Back to Life: A Tale of Two Buildings

You might not expect a cardio therapy lab so close to your Kung Pao chicken, or a dialysis clinic next door to a shoe store, but that’s exactly what you’ll find at Centra Southside Medical Center in Farmville, Virginia.

Housed in a former big-box store—52,400 square feet to be exact—the clinic anchors an aging strip mall built in the 1970s. Today, the facility brings healthcare to an underserved community, including primary care, orthopedic, psychiatry, nephrology, and imaging clinics, as well as physical rehabilitation and laboratory space. The facility will also feature a much-needed dialysis center (located where the former store’s garden center used to be) that is independently operated by the University of Virginia Health System.

Our latest healthcare project brings to light a growing national trend: the transformation of unused retail stores into dynamic, comprehensive centers for healing. It makes sense, when all the facts are laid out. To start, it’s a great deal for healthcare systems, which are looking for reasonably priced real estate and have found it in vacant strips malls and retail stores. Then there’s the fact that the infrastructure is already in place—established sewer lines, electrical grids, and parking lots make it an even sweeter deal. Plus, people are already familiar with the location.

Architecturally speaking, it’s win, and putting such a building back into use for the community is the greenest thing we as designers can do, says vice president of our healthcare studio John Michael Currie, FAIA, FRSPH.

“Their large floor plates, high ceilings, and widely spaced columns are a good palette to do this kind of work because the building doesn’t get in the way,” he says. “The basic bones of the building don’t interfere with how you want to plan it out.”

But getting a vacant store to look (and operate) like a healthcare clinic takes a lot of work and creativity, says Ian McAteer, the project’s lead designer.

Our healthcare design team tackled the exterior of this vacant retail store.
Our healthcare design team tackled the exterior of this vacant retail store.

“Getting started on a project like this has a lot to do with how you approach the whole building—what does the outside look like? You walk into a Walmart and you’re immediately struck by this blank, intimidating wall. We didn’t want that to happen for Centra’s patients.”

So the team created multiple entrances for the 300-foot-long building. Each entry was designed to have a distinct look that complements one another and culminates into one cohesive façade.

A reconfigured entrance breaks up the big-box feel and floods the lobby with natural light.
A reconfigured entrance breaks up the big-box feel and floods the lobby with natural light.

Other surprises during construction led to a larger overhaul to the building’s shell than planned. Where the design team thought they were working on one building, they discovered two separate structures, one built in the 1970s and one built in 1990. The roof also needed to be replaced, a perimeter drainage system installed, and the exterior walls reinforced, insulated, and weatherproofed.

Bringing the exterior of the building back down to a human scale was challenging, but converting the interior of the former department store into a comforting space for patients was another story entirely.

“Inside is where you really start to see just how huge of a building it is,” Ian says. “You’ve got to break up the space so it doesn’t look or feel like one giant warehouse.”

Before the transformation, the interior of the building was oversized and lacked natural light.
Before the transformation, the interior of the building was oversized and lacked natural light.

The floor plan is broken up into a pod system, where each clinic gets its own space. It’s kind of like buildings inside of a building, and that’s the point.

“With a footprint this large, we can give patients more,” says John. “Instead of only offering traditional clinic space where a doctor is treating a patient, we can also add in other significant resources for the patient, all in one location.”

Then there were the 20-foot ceilings that needed to be addressed. The design team reworked the ceiling configuration, substantially lowering them to create a cozier, more intimate space for patients to feel nurtured. This strategy also solved another issue at hand—it created a second story within the building so that the mechanical systems had a place to live. One major downside to renovating a big-box store for healthcare, Ian says, is that these buildings don’t have near the HVAC or plumbing systems that are needed for today’s healthcare environment. And that’s a problem, because specific systems must be in place to keep healthy people healthy and to heal the patients who are ill.

No space showcases the importance of these systems better than the lobby, which is zoned and color-coded. Those patients who are noticeably sick, say with the flu, are kept in one area that is separate from those patients who aren’t sick. If a sick patient sneezes, that sneeze will remain essentially contained within that zone, protecting the healthy patients. This works because fresh, clean air is brought into the zoned waiting areas, which is then pulled into the return air systems before the used (potentially germ-ridden) air has a chance to settle into neighboring areas and corridors.

“That set-up in the lobby is where the integration between architects, engineers, and interior designers is so crucial,” says Ian.

Color-coded flooring and specialized mechanical systems come together to create zones that keep germs away from healthy patients.
Color-coded flooring and specialized mechanical systems come together to create zones that keep germs away from healthy patients.

In any project, interior design is important. But in a project like this—large, open, and full of potential—good interior design is one of the few ways we can make the space more accessible to patients seeking a healing environment. Working within Centra’s existing color palette, the interior design team brought in warm tones and natural finishes to create a friendly environment. (Take a look at the wood flooring. It’s a color called Graham Cracker.) Accent colors were then used for intentional wayfinding so patients wouldn’t get lost or feel like they were in a maze.

Natural light was another key element to creating the right atmosphere. Because of its size, most of the space does not have access to natural light, so taking advantage of the places that did have access became an important element. The building’s main entrance features a glass entry tower that allows light to spill into the front lobby.

“We’re getting more comfortable with reusing buildings in healthcare, and we’re getting more creative applying good design principles and integrating efficient systems into those buildings,” says Ian. “Adaptive reuse is nothing new, but it’s becoming more prevalent in the healthcare industry.”

But rehabbing existing buildings doesn’t just boil down to efficiency, or even economics. More often than not, it’s about bigger issues at play, because these types of adaptive reuse projects can enliven and rejuvenate older neighborhoods and developments. Before the renovation, this community had no urgent care center, and the closest option for dialysis treatment was an hour away.

Not only is Centra’s new facility offering much-needed healthcare to a historically underserved community, it’s also been a catalyst in redeveloping the whole site, attracting new tenants and jumpstarting the area’s revitalization.

“Here you had an unused building that was sitting doing nothing,” John says. “It wasn’t creating jobs, generating a tax base, or healing patients. Now, all of that is reversed. The building is alive again.”

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