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PLANNING MODERN

PSYCHIATRIC CARE FACILITIES


RUSK STATE HOSPITAL + BEYOND

DRAFT_Jan 20 2017
DRAFT_Jan 20 2017
A TEXAS HOSPITAL
PLANNING MODERN
PSYCHIATRIC CARE FACILITIES
RUSK STATE HOSPITAL + BEYOND

JANUARY 2017

THIS STUDY WAS PREPARED BY:


CENTER FOR SUSTAINABLE DEVELOPMENT
THE UNIVERSITY OF TEXAS AT AUSTIN
SCHOOL OF ARCHITECTURE
csd
Center for Sustainable Development

ON BEHALF OF:
TEXAS DEPARTMENT OF STATE HEALTH SERVICES

DRAFT_Jan 20 2017
DRAFT_Jan 20 2017
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 Candiate
Kathleen Conti, MSHP Candidate
Zhun Jiaoz, M Arch II Candidate
Jason Melling, MLA Candidate
JinWon Lee, MSHP Candidate

DRAFT_Jan 20 2017
DRAFT_Jan 20 2017
CONTENTS
1 Summary
1 Introduction
1 Part 1_RESEARCH
2 Best Practices
3 Consultations
4 Programming
5 Idealized Model
1 Part 2_RUSK STATE HOSPITAL
6 Existing Conditions
7 Scenarios
8 Applied Model
9 Visualization
10 Implementation

1 Appendices
A Sources
B Photo References
C Exterior Building Conditions
D Letter from THC
DRAFT_Jan 20 2017
Visualization of future central esplanade for the new Rusk State Hospital campus

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TEXAS HOSPITAL20 2017
SUMMARY
The most current global trends in mental health hospital, RSH has been providing The work was then essentially conducted
health care and treatment focus on a comprehensive psychiatric treatment in two parts. The first part focused on
patient-centered model that supports and care for the citizens of Texas since qualitatively research on best practices,
empowerment and recovery. Such 1919. It has funding for 325 patients but identifying programming goals, and the
recovery-oriented models replace currently only serves 245 patients due to creation of an “Idealized Model” to more
paternalistic, illness-oriented perspectives the deplorable state of its facilities. precisely define key spatial relationships.
with collaborative, autonomy enhancing Part 2 then worked to apply the findings
approaches. These approaches have ASSIGNMENT from Part 1 to a preliminary development
proven successful at treating people To address a number of these concerns plan for the Rusk State Hospital campus
suffering from mental illness and helping the Texas Department of State Health in order to “test” the Idealized Model. Part
them to cope with everyday life. They Services (“DSHS”) retained The University 2 concluded with the design of an “Applied
are characterized as self-directed, of Texas at Austin’s Center for Sustainable Model.”
individualized, empowering, holistic, non- Development to undertake a study to
linear, strength based, peer supported, and PART 1: RESEARCH
investigate how behavioral health facilities
respectful (CAMH 2008). However, these should be designed to support modern Part 1 involved a lengthy review of literature
programs are only effective if the physical psychiatric care models so that physicians, on best practices, successful precedents,
environment of the behavioral health nurses, administrators, and staff can and current design trends for modern
facilities is mutually supportive. Much provide the best possible treatment and behavioral health facilities across the
research has illustrated that conventional care for the people of Texas. U.S., Canada, and Europe, in the interest
hospitals and psychiatric asylum facilities of determining the state of knowledge
can only intensify mental illnesses. The purpose of the study, to which this on the relationship between behavioral
report concludes, was to understand at how health and the physical environment. This
Recognizing that current mental health architecture can—and should—support research confirmed a fundamental concept
care best practices are in conflict with its the programs and care models for mental that therapeutic design principles must
system of aging state hospital facilities, the health treatment. The study engaged in extend beyond traditional interior spaces to
Texas Legislature approved a long-term design-based research to explore and accommodate a more normalized physical
plan addressing fundamental changes for demonstrate a planning process and spatial environment with clear and meaningful
state and local hospitals in 2015 (DSHS, model that could be specifically applied and access to the outdoors and to natural
2015). A supplementary study to the then tested as a preliminary development landscapes. Design approaches that focus
State Hospital System Long-Term Plan plan for Rusk State Hospital, but could be on the therapeutic properties of landscape
concluded that a number of the state’s applicable to all DSHS facilities. are paramount to a patient’s well-being and
behavioral health facilities did not meet recovery.
current criteria for clinical best practices The UT Austin team was composed of a
(Cannon et. al., 2014). multi-disciplinary group of professionals The research also pointed to design
with expertise in urban design, approaches that are more modular and
Rusk State Hospital (“RSH”), which has architecture, landscape architecture, are determined by a manageable (defined)
been providing comprehensive psychiatric clinical psychology, and historic number of patients and support staff per
treatment and care in east Texas since preservation. The disciplinary diversity unit. Spaces should be appropriately zoned
1919, was identified as one of five facilities of the team created a constructive for optimizing treatment opportunities and
assessed to be most in need of major environment in which an integrated focused on patient privacy, social activities,
repairs and system improvements. As one approach could be derived. and physical health; all should be arranged
the largest inpatient behavioral around a central, organizing outdoor space.

DRAFT_Jan 20 2017 SUMMARY_ix


LEGEND
GREEN OUTDOOR SPACE : FROM PRIVATE TO PUBLIC

HARDS CAPE SOFT SCAPE GREEN SPACE


(ACTIVATED) (ACTIVATED) (INACTIVATED)

PRIVATE SEMI-PRIVATE PUBLIC

UNIT
PATIENT ROOM
STORAGE & MAINT.
UNIT UNIT
ACTIVITY SUPPORT FACILITIES
UNIT CENTRAL COMMUNITY
CONTROL POINT MEDICAL SERVICES SERVICES
CENTRAL
ADMINISTRATION ADMISSION
SUPPORT FACILITY

