By Jason Costello
SANDWICH, Mass. — Cape Cod has one of the largest concentrations of senior citizens in the country, and the number of residents aged 65 and older is predicted to more than double between 2015 and 2030. These residents will have increasing needs for rehabilitation services and expertise as they age. Spaulding Rehabilitation Hospital Cape Cod (SCC) in Sandwich is the only rehabilitation hospital on Cape Cod, providing advanced rehabilitation care to help people transition to home following illness, injury or surgery. Currently, Spaulding Cape Cod’s staff cares for about 1,100 inpatients and provides more than 100,000 physician visits and outpatient therapy appointments annually.
To better serve this aging population, SCC engaged Boston-based Margulies Perruzzi Architects (MPA) to design a two-story, 6,230-square-foot addition and a 12,800-square-foot renovation of space in the existing 60-bed inpatient rehabilitation hospital. The expansion of the hospital, which began in May 2015, addresses space constraints, enhancing accessibility and preparing the hospital to meet projected demand for outpatient services. With the expansion, which was completed in August 2016, SCC estimates that it will increase its capacity to provide 80,000 additional therapy visits and 10,500 additional physician visits over the next five years.
Spaulding’s goal for the project was to enhance the patient experience through improvements to both the inpatient and outpatient environments. The project expanded SCC’s physician services clinic by 33 percent and added eight new outpatient therapy rooms, doubling the private treatment space and increasing SCC’s outpatient capacity to accommodate up to 21,000 more visits per year by year six. A new, multipurpose room on the first floor will be used for current and planned wellness and education programs and community-based support groups, and a quiet room gives nursing mothers or anxious children a private space to wait for appointments. In the inpatient unit, five speech therapy rooms were added, the inpatient rehab gym was renovated, and a patient/family resource room was created.
MPA collaborated with SCC staff throughout the design process to incorporate workflow enhancements and design the renovations to exceed ADA requirements. The hospital’s Patient Family Advisory Council, as well as mobility-impaired patients, provided suggestions for improving comfort and accessibility.
MPA redesigned the reception area and expanded the lobby, registration and waiting areas to enhance accessibility for patients with mobility impairments, provide private spaces for registration and improve workflow. The reception area’s hospitality design includes a curved reception desk with two custom-height counters that allow patients to comfortably stand or sit in a wheelchair at registration. Exam treatment rooms feature grab bars at the exam table locations to make transitions easier for patients.
To provide long-term flexibility for the hospital, the patient gyms were designed to accommodate future changes in equipment and layout. The electrical power supply is laid out in a grid of flush-mounted floor receptacles to minimize tripping hazards. Low-maintenance rubber floors were used in the rehab gyms and clinical corridors. Since walking is a key component of a rehab therapy program, MPA worked with SCC to integrate “mile markers” into the flooring pattern at 10-foot increments to provide therapists with accurate distances without the need for additional signage or markings.
The expansion and renovation of SCC was a complex, multiphase project that required careful coordination among the clinical staff, design team and contractors. Phased over 10 months, MPA worked closely with construction manager Columbia Construction Company, based in Reading, Mass., to sequence construction work, permitting the hospital to maintain normal operations without impacting inpatient and outpatient care. The first phase renovated the public waiting area and reception in place. While this required the construction of a temporary registration area, the new reception was the first space to open, creating a “wow” factor and excitement for the project. Setting expectations for staff and patients limited shut downs and allowed the construction manager to maintain the construction schedule.
“Thanks to a beautiful and functional design, we have an enhanced environment of care,” said Maureen Banks, president of SCC. “This vital resource will be able to meet our patients’ needs well into the future.”
The project team also included the owner’s project manager Colliers International, based in Seattle; Boston-based civil engineer BSC Group; Marion, Mass.-based MEP engineer Thompson Consultants; and North Providence, R.I.-based structural engineer Odeh Engineering.
Jason Costello, AIA, EDAC, is an associate principal and partner at Margulies Perruzzi Architects.