Residential Units 255,000


Maximum Security Unit 51,700
Administration 28,800
Admissions 5,200
Central Medical Clinic and Pharmacy 11,200
Central Support Programs 22,000
Central Food and Environmental Services 32,200
Maintenance and Groundskeeping 22,500
Community Services 1,800

Warehousing 21,100

TOTAL ESTIMATED FLOOR AREA 451,500

26

SECTION 5 IDEALIZED MODEL_71


_Control + Security

WAREHOUSE SPORTS FIELD

ALLOTMENT GARDENS GREENHOUSE


LOADING ZONE
LOADING ZONE

VISITATION THERAPY SECLUSION THERAPY SHOWER THERAPY SECLUSION THERAPY SHOWER SHOWER THERAPY SECLUSION
SECLU
USION THERAPY SHOWER THERAPY SECLUSION
SECLU
USION THERAPY VISITATION
REFUSE ROOMS ROOMS ROOM
ROOMS
MS ROOM
MS
ROOMS

STAFF BR
BREAKROOM,
RREAKROOM,
EAKROOOM STAFF BR
BREAKROOM,
RREAKROOM,
EAKROOOM
PATIENT LAUNDRY PATIENT LAUNDRY
R PATIENT PATIENT
LOCKER ROOM & LOCKER ROOM &
LAUNDRYY LAUNDRYY
MULTI-PURPOSE ROOM MULTI-PURPOSE ROOM

SERVICE MEETING ROOMSM /


FLEX OOFFICE

READING
READING

READING

READING

ROOM
M
ROOM
M

ROOM
M

ROOM
M

D
D

D
MEETING ROOMSS /
DAY DAY DDAY
A ROOM DDAY ROOM
FLEX OFFICE
F
ROOM ROOM

ARCHIVE DINING HALL

EXERCISE
EXERCISE

EXERCISE

EXERCISE

PATIENT
PATIENT

PATIENT

PATIENT

N
N

C
N
C

C
DINING HALL

PATIENT ROOMS

PATIENT ROOMS
MULTI-

R
PURPOSE LANDSCAPE METALS 2 BEDSS
20 NURSE’S 20 BEDSS NURSE’S 200 BEDS NURSE’S 200 BEDS
MR MR NURSE’S

STORAGE
STORAGE

STORAGE

STORAGE
STATION STATION STATION STATION
ROOM:
PATIENT
PA
AATIENT RO
ROOMS
OMS PA
PATIENT
AATIENT ROOMS
ROOMS PATIENT
PAT
TIENT ROOM
ROOMS
M
MS PATIENT
PAT
TIENT ROOMS
ROOM
M
MS
ZONE

STAFF MEDICATION MEETING MEDICATION MEETING MEDICATION MEDICATION


Z

ROOM ROOM
PARTS
LOADING
A

LOADING ZONE
SECURE UNIT
STORAGE DE-ESCALATION TREATMENTT DE-ESCALATION TTREATMENT DE-ESCALATION DE-ESCALATION STORAGE

CONFERENCE FOOD FOOD ROOM ROOM ROOM ROOM ROOM ROOM

ROOM WAREHOUSEE WAREHOUSE FLEX


DIRECTOR’S REFRIGERATOR FREEZER SPACE
OFFICE
ASST. DIRECTOR
DIRECTOR
OFFICE
2 UNITS CAN BE SECURED
INDOOR
RECREATION
BASKETBALL
A COURT INDOOR
RECREATION
REFRIGERATOR FREEZER
SERVICE

OFFICE
FOOD

MULTI-PURPOSE
DISH CLEAN

STORAGE DE-ESCALATION DE-ESCALATION


DE-ESCALATION DE-ESCALATION STORAGE
RECEPTION
RECEPTION
RETURN &

CARPENTRY VEHICULAR REPAIR TREATMENTT TTREATMENT ROOM


R ROOM
SERVICE

ROOM ROOM
STAFF

ROOM ROOM
D ZONE

KITCHEN
LOADING

MEDICAL MEDICAL MEDICATION MEDICATION


ROOM MEETING ROOM MEETING
PA
ATIENT ROOMS
PATIENT ROOMS PPATIENT
ATIENT
A ROOMS
ROOMS PATIENT
PAT
TIENT ROOMS
ROOM
M
MS PATIENT
PAT
TIENT ROOM
ROOMS
M
MS
O