CENTRAL ENVIRONMENTAL SERVICES / HOUSEKEEPING

CENTRAL FOOD

MAINTENANCE WAREHOUSE
GROUND KEEPING
PLANT VACANT ROAD

Diagram of the Idealized Model

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A TEXAS HOSPITAL 20 2017
The elements of best practices were of aggression, and to promote healing. PART 2: APPLIED MODEl
organized into a series of programmatic The Idealized Model also incorporates
modules or diagrams at varying scales to elements that may seem simple but are In order to test the Idealized Model, part 2
illustrate fundamental design properties, really revolutionary in the design of mental focused on its application to the contextual
differing levels of freedom and the health facilities—such as a window in every characteristics of the Rusk State Hospital
scalability of various programming room to allow for natural light and the (RSH). In order to appropriately apply the
components. opportunity to look upon nature. model to RSH, a compendium of the history
of RSH and a chronology of its construction
Through in-depth consultation with Furthermore, in attempting to reflect the was studied; existing site conditions were
DSHS and staff at RSH, this qualitative ranges of environments in which people assessed, which included a survey of the
research help to identify best practices typically conduct their daily lives, the exterior and interior conditions of the
in the Texas context and defined Texas- Idealized Model organizes four units into existing buildings, and then evaluated
specific programming goals; establishing a quad that provides shared space for based on their physical capability for re-
a platform from which a new spatial and therapeutic treatment, dining, recreation, use, their adaptability to “best practice,”
functional model could be defined for and staff operations: a neighborhood and how best to integrate them into a new
modern behavioral health care facilities in of sorts. Central support programs are development plan.
Texas. This work has provided DSHS with organized into what best practices call a
some very specific programming goals “therapy mall” or “treatment mall,” offering One of the most notable features of the
that will help to lay the ground work for all patients amenities or functions they are existing campus is the 1886 Administrative
future facilities, set within the financing and likely to utilize in their communities, Building (Building 501). Originally
staffing regimes mandated by the Texas such as clothing stores, libraries, cafes, constructed as a prison, it was renovated
Legislature. movie theaters, fitness rooms, and salons. from a two-story structure to a three-story
The Idealized Model centrally organizes structure in 1919 to accommodate the
This research resolved into the design of an these uses around an outdoor type mall, growing psychiatric population of the state.
“idealized” model, which more-precisely, reestablishing patient opportunities to At about 600 feet long, it is an iconic piece
spatially composed the goals and objectives occupy a hierarchy of outdoor spaces and of architecture for the entire campus.
for treatment and operations for state providing patients with a sense of existing
hospital systems as a whole. The Idealized The components and principles of the
within a broader community. The program
Model was an exercise in optimal spatial Idealized Model were then applied to the
as a whole encourages patients to take an
relationships with no contextual influence. spatial, physical, and cultural landscape
active role in their treatment. The purpose
of the Rusk State Hospital, resulting in
is to ensure the architectural programs
Fundamental to the Idealized Model was a series of spatial and functional “tests”
support the therapeutic programs such that
the organizing of “home-like” therapeutic that quantified space and operational
the buildings and outdoor spaces become a
units composed of a small number of relationships among departments. In
recovery-focused tool themselves.
private bedrooms around a welcoming and consultation with RSH staff and DSHS,
directly accessible outdoor courtyard. This Finally, the Idealized Model was designed test-fit scenarios were considered in the
is in contrast to traditional units, which and organized to provide for a general contexts of “best practice,” legislated
tend to be centered on the nurse’s stations, planning process that could be applied staffing and funding, the historic identity
an unintentional focus which adversely to other DSHS facilities. It is meant to of the RSH, and topographic and spatial
hinders patient-centered care models. be utilized as a “kit of parts” that can be constraints.
reorganized in the context of a specific
Architecture that focuses on the Through ongoing refinement, review,
hospital site, scale, and program.
therapeutic properties of nature and the and discussion with the project team
powers of choice for patients has been and steering committee, an “Applied
proven to help reduce stress and incidents Model” was finalized into a preliminary

DRAFT_Jan 20 2017 SUMMARY_xi


Visualization of interior courtyard within new patient unit

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TEXAS HOSPITAL 20 2017
development plan for RSH. The Applied Passive versus active surveillance: One of the corner pins of the patient-
Model provided significant focus and centered care model is caring for patients
meaningful attention to critical landscape The design-based research has been in environments that simulate everyday
spaces between the buildings, working innovative in promoting a therapeutic life in order to provide them with tools to
with the noteworthy topography to provide model that moves from one based on active be functioning members of society. The
opportunities for interesting outdoor surveillance to one that promotes a patient- campus-like arrangement of buildings
therapeutic spaces. focused model using passive surveillance. better replicates the home environment
Models based on active surveillance and through the design of discrete units up to
CONCLUSIONS security goals use direct sightlines as the community environment through the
the primary determinate of architectural treatment mall. It becomes not only a place
This project has provided tremendous
form. The result is an architectural form for healing but a place for living.
insight into the opportunities and
that always places the nurse’s station at a
constraints within designing a new,
central and prominent location within the This research intends to highlight the
state-of-the-art Texas model for RSH and
residential unit. active role architecture has in the care
other DSHS facilities that best support
program, just as the programming has an
progressive care models. Designing spaces Contrary to these previous designs, active role in the architecture. There is a
that support the care and treatment the courtyard model is an architectural reciprocal relationship between the form
programs for people with mental illness is form that allows for degrees of freedom, and the therapy. The results have and will
a complex and multifaceted issue. choice, and privacy, while still providing continue to provide great insight into all
necessary surveillance to patient- future investment in the behavioral health
There are three innovative themes
occupied spaces such as the day space or facilities particularly for the state of Texas
expressed through the idealized model
courtyard. Rather than having the nurse’s but also beyond. By researching, sharing,
and its application to RSH that are
station as the central focus, the outdoor and applying information, the goal was to
transformative to the way mental health
courtyard and access to nature are the raise the level of design for therapeutic
care facilities are arranged:
foci and the nurse’s station is provided in environments and lay the groundwork for
Central role of nature and access to a more discreet location, which results in the creation of better mental health care
outdoors: improved mentality for patients and better facilities.
relationships between patient and staff.
The fundamental organization of “home-
like” therapeutic units around a directly A campus of healing and living:
accessible outdoor courtyard provides the
A final fundamental approach that makes
much-needed access to the therapeutic
this research and design innovative is
properties and relief of stressors provided
strategically moving away from a singular
by nature. This arrangement, coupled with
“mega-building” and moving towards
a hierarchy of other outdoor spaces and
a series of buildings in a compact,
therapeutic programs, helps to support
pedestrian-focused, campus-like setting.
best practices in mental health care and
This not only allows for greater adaptability
treatment that are patient centered to
to a wide variety of sites and flexibility to
support empowerment and recovery.
support a range of demographic profiles,
but also provides for a better simulation of
the social and community dimensions of
public life.

DRAFT_Jan 20 2017 SECTION 2 BEST PRACTICES_xiii


DRAFT_Jan 20 2017
1 INTRODUCTION
_Research Assignment
_Research Process
_Schedule
_Strategic Issues
_Performance Objectives

DRAFT_Jan 20 2017
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

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A TEXAS HOSPITAL 20 2017
_Research Assignment
Recognizing that current mental health Rusk State Hospital (RSH), which has
care best practices are in conflict with its been providing comprehensive psychiatric HOW CAN
TEXAS STATE HOSPITALS
system of aging state hospital facilities, the treatment and care in east Texas since
Texas Legislature approved a long-term 1919, was identified as one of five facilities

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

The purpose of this study is to understand


at 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, but could be applicable to
all DSHS facilities.

