COUNCIL BLUFFS, Iowa—Nebraska Methodist Health System’s Jennie Edmundson Hospital recently unveiled its state-of-the-art cardiovascular suite, marking a significant advancement in heart care for Council Bluffs and the broader southwest Iowa region. The space, designed by RDG Planning & Design, allows the hospital to expand its reach and enhance its cardiovascular services. It officially opened its doors on Monday, April 1, 2024.

Located between the hospital’s emergency room and radiology department, the suite benefits from its adjacency to those departments, operating rooms and locker rooms which can be accessed if needed. It features all-new equipment and is designed to streamline operations, enhancing the hospital’s ability to perform advanced procedures and manage patient care more effectively.

“Working alongside the hospital, our goal was to create a space that meets the evolving technological demands of cardiovascular care and fosters a comforting atmosphere for patients and their families,” said RDG Architect and Partner Katie Ramsbottom, AIA. “Through our design, we aim to contribute to the hospital’s vital work, ensuring that the residents of Council Bluffs and the surrounding region have access to the best cardiovascular care available.”

The cardiovascular suite features all-new equipment and is designed to streamline operations, enhancing the hospital’s ability to perform advanced procedures and manage patient care more effectively. Photo by Thomas Grady Photography.

The newly designed, 5,700-square-foot suite replaces the hospital’s existing outdated and undersized cath labs and includes two Class 2 imaging rooms, a minor procedure room, four prep/recovery rooms and support spaces. The design prioritizes patient and family experience, with a dedicated family waiting room and user-friendly flow of movement, as well as clear separation between family-access spaces and procedure spaces. A shared storage room between the two imaging rooms reduces the need to duplicate equipment.

“Moving into this new space reinforces Methodist Jennie Edmundson’s commitment to cardiovascular care in Council Bluffs and the entire Southwest Iowa region. Our program had outgrown the previous space, and because of that, it restricted what the team was able to provide patients in terms of new procedures and advanced technology,” said Marcia Keith M.S., BSRT (R), Methodist Jennie Edmundson Hospital Service Leader – Cardiovascular Service Line. “We now have an additional cardiologist and an interventional radiologist who will also help increase the services we can now offer. The new suite will also make the workflow more efficient and allow us to bring in much-needed advanced technology and other tools and equipment to better care for the patients in our community. The space is beautiful, and we enjoyed working with RDG to make our vision a reality.”

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WAUKEE, Iowa—On February 21, 2024, RDG Planning & Design joined The Iowa Clinic to celebrate the official opening of the healthcare institution’s latest facility. The new facility continues a partnership between RDG and The Iowa Clinic, following collaborations on several local clinics in surrounding communities, including Grimes, Adel, the North Waukee – Alice’s Road dermatology clinic and a new specialty infusion center in West Des Moines.

Strategically located in Waukee, Iowa’s Kettlestone development along Grand Prairie Parkway, RDG’s design for this forward-thinking project introduces a unique blend of clinical services, ambulatory surgery and Iowa’s first outpatient cardiac catheterization lab under one roof, setting a new standard for patient care in Iowa.

“This project embodies The Iowa Clinic’s commitment to providing the best possible patient care. We’re deeply proud to help bring to life a facility that meets the comprehensive needs of today’s healthcare landscape and also anticipates the demands of tomorrow,” said RDG Interior Designer and Senior Partner Leann Pederson, IIDA, CHID, LEED AP.

Design for the clinic encompasses approximately 56,000 square feet of space, including a 35,000-square-foot medical office building and a 21,000-square-foot ambulatory surgery center. Designed for expansion, the center aims to adapt to the growing health needs of Waukee’s residents, offering services ranging from urgent care and imaging to family medicine, orthopedics and pediatrics. RDG provided architecture and interior design services in collaboration with Ryan Companies (contractor), Shive-Hattery (civil engineering) and Raker Rhodes (structural engineering).

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AMES, Iowa—ChildServe recently announced the completion of its $8 million Ames, Iowa, expansion project and hosted a celebratory grand opening on Wednesday, September 27, at 1915 Philadelphia Street in Ames. Since its opening in 1995, ChildServe in Ames has been a staple in the community for families raising a child with special healthcare needs. The expansion doubles the current footprint when it comes to physical space and it will also double the number of children served at the Ames campus.

“ChildServe provides a continuum of services for children with special healthcare needs in four key areas: autism services, pediatric rehabilitation, complex medical care and community-based services,” said Kate Reynolds, ChildServe – Ames Director. “We partner with local hospitals, pediatric specialists and healthcare providers to improve outcomes and make life a little easier for families caring for children with special healthcare needs.”

