A Health and Wellness Village for the Next Generation

An aging strip mall is converted into a community center for care, nutrition and family services as the industry moves to a consumer-driven model.

The healthcare industry is in the midst of a fundamental shift in how care is managed and delivered. In a competitive landscape, with costs rising and disruptive technologies taking hold at a rapid pace, providers and insurance companies are increasingly focused on keeping people healthy and out of hospital beds. Going forward, more care will be delivered at the community level, in smaller, more nimble environments that serve a variety of roles and diverse communities.

Many of these changes are already taking place, a move the industry has branded as Health 2.0. But the question facing industry executives is, what’s next? How can the facility model be transformed to deliver care more efficiently and more effectively, in ways that keep people healthier for longer by systematically changing daily human behavior?

LPA architects, researchers and designers from across disciplines recently came together with LPA Healthcare Directors Muhsin Lihony and Rick Wood and for a design charrette, diving into these questions. The goal was to develop a new model that would meet the future needs of providers, developers and the community. The LPA team was joined by healthcare executives, who are focused on delivering a holistic menu of care to patients.

For healthcare companies, the days of emphasizing large, centralized hospitals are over. “Healthcare is going to you,” said one executive. “It’s going to the community.”

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Technology will play a major role in the transformation. People will have access to expert advice and care in new ways, with virtual diagnosis and automated services growing more common. New facilities can operate as remote distribution centers, doing a better job of addressing the “last mile” of connecting patients to medications and care. The next generation of facilities will need to be convenient and serve multiple roles, with free time an increasingly diminishing commodity for families.

Discussions quickly focused on the aging inventory of shopping centers around the country. Easy access and a connection to shops and entertainment will be imperative. “If I am by a big retail space, that’s perfect for us,” one healthcare executive said. “It doesn’t have to be a medical office building.”

As discussions progressed, several themes began to emerge. The family is key, the healthcare experts agreed. Any facility should include elements that make things easier on parents, while improving the health and wellness of everyone in the family. A mother and her kids should be able to receive the same range of holistic care as a pro athlete, LPA Senior Project Designer Jeff Schaub said.

Kindergarten, daycare centers and an array of youth-centric amenities seem a perfect fit. Companies are already partnering with schools to do clinics and events for young athletes, integrating services with the local schools.

At the same time, the facility must address the business side of the industry, which is looking for new and efficient ways to provide care while lowering costs. Demand is growing for quality behavioral health, assisted living and skilled nursing facilities. Surgical spaces are an important revenue driver, but future hybrid operating rooms will look much different and require a much smaller footprint. It also makes sense to include birthing centers, as quality medical care, wellness and long-term health become the focus of care.

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LPA President Dan Heinfeld and Design Director Jeremy Hart began sketching out ideas, focusing on an existing Southern California shopping center anchored by a big box home improvement store and a free-standing department store. The initial focus was how to efficiently use the bones of the existing center to create something completely different.

“This is a way to maximize development flexibility and make healthcare more affordable by using the existing buildings,” Heinfeld said. “We can keep 60 percent of retail center and reduce parking by 50 percent by promoting pedestrian activities, and complementing mass transit opportunities.”

As a design started to take shape, sections of the surface parking lot were converted into a farmers’ market, taking advantage of the space to deliver fresh produce to the community. The shell of the existing home improvement store can be converted into a multistory service center, with open spaces for family activities. A cooking school can focus on good eating habits, helping to make nutrition a core value of the center. Spaces are flexible, allowing new technologies and different functions for patients.

The next-generation facility will serve different roles in the community, reflecting rapid changes in the population profile, workforce roles and digital technologies. A rooftop distribution center will use drones to deliver products to customers. Sections will serve as a fitness center, linking exercise and care in the same facility. Rejuvenation services, Lamaze classes and a day-spa all come together in this health and wellness version of a mixed-use center.

“The idea of a village is to collectively serve the community and provide choices in a one-stop setting,” Lihony said. “It all goes back to the neighborhood.”

This story originally appeared in Catalyst Issue 2 2019. Subscribe today to receive Catalyst, a quarterly publication that takes a deep dive into design ideas, industry leaders and initiatives.