DRAFT_Jan 20 2017 SECTION 1 INTRODUCTION_3


_Research Process
PHASE 1 ä 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 ä The range of RSH’s expected hospital and testing the Applied Model for the Rusk
physical planning options for RSH operations (Programming); State Hospital property. Additional studies
buildings and grounds based on preferred investigated in more detail the particular
relationships between treatment options ä Stakeholder ideas, expertise, and characteristics of a preferred scenario
and facilities configurations. concerns (Consultation); for RSH. Phase 2 concluded the study
with a refined development plan for RSH,
The study began with a thorough review of ä Strategic plan questions related to
visualizations and a phasing strategy.
all background documents, site visits to the design of facilities (buildings,
RSH and Austin State Hospital, analysis of landscape, and infrastructure) that
existing conditions at RSH, and research need to be addressed in pursuit of a
on best practices for mental health care new model for treatment and care;
facilities. Consultations with state hospital and,
physicians, nurses, administrators, and
ä Idealized and applied design options
staff assisted in more precisely defining:
related to the strategic plan questions.

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A TEXAS HOSPITAL 20 2017
_Schedule

Phase 1 Phase 2

Review_Internal Report
DSHS

DSHS

Phase 2_Draft Report


Phase 1_Final Report
1 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
c of

Final Report
Final R
Report
Final Recommendations
and Deliverables
Renderings
Production

September

November

December
February

October
January

January
August
March

April

June
May

July

DRAFT_Jan 20 2017 SECTION 1 INTRODUCTION_5


_Strategic Issues
Foremost, the team identified the following How can the hospital create an efficient, A thorough site analysis is necessary to
strategic issues to inform the research comfortable and desirable place for staff understand appropriate location for the
directives and design solutions: to work? future hospital within the RSH property.

How do you create the most therapeutic A critical part of the care provided at RSH How can the facility establish an
environment focused on recovery and is dependent on providing the best work appropriate new identity while preserving
rehabilitation? environment for staff so their care is the cultural importance of the historic
supported by the physical environment and campus and buildings?
RSH is focused on stabilizing psychiatric their own personal needs are met.
symptomatology (recovery) and providing A number of buildings within the existing
education and treatment (rehabilitation) in How can quality of care be assured and hospital campus are 50 years or older
order to successfully transition patients to supported through optimal operational and may have historical and cultural
a less restrictive environment. To achieve efficiencies? importance for the community and state.
this goal, the built environment has to Any preservation, modernization, and
be designed and organized to support A new plan for RSH should maximize all adaptive re-use of significant buildings
therapeutic programs and improve mental operational strategies in staff work flow, needs to be done with regard to the
health. management and movement of materials suitability of achieving best practices and
and services, use advanced technology, the use of economic resources.
What are the most advanced models for support environmental sustainability,
psychiatric care and how do these models and provide long-term flexibility and Can the hospital continue to be an
inform the design of a world-class, state- adaptability. exemplary social and economic benefit to
of-the-art hospital? the greater community of Rusk?
What is the most appropriate location for
Research and review of the most current, a new hospital complex within the physical The redevelopment of RSH provides a
state-of-the-art hospitals identified and cultural landscape of Rusk? prime opportunity to create a new “face”
successful design elements and functions for the town of Rusk and the greater
necessary to deliver the most advanced The Rusk State Hospital property covers community. The new plan should continue
care and treatment for mental health over 600 acres, about 50 acres of which are to support RSH as an exemplary neighbor
illness. currently occupied by the existing hospital and help to further de-stigmatize mental
with the remaining site generally occupied illness and its treatment.
by forest and a small lake. North Dickinson
Drive (Route 69) cuts diagonally through the
property in a Northwest/Southeast manner.

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A TEXAS HOSPITAL 20 2017
_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 following -
Financial
all of 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

DRAFT_Jan 20 2017 SECTION 1 INTRODUCTION_7


DRAFT_Jan 20 2017
2 BEST PRACTICES
_Overview
_Precedents
_Patient Room Scale
_Unit Scale
_Quad Scale
_Institution Scale
_Landscape Scale

DRAFT_Jan 20 2017
“THE RECOGNITION THAT ARCHITECTURE
WHICH AIDS HEALING FOR PATIENTS IS BASED ON
CLASSIC INGREDIENTS SUCH AS LIGHT AND SHADE, QUIETNESS,
MATERIALS, COLORS AND GREEN LANDSCAPE ELEMENTS…(AND) INGENIOUS
ARCHITECTURAL SOLUTIONS WHICH RESULT IN A CALMING LAYOUT AND THE
CREATION OF ENGAGING SPACES WITH A HIGH DEGREE OF TRANSPARENCY.”
GIDEON SYKES
8
PSYCHIATRIC HOSPITAL DEMONSTRATES THE HEALING POWER OF GOOD ARCHITECTURE

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TEXAS HOSPITAL 20 2017
_Overview
In recent years, behavioral health care patient management protocols, as this may patients and hospital caregivers. Providing
has evolved to include active treatment, be at the expense of patient well-being and day rooms and other shared spaces with
integration with primary care, normalizing chances for recovery. movable seating, for example, gives
environments, community care, patient patients the ability to control their personal
empowerment, and a focus on the overall Although the process can be lengthy, and space and interactions with others.
continuum of care. Identified as the the length of treatment varies from patient
patient-centered care model, this approach to patient, admittance to a psychiatric The therapeutic platform must extend
understands that services for individuals hospital is not meant to be permanent. beyond traditional interior spaces to
with behavioral health issues cannot be Hospital environments must be designed to include outdoor environments: that is,
optimized without attention to all aspects be supportive of recovery; in a manner that buildings and sites that offer a holistic
of their health and well-being. It is a help patients recover from their illness and setting with access to the natural
proactive model addressing wellness, prepares them to be functional in society or landscape, views, and daylight. The
medical, behavioral, psychosocial, and a less restrictive environment. positive influence nature has on a person’s
basic human needs in an integrated and state of mind has long been established.
The quality of the physical environment, Studies indicate that physical environments
coordinated manner. This model places
including ones access to nature, is which take advantage of the therapeutic
emphasis on non-traditional services such
intrinsically linked to a patient’s well-being properties of landscape are paramount to
as wellness and fitness, nutrition and
and recovery, as well as the comfort, safety, a successfully designed health care facility.
access to healthy foods, development of
and performance of staff (Karlin, 2016). The impact of the views from a patients’
coping strategies, everyday living skills,
Literature confirms that the environment room and day-spaces must be thoughtfully
educational and training programs for
influences mental health and illness considered, as must be a patient’s ability to
gainful employment, and housing support.
is neither passive nor minor. The built easily access the outdoors.
As behavioral health care practices shift environment has considerable influence on
to a more patient-centered care model, the behaviors, relationships, stress, health, An equally critical part of any progressive
the design of facilities for psychiatric care and happiness of people – regardless of mental health care and treatment strategy
must change to support new treatment and whether they are afflicted with a mental is the quality of the work environment for
care approaches. Antiquated behavioral health illness or not. “Psychiatric patients staff and caregivers. Staff are only able
health facilities far from support patient are much more reactive to the physical to provide the best client care when they
empowerment and recovery; in fact, milieu than healthy controls – which are in the best possible work environment
studies show they may actually exacerbate suggests that the environment is a critical to support their programs and meet their
mental illness. In these facilities, patients element of psychiatric intervention” daily needs.
perceive treatment as an incomprehensible (Golembiewski, 2015). Mental illnesses can
intensify by being confined in locked rooms The exterior impression of the hospital is
and unhelpful process that is out of their
or wards. A facility that is noisy, lacks even fundamental to the overall design as
control simply based on the aesthetics
privacy, and/or hinders communication it can work to de-stigmatize mental illness
and condition of the facility alone. When
with staff increases stress and agitation in and convey an attractive and welcoming
treatment has no perceived positive effect,
patients. presence to the community, patients,
patients feel that the effort needed to
and staff. Mental health facilities can
control their illness is also meaningless
Mental health care facilities best practices be exemplary neighbors for the larger
(Golembiewski, 2015).
emphasize design that minimizes noise community; therefore, the appearance
Current guidelines on the design of and crowding, decreases the sense of should reflect the importance of the work
mental health facilities appear to reflect confinement, increases a patient’s sense done.
only society’s main concerns with people of control, and offers a variety of home and
with mental illness, that of suicide risk community-like activities. Features like
and the threat of violence, crime, and single-patient bedrooms with private toilets
arson. (Golembiewki, 2015). Behavioral may increase the building cost but research
health facilities cannot simply be designed suggests that inital costs are arguably
primarily to improve staff efficiencies and offset by the reduced stress and trauma for

