- Good afternoon, and welcome to today's Architecture for Health Visiting Lecture Series.

My name is Dr. Greg Luhan.

I'm the department head in the Department of Architecture at Texas A&M University.

Today, I have the distinct pleasure of introducing Harold Adams, FAIA.

After graduating from Texas A&M University with a bachelor of architecture degree in 1962, Harold Adams worked in Washington in DC for John Carl Warnecke and Associates, where he worked with President and Mrs. John F. Kennedy on several important projects.

He was later the project manager for the president's grave site in Arlington National Cemetery.

He joined RTKL in 1967, and became the president in 1968, CEO in 1971, and chairman in 1987.

Mr. Adams retired on May of 2004, and is chairman emeritus of RTKL Associates Inc, and RTKL International Ltd, one of the world's largest multidisciplinary design firms.

Under his 37-year leadership, the firm developed into an international practice with 10 offices in the United States, and offices in London, Tokyo, Shanghai, and Madrid, with a reputation for design and management strength.

Mr. Adams' contribution to the architectural profession at the international, national, state, and local levels were recognized in 1983 when he was elected and elevated as fellow in the American Institute of Architects.

He served as chancellor of AIA College of Fellows for one year, and founded and chaired for 17 years, AIA's Large Firm Roundtable.

In 2014, Mr. Adams was selected as the Texas A&M Institute of Advanced Study, TIAS fellow, where he is the recipient of the Kemper medal, one of the highest AIA's honors for leadership in the profession.

He was honored by the Society of American Military Engineers with the first Max O. Urbahn Medal for achievement in architecture, and is one of the first Americans to hold first-class Kenchikushi architecture license awarded by Japan's Ministry of Construction.

He is active in practice.

While he was active in practice, Mr. Adams held licenses in 44 states, Japan, and the United Kingdom.

Most recently, the National Academy of Construction awarded him the Ted C. Kennedy Award, the academy's highest honor for his distinguished contributions to the industry and expertise as a service to the profession.

Please join me in welcoming Harold Adams.

(audience applauds) - Thank you, Greg.

- Thank you.

- I'm delighted to be here today after having served for 37 years as the chairman, CEO of RTKL, to introduce some new people.

They've only been with the firm 29 years or 20 years.

And I especially wanted to give a little whoop because they're both Aggies.

- [Audience Member] Whoop!

- One's the class of 1990, Larry is 1990, and Michael is of '96.

So we've got two good Aggies here who've gone through the program here and are coming back each year to contribute to this great institution.

Our two speakers that are here with us today came down from the Dallas office.

Larry McKillop, who is the person that's been, graduated in 1990.

And he will lead off the effort.

Has 29 years, as I've mentioned, in the healthcare experience.

And then Michael St. Clair, who's an AIA and associate principal at CRTKL.

Both have a long resume of work on multiple types of projects in healthcare.

Michael especially has worked with a lot of children's hospitals and women's hospitals.

We are also delighted to have with us today as a stand-in for Patrick Casey who had a health problem and couldn't come today, but we've got a person that has been working with Patrick on the project, and that is Ed Hengtgen, who is at the University of Miami.

And he will join us by Zoom today.

We're delighted to have Ed with us, and look forward to learning a lot about the work (murmurs) at the firm as it stands today.

Thank you.

(audience applauds) - Thank you, Harold.

- Thank you.

- Thank you for that great introduction.

My name is Larry McKillop, and this is Michael St. Clair.

And on the Zoom meeting, we have Ed Hengtgen.

Ed, do you wanna say hi?

- Hello.

- You all get to participate today in our presentation.

This afternoon, we're gonna give a quick little two-minute bio of CRTKL, and then we'll have Ed talk about the University of Miami health system.

There's two projects we're gonna talk about.

And so to give you a little background, Ed is working with us on two projects.

And the university is a great facility, and Ed will give you a little info on that here in just a little bit.

Then we'll jump into the topic that we were given, which is a system-wide approach to branding.

We'll talk a little about branding 101.

And then Ed will talk a little bit about three brands that really happen at University of Miami Health.

And then we will run through the reinforcements of architectural standards and how they can impact branding.

And then we're gonna talk about two projects that we're currently working with at the University of Miami, and kinda give you a heads-up of kind of what's happening there.

They're very early on in the project, but we thought we'd share those with you as well.

So, CallisonRTKL is the fifth largest architectural firm in the country.

We have over 1400 employees.

We utilize, our specialties are healthcare, retail design, commercial design in workplace.

As Harold mentioned earlier, Michael and I are out of the Dallas office and we work in the healthcare group.

As far as our healthcare group, we have an office in LA, Chicago, DC, Dallas, and Miami.

We're ranked 11th in healthcare design, number one in retail design, and as I mentioned earlier, fifth overall.

You know, we pride ourselves on collaboration.

We work with our clients hand in hand.

You know, just a fortitude of, being able to just call Ed and say, "Hey, Ed.

Patrick's down.

