Party Walls

“Trends in Healthcare” is a recurring series that focuses on exciting new designs and technologies we’re seeing in healthcare projects and provides best practices on how to ensure that these latest trends are accessible to persons with disabilities. We build on the wealth of knowledge we gain from working with healthcare design teams, construction crews, and practitioners to provide practical solutions for achieving accessible healthcare environments.

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Anyone who has ever had to take a trip to the hospital knows how much time is often spent in the waiting room. As a result, our experience in that space can shape our perception of the entire visit. In fact, studies have shown that a visitor’s impression of the waiting room itself contributes significantly to the likelihood of a return visit.^[1]  The length of wait times can vary – from a relatively short wait for a screening, to an average of 40 minutes in emergency departments, to the better part of a day if you are waiting for a family member to receive treatment.^[2] As healthcare providers strive to remove pain points within the patient experience, they are turning to a number of design strategies to help create a more pleasant waiting room experience. One of these strategies is to ensure that patients and visitors have access to electrical outlets.

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As the country continues to confront the realities of the COVID-19 pandemic, the way we navigate spaces is changing. One of these changes is the way we interact with common use objects that traditionally require hand-operation, like doors. While automatic doors have always been a good option for providing greater access to people with disabilities, hygiene concerns associated with the spread of disease have presented another argument for their use. The rise of touchless technology as a result of this pandemic will increase the use of automatic doors not just for accessibility or convenience, but for public health as well. For anyone considering incorporating automatic doors into their designs, either for new construction or as a retrofit, here are some important things to consider:

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As humans, we spend a lot of time indoors. Studies by the U.S. Environmental Protection Agency indicate that under normal circumstances the average American spends over 90% of their life indoors. With the spread of COVID-19 and widespread voluntary and involuntary quarantine, the rise of work from home policies and new direction to social distance has resulted in a further increase to the amount of time we spend indoors. Now more than ever, people are cognizant of the air they’re breathing and the surfaces they’re touching. The buildings that we live, work and play in impact our physical and mental health. With certain building and design considerations, we can make these impacts beneficial.

We recruited some experts at SWA to fill us in on the various considerations when it comes to the health and comfort of a building, as well as some certifications that assure these considerations are met.

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Last year, a young New Zealand lawmaker shut down a fellow member of parliament who was heckling her climate change speech with two words: “OK, Boomer.” This simple phrase started an online wildfire and ignited a conversation about the generation known as “baby boomers.” Born just after World War II, this demographic represents a period of growth, hope, and prosperity. The building, real estate, and senior housing industry has been thinking about the boomer generation for a while now. Between the years 1946 and 1964, 76 million babies were born. Every day until 2030, 10,000 of these individuals will turn 65, which means they will likely be retiring, and eventually considering how and where they want to age. This poses the question: how are we going to meet the growing demand for housing and care for this population?

Important Considerations for Senior Living

Whether you or someone you love is considering staying in their home as they age or moving into a senior living facility, there are a few important factors to keep in mind. SWA services for senior living revolve around the following three factors:

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The 2010 ADA Standards and the A117.1 Standard for Accessible and Usable Buildings and Facilities require the bottom 10 inches on the push side of a door to be smooth and free from any obstructions for the full width of the door. While there are some exceptions (e.g., sliding doors or tempered glass doors without stiles), this requirement applies at the following locations:

• 2010 ADA Standards:
  • Public and Common Use Areas: All doors along the accessible route
  • Accessible Dwelling Units: The primary entry door and all doors within the unit intended for user passage
• A117.1 Standard:
  • Public and Common Use Areas: All doors along the accessible route
  • Type B Dwelling Units: The primary entry door
  • Type A and Accessible Dwelling Units: The primary entry door and all doors within the unit intended for user passage

The door surface provision is intended to ensure the safety of people with disabilities who require the use of a wheelchair, walker, cane, or other mobility aid. It is common to utilize the toe of the wheelchair or leading edge of another mobility device to push open a door while moving through it. The smooth surface allows the footrest of a wheelchair or other mobility device that comes into contact with the door to slide across the door easily without catching.

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If you are a parent like me, I am sure you cherish your kids and seek to offer them the best opportunities in life. I even moved to a different school district. And, while the education is top-notch in my town, I have come to realize that it really doesn’t matter what school district you are in…all our schools need help. I am not talking about smaller class sizes, better pay for teachers, after-school programs, and more school supplies, although those are important. School buildings need attention. With budgetary pressures, a lot of maintenance and repairs are being deferred and schools are not aging well. Whether it is repairing existing systems, replacing systems at the end of their useful life, renovating, or building a brand-new school to service your community for future generations, advocate for your Board of Education (BoE) to think holistically about improving the conditions for our children.

Why My Call to Action?

This year I was asked to join our elementary school’s Tools for Schools committee, which is tasked with implementing an indoor air quality (IAQ) management plan. This experience gave me an opportunity to get involved and provided me insight into the school’s systems and the operations and maintenance (O&M) processes that were in place.

Unfortunately, at the start of the 2018 school year, mold issues were identified in our local middle school and the building was closed. In fairness, I quickly realized that buildings were outside the BoE members’ knowledge base. Afterall, they are educators, not facility managers or building scientists. They sought outside consultants but didn’t know the right questions to ask. After some time, the BoE decided to get input from local experts in the community. Fortunately, we have several experts (including me) who were willing to volunteer their time. As part of a task force, we laid out a strategy to remediate the mold issues in the school and to implement short- and long-term repairs to minimize/eliminate water incursion and elevated moisture issues within the building.