DRAFT_Jan 20 2017 SECTION 1 INTRODUCTION_11


9

10

12_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
_Precedents
Global trends in mental health care and ä Southwest Centre for Forensic Mental Rigorous review and research of the
treatment strategies focus on patient Health Care – St. Thomas, Canada physical design qualities and spatial
care, empowerment, and recovery. Such (2013), requirements of these hospitals and other
programs are housed in well-designed, research on best practices was a key
state-of-the-art facilities that support ä Broadmoor Hospital - United Kingdom component of the study. Through gathering
therapeutic programs which promote these (2017), and sharing of information, the goal is to
patient care strategies. raise the level of design of therapeutic
ä St Bernard’s Hospital, Thames Lodge
environments and lay the groundwork for
A key component of this study was to review Medium Secure Unit – United Kingdom
the creation of better mental health care
and document a number of current state- (2016),
facilities.
of-the-art public mental health facilities in
ä Our Lady of Lourdes Hospital: Acute
the US, Canada, UK, and beyond that reflect The following provides a target of the best
Psychiatric Facility - Drogheda, Ireland
current best practices in patient care and practice elements at the various scales of
(2015),
treatment. The facilities identified included a hospital – patient bedroom, unit, quad,
ä Danish psychiatric regional hospital in institution, and landscape, as identified
ä Worcester Recovery Center and through the research, precedents, and
Slagelse – Demark (2014),
Hospital, Worcester, Massachusetts consultation with DSHS and staff at RSH
(2012), ä Kronstad Psychiatric Hospital / Origo and other staff hospitals.
Arkitektgruppe - Bergen, Norway
ä Oregon State Hospital – Salem (2013)
(2013),
and Junction City (2015), Oregon,
ä Helsingor Psychiatric Hospital -
ä Vermont Psychiatric Care Hospital –
Helsingor, Denmark (2005),
Berlin, Vermont (2014),
ä Helix, Forensic Psychiatric Clinic of
ä VA Palo Alto Mental Health Center -
Stockholm – Sweden (2012), and
Palo Alto, California (2012),
ä Psychiatric Building, Östra Hospital –
ä Centre for Addiction and Mental
Gothenburg, Sweden (2007).
Health, Queen Street – Toronto,
Canada (2014),

10

DRAFT_Jan 20 2017 SECTION 2 BEST PRACTICES_13


15 8

2’-7”
Storage Low Shelving Desk DUPLEX BEDROOM

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”
3’-6”

Storage
zone Patient zone
2’-1”

11
2’-7”

Storage
SINGLE-PERSON
3’-6”

zone
Patient zone
BEDROOM
12’
5’-11”

Bathroom
24’-0”

Nature
1’-6”

Corridor
minimum 7 feet wide

Bathroom
3’-6”
3’-6”

11’-9”
12’

6’-6”
3’-6”

Patient zone
Storage
zone
2’-1”

4’-10” 4’-2” 4’-6” 1’-8” 12

14_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
_Patient Room Scale

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


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

13 14 15

DRAFT_Jan 20 2017 SECTION 2 BEST PRACTICES_15


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

16

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

16_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
_Unit Scale

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

17 18 19

DRAFT_Jan 20 2017 SECTION 2 BEST PRACTICES_17


Direct access for delivery of food + 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

Vegetated screening Vegetated screening


Quad entrance
Easy access to central activity + support
20

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

18_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
_Quad Scale

ä Grouping units to allow for ä Safe and secure outdoor


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

21 22 23

DRAFT_Jan 20 2017 SECTION 2 BEST PRACTICES_19


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

Centralized
support +
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

24

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

20_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
_Institution Scale

ä Create an overall environment ä Expanded use of peer support


that promotes wellness & services to complement clinical
rehabilitation. care by licensed staff.
ä Contribute to “place-making” ä Active patient-focused treatment
through design excellance. offered in “therapy malls” that
offer amenities that consumers
ä 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
ä Distinct, welcoming main lobby theaters, fitness rooms, and
and admissions area, which are salons.
filled with natural light and clear ä Share support rooms to create
wayfinding. multi-purpose/flexible spaces.
ä Separate patient admission ä Incorporate space and functions
processing area from main for community access to help
entrance. reduce stigma associated with
ä Integration of research and on- behavioral health issues.
site education.