Can you step up?"

And, you know, Ed's working with us on the project hand in hand, day to day.

We really appreciate his input.

And the collaboration that we have with our clients really make a difference in our projects.

We've been in business for over 100 years.

We've got a lot of professionals that we can tap as resources as well, and we really accelerate our clients' businesses.

And really, our mission, like everybody else, is we just wanna make a better place for the world.

Ed, you wanna talk a little bit about University of Miami?

- Sure.

(Ed chuckles) University of Miami, those that don't know, is we are located in Miami, not in Ohio.

We have a (murmurs) guy here now, but university, as far as my goal or my role, is I'm the director or the assistant vice president for planning, design, and construction, and manage all of our healthcare construction for the university.

I've been with the university 11 years.

We're an academic medical center.

We also have our academic program, which we have a school of medicine and 11 other schools that offer degrees in our Coral Gables campus.

And the medical campus is located in Downtown Miami, right next to Downtown.

And the university has multiple satellite practices throughout the Dade and Broward counties, which are fairly large down here.

So our mission is to teach and to serve the community, and also to create academic excellence with our students and our med students.

- So really, I just wanna talk a little bit about the importance in branding.

And really gearing it towards kind of the, you know, the healthcare environment, our health and wellness environment, and talk about why it's important to the brand.

Really, you know, as things are moving, there's a shift in healthcare and wellness to engagement in the community.

So as Ed mentioned before, there are a lot of satellite campuses.

A lot of campuses that are doing multiple things, multiple disciplines around.

So really being able to have that branding and being able to have that consistency across the system is important for that community engagement.

Also, differentiation in the marketplace.

A lot of trends are moving towards consumer, consumer choice in health care.

So really healthcare organizations and systems are just like any other organization, are really looking at how they can differentiate themselves in the market.

The other thing, other important piece of this is that reliability, consistency, and familiarity.

And so you know that when you're walking onto a University of Miami property, when you're working or you're being cared for, or if you're going in for treatment, that you've got that consistency, you've got that familiarity.

And so that's really important in the healthcare market.

And then also, really, exuding confidence and accountability.

You can't see the screen here, but there's a lot of brands that are here like Target, Apple, Coca-Cola, Amazon, Facebook, and Nike.

And so a lot of those brands are, you know, they're familiar and there's are familiar, and there's a comfort level with those.

And then that's kinda where that confidence comes from.

It's a known quantity when you see that brand.

And really, branding isn't just about the tangible, the logo, the tagline.

There's the product and there's a building in the branding.

But really, what we're really about is, and really looking at, again, in that health and wellness environment, it's really about branding the experience.

A brand is the perception of a product based on what people see, hear, feel, and experience.

It's not what you say it is.

It's not what they say it is.

It's the total experience.

So it's really important in that healthcare branding.

As far as our approach and taking a look at what makes a brand strong, we look at three things; our convictions, our connection to the community, and that consistency.

So, the way we do business as a firm, we really want to understand the industry and the operational delivery models within the healthcare industry and within those healthcare systems that we're working in.

And also to build that brand, is create that comfortable and accessible environment within communities is always a goal.

And then also, we as a firm, it's very important to us and it's very important to the clients that we work with, and you'll hear a lot about that more in the presentation, is leveraging that research and data to really enlighten the issues that are important to our clients and that are important to our patients and families who we serve in the community.

And then also, it goes without saying that providing that high level of service is very important in branding.

Because again, that's really what you're, that's what you're selling, that experience, that service.

And then also that connection to the community is very important.

And then also the consistency is, that's last and probably most important, is that consistency of experience that you have from facility to facility.

And so always when we're developing the brand, the role of place is always, you know, it's a big role.

And really what we have the opportunity to do is really, really galvanize that brand with the places that we create.

So it's really, really very exciting.

So I'm gonna hand it over to talking about that, handing this back over to Ed and talk about the University of Miami health system and the UHealth brands.

- It's about the University of Miami that in the health system, we have multiple main brands and facilities that have different levels of exposure to our patients in our region.

One of our biggest brand is the Sylvester Comprehensive Cancer Center.

We currently have 10 facilities that are branded under Sylvester.

Sylvesters were a family that donated substantial dollars to the university, and we named the cancer center after them.

And so we have 10 locations, several major, and they're a big part of just about all of our major satellite practices.

Unfortunately, cancer is ever-present in our lives today.

Just probably everybody on this call has had somebody that has struggled with cancer or lost somebody to cancer, and the university really takes that to heart.

And personally I've been there and been a family member treated by Sylvester, my wife, and we've been all in for Sylvester.

And they seem to have a great impact on our community.

And part of that is that Sylvester's recently designated an NCI cancer institute.

And we're the only one in south Florida and one of two in the state of Florida.

So we are doing all things great for Sylvester.

And part of that is making sure whenever you go to, when you go to one of our locations, you have the ability to get the same level of care.

And this is Bascom Palmer.