I am not saying you must get involved at this level, but I do encourage you to attend a BoE meeting and start asking questions related to IAQ. Ask if the school has deferred maintenance needs and if/when these are being addressed in the annual budget. Ask when (if) comprehensive physical needs assessments and energy audits were performed on all school buildings. Educate yourselves; then help educate your BoE and your community on IAQ guidelines for schools. Here are some great resources:

• EPA’s Indoor Air Quality Guidelines for School Building Upgrades
• Operations & Maintenance Tools from the New York City Department of Citywide Administrative Services (DCAS) Division of Energy Management (DEM)
• EPA’s Indoor Air Quality Master Class Professional Training Webinar Series
• ASHRAE’s Advanced Energy Design Guide for K-12 School Buildings
• EPA’s School IAQ Assessment Mobile App
• USGBC’s The Center for Green Schools
• NIOSH’s Dampness and Mold Assessment Tool – School Buildings

How Can SWA Help?

In working with schools, I have learned that one of the greatest challenges school decision-makers face is not knowing where to turn for support and guidance. Steven Winter Associates, Inc. (SWA) has been working to improve educational facilities for decades. Whether you have questions related to mold, moisture, comfort, absenteeism, accessibility, high utility bills…on up to zero energy design and progressive learning environments, SWA can support you. Here is just a sample of past school projects that SWA has worked on:

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When designing accessible parking spaces, it is important to remember that the slope of the ground surface for the entire parking space and adjacent access aisle must not exceed 2% in any direction. We frequently see noncompliant slopes at accessible spaces, especially when the ground surface is asphalt or permeable pavers.  The slope along the perimeter of spaces at curbs or gutters is frequently more than 2% at up to 5%, which requires careful detailing and planning on the part of the architect, civil engineer, and on site contractors to ensure that a compliant slope is achieved at the accessible parking spaces. At parking structures and precast garage systems, we have found that important details and coordination needed to achieve compliant ground surface slopes are often overlooked.

 

In parking structures, it is common for an area along the perimeter of the slab (adjacent to walls or parapets) to slope in excess of 2% for drainage purposes. In some cases, this slope is embedded into the precast system. As a result, accessible parking spaces must be located away from the sloped edges during the initial design phase.

In other cases, noncompliance results from the application of a cast in place (CIP) wash applied to the top of the precast slab. In the detail shown below, note the slope condition at the CIP topping. The wash is often indicated only in section details on the precast drawing set, making it easy to miss if designers are not specifically looking for how these details affect accessible parking spaces. The entire project team involved in the design and/or construction of the garage must be made aware of where accessible parking spaces are located and understand the specific slope requirements to ensure that details are properly coordinated.

Once the garage is constructed, it is nearly impossible and very costly to fix noncompliant slopes at the head of accessible parking spaces. In some garages, we have been able to solve the problem by shifting the striping at accessible parking spaces. This results in the steeply sloped ground surface being located fully outside of the parking space and access aisle. The problem is that this solution is dependent upon whether the spaces can be shifted without compromising the minimum required width of the drive aisle or obstructing access to other parking spaces.

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Last month, I had the opportunity to attend the Environments for Aging conference in Salt Lake City. Hundreds of professionals involved in the complex world of senior living gathered to learn from each other and to explore products and services that are designed for the senior population. It was not surprising to see the level of interest in the event; according to the US Census Bureau, 20 percent of the current US population will be 65 or older by 2029. The Baby Boomer generation, which accounts for the majority of that 20 percent, is moving into their 70s and are beginning to consider how and where they want to age. Some Boomers prefer to remain in their current homes in the communities that they helped build. Others want to move into smaller homes or prefer to transition to senior living communities. Many of these senior living communities are popping up both in suburbia and active urban centers in response to the current trend in senior housing preferences.

There are many senior housing typologies: among the most common are independent living, assisted living, and dementia care. Each type of living arrangement has specific needs that must be addressed from a design perspective.

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“Trends in Healthcare” is a recurring series that focuses on exciting new designs and technologies we’re seeing in healthcare projects and provides best practices on how to ensure that these latest trends are accessible to persons with disabilities. We build on the wealth of knowledge we gain from working with healthcare design teams, construction crews, and practitioners to provide practical solutions for achieving accessible healthcare environments.

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According to the U.S. Centers for Disease Control and Prevention (CDC), falls account for 3 million injuries treated in emergency rooms, 800,000 hospitalizations, and 28,000 deaths each year in the U.S. One in five falls cause serious injuries such as concussions/traumatic brain injuries and hip fractures. Not only is this a public health concern, it is extremely costly. According to the CDC, medical costs directly related to injuries resulting from falls totaled more than $50 billion in 2015.^[1] Within hospitals and long-term care facilities, effective implementation of interventions and design strategies to reduce patient falls are key to increased patient safety and decreased medical costs. However, it may not be possible to eliminate patient falls altogether, so features like a properly installed nurse call system can be life changing.^[2]

Accessible Nurse Call Stations

Most state and local standards and regulations require nurse call devices in each public toilet room and within inpatient bath, toilet, and shower rooms.^[3,4] Where provided in spaces required to be accessible, the nurse call device must also be accessible. An accessible nurse call device is one that meets the following requirements: (more…)

2018 has been a year to remember for SWA’s Party Walls blog. Our consultants have shared their passion for high performance buildings by recounting stories from the field and providing information, new findings, and best practices to improve the built environment.

Whether discussing topics based in New York City or Southeast Asia, here are our fan favorites from 2018…

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