25 26 27

DRAFT_Jan 20 2017 SECTION 2 BEST PRACTICES_21


SEMI-PRIVATE

GARDENS
PRIVATE

COURTYARDS

PUBLIC
SEMI-PUBLIC
CENTRAL
COMMONS GREEN

28

Courtyard
Semi-private landscape
Semi-public landscape
Public landscape

22_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
_Landscape Scale

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


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

29 30 31

DRAFT_Jan 20 2017 SECTION 2 BEST PRACTICES_23


DRAFT_Jan 20 2017
3 CONSULTATION
_Engagement Overview

_What Was Heard + Learned

DRAFT_Jan 20 2017
32

26_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
_Engagement Overview
SUMMARY OF MEETINGS DSHS RUSK COMMUNITY

2016: Consultation with Rusk State Hospital Consultation with Rusk community
clinical staff and physicians, as well as stakeholders provided useful feedback
February 8_Project Kick Off Meeting
with staff from other DSHS operated regarding strategic issues and was
March 4_Austin State Hospital Visit hospitals within the State of Texas, proved characterized by innovation and an
invaluable in confirming best practices for overwhelming desire to construct a first
March 11_Rusk State Hospital Visit and
Stakeholder Meeting a mental health care facility and defining a class facility that supports patient care and
usable program for the hospital. Hospital recovery and continues to benefits the local
March 30_Huntsville Prison Site Visit Superintendent Brenda Slaton, Assistant community and those who work there.
Superintendent Michelle Foster, and their
April 6_Steering Committee Meeting
staff of administrators, physicians, and
May 16_Steering Committee Meeting clinical staff were critical participants
in the stakeholder process and provided
May 20 + 25_RSH Site Visit and
Stakeholder Meeting vital information regarding hospital
programming, needs, and deficiencies.
June 7_RSH Site Visit
RSH
June 29_Steering Committee Meeting
Consultation with both clinical and
July 21_Stakeholder Consultation at
community stakeholders was a critical
Rusk State Hospital
component to the overall process for
August 8_Steering Committee Meeting identifying strategic issues within Rusk
State Hospital. While project team
September 20_Steering Committee
Meeting intentions were always to conduct
stakeholder meetings at key points in
September 27_Comissioners Briefing the project schedule, it became quickly
apparent that in order to really identify
October 25_Steering Committee
realistic options and specify intended goals
December 13_Steering Committee for treatment and care for the hospital, the
team needed to speak with the clinical and
2017:
community stakeholders frequently, who
January 19_Steering Committee best know the hospital itself.

DRAFT_Jan 20 2017 SECTION 3 CONSULTATIONS_27


33

34 35

28_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
_What Was Heard + Learned
While many meetings and conversations CLINICAL STAKEHOLDER GROUP COMMUNITY STAKEHOLDER GROUP
took place prior, the primary stakeholder
consultation took place on-site at the Feedback from this group upheld the Members of this stakeholder group
Rusk State Hospital on July 21, 2016. That consistent theme of a desire for patient repeatedly conveyed that the Rusk State
morning, the project team and members well-being and for a facility that reduces Hospital is seen as a thriving part of
of the DSHS staff met with the clinical and the stress on both patients and staff. the local community and employment
staff stakeholder group. In the afternoon, Staff provided feedback on project team base. This group was asked to provide
the team met with members of the greater programmatic diagrams of best practices feedback regarding the exterior influences
Rusk community. A summary of findings and hospital usages through a variety of of the hospital campus and the role, or
from each meeting follows. group exercises. A desire for the hospital lack thereof, of the older buildings in the
site to allow for better movement and hospital site. Many stakeholders from
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.

DRAFT_Jan 20 2017 SECTION 3 CONSULTATIONS_29


DRAFT_Jan 20 2017
4 PROGRAMMING
_Overview
_Hospital
_Patient Unit
_Patient Quad
_Maximum Security Unit
_Maximum Security Quad
_Adminstration
_Admissions
_Central Medical Clinic +
Pharmacy
_Central Support + Treatment
_Central Kitchen +
Environmental Services
_Maintenance and Grounds
_Community Services
_Outdoor Recreation

DRAFT_Jan 20 2017
36
32_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan
TEXAS HOSPITAL 20 2017
_Overview
In order to create design options for how In summary, the plan for the Rusk State ä Central Support Programs to provide
the buildings and grounds of the Rusk Hospital needs to accommodate: a centralized system of therauptic
State Hospital might be composed and spaces and programs which are
support best practices, it was necessary ä 320 residential beds of which, 40 beds accessed by the general population.
to understand and define the expected are identified for “swing”. The desire is to create a community-
functional and operational requirements like setting to promote patient recovery
ä 45 maximum security beds.
of RSH and of their care and treatment by providing functions they would find
programs. A new programmatic model was ä Residential Units that are composed in everyday life, such as a cafe, salon,
prepared through a review and analysis of: of no more then 18 – 22 patients library, gymnasium, medical clinics,
of similar illness and/or treatment classrooms, central park, etc.
ä The existing programs and floor areas
requirements. Secured but
at RSH today; ä Central Food and Nutrition Services
unrestricted access to communal day
prepare and serve food to patients;
ä State-of-the-art hospital precedents; spaces and that are serviced/surveyed
provides consultation to clinicians, and
by a nurses desk.
ensures patient therapeutic dietary
ä Best practices in mental health care;
ä Maximum Security to receive male requirements are met.
ä Consultation with both clinical and patients admitted on criminal
ä Environmental Services and Laundry
community stakeholders; and commitments that used a deadly
provide a safe, clean, and pleasant
weapon, caused/threaten serious
ä Legislative funding for beds and environment.
bodily injury or other offenses that
staffing. require heightened security. ä Community Services includes a
Operational efficiencies and space Court of Law, the Tyler Junior College
ä Administration which is the
optimization was also reviewed in light of of Nursing, and Family and Staff
overarching bodies responsible for
the spatial and programmatic requirements Residences.
running all facets of the hospital.
in order to be as efficient as possible.
ä Maintenance and Grounds Keeping
Legislated staffing requirements were also ä A separate Admissions where
provides a safe and therapeutic
taken into consideration. patients are admitted to the hospital
environment by managing the physical
and undergo an initial psychiatric
The following sections provide more plant, mechanical systems, and
evaluation .
detail regarding each of the components outdoors.
and their spatial requirements. The ä Central Medical Clinic and Pharmacy
ä Outdoor recreation and gardens could
floor areas identified should be read which completes the admissions
include a number of sports fields,
as general estimates. They are based evaluation, annual physical
passive outdoor gardens, mediation
on the understanding of the program assessments, provides service calls
gardens, greenhouses and vegetable
requirements in order to understand the to patients, and coordinates services
gardens, walking trails, cookout space,
general size of the overall hospital and with outside medical providers (i.e.
therapy animals, and the lake.
the necessary spatial and operational Optometry). Pharmacy prepares
requirements of the institution. and dispenses medicine to Units,
maintains drug inventory, and provides
consultation to clinicians.