As you see on the screen here, we have five Bascom Palmer facilities in our satellites, as well as the main Bascom Palmer Hospital.

And Bascom Palmer Hospital is the number one eye hospital for 11 years running.

I believe it is by the US news and world report.

So it's a nationally recognized major brand for the University of Miami.

So they carry their, they carry their own brand as well, and do great things.

A lot of philanthropy is associated with Bascom Palmer.

And we're competing against people's phones, doing eye care and things that you could do.

And so Bascom Palmer is up against that as a, it was a hundred bed hospital.

I think now we have five inpatient beds for late surgical over night stays, but eye care has changed dramatically over the years.

And then we also have our general brands.

This is the sort of our bigger brands or the UHealth tower.

That is our main tertiary hospital, 450 beds.

And they support our cardiac program, urology program, also surgery.

Our major surgery program for Sylvester is done out of, out of the UHealth and (indistinct).

(Ed chuckles) Some of the advantages for standard design standards.

It does improve patient care outcomes.

We find that if we have a high level of standard of the university, that our patients are more comfortable, that they move around.

A lot of our patients are seen in multiple locations.

And so that's really important to us, especially with our multiple Sylvester locations.

They might come to the hospital for a surgery or for some care, but they might see their practitioner in one of our satellites because it's closer to their home.

They might come to another location to have their linear accelerator radiation treatment, and then go to another location for their medical oncology CTU treatment.

So, we think it's very important that when patients move around, when they come into our buildings, it feels like home to them, as at the other locations they've been to.

So, one of the big reasons we also have a standards is that we have a ton of repetitive space.

We have, you know, about 5 million square feet of space on all, all of our sites.

We have a total of 30 outpatient clinics, clinical buildings.

We have three big ones in design, two of which our CRT (murmurs) team is helping us out with, which is great.

We have over hundred and, 1200 exam rooms.

We'll talk about that in a little bit, but they've almost 200 in design.

And our CTU pods is one of our bigger repetitive spaces as well.

And we have almost a 350 with almost half of that in design on these two large projects, that CRTKL is helping us with.

And multiple ORs.

We're building several ambulatory surgery, two ambulatory surgery centers with plus our ORs and our hospital learning just in ambulatory surgery.

We have three ambulatory surgery centers plus our main hospitals as well.

So the examiners have been changing over time based upon how we process and do exam treatments.

Education has become a great part of that.

Not only are We educating our patients, we're also educating their family members to help take care of them.

We wanna make sure that our physicians in the exam rooms have a good way in and out.

No longer our physicians taking notes on their laps and their paper charts, everything's now digital.

So we have our electronic medical records and the physicians need to be able to engage with the patient, the patient's family member while they're working on a computer.

And that's something that has changed.

And we have a lot of legacy exam rooms that weren't designed to accommodate that.

The families again are a big part of our care, especially in our cancer environment.

Well, sometimes our patients, aren't all there, a lot of worry going on and they need somebody else to help them understand what they need to be doing to take care of themselves.

And increasingly technology is a big part of how we treat our patients and deliver care in our exam rooms from our obviously our ophthalmology exam rooms.

A big, big part of that is a digital camera, a videography of the lenses and eyes, and be able to show that back to the patients in the room, as well as being able to bring in our higher skill sets into a standard exam room through virtual care with partnering physicians.

We do a lot of partner physicians within the university to help out certain (murmurs) that we have.

They might need to drag a couple physicians into a meeting with a patient and their family.

And we're able to do that within our exam rooms.

This is back to the sort of the original exam rooms back in the day where we had a, you know, a door swinging into the rooms, providing some screening to the patient and the sink was sort of, kind of hidden.

And we had these zones that we still kind of look at it, but we've kind of taken this and taken it one step further in our development of our exam rooms.

Next slide.

Also, it's interesting we have a lot of vendors out there that try to sell you this improved exam function, and it's all about their casework, their benches.

And none of it really seems to work in mass from any of these vendors.

So we have gone to doing our own design.

And it started out with, our number one idea was never to have the patients back or the physicians back to the patient.

And we mocked it up.

We created multiple mock ups as you can see here, full scale.

We ran the physicians and nurses through these areas and, next slide.

And you can see when we had sort of a mock-up done a little bit more detailed.

We found out that the desk wasn't quite working for us and the physician still couldn't see the patient on the exam room.

So I mocked up our desk and we got the saw out and cut into it.

And this desk that you see in the lower right-hand corner, that was the field modification.

That is basically the desk that we have today, that we replicate throughout our system.

The next slide.

And this is sort of what we're creating in our exam rooms.

One of the things that we wanted to make sure is that we were able to get the position in and out of the room without having to go through the family zone.

So the physician comes in, they're able to greet at the door.

Hand washing is super, super important.

I strongly recommend if you're gonna see your physician and he doesn't wash his hands before he touches you, ask them to wash their hands.

Everybody thinks that the alcohol is, you know, this miracle alcohol hand rub is good, but it doesn't remove the (murmurs).