OFFICE ROOM ROOM

EQUIPMENT NURSE’S NURSE’S NURSE’S NURSE’S

STORAGE
STORAGE
STORAGE

STORAGE
LAUNDRY STORAGE 220 BEDSS STATION 20 BEDSS STATION STATION 200 BE
BEDS STATION 200 BE
BEDS
O

PANTRY
R STORAGE OFFICE
DINING HALL

DINING HALL

READING
READING
READING

READING

ROOM
ROOM
ROOM

ROOM

D
D

O
FLEX

A
O
O

MEETING
N ROOMSS /
DAY ROOM
M DAY ROOM
M DAY
AY ROOM DAY ROOM
FLEX OFFICE
F
SPACE MEETING
E ROOMS
O /

CLEANING FLEXX OFFICE

EXERCISE
EXERCISE
EXERCISE

EXERCISE

PATIENT
LAUNDRY SUPPLIES

PATIENT
PATIENT

PATIENT

E
R
E
E

E
R

LOADING ZONE STAFF BREAKROOM,


R O STAFF BREAKROOM,
R O
PATIENT LAUNDRY
R PATIENT LAUNDRYY PATIENT
N N
PATIENT
LOCKER ROOM & LOCKER ROOM &
LAUNDRY
D D
LAUNDRY
MULTI-PURPOSE ROOM MULTI-PURPOSE ROOM

SHOWER THERAPY THERAPY SHOWER THERAPY THERAPY VISITATION

SECLUSION SECLUSION SECLUSION


U U
SECLUSION
VISITATION ROOMS SHOWER THERAPY ROOMS THERAPY SHOWER ROOMS
ROOM
MS ROOM
MS
ROOMS
THERAPY THERAPY

2 QUAD CAN BE SECURED


CAFE FOR PATIENTS PROGRAM PROGRAM PROGRAM
STORE SALON MUSIC ROOM ROOM ROOM
PEER COMPUTER PROGRAM

RESTAURANT
SUPPORT ROOM ROOM
KITCHEN
PATIENT READING PROGRAM
CHAPEL EDUCATION ROOM LIBRARY ROOM
AUDITORIUM / CHURCH TEACHING PROGRAM PROGRAM PROGRAM
CLOTHING STORAGE RESTROOMS
O CAFE FOR STAFF GYMNASIUM KITCHEN ART ROOM ROOM ROOM

SALLY PORT

VISITATION THERAPY SECLUSION THERAPY SHOWER THERAPY SECLUSION T


THERAPY SHOWER SHOWER THERAPY SECLUUSION
SECLUSION THERAPY VISITATION
SHOWERS PATIENT ROOMS PATIENT ROOMS SHOWERS
ROOMS ROOMS ROOM
MS
ROOMS

POST
OFFICE
STAFF BR
RREAKROOM,
EAKROOM
BREAKROOM, STAFF BR
BREAKROOM,
RREAKROOM,
EAKROOOM
MEETING ROOM PATIENT EXERCISE READING ROOM / LIBRARY EXERCISE PATIENT MEETING ROOM PATIENT LAUNDRY
R PATIENT LAUNDRY
R PATIENT
DE-ESCALATION

DE-ESCALATION

STORAGE VISITATION SECURITY


SECURRRITY VISITATION READING ROOM / LIBRARY LOCKER ROOM & LOCKER ROOM &
STORAGE LAUNDRY
LAUNDRY LAUNDRY
MULTI
MULTI-P
PURPOSE
URPOSE ROOM
MULTI-PURPOSE MULTI-PPURPOSE
MULTI PURPOSE ROOM
MULTI-PURPOSE CLOTHING
ROOM

ROOM

TREATMENT TREATMENT
DAY ROOM
DAY ROOM CENTER REIMBURSEMENT
NURSE’S MEDICATION
STORAGE STORAGE
MEDICATION NURSE’S MEETING ROOMSM /
STATION STATION
ARTS/ LIBRARY
FLEX OOFFICE
SOCIAL
READING