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_33


_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
sq ft

* VEHICULAR ACCESS AROUND PERIMETER FOR EMT, SERVICES, AND MAINTENANCE

34_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
The entire program for the hospital combines all the
components previously described in an orderly and
logical arrangement.
NATURE

FAMILY STAFF
NURSING SUITES RESIDENCE
COLLEGE
1,600
sq ft

5,000 3,200
sq ft sq ft

NATURE

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 &
GROUNDS
20,000
sq ft
Square Feet

Residential Units 240,000


CENTRAL FOOD
SERVICES & 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 Grounds keeping 20,000
3,000
sq ft sq ft
Community Services 2,000
Warehousing 18,000
TOTAL ESTIMATED FLOOR AREA 447,500

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_35


_Residential Unit

FACILITIES SHARED WITH ANOTHER UNIT

PATIENT ENTRY

* SIZED TO FIT UNIT (20 BEDS)


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

DE-ESCLATION ROOM MED. STO-


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

900 TREATMENT ROOM 600 NURSES 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

36_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
A residential unit consists of a small grouping of
about 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, group therapy / multi-purpose room,
recreation room, and outdoor basketball court.
STAFF MEETING
LOCKERS, ROOMS / FLEX
BREAKROOM, OFFICES
VISITATION Square Feet
& RESTROOM
400 Patient Bedrooms (20 beds x 200 sqft/each) 4,000
(RECOVERY sq ft
TEAM &
SUPPORT
STAFF)
Unit Activity
Communal / Social / 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 Visitation* 200
sq ft COURT
Recovery Plan Meeting / Team Offices* 500
INDOOR ACTIVITY
800 1600
Staff Breakroom, Lockers and Restrooms* 500
sq ft sq ft
Unit Control
* 37’ X 42’

Nurses Station and Desk 600


Medication 200
Storage 200
Other
Environmental Services: Storage/Refuse/Linen* 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

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_37


_Residential Quads
QUAD ENTRY
UNIT ENTRY CONNECTION TO CENTRAL SUPPORT & MEDICAL

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
ENVIR. SERVICES
STORAGE / REFUSE / HALF
LINEN BASKETBALL
400 800 COURT
1000 sq ft sq ft sq ft

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

SCALE UNIT ENTRY


100
sq ft

38_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
A Residential Quad is a grouping of four (4)Units
which share program, therapy and service space. A
Residential Quad services 80 patients.
UNIT ENTRY
Rusk State Hospital has been identified for
replacement of 280 residential patient beds (3 1/2
UNIT 2 Quads or 14 Units) plus the need for two “swing” units
for a total of 320 Residential Patient Beds. Swing
Units are extra beds only used in the event that a
populated Unit needs to be temporarily relocated or
used to support another state hospital.

NATURE

INDOOR VISITATION COMMUNAL DINING /


ACTIVITY MULTI-PURPOSE
900 sq ft
FOOD SERVICE &
ENVIR. SERVICES
STORAGE / REFUSE /
LINEN
800 400
sq ft sq ft 1000 sq ft

UNIT 4

NATURE

Square
Feet

1 Quad (4 Units or 80 Beds) 60,000


UNIT ENTRY
3.5 Quads (14 Units or 280 Beds) 210,000
2 Swing Units (40 Beds) 30,000
TOTAL ESTIMATED FLOOR AREA 240,000

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_39


_Maximum Security Unit

FACILITIES EXCLUSIVELY SHARED WITH ANOTHER MAX SECURITY UNIT

PATIENT ENTRY

MAXIMUM SECURITY UNIT


* SIZED TO FIT (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 NURSES 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

200 200 200


4 sq ft 8 sq ft 12 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

40_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
The Maximum Security Units are spatially the same as
residential units except for that it requires heightened
levels of security, less patients per Unit, and separate
support program space.

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 sqft) 3,000
TEAM &
SUPPORT Unit Activity
STAFF)

Communal / Social / 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
* 37’ X 42’
Nurse’s Station and Desk 600
Medication 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

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_41


_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 &
ENVIR. SERVICES
STORAGE / REFUSE /
LINEN
400 800 1600
1000 sq ft sq ft sq ft sq ft

** SECURE * 37’ X 42’


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

100 STAFF ENTRY


sq ft UNIT ENTRY

42_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
A Maximum Security Quad contains three (3)
Maximum Security Units instead four like a standard
Quad. The remaining space is occupied by uses found
in the central support department that benefit from
UNIT ENTRY having their own functioning space within maximum
security. Maximum Security must be somewhat
autonomous from the residential quads and central
UNIT 2 support services.

NATURE

INDOOR VISITATION COMMUNAL DINING /


ACTIVITY MULTI-PURPOSE
900 sq ft FOOD SERVICE &
ENVIR. 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
1000 MUSIC
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 1000 400 Staff Breakroom, Lockers, and Restrooms 1,000
sq ft sq ft sq ft

Additional Restrooms 250


Additional Storage 250
Circulation / Mechanical and OPS 2,500
3 Units (45 Beds) 45,000
TOTAL ESTIMATED FLOOR AREA 60,000

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_43


_Administration
MAIN HOSPITAL
ENTRY

CENTRAL
SECURITY MEETING ROOMS LOBBY &
WELCOME
400 400 400
sq ft sq ft sq ft CENTER
CONNECTION 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 WORKE 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 TRANING 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

800
sq ft
CIRCULATION & MECHANICAL OPS * EASY + CLOSE CONNECTION TO CENTRAL SUPPORT & CENTRAL MEDICAL

SCALE

100
sq ft

44_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
The Administration body is a multi-faceted
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
Superintendent and Support
RESIDENTIAL PSY- COMMUNITY DIREC- PATIENT 1,000
SERVICES CHOLOGY RELATIONS TOR TRANSPORTATION
Chief Nurse Executive and Nursing Support
400 200 400 200
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 Residential
Services 600
UTILIZATION QUALITY
MANAGEMENT MANAGEMENT HEALTH INFO. Director of Community Relations and Support 600
MANAGEMENT
Central Security 400
600 600 1200 Information Technology (IT) 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 2,400
Meeting / Multi-purpose Rooms 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

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_45


_Admissions
PATIENT ENTRY

VAN ENTRY
(SALLY PORT)
400
sq ft

LOBBY /
WAITING
ROOM

VISITOR ENTRY 800


sq ft

RECEPTION

PATIENT SNACK PHOTO & ID SECURITY OFFICE MEDICAL


(KITCHEN) (SWITCH BOARD) OFFICER ON
OPTIONAL 200 sq ft
DUTY
CENTRAL 200
OFFICE
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


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

600
sq ft

300
sq ft
RESTROOMS * CONNECTION TO CENTRAL MEDICAL + PATIENT UNIT
300 STORAGE
sq ft

800 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

46_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
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

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_47


_Central Medical Clinic + Pharmacy

PATIENT ENTRY

WAITING
AREA
600
PODIATRY sq ft PHYSICAL & OCCUPATIONAL
OPTOMETRY THERAPY

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

ECG & ISOLATION


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

ISOLATION
* SECURE + EASY CONNECTION TO ADMISSIONS & CENTRAL SUPPORT ENTRY

250 RESTROOMS
sq ft

250 STORAGE
sq ft

1,500 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

48_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
The Central Medical Clinic provides annual physical
health assessments of patients, provides 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 & Restrooms 800
Additional Restrooms 250
Additional Storage 250
Circulation / Mechanical and OPS 1,500
TOTAL ESTIMATED FLOOR AREA 10,500