You should always ask your physician to wash their hands and they should do it out of routine.

And the we're able to get to the desk here.

And then we have this, what we call the dialogue triangle.

Where if you have a family member sitting around the desk or the patient's on the exam table, or at a chair, we want to always have this conversation with our patients around this dining room table as we kind of looked at it, the kitchen table, and that's sort of what the (indistinct) allowed us to do.

It allows the physician to rotate, show the monitor and be able to type on the computer without having their back, and then get out of the room.

The patients are going early with a staff member and there'll be in there, the physician will come in as they bounce from room to room, seeing our patients.

And usually the nurse will close out and follow up with follow up appointments.

So we created these three zones and it works very well.

Again, the sync is super important.

We wanted the physician to trip over it, coming into the room, so they'll use it.

Otherwise we have these old legacy rooms where the sink is as far away as you can get from the door and they just don't use it.

Next slide.

And this is a good look at our exam rooms.

Real important here on multiple things are the way we work our curtains, the way the exam tables in there.

You can see we have a highlight of wall between what we call our towers.

The piece of artwork, we're gonna believe the artwork's important on that accent wall, because it's somehow a relieve as the patient's sitting there waiting for the physician to come in, something to look at.

On the slide and the right, you can see the multiple different storage units that we have.

We have on the patient area we have a wardrobe, sown gowns, clean gowns up above that would be put out by the staff.

On the right-hand side of the position zone, we have a supply cabinet that pulls out like a pantry cabinet (murmurs) a kitchen, and a couple of drawers.

And then there's our sink, with a hand washing station as we call it because it's got paper towels and soap.

One of the things about the hand washing station that you see on the right, that we use these everywhere, not just an exam rooms.

Our goal's to have repetition, and this isn't a nurse station and in a surgical area that we'd like to use this whole cabinet and sink.

The sink is very clean and tidy.

Porcelain is easy to clean.

Rounded surface on top so that we don't have water standing on the sink that can grow bacteria.

A lot of thought has gone into our fixtures, infrared faucets and whatnot.

Next slide.

You kind see that we've done a lot of renovation to our old legacy exam quarters exam rooms on the left.

Beautiful as it was at one time, but you can see on the right, you can see the UM standard coming into play, the colors, the warm lighting, the richness of the doors and the plastic laminate wood selection that we use, next.

But we also have interior design finishes.

We just kinda see inside here that we publish and produce, which looks at our warm colors and repetition of design.

We have new binders.

We also have them digitally online, and this helps us share our products with our clients, our users.

As our department we believe, we truly believe that we're here servicing our users.

And also helps our consultants, that we can give it to our consultants.

These are our colors.

And this is important for that we have repetition within our spaces.

We do the same thing with furniture and the colors of furniture.

We often have our users wanna go to Ikea and buy chairs and things, as you know, those fabrics aren't gonna handle the cleaning that we put to them.

They're not microbe proof (murmurs) can cause infections.

And they also won't stand the test of time.

Artwork like I talked about is super important.

We have a standard art that like use prints.

We kind of have a floral and fauna approach that we like to use sort of a generic in some set that you could have different departments using exam rooms.

We like to call our exam rooms multipurpose or multi-specialty.

So in the morning you might have one type of practice, in the afternoon in another, and we don't have to worry about the artwork being inappropriate in a room that might have somebody else.

All calming and reassuring with the flora, fauna and wildlife.

And then we throw a couple of mascot pictures in there as well from the (murmurs) lab.

Signage is the same way.

When you go into our buildings, we have signage and we have a lot of buildings.

So our signage is cost effective.

And we'd like to think very professional.

And we're able to repeat the signage throughout our buildings.

We also have other interiors that kind of blends through that you see and sort of the brand coming through with our signage and the way we approach our finishes.

I think that's it, yeah.

- All right, so just to give you a little bit about the project.

The first project that we're gonna look at is Doral, and how we're gonna take a look at the schedule and just kind of the overall process overview of how we work and how we're engaging with the client, how we're engaging with Ed in the facilities team.

But where we are in the process, just to give you an idea, we're at the schematic design level right now.

And we're really, we're doing that engagement.

We're doing three months of schematic, I've done three months of schematic design meetings.

And then we're gonna go moving into the next stage, would be designed development after that.

Yeah, go ahead.

And then really also, just to give you an idea of the number of people that were, you know, engaging in this process.

There's a lot of people that we get, that we get involvement from clinicians, physicians.

And actually 108 users that we're working with for this clinic and something similar to what we're working with at Sole Mia as well, that we'll talk about in a minute.

And taking a look at the overall program, just kind of give you kind of bird's eye view.

We're looking at about 150,000 square foot building right now.

That includes 33 exam rooms, eight operating rooms, three the endo procedure room, endoscopy procedure rooms.

And then we have 33 chemotherapy unit chairs that are also there, for the CTU infusion chairs.

And then also there's also a breast center, mammography women's center, women's imaging center that is also located up on the clinic floor.

