Emory Customizes Musculoskeletal Care – HCD Magazine Leave a comment

Emory Healthcare’s musculoskeletal service line has been expanding for decades, growing in services as well as footprint around the metro Atlanta area. It’s most recent addition—the new 180,000-square-foot outpatient Emory Musculoskeletal Institute in Atlanta, part of Emory University’s Emory Healthcare—embodies a lot of the lessons and ideas gathered along that journey.

“The facility was an evolution of design, test, iterate over 30 years,” says Dr. Scott Boden, professor and chair of the Department of Orthopaedics in Emory University School of Medicine and director of the institute and the visionary behind the project.

After arriving at Emory University in 1992, Dr. Boden initiated the decision to move the musculoskeletal group to its first freestanding facility off campus. Its previous location wasn’t efficient, with parking and traffic issues that created a time-consuming arrival and departure experience for patients and staff.

Relocating two miles away, the group retrofitted a former bookstore into a 19,000-square-foot sports and spine center. And while the location addressed some of the previous issues (it had its own parking, for example), the existing layout wasn’t ideal for accommodating all its clinical needs, including exam rooms, X-ray equipment, and support staff offices.

The organization spent the next several years trying to find the right fit, including moving into a renovated office building in an executive park in 2004. Then, in 2016, the organization relocated its sports medicine division into a new 100,000-square-foot complex built in collaboration with the Atlanta Hawks professional basketball team on the same executive park campus.

That setting, on 55 acres acquired by Emory, was closer to what Boden envisioned as the best design—but still, there were constraints. For example, while there were better sight lines to patients, the building layout meant that clinical spaces had to wrap around the Hawks’ professional practice courts, which separated support staff from patient care areas.

During the design and build of the sports medicine project, Boden was asked to lead a task force to decide on the optimal use for the land adjacent to the facility.

The task force recommended a health innovation district, which would include a new central home for Emory’s musculoskeletal service line, including orthopedics and spine care, physical therapy and rehabilitation, imaging, ambulatory surgery, and research—all together under one roof with an optimized design for a highly efficient patient and staff experience.

Opened in October 2021, the 180,000 square-foot, six-story Emory Musculoskeletal Institute contains 117 exam rooms, four ambulatory surgery suites, six injection procedure suites, a physical therapy gym, advanced imaging suites, and an entire floor dedicated to education and research space. “We were finally able to design the entire facility from scratch, with no constraints,” Boden says.

 

Outpatient planning and design

Bill Leggett, principal at HKS (Atlanta), the firm behind the project’s architecture and interior design, says a guiding principle throughout the design and planning of the new facility was the idea of using the building form to communicate the building’s purpose. Specifically, soft curved walls and corners are designed to reflect the fluidity of motion that the institution ultimately aims to help patients maintain or return to, he says.

Another design goal was to tell the story of the musculoskeletal system’s key elements—bones, muscles, cartilage, and nerves—using the building floors, walls, ceilings, and glass structures. “Throughout, we took advantage of where we can utilize components of the body in the design of the building,” Leggett says.

For example, on the exterior, precast panels have a texture that’s designed to reflect the structure of the bones, while graphics on the glass curtain wall represent nerve veining.

Inside, wavy patterns in the terrazzo flooring and ceilings on the first floor are designed to reference muscles. Additionally, the walls of the lobbies on the clinic floors feature glass graphics and images, such as bone under a microscope, with accompanying text that explains what viewers are seeing. “It’s truly an educational building,” Leggett says.

 

Musculoskeletal care and research

To create an easily navigable and efficient patient travel, the building is organized to reflect the typical journey of musculoskeletal care, support an integrated care concept, and help patients avoid unnecessary steps and orient them throughout.

For example, using the main entry or a secondary entry (via the elevators from the adjacent parking deck), patients enter a light-filled, double-height lobby on the first floor, where they can access a centralized registration area, café, or imaging and diagnostics.

Additionally, a spacious physical therapy room was strategically placed at the far end of the first floor, visible upon arrival. “From a journey perspective, the patient can see the end of their journey,” Leggett says. “Physical therapy is often the final piece of their care.”

Moving up through the facility, surgery is located on the second floor while clinic spaces are on floors three to five; there’s also a canopied deck for respite on the third floor, which offers views of downtown Atlanta in the distance.