SECURITY
READING

READING

CRAFTS
ROOM
M
ROOM
M

ROOM
M

D
D

DAY DAY DDAY


A ROOM
20 BEDS
E 200 BE
BEDS
BEDS MEETINGG ROOMSS /
F
FLEX OFFICE
ROOM ROOM
TRUST
SECLUSION SECLUSION DINING HALL
ROOMS ROOMS FUNDS COURT
EXERCISE
EXERCISE

EXERCISE

PATIENT
PATIENT

PATIENT

N
N

C
C

BASKETBALL
A COURT DINING HALL
CASHIER/
PATIENT ROOMS

PATIENT ROOMS

TEL-

ENTRY
GROUP THERAPY/
PATIENT
R

CONFERENCE MULTI-PURPOSE
2 BEDSS
20 NURSE’S 20 BEDSS NURSE’S NURSE’S 200 BEDS
STORAGE
STORAGE

STORAGE

THERAPY
ACTIVITY
THERAPY STATION STATION STATION PROPERTY
PATIENT ROOMS

PATIENT ROOMS

PATIENT
PA
AATIENT ROO
ROOMS
OOMS PA
PATIENT
AATIENT ROO
ROOMS
OMS PATIENT
PAT
TIENT ROOM
TIENT ROOMS
MS CENTRAL
A
R

MEDICATION MEETING MEDICATION MEETING MEDICATION


ROOM ROOM TRAL IT SECURIT
CENTRAL
CENT TY
SECURITY
STAFF MEETING
MEETINNNG ROOMS / DIN
NING HALL
DINING DINING HA
AALL
HALL MEETING RROOMS
OOMS / STAFF
BREAK OFFICE
FLEX OFFIC
CE BREAK
FLEX OFFICE
OFFFICE INDO OR
INDOOR
STORAGE /
ROOM/ RECR
RREATION
RECREATION ROOM/ STORAGE /
STORAGE
WAITING AREA
MAINT LOCKER MAINT DE-ESCALATION TREATMENTT DE-ESCALATION TTREATMENT
REATMENT DE-ESCALATION STORAGE
LOCKER

OFFICE
SECURE UNIT
ROOM ROOM ROOM RROOM
OOM ROOM
RESTROOMS
R STORAGE
OFFICE
OFFICE

OFFICE
INDOOR BASKETBALL COURT INDOOR TREATMENT SPACE
SECOND FLOOR DETAIL
DETAIL RECREATION OFFICE
INFECTION EMPLOYEE

RECREATION
CONTROL HEALTH

OFFICE ISOLATION
MAXIMUM SECURITY
SALLY PORT

STORAGE DE-ESCALATION
ECG +
IMAGING MEDICAL
DE-ESCALATION DE-ESCALATION STORAGE EXAM MEDICAL
ROOM T
TREATMENT ROOM TTREATMENT
REATMENT ROOM ROOM OFFICE
ROOM RROOM
OOM LAB MEDICAL
EXAM MEDICAL
ROOM OFFICE
DENTAL
EXAM DENTAL
MEDICAL MEDICAL MEDICATION AFTER ROOM OFFICE
ROOM MEETING ROOM MEETING HOURS
CART
PHARMACY FLEX
EXAM FLEX
PATIENT
AATIENT ROOMS
PA ROOOOMS ROOM PATIENT
AATIENT ROOMS
PA ROOOMS ROOM PATIENT
PAT
TIENT ROOMS
ROOM
M
MS ROOM OFFICE
FLEX
NURSE’S NURSE’S NURSE’S FLEX
STORAGE

EXAM
STORAGE

STORAGE

220 BEDSS STATION 20 BEDSS STATION STATION 200 BE


BEDS STAFF MEETING MEETING
ROOM
FLEX
OFFICE

EXAM FLEX
LOCKERS ROOM ROOM ROOM OFFICE
DINING HALL
BREAKROOM
& SECURITY
DINING HALL
RESTROOMS STORAGEE OFFICE
READING
READING

READING

ROOM
ROOM

ROOM
D

O
A
O

O
A

MEETING ROOMSS /
DAY ROOM DAY ROOM DAYY ROOM OBSERVATION
FLEX OFFICE
F ROOM 1
MEETING
E ROOMS
O /
FLEXX OFFICE
OFFICE
EXERCISE
EXERCISE

EXERCISE

PATIENT
PATIENT

PATIENT

E
R

OBSERVATION
E

E
R

ROOM 2 LOBBY
STAFF BREAKROOM,