Imaging, we have MRI, an MRI, CT, SPECT-CT, and PET-CT for nuclear medicine.

And then also bone density and then general radiation, and then RNF room, as well as ultrasound.

And then we also in the radiation oncology, we have five exam rooms actually now.

And then we have two linear accelerator systems that are also for the radiation oncology , and for that targeting of tumors within the system.

And then also we've got a parking garage that's located there as well, that's behind the building.

So what you're looking at is the site plan.

It was a very tight site, that's in the Doral community, which is really kind of a planned urban development out in Miami.

And so really, you know, some of the site constraints that we had, we had a very limited footprint and we did have to get parking onto the site.

That front area that onto the south really engages the street, really is what engages the community.

And that's where we have our ceremonial entrance.

And then as you move around the building to actually where the most of the patients are coming in, or being dropped off, or also for valet parking or on the north, north side of the building, there in that big pink mass, it's in between the parking garage and the building.

So really creating that sense of arrival, arrival sequence between the parking and making sure that we have the safe arrival sequence from the parking garage.

'Cause as you can see it's several lanes traffic there.

So we've got basically a connector that's on the second floor, so people can come down from the elevators.

And then we also were not all of the major parking is up on the upper floors.

And taking a look at the stacking.

So, you know, typically the areas that we will have on the ground floor, like radiation oncology with those linear accelerators, they're basically housed in the forefoot of concrete that are in there.

So those being on the first floor at a radiation oncology is very important.

And we do have lab up on the second floor.

We have the imaging piece radiology and also some of our endoscopy procedure rooms are up there as well as sterile processing.

that serves the ORs up on level three.

And then we had clinic modules up on level four, and then the CTU infusion is up on the fifth floor, on the top floor.

And that's typical of the facilities within UHealth 'cause really those patients are there for hours on end and really giving them good views.

And patients are just in a, it's a very intense time that they're spending in there.

So, them being on the upper floor is very important.

And taking a look at, again, as we go through the branding I had talked about, really the experience is very important at UHealth facilities in that outpatient arena and in all of their facilities.

But really to take a look at that, you know, coming into that entry sequence, that long promenade and really a very open and inviting public lobby space and a clear path to the elevators going up to the floors.

And then also mentioning on, you know, in that, that the floor, that first floor is again, that radiation oncology with those intense procedures and actually giving the radiation oncology patients their own entrance, off of that main lobby, to be able to get in and out because their treatments are fairly, fairly rapid.

And then taking a look at, again, going up on the upper clinical floors on that second floor, the endoscopy suites are on there as well as your imaging, MRI, CT, and those functions.

And then central sterile is on this floor as well.

So central sterile serving the ORs, and they're also linked by an elevator that goes directly from the sterile core and the sterile processing or that (murmurs), instrument sterilization is occurring and then going directly up into surgery, into the ORs.

And really the other thing too to mention you see the blue arrow along that back corridor, and then you see the red circulation arrows in the front.

It really is very crucial with the experience here at UHealth, to be able to have that front of house experience is separated from the back of house experience.

So what we have created on all of the floors is those blue elevators up on the upper right-hand corner come directly from the loading area, the loading dock, and your maintenance and all of your service, building service supports.

So those go up to the floor.

We really create back of house flow along that back corridor, to be able to get materials into the departments.

And that also affords there to the front of the building on the south with the better views and really the views into the community.

And there's also one of the things that is there is a park across the street and museum that's being built now.

And then going on level three is our operating rooms, the operating suite.

And really the way this is organized as many most that we see anymore, the red operating rooms that are highlighted in red are really organized around a sterile core.

And that sterile core as I mentioned, that goes around that strip that's in between the ORs, that has access down directly to the sterile processing.

Also about the patient experience.

Again, as they come off of those red elevators, they're immediately greeted by a greeter function, a person that can, that can check people in if they miss central registration down below, but they're really there mainly to greet traffic.

They're kind of like a concierge more or less, with that and direct people into the public waiting.

And then on level four, as we talked about before, as ED talked about the standard clinics, we're also taking a look at, and we're implementing standard clinic modules.

So, each one of these modules within the clinic on this clinic floor, you've got 30 exam rooms, but they're really broken down into two modules of 15.

And it'll really be a little clearer when we start looking at Sole Mia, how those are, how those clinic modules are broken down.

They're a little bit, we're more diagrammatic at that point on Sole Mia.

So you can, you can see that.

But again, maintaining that patient experience, that separated from the flow of service, that comes in the back of the floor.

And then taking a look at level five, the chemotherapy unit.

What we were able to do was to be able to afford natural light into all of the bays.

So, as you come off the elevator, they have their own check-in process because they have a patient navigation team on this floor to help navigate the patients throughout their treatment.

And we are those, the red squares that are all along the perimeter of the building of the floor plate, as those are the infusion stations.

And so what we also we're able to do around those, at the back of those infusion stations is everybody has a family porch, if you will, that surrounds those infusion stations.

