Adaptive reuse, the trend of turning vacant commercial and residential spaces into new property types, is hitting the healthcare industry and driven by a number of factors. First, the pandemic brought retail to a grinding halt and many commercial properties are being sold off or are up for new leases; leaving plenty of space available for healthcare uses. Secondly, patients prefer receiving medical care in outpatient settings when they can. It’s easier then navigating through sprawling hospital campuses. Additionally, vacant retail space offers an advantage for healthcare systems creating new facilities as these buildings usually offer open floor plans and require less demolition. These spaces can be more cost effective for reuse than renovating another building type.

Advocate Aurora Health (AAH) is seizing on this opportunity. Its newest healthcare facility in Racine, Wisc., located in a former Pier 1 Imports store is a great example of this adaptive reuse. Zimmerman Architectural Studios designed the 9,600 square foot clinic to provide primary care, urgent care, imaging, and on-site laboratory services and CG Schmidt was the general contractor. Construction began on the $7.25 million health clinic in May 2020 and finished in December 2020 to convert the former retail store into an outpatient clinic. The facility began seeing patients in February 2021.

Dramatic Changes and Challenges

Along with the interior renovation, the exterior of the building was upgraded. The vestibule was expanded to enhance patient circulation. New windows were cut in along the front facade and along the back where the staff offices and break room are located to bring more natural light inside. New air handling units were installed along with a new emergency generator and electrical transformer added to the site to support the utility needs of the clinic.

Identifying any existing utility gaps and developing solutions is key to successfully redeveloping vacant retail space into a healthcare use. On this project, the design team and client identified the need for an emergency generator. The existing site was very constricted so the location of the generator was reviewed and evaluated by the team to find the best solution. The final location was selected because of the close proximity to the electrical room, which reduced wire lengths and costs. In addition, the building needed its own electrical transformer installed. The existing building shared a transformer with the neighboring building. This installation required close coordination with the electrical company and the neighbor to install it during off hours to eliminate down time. The cut over went well and was done in a shorter period than originally anticipated.

CG Schmidt reinforced the roof deck for new air handing units, and openings [in the roof] for ductwork and roof access. The team also added structural steel lintels over the storefront windows in the front and back of the building to support the roof joists. Structural footings and foundation work was done for the vestibule addition.

Sustainability

While AAH did not go through the USGBC LEED certification, the organization has a Healthy Spaces Roadmap that all construction must follow and meets or exceeds LEED. The project recycled 85 percent of materials; uses PVC-free flooring and PVC-wall coverings; incorporates water reduction standards and systems commissioning on the mechanical systems; and used prefab walls, plumbing, electrical and all ductwork, over 25 percent, which is quite high for a buildout.

By adaptively reusing vacant retail spaces, healthcare systems like AAH can add new clinics in locations that are currently underserved and provide better access to services for their patients. In fact, this newest AAH clinic is near major roads and on bus routes, allowing for easy access for patients.

Patient Model

This facility uses a patient self-rooming model for the 11 exam rooms. When patients arrive and check in, they are directed to the exam room where they will be seen. This model reduces the wait times and the need for waiting area space. The clinic features a collaborative staff work area surrounded by exam rooms, which reduces footsteps for clinical staff and improves communication. The clinical work area also provides a line of sight to all exam rooms for better flow management.

Diversity and Inclusion

Economically strong, vibrant communities are beneficial in the construction industry because they help build and develop the construction workforce for the future. Increased participation of under-utilized businesses provides better work opportunities for under-represented groups. Engaging diverse and local businesses benefit communities by job creation, mentorship of growing firms, and valuable job training and desirable skills. For the AAH adaptive reuse project, 32 percent of the construction team was considered diverse and over 20 percent lived within the county boundaries. Additionally, 24 percent of the Trade Management Partners (TMPs) used to equip the facility were operated by or employed by diverse individuals.

The Future

Repurposing commercial space is a viable option for healthcare systems because this often saves both time and money, with the collateral benefit of reinvigorating the community and bringing care closer [to the community]. This new AAH clinic is providing more access to high-quality care for people in one of the fastest-growing residential and commercial areas in the state. The health center is projected to see approximately 16,500 patient visits annually by the end of its fifth year. 

Mark Lillesand, CG Schmidt Vice President, serves as a company leader in the area of Lean Construction and may be reached at Mark.Lillesand@cgschmidt.com or 414- 577-1142. With over twenty years of experience, Mark has extensive expertise in the healthcare market for clients such as Advocate Aurora Healthcare and Ascension Health. Mark is a member of the Lean Construction Institute – Wisconsin Community of Practice and a member of Wisconsin Healthcare Engineering Association. 

CG Schmidt, a family-owned company since 1920, is a leader in construction management, general contracting and design-build services throughout the Midwest. For more information, visit www.cgschmidt.com or follow the firm on Facebook, LinkedIn or Twitter.

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