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_49


_Central Support + Treatment

STAFF ENTRY

EASY + SERVICE CONNECTION TO


STAFF
CENTRAL MEDICAL,
LOCKERS, FLEX ADMINISTRATION & PATIENT
BREAKROOM, UNIT
& 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 BARBER / READING COMPUTER PEER
sq ft PROGRAM ROOMS LIBRARY
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

500 RESTROOMS
sq ft

800 STORAGE
sq ft

3,000 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

50_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
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 sq ft
Music 400
EDUCATION ROOMS
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

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_51


_Central Kitchen + Environmental Services

EASY 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
200 200
FOOD STORAGE WALKING STORAGE OFFICES LOCKERS,
sq ft 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 BAY

400 RESTROOMS
sq ft

400 STORAGE
sq ft

2,400 CIRCULATION & MECHANICAL OPS


sq ft

SCALE

100
sq ft

52_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
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 16-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
EASY CONNECTION to collect, sort, and send out dirty linens and then
TO UNITS receive, sort, and delivery clean linens to the 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
Flex Meeting Rooms 800
LOADING BAY
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

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_53


_Maintenance + Grounds Keeping

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 GROUNDS KEEPING 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

54_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
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
Grounds Keeping 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

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_55


_Community Services

CONNECTION TO POSSIBLE CONNECTION TO


ADMINISTRATION ADMINISTRATION , AUDITORIUM
AND UNITS
** LECTURE/TRAINING ROOMS,
RESIDENCY PROGRAM

COURT OF LAW TYLER JR. STAFF RESIDENCE FAMILY RESOURCE CENTER


(BOARDING ROOMS)
COLLEGE OF
NURSING 400 400
sq ft sq ft

1700 800 800 400 400


sq ft sq ft sq ft sq ft sq ft
INCLUSIVE TO 1600
ALL D.S.H.S. HOSPITALS sq ft

800 800
sq ft sq ft

3200
sq ft

5000
sq ft

EXCLUSIVE TO
RUSK STATE HOSPITAL

SCALE

100
sq ft

56_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
Community Services includes those uses within the
Hospital that liaison with the greater community
beyond the hospital. This includes the Community
Relations Department and the Court of Law. The
Community Relations Department is responsible
for implementing and supervising a comprehensive
volunteer program including recruitment, selection,
orientation, placement, training, and recognition of
volunteers. Additional responsibilities include: the
Public Information Office; Clothing Center; and Family
House. Community Relations and the Court of Law
requires a close and connected spatial relationship
within or near Administration.

Specific to RSH, the Tyler Junior College of Nursing,


the Family Residences, and the Staff Housing 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.

Square Feet

Court of Law 2,000


Nurses College 5,000
Staff Housing 3,200
Family Residences 1,600
TOTAL ESTIMATED FLOOR AREA 20,000

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_57


_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

58_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
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

DRAFT_Jan 20 2017 SECTION 4 PROGRAMMING_59


DRAFT_Jan 20 2017
5 IDEALIZED MODEL
_Overview
_Plan
_Axo
_Pedestrian Circulation

_Vehicular Circulation +
Parking
_Landscape Structure +
Function
_Control + Security

_Medical Access +
Medication Delivery

_Food + Environmental
Services Access

DRAFT_Jan 20 2017
_Overview
An Idealized Model was prepared based sharing, security, and operations. It is difficult to replicate exactly on an existing
on the need to understand the design essentially a single plan focused around site, which will have a number of contextual
parameters for a hospital plan which could a central treatment zone. Administrative influences, such as topography, servicing,
be applicable anywhere, meaning it had no and associated functions are located in a access, vegetation, historical structures,
contextual influences. Working with the two story main building to provide some etc.
programming requirements, best practice presence and identity for the hospital.
features, and RSH’s staffing parameters, Roads are provided externally to maintain a The Idealized Model equals approximately
this Idealized Model is an exercise in walkable, campus-like setting. Appropriate 451,000 square feet of floor area.
optimum spatial relationship. provisions for service and emergency
access is provided through “shared space”
Fundamental to the Idealized Model is type ways.
the organizing of individual therapeutic
units, that include 20 single bedrooms The Idealized Model also provides a general
and shared support spaces, around a planning process that could be applied
controlled outdoor courtyard space. The to other DSHS facilities. It is meant to
courtyards work out to be approximately be utilized as a “kit of parts” that can be
80 by 80 feet in size or around 6,000 reorganized in the context of a specific
square feet. Four units are organized into hospital site and program. It is important
a quad to allow for efficiencies with space to note that this exact model would be

62_PLANNING MODERN PSYCHIATRIC CARE FACILITIES ADRAFT_Jan


TEXAS HOSPITAL 20 2017
_Plan

LEGEND
GREEN OUTDOOR SPACE : FROM PRIVATE TO PUBLIC

HARDS CAPE SOFT SCAPE GREEN SPACE


(ACTIVATED) (ACTIVATED) (INACTIVATED)

WAREHOUSE SPORTS FIELD PRIVATE SEMI-PRIVATE PUBLIC

UNIT
ALLOTMENT GARDENS GREENHOUSE
PATIENT ROOM
LOADING ZONE
STORAGE & MAINT.
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

UNIT CENTRAL COMMUNITY


REFUSE 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 /
CENTRAL
ADMINISTRATION ADMISSION
FLEX OFFICE

READING
READING

READING

READING
SUPPORT FACILITY

ROOM
ROOM

ROOM

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

ARCHIVE DINING HALL

EXERCISE
EXERCISE

EXERCISE

EXERCISE

PATIENT
PATIENT

PATIENT

PATIENT
DINING HALL

CENTRAL ENVIRONMENTAL SERVICES / HOUSEKEEPING

PATIENT ROOMS

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

STORAGE
STORAGE

STORAGE

STORAGE
STATION MR STATION
MR 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
CONFERENCE FOOD FOOD ROOM ROOM ROOM ROOM ROOM ROOM

ROOM WAREHOUSE WAREHOUSE FLEX


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

GROUND KEEPING
OFFICE
FOOD

MULTI-PURPOSE

PLANT VACANT ROAD


DISH CLEAN

STORAGE DE-ESCALATION DE-ESCALATION


DE-ESCALATION DE-ESCALATION STORAGE
RECEPTION CARPENTRY VEHICULAR REPAIR
RETURN &

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
LAUNDRY

PATIENT
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 ROOMS SHOWER THERAPY SECLUSION THERAPY FLEX STAFF BREAKROOM,