And they also have the views, the views that you can see from the facility.

The one challenge that we do have being in an urban site, we understand that not everybody is able to be afforded the view of the front building.

So, we added on the north and the west side, a green roof to be able to kinda mitigate what you're seeing around you more, not as much of the urban, but be able to really be able to bring that green roof experience.

So that family members that are, are sitting on those porches, their view is buffered by a green roof and something, something nice to look at.

Then of course the mechanical space, can't forget that.

So this is taking a look at just, we're still again at the schematic design level, but this is taking a look at the front view of the building off of the main drive there in Doral, and kind of capturing that ceremonial entrance.

The architecture that UM employees is very elegant.

Their buildings are very much about their brand as well.

And so that was one of the things that we really wanted to capture.

And as Ed said, we really also wanted to bring down to the ground level for that community engagement with that, the canopy that that overhangs and be able to shield from the rain, 'cause it rains usually every day in Miami, especially in certain parts of the year.

And then also the brand that we do have those that outcrop on the ground floor is, it does have the linear accelerators that we talked about.

So really what we did is pulled those out and use those as part of the brand with the UM logo on there.

So that's kind of the direction that we're going.

And as we do, you know, moving around the building, that area with the V columns there, is basically an outdoor space, a covered outdoor space that's adjacent to a food service, kind of a grab and go at this location.

But really to be able to, again, allow for patients and visitors and staff to be able to go out, you know, and to engage that.

And it also really engages the community as well, that covered patio area.

And we've also talked about having things like food trucks being brought in, you know, that can, and also certain events that really utilize that patio as kind of an extension of the food service.

And then also taking a look at the materials.

We're predominantly glass on this building and it is, it is southern Florida.

So we are looking at different devices to really be able to mitigate the sunlight and sun saturation into the building.

We are looking at the sustainability factors making sure that we're, that we're being responsible as well.

So taking a look at the Sole Mia project.

So this campus that we're looking at Sole Mia, it's a bigger expanse of real estate, that we're able to, that we're able to work with here.

Just to kind of give you the context that site in the orange, the orange platform is our building, is Sole Mia.

And then in the rounding, it's that it's the Sole Mia development that comes off in that loop drive, Sole Mia drive.

So really, you know, the idea is with Sole Mia, talking about that engagement into the community, their north is sorry to the left, but really on that north side is a planned urban development.

So it's got residential and retail area.

So we'll talk a little bit about how we're connecting into that as well.

So looking at that, kind of a blow-up enlargement of that, of that space of our site.

Really what we're looking at is to be able to bring this the most of the patients, and most of your visitors are coming in off of the southeast corner there.

And there are, is rather the southwest that lower right-hand corner and creating a loop drive in there.

And we are able to, there is a patient drop off, and valet there, but then there's also a loop to where patients who are self parking can go directly into the parking garage.

One of the things that we are also talking about engaging the kind of that development next door is creating kind of a Paseo and a pedestrian walk in green space that connects, visually connects over to the adjacent development.

And then to take a look at the stacking, very similar to what we see, we saw at Doral, but we've got a much expanded, much larger footprint here.

So really able to get more of the functions like your surgical platform, imaging, really down on that lower level, the lower two levels.

And so it's a little bit, a little bit more spread out.

And then the clinics are on the upper floors.

We do have shelf space in there for future clinics for future clinic growth.

And then also as in most of the facilities, the chemotherapy units, CTU infusion chairs are up on the to afford for the best views.

So, just taking a look at the overall building layout in that first floor, you know, as we've said, the common theme is that being able to separate that back of house flow from the front of house and really creating that arrival sequence and that experience.

Even as you're coming in off from the parking garage, we have a closed, basically an enclosed with glass walkway that takes you from the parking garage into the main building.

And then along with that, the main entrance that's there kind of in the center.

And then down on that south side is where we had the rear dock again, for those patients that have a really quick turnaround, and so a be able to get them in and out of their treatments.

And as we're showing those, the dotted lines are basically showing that public entrance.

And then from the loading dock to the north, we are presented with a bit of a challenge on this site, in that we had the adjacent site to the north.

They have a garage access and some of their loading, some of their materials are coming through there.

So what we are needing to do, are looking at doing is having the screen wall between that healing garden as you arrive, and then in between the healing garden and the loading dock.

'Cause again, really wanting to make sure that we guard that experience, that patient experience.

And then here's the blue arrows and dash lines is really showing that back of house circulation from the loading dock.

One of the things that I would also wanna mention, and part of the part of the brand is that when you walk in, we have looked at one facility that they'd done, you know, fairly recent was the Lenore project.

We've referenced that all the time, but really getting that Lenore experience.

But a couple of things that really stood out to me when I walked into the building for the first time is, there's a fragrance that you walk in when you walk into the UM facilities, that's a very calming and soothing.

So, I mean, really, they've really paid attention to a lot of the details that, you know, and a lot of clinical or in a lot of wellness environments you don't always get.