Each clinic floor houses X-ray rooms so patients don’t have to travel back down to imaging on the first floor. To help create consistency on the floors for more efficiency, public spaces, including waiting areas and checkout desks, are the same on each floor, arranged along the front exterior glass with views of the main entrance to help with orientation, Leggett says.

Physician work zones on clinic floors have an open layout to allow visibility through the clinics and facilitate easy collaboration and consultation, Boden says.

Another key goal of the project was to bring research into the building to make it more easily accessible and help bring new clinical treatments to the bedside faster, Leggett says.

Located on the sixth floor, the research lab juts out at a sharp angle to represent the cutting-edge research that will take place there. Inside, the department houses a large conference center, bio-skills training room, animal holding room, and a large lab set along the front of the building to bring natural light into the space.

 

Interior design details

For the interior design, the project team created a restrained, contemporary aesthetic that’s achieved through clean lines mixed with the waves and curves of the fluidity concept.

Specifically, a neutral color palette is complemented by warm wood accents and pops of color, including a blue gradient on the glass partition walls of the registration desks and furniture. This blue accent color, also featured at the elevator lobbies for example, ties into Emory’s branding.

Materials, including patterned metals used on the ceilings of elevator lobbies to represent the porous nature of bones and wood wall panels behind the reception desk representing muscle and bone under a microscope, were chosen to represent key musculoskeletal components.

Additionally, more than 200 works of art, with nearly half created by metro Atlanta artists, help reinforce the theme of dynamic movement, through colorful, abstracted forms evocative of muscles, tendons and even molecules says Nancy Sokolove, an art consultant with May Architecture (Atlanta), the art consultant for the project.

“Particular consideration was given to using color as a method of wayfinding throughout the building’s six floors.”

For example, the waiting areas on the clinical floors feature identical imagery on the forward-facing wall—birch wood circles screen-printed with details of a series of abstract paintings by a local artist—that’s done in the assigned color for that floor (the third floor is blue, for example), with the other artwork on each floor following the same color cues, says Sokolove.

 

Future of musculoskeletal care

In addition to research and integrated clinical care, the Emory Musculoskeletal Institute offers support for 10 regional offices and has set the bar for how Emory will evolve the campus into an innovative health district.

“The two themes we came up with during the task force were healthy society and innovative,” says Boden. “Over the next several decades, the land will be developed in support of those two themes as well as some live/work/play infrastructure.”

In the meantime, the new institute will continue to offer patients a more convenient and holistic approach to musculoskeletal care. “Our approach to musculoskeletal care is bringing together all the disciplines so they are seamlessly integrated,” says Boden. “We take the confusion and ambiguity out of who you should see when, and it’s all in the same facility.”

Joann Plockova is a freelance writer based between Jupiter, Fla., and Prague, Czech Republic. She can be reached at joann.plockova@gmail.com.

 

Project details

Project name: Emory Musculoskeletal Institute

Project location: Atlanta

Project completion date: October 2021

Owner: Emory Healthcare

Total building area: 180,000 sq. ft.

Total construction cost: $90 million

Cost/sq. ft.: $470

Architecture: HKS Inc. Atlanta

Interior design: HKS Inc.

General contractor: Brasfield & Gorrie, Structor Group

Engineering: Newcomb & Boyd Consultants and Engineers (MEP), Uzun & Case (structural), Kimley-Horn (site/civil), Newcomb & Boyd Consultants and Engineers (telecom)

Builder: Brasfield & Gorrie, Structor Group

Art consultant: May Architects

AV equipment/electronics/software: Bogen, Ericsson, Notora, Aruba, AT&T

Carpet/flooring: Mannington Commercial, Interface, Studio Marmi, Tilebar, Sassuolo, Iris Us, Teroxy, Stonehard, Nora, Mannington, Altro, Armstrong, Gerflor, Plae

Ceiling/wall systems: Armstrong World Industries USG, Arktura, Focal Point, Carnegie, Altro, Plyboo

Doors/locks/hardware: Allegion

Furniture—seating/casegoods: Herman Miller

Handrails/wall guards: CS Acrovyn, Alvarado

Headwalls/booms: Skytron

Lighting: Mean Well, Precision Lighting

Signage/wayfinding: The KMA Group

Surfaces—solid/other: Wilsonart

Wallcoverings, wall protection: Forbo, MDC, Construction Special Ties

Other:

Fish Lab Eq Vendor: Aquaneering

Booms, shelving, SPD items: Skytron

Food Service: Vision Builder

Project details are provided by the design team and not vetted by Healthcare Design.

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