The expansion project, designed by RDG Planning & Design, meets multiple needs for the organization, including additional space to provide treatment to more than 200 children on a waitlist for outpatient therapy as more clinicians are hired. Designed with both patient and caregivers in mind, the rooms are warm and welcoming, modular in size and divided by each therapy to allow for maximum flexibility between services. Story Construction was the general contractor on the undertaking.

The expansion also includes a customized space for the Autism Program, which offers a range of services for individuals with autism. The program features a unique floor plan where children can smoothly transition between individual and group therapy activities, classroom activities and play. The Georges Niang Therapy Gym, a fully equipped facility with state-of-the-art technology and equipment, serves as a space where children across multiple services can work toward their goals.

“The completion of this project marks a milestone not just for RDG or ChildServe, but for the community as a whole. It underscores the power of partnership and innovation in creating spaces that nurture hope, progress and possibility for children and families navigating the complexities of specialized healthcare needs,” said RDG Project Manager, Aaron Fulton. “We are honored to be part of a legacy that’s helping redefine pediatric healthcare, and we look forward to witnessing the many ways this space will positively impact families in Ames and beyond.”

The expansion project was made possible through generous donor support and a $2.7 million grant from the Iowa Economic Development Authority. The philanthropic support totaled over $4.7 million, which included a $1 million lead gift from donor Connie French.

“I’m grateful to each of our donors and the greater Ames community for their support in making this expansion project possible. We are excited to welcome more local children who can benefit from ChildServe’s expertise and wide array of programs and services. This expansion project has been an amazing reminder that when we all move forward together, we can make a lasting difference for our community,” said Dr. Teri Wahlig, ChildServe CEO.

The Ames expansion is part of ChildServe’s regional growth strategy, which includes enhancing its campuses in Ames, Des Moines and Iowa City to serve as regional centers.

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NORTH LIBERTY, Iowa—Steindler Orthopedic Clinic, one of Iowa’s largest independent orthopedic practices, officially broke ground on its new clinic and ambulatory surgery center (ASC) on Tuesday, July 25, 2023. Joining Steindler at the groundbreaking were design and construction team members, including representatives from RDG Planning & Design and Miron Construction Co., Inc. The groundbreaking event occurred at the clinic’s new location on Kansas Ave in North Liberty, just north of Forevergreen Road.

“Today’s ceremony marks the beginning of construction and represents the first step in a new journey. It’s the culmination of countless hours of planning and diligence, and we couldn’t be happier to have the project underway finally,” said Patrick Magallanes, JD, MBA, MPA, FACHE, president and CEO of Steindler Orthopedic Clinic.

Estimated to be completed in early 2025, the clinic and ASC are situated on a multi-acre plot of land and oriented toward nearby thoroughfares, allowing for ease of entry and improved visibility into the facility. To reduce redundancy, RDG’s design allows the ASC to function separately from the clinical spaces while leveraging and sharing many back-of-house areas.

“It’s been an honor to work alongside Patrick and the team to develop a vision for this new clinic,” said RDG Architect and Partner, Will Downing, AIA. “We are excited to celebrate this pivotal first step and continue to collaborate on what will ultimately become both a place of healing for patients and a valuable asset to the community.”

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Addressing the need for well-designed behavioral health facilities is critical. From 2007 to 2017, the CDC reported a 40 percent increase in suicide rates, making it the 10th leading cause of death. In Iowa alone, suicide is the ninth leading cause of death. Although these numbers are startling, there are numerous medical facilities across Iowa and the nation working to address the country’s growing behavioral health needs. One such facility is MercyOne North Iowa Medical Center in Mason City, Iowa. RDG’s work on this project, which was designed in collaboration with BWBR, the Design Architect and Behavioral Health Planner, helped us establish three critical considerations where design can support the treatment and well-being of patients: admittance procedures, patient rooms and patients’ overall sense of control.

Design for the First Impression

For patients and loved ones, the intake room is their first point of contact. Creating a dedicated intake room can help expedite the admittance process and allow specialists to see patients more quickly. In addition to reducing the time it takes to admit patients, placing intake rooms near security and other needed amenities (e.g. lockers for patients’ personal belongings), helps ensure a safe area where providers can start or finish evaluations, and where patients can change into scrubs or gowns before entering a unit floor.

The behavioral health intake room at MercyOne North is its own dedicated space, part of an “on-stage, off-stage” design that separates it from the rest of the unit. Tim Mason, nurse manager of behavioral health services at Mercy North Hospital, explains how this approach has made a positive impact on the overall patient experience: “We strive to have the time it takes from the moment patients first enter the emergency department to when they step onto the unit floor be 120 minutes or less.  [Since the addition completed], we’ve seen a significant decrease in the number of patients having to wait in ED rooms.” Positioning the intake room “off-stage” helps moderate anxiety for new or current patients and allows staff members to work in a space out of sight but still within proximity to patients in case treatment or intervention is needed. The “on-stage, off-stage” approach also helps mitigate distraction, enabling providers to be more efficient in their clerical work and separating high-risk individuals from sensitive areas like medication rooms.