So there's that.

And then also in their public lobby, there's a piano.

There's a piano that sometimes people come walk up and play the piano, but then if that it's always going.

So, just taking a look then on that second floor, that's the OR module.

You can kinda see that separation of flow, those yellow areas that are to the east.

There's is that public flow coming off of the public elevators.

Once you go into those blue spaces, those are basically your prep and recovery bays, and then that goes into the OR.

The areas of red are your procedural areas.

And so, again, it's really that separation of flow of service, where you get those intense services that are back off of that public zone.

And then on the third floor, we're looking at a rehab and then also their ortho, at sports med cohorting those clinics with the ortho, with the rehab and sports medicine.

And also those green areas, what we're looking at as well as really being able to accommodate the rehab area 'cause some of the things that they do, there it's outdoors, that'd well for that.

And so we really have created or creating this roof deck similar to what they have in other locations, this location being on the third floor, adjacent to the rehab, it's really good, good access there.

And then we'll also have access to that roof for other events in the community and events within the system can be, they can occur there also on that roof deck.

And then the shelled floor.

And then this really, this slide just kind of shows you the clinic modules.

So there's a little bit of a separation.

So I mentioned before, it wasn't as easy to see on the Doral plan, but you can see it here 'cause we haven't gotten to the level of laying everything out just yet.

But those three exam pods, and basically what that those are geared for is to be able to have pods of 15 exam rooms, but in a multidisciplinary, in a multi multidisciplinary clinic it allows for, you know, to be able to have some separation of clinic, but also flow back and forth between the clinics to be able to, if you know, if some clinics are busy and if some clinics are over time, you know, as some clinics get more volumes than others, they can ebb and flow into to each other in those multi-specialty clinic, in that multi-specialty clinic environment.

So really looking at flexibility, it's part of that, that building resilience and sustainability.

And then on level six, again, the CTU, that's all that's on the top floor, affording the views.

We're fortunate on the CTU to have a lot of open space around.

So, not have having to put as much of the green roof in that site mitigation, (murmurs)the best views on Sole Mia are to the east.

There's the part of the development, there's high rise development that overlooks the park, and then also a lagoon that's over there as well.

So those are, those are really the best views of the building.

So we've tried to add as we go up the building really orient the views to that, to that east side.

And so that's kind of the end of our presentation.

I wanna, we wanna thank you for having us here today, and wanna open it up for any questions you may have.

- (indistinct) before you do that real quick, Michael.

- oh, go ahead.

- So as you can see from the project, we kinda gave you a little history of what branding was.

We talked about how the University of Miami has standards that they use to help define their brands.

So when you go into facility A, you walk into that exam room it's the same as when you go into a facility B.

Consistency is what we talked about in that branding message.

Our lobbies have very similar materials and we execute that throughout the entire building.

And so the design team now has about three months to continue developing that design that you saw today and illustrating how that brand can be strengthened through the architecture.

So with that, we'll go ahead and turn it over to questions and answers.

I think we're about right on time.

- Sure.

- I have one question.

It was about how, I was wondering maybe if there was a way this hospital was possibly a disaster proof, or at least was able to be build in a way where when (indistinct) for like damage during disasters?

- The question was, was the facility being designed to be resilient against hurricanes and weather and that type of situation.

And the University of Miami has several buildings on campus, and certain buildings they consider a critical access building.

Right now in the discussions we've had with Ed, and the University of Miami, this building is not a critical access facility.

The goal here is that patients will leave five o'clock and doctors will as well.

With that said, there are certain implications that we'll add to the building infrastructure to make sure that it won't go down completely during a weather condition, and it'll have some kind of resilience.

Any other questions?

- I think Ed is muted.

- Ed, do you wanna comment on that?

Unmute.

- There you go.

- There you go.

- No, I'm just, can you hear me?

- Yes, yes.

- Can you hear me, Larry?

- Yes, we can hear you.

Can you hear us?

- Okay, so yeah, the south Florida building code or Florida building code requires that where our buildings are very resilient.

The biggest issue that would be differentiating us from one of our hospitals is 24-hour operations.

And like Larry said, our facilities usually open til seven or later, depending upon what's going on.

Our CTUs and our MRIs are very, very busy.

But our goal is to be able to shut the building down and get out of the building if there's a major weather, storm coming our direction, and then be able to open it up rapidly as possible.

And that way we will have a generator and simmer and keep our air conditioning running just slightly so that it won't have any mold growth.

So that we can open it back up speed to market after the event has passed.

- Any other questions?

- That's it?

- Hi, I have a comment.

Can you hear me?

This is George Mann.

First of all, thank you to Harold for introducing you and thank you for CRTKL for your support of our program, with very interesting as this one was.

And I'd like to point out to the students, the clarity that you have to rethink in the Zoom world about your drawings.

These drawings were very, very clear, and the zoning particularly on the stack section was very clear for a client to understand, but not only a client, your colleagues, your engineers, your younger designers who develop plans further.