SECLUSION
VISITATION THERAPY ROOMS THERAPY SHOWER THERAPY ROOMS THERAPY
ROOMS
OFFICE

ROOMS
LOCKER ROOM &

SHOWERS

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
AUDITORIUM / CHURCH

STORAGE
TEACHING PROGRAM PROGRAM PROGRAM

STATION
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 SERVICES

STORAGE
SOCIAL
DE-ESCALATION
FLEX OFFICE

EXERCISE
BARBER /
SALON
ARTS/ LIBRARY
SECURITY

READING
READING

READING

CRAFTS

ROOM
ROOM

ROOM

DAY DAY DAY ROOM


20 BEDS 20 BEDS

STORAGE

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

EXERCISE
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 TREATMENT SPACE
SECOND FLOOR DETAIL INDOOR
RECREATION
BASKETBALL COURT
RECREATION OFFICE SHOWER THERAPY THERAPY

INFECTION EMPLOYEE

SECLUSION
CONTROL HEALTH
SECLUSION

ROOMS
SHOWERS
OFFICE ISOLATION

THERAPY

THERAPY
ROOMS
SALLY PORT
ECG +
DE-ESCALATION
IMAGING MEDICAL

MAXIMUM SECURITY 2ND FLOOR PLAN QUAD 2ND FLOOR PLAN MAIN BUILDING 2ND FLOOR PLAN BASEMENT FLOOR PLAN
STORAGE DE-ESCALATION DE-ESCALATION STORAGE MEDICAL
EXAM
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 ROOM PATIENT ROOMS ROOM PATIENT ROOMS 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 PATIENT LAUNDRY

PHOTO & ID
PATIENT
LOCKER ROOM &
INTERVIEW

INTERVIEW

INTERVIEW

LOCKER ROOM &


LAUNDRY
KITCHEN

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 SECOND FLOOR PLAN 50 200

0 100 FT.

DRAFT_Jan 20 2017 SECTION 5 IDEALIZED MODEL _63


LEGEND
_Axo
GREEN OUTDOOR SPACE : FROM PRIVATE TO PUBLIC

HARDS CAPE SOFT SCAPE GREEN SPACE


(ACTIVATED) (ACTIVATED) (INACTIVATED)

PRIVATE SEMI-PRIVATE PUBLIC

UNIT
PATIENT ROOM
STORAGE & MAINT.
UNIT UNIT
ACTIVITY SUPPORT FACILITIES
UNIT CENTRAL COMMUNITY
CONTROL POINT MEDICAL SERVICES SERVICES
CENTRAL
ADMINISTRATION ADMISSION
SUPPORT FACILITY

CENTRAL ENVIRONMENTAL SERVICES / HOUSEKEEPING

CENTRAL FOOD

MAINTENANCE WAREHOUSE
GROUND KEEPING
PLANT VACANT ROAD

64_PLANNING MODERN PSYCHIATRIC CARE FACILITIES A TEXAS HOSPITAL DRAFT_Jan 20 2017


_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 Grounds keeping 22,500
Community Services 1,800

Warehousing 21,100

TOTAL ESTIMATED FLOOR AREA 451,500

DRAFT_Jan 20 2017 SECTION # SECTION TITLE _65


_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
MS
ROOMS 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-
200 BEDS

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

STORAGE
STORAGE

STORAGE

STORAGE
STATION ?D STATION
?D STATION STATION
ROOM:
PATIENT
PA
AATIENT RO
ROOMS
OMS PA
PATIENT
AATIENT RO
ROOMS
OMS 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 STORAGE DE-ESCALATION TREATMENTT DE-ESCALATION TTREATMENT DE-ESCALATION DE-ESCALATION STORAGE

CONFERENCE
ROOM
FOOD
WAREHOUSEE
FOOD
WAREHOUSE FLEX
SECURE UNIT ROOM ROOM ROOM ROOM ROOM ROOM

DIRECTOR’S REFRIGERATOR FREEZER SPACE


OFFICE OFFICE INDOOR

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

OFFICE
FOOD

MULTI-PURPOSE
DISH CLEAN

STORAGE DE-ESCALATION DE-ESCALATION


DE-ESCALATION DE-ESCALATION STORAGE
RECEPTION
RECEPTION CARPENTRY VEHICULAR REPAIR
RETURN &

TREATMENTT TTREATMENT R
ROOM ROOM
SERVICE

ROOM ROOM
STAFF

ROOM ROOM
D ZONE

KITCHEN
LOADING

MEDICAL MEDICAL MEDICATION MEDICATION


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

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
A

PANTRY
R STORAGE OFFICE
DINING HALL

DINING HALL

READING
READING
READING

READING

ROOM
ROOM
ROOM

ROOM

D
FLEX D

O
A
O
O

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

CLEANING FLEXX OFFICE

EXERCISE
EXERCISE
EXERCISE

EXERCISE

LAUNDRY

PATIENT
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 PATIENT
N
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 SECLUSION
U
VISITATION ROOMS SHOWER THERAPY ROOMS THERAPY SHOWER ROOMS
ROOM
MS ROOMS
ROOM
MS
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 TTHERAPY SHOWER SHOWER THERAPY SECLUUSION
SECLUSION THERAPY VISITATION
SHOWERS PATIENT ROOMS PATIENT ROOMS SHOWERS
ROOMS ROOMS ROOM
MS
ROOMS

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

DE-ESCALATION

STORAGE VISITATION SECURITY


SECURRRITY VISITATION READING ROOM / LIBRARY LOCKER ROOM & LOCKER ROOM &
STORAGE LAUNDRY
LAUNDRY
LAUNDRY LAUNDRY
MULTI-PURPOSE
MULTI
MULTI-P
PURPOSE
URPOSE ROOM 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
SECURITY
READING
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 SECURITY
CENTRAL
CENT SECURITTY
STAFF MEETING
MEETINNNG ROOMS / DINING
DIN
NING HALL HALL
DINING HA
AALL MEETING ROOMS
ROOMS / STAFF
BREAK FLEX OFFIC
OFFICE
CE BREAK
BREAK
FLEX OFFICE
OFFFICE INDO OR
INDOOR
STORAGE /
ROOM/ RECR
RREATION
RECREATION ROOM/ STORAGE /
STORAGE
WAITING AREA
MAINT LOCKER MAINT DE-ESCALATION TREATMENT DE-ESCALATION TTREATMENT
REATMENT DE-ESCALATION STORAGE
LOCKER

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

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

OFFICE ISOLATION
MAXIMUM SECURITY
SALLY PORT

STORAGE DE-ESCALATION
ECG +
IMAGING MEDICAL
DE-ESCALATION DE-ESCALATION STORAGE EXAM MEDICAL
ROOM TTREATMENT 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 ROOM
ROOMS
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