The behavioral health intake room at MercyOne North is separate from the rest of the unit, helping to expedite the admittance process and allow specialists to see patients more quickly.

MercyOne North’s Behavioral Health Unit also includes a central nurse station with open site lines and features that encourage staff and patient interaction without appearing overbearing or institutional. Should they need to, staff can step back into lockable spaces to allow for security or additional aid, while at the same time allowing staff to conduct work just as they would in any other part of a hospital.

Design to Support Settling In

For behavioral health facilities, patient room design is especially critical in helping reduce risk and maintain a sense of dignity and comfort. Taking cues from the hospitality industry, design for these spaces can include amenities such a desk or armoire and a mix of engaging colors and natural materials, which help create a greater sense of control and alleviate stress. Additional amenities – exercise rooms, group therapy spaces, lounging areas – add a sense of familiarity and help deinstitutionalize the environment. While items like furniture and fixtures should be anti-ligature or fixed to prevent harm, subtle changes in the way we design and present these elements can ultimately help destigmatize the environment; as Mason explains, “Even though [patients] may be forced to be here, they are not prisoners. Providing an environment that’s warmer and more open gives the feeling of a place that’s providing help.”

1. Furniture that is tamper-proof, doors that are ant ligature and windows with integral blinds and lamented glass are a few basic steps to ensure patients are safe in the privacy of their rooms.
2. Resilient materials such as laminated woods and solid surfaces offer longevity as well as a sense of higher design that feels more hospitality-centered versus institutional.
3. Offering multiple seating and leisure options within a patient’s room can help give a sense of control. These areas can also be positioned to be in a direct line of sight of the door and encourage productive activities such as reading or watching the natural environment outside the window.
4. Providing natural daylight contains natural “cues” that help regulate the human circadian clock and activate the hormones required for normal biological functions and regulate mood.
5. Incorporating cooler colors in the overall pallet can create a calming environment, while warm wood grain VCT flooring offers an easily maintainable material that helps bring depth to a room.
6. Providing a TV behind a well-designed tamper-proof case can create a sense of control and familiarity. Override controls combined with set hours of screen time for patients can allow for positive distraction and decompression.
7. Adding fixed, anti-ligature paintings or pictures to a room may serve as a positive distraction for patients and create a design that feels more hospitality-centric, rather than clinical.
8. Encouraging patients to personalize their rooms by bringing in pictures or offering them books from the facility’s library can create a greater sense of control, instill a personal connection to the space and serve as a positive distraction.

(See featured image above for specific examples in use.)

Maintaining visual confirmation of patients’ whereabouts is vitality important, particularly when they are left alone in their rooms. Designing the overall space to maximize site lines to patient rooms allows for less obvious observation methods, such as windows or cameras, and can help offset feelings of unease or paranoia. A simple sidelight at the door in conjunction with a camera enables practitioners to observe patients in a way that feels supportive rather than controlling. Likewise, lighting plays a critical role in enhancing mental well-being. Daylight contains natural “cues” that help regulate the human circadian clock and regulate mood, so it’s important to provide access to views to the outside as well as exposure to natural light. Color tuning artificial light, which mimics the daylighting cycle and allows for changes in intensity and color, can also assist in patients’ overall sense of comfort.

Design for a Greater Sense of Control

Whether in patient rooms or in activity or common spaces, offering patients a greater sense of environmental control can aid in treatment and improve demeanor. One innovative example of this is MercyOne North’s sensory room. Equipped with controls to change the color or brightness of the lighting, speakers that can play music or soothing sound effects and comfortable, plush seating, the room offers a space where patients with heightened anxiety or who feel overstimulated can come to decompress. “Our staff can recognize when patients are getting upset or worked up and direct them to the sensory room,” explains Mason. “This allows for those patients to get some quiet time, listen to music, meditate or read. Staff can also sit in there with individuals and talk through the situation to help calm things down.”

Behavioral health facilities are often associated with sterile design elements, but safe design doesn’t have to equate to design that looks and feels overtly institutional. By using materials that evoke comfort and subtly incorporating ways to monitor patients, these environments can ones that feel supportive rather than punitive. Many of the concepts in this article follow current best practices, but as our understanding of mental health treatment evolves, it’s critical to consider new and potentially more effective approaches that can contribute to the overall comfort and well-being of behavioral health patients and those who care for them.

Aaron Fulton, Associate AIA is an architectural intern at RDG Planning & Design. An experienced designer and technician, Aaron brings his deep understanding of design standards to work for the firm’s Healthcare Studio.

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