So, keep in mind that I think Zoom is gonna be here to stay in different forms, and it requires a different kind of approach to graphics.

And I do hope that Patrick gets better and it was nice to meet you.

Thank you.

- Thank you.

As George mentioned it was, you know, this project actually is kind of a hybrid process.

We go to the University of Miami to work with Ed and his team, but we have several users that will also Zoom in as well.

So, our society of architecture has changed quite a bit in the last two years, and we've kinda rolled with the punches and figured out how to work.

For example, we had some technical technical difficulties here today.

I apologize for that, but the way we had to work things, but we found a way to make it work.

So thank you.

And thank you for having us.

- We've become very (murmurs).

(Michael chuckling) - Yes.

- There's a question from Perry Carol, what are the overall interior dimensions of the standard exam room that has the three zones?

- 10 By 12.

- You wanna repeat the question?

- Oh, yeah.

I'm sorry, thank you.

The question was, what are the standard, what are the interior dimensions of the standard exam rooms that accommodate, that we're standardizing.

That's a 10 by 12, 120 square feet.

- Yeah, and the University of Miami has gone through several mock-ups and some progress that you saw earlier in the process to really come up with that as the universal design.

All of our clinics are multidisciplinary.

So, one day you may have a GYN practice near there, the next day it may be a different type of a specialty.

So that's the key with a 12 by 10.

Any other questions?

- [Learner] For the exam room do you still have a need for a consult room, or do you envision that happening in that exam room?

- We do have some consult rooms that are, that are in there.

I mean, you really, it comes down to throughput usually.

I mean, Ed if you wanna chime in just kinda with the model at UM, but typically it comes down to throughput and being able to get, if you have consults that really it may need to include a family member, if you've got elderly parents.

It's being able to have consults and sorry, I didn't mention that before in the plan, we do have some consult rooms in the (indistinct).

- We have very few consult rooms 'cause we can't trust our physicians make them exam rooms.

So we just prefer to give them a standard exam room that they can obviously do consults in them as well.

So, to maintain our flexibility, if we have consult rooms are generally on the surgical floors where they might be putting a family member in post-surgery to talk to them.

Or also we have consults in our women's mammography areas.

- oh, yeah.

- Where they might have to tell somebody based upon the imaging that's come back from their mammography, if they have a problem or they've seeing the tumor or something like that.

So, we do have a few of those, but typically we just use our standard exams for consult as well as physical exams.

(man coughs) - Any other questions before we wrap up?

- I like the idea that you were mentioning about the extended brand and how it flows through everything that you do.

Can you explain that from a corporate side, through any pint that you may be working with and how the architect's brand continues to have impact?

- (murmurs) that one.

- So I'd say I kinda go back to the slides that I was looking at.

You couldn't see all of the slides.

I apologize for that, but, you know, there's that, that really, what we do is...

There is the brand of architectural firms, but we're really, in the world of healthcare design and planning, really being able to understand what the branding is for the community or how a facility engages the community is really important, through that in community engagement and then also the research and development.

So we've been really fortunate on this project.

They have had a lot of robust discussions and they went through the whole process.

So we really kinda have some living labs to be able to take that, and work with that.

So, really it's, it kinda provides for us a good framework.

- Yeah.

- And infrastructure to really infuse what we do as a profession and look at things like public areas, where you are looking at the infrastructure of clinics, 'cause it's about operations.

It is about a patient experience, but in projects that we do it's looking at those opportunities for the delight, I guess as well.

- Yeah, it's important to note that (indistinct).

No, I was just saying that CRTKL have been on our team.

We had started this project before the pandemic had hit with another design firm.

And we had a much more challenge with them listening to us and wanting to do what UM wanted to do as far as branding was concerned, our standard exams, and the pandemic allowed us to go back in and hire somebody that was gonna listen to us 'cause we paying the bills.

And we have certain things that we wanna see to maintain our branding and our continuity between our different locations.

And they've done a wonderful job taking our standards and making them better.

And I think that's the key.

- I think that concludes today's presentation.

Thank you very much for joining us and (indistinct).

(indistinct chatter) (Michael chuckling) (audience applauding) - Thank you.

(audience applauding) - So thank you, Larry, Michael and Ed for your time.

So, I'd like to reiterate that the lecture series continues on.

Next week, we have two lectures, one for the students that are in the class.

So it's an extra credit assignment on Wednesday, November 10th at 2:30 to 3:30, here in the studio by Grisham Smith Architects, collaborating to design and build a new hospital for Baptist Health Care Brent Lane campus in Pensacola, Florida.

And also continuing our typical lecture series on Friday, November 12th, here again at 12:40 in the studio, healthcare design, a world of opportunities for complex topology with Matteo Fabiano from (murmurs), Robert Dung and Professor Shimeji, making the introduction.

So thank you all again for a fantastic presentation, and to CRTKL for your presentation today.

I look forward to seeing you, and Gig Em Aggies!