By Roxanne Squires
Fort Mojave Indian Reservation, Ariz. — DLR Group’s Phoenix office announced the opening of its new dialysis center, with the Fort Mojave Indian Tribe cutting the ribbon to the clinic on March 1, 2018. The central location will allow members across Arizona, Nevada, and California to easily access the facility and specialized services.
Construction of the $1.9 million, 5,100-square-foot facility began February 2017 as DLR Group worked closely with the community — including the clinic’s future patients and providers — to gain a clear understanding of the tribe’s desires for the clinic. The tribe’s input aided the design process with the intention to create a comfortable and welcoming environment for the dialysis patients throughout their private treatment.
The clinic ultimately aims to improve patient care by personalizing the treatment each patient will receive. Originally conceived as true home therapy, it was determined that a centralized facility on the reservation would function much better at a lower cost to the Tribe. Given that the tribal administration has not only paid for the building but also for the treatment service — no tribal member will pay for their treatment — the residual effect is to hopefully reduce the need for the service over time.
“A primary challenge the team ran into during construction was managing the quality of available domestic water,” stated DLR Group Healthcare Leader Richard Beach, AIA.
According to Beach, the water available at the site is of poor quality and the nature of the dialysis treatment requires the water to be completely pure. Although the home therapy approach includes a portable reverse osmosis (RO) machine that accompanies each dialysis machine, due to the extreme hardness of the available water, it was necessary to install a large system of water conditioning and RO treatment at the water service entry point to the building.
“The installed system is equivalent to what would typically be found in larger dialysis treatment clinics, with a higher volume of patients. The resulting system has a large footprint, requires a significant amount of electricity and water, and needs constant monitoring during operations to maintain the required quality,” said Beach.
In its efforts to deliver a healing atmosphere, DLR Group integrated earth-toned masonry units with horizontal bands of gray stone, along with interior wood doors and frames, and wood-framed windows. There are windows in each patient room and a pop-up clerestory over the centrally located nurse station providing natural light to all patient and staff work areas. An interior palette of warm tones, modern patterns and easily maintained finishes also support a more soothing environment.
The clinic design includes eight private treatment rooms with accessibility from a central nursing work area. Prior to the clinic opening, patients endured 30- to 60-minute commutes, two to three times a week to the nearest community dialysis clinic where they shared an open treatment space with up to 20 other patients. Now, this clinic allows for capacity to treat up to 16 patients a day. The individual spaces provide the privacy and separation many desired without compromising the level of care required by the nursing staff.
“The clinic better serves its community by expanding the reach of healthcare into rural areas,” Beach said in a statement. “This new location will ultimately save patients over an hour on what would otherwise have been a round-trip commute to Bullhead City for treatment.”
The building’s structure plan also considered an east/west orientation to allow for the most strategic control of the occasionally disturbing desert sun exposure and advantageous positioning to achieve natural light.
“The internal plan is quite simple: public access functions on the east, private treatment spaces in the center and support/service functions on the west,” said Beach. “Access control is accomplished at the front door and lobby. Due to the perception that the clinic may store drugs attractive to others, the building’s security system helps to protect the safety of the staff and patients. The building’s material choices were made based on ease of maintenance, simplicity and long-term lifespan. Integral colored CMU exterior walls require little if any maintenance while the deep roof framing members provide volume for exceptional insulation value.”
Since dialysis treatment requires a certain amount of time, the tribal leadership sought the ability to offer as many comforts as possible, while ensuring patient safety, staff access and visibility, and individual control. One unique element of each treatment room is the large photograph displayed above the work counter. The tribe supplied all the photographs of natural areas in and around the reservation, and each room received a different image.
“We are most proud of the facility’s ability to positively impact the lives of the patients who will be treated,” said Beach. “The community has waited a long time for this service to be introduced to the reservation and it meets a promise made by the governing Council from years before.”