first_imgE4H Environments for Health Architecture,by Jennifer Arbuckle, Partner, E4H Environments for Health Architecture There is a continuing trend throughout the country towards an integrated, “one-stop shop” medical village.  The objective is to modernize and improve care delivery by integrating hospital care with retail, housing, elder care and living systems. As market forces drive the need to streamline, consolidate and achieve greater efficiencies, while consumers expect greater access and convenience, and as reimbursement models favor holistic care rather than periodic treatment incidents, a more comprehensive architectural design approach is needed. The healthcare village approach is evident in the new partnerships forming among healthcare providers, government agencies and real estate companies to pursue these projects, reflecting greater collaboration and a more coordinated way of delivering care. More frequently we are seeing urgent care, elder care, preventative care, health education, and other outpatient services clustered in one-stop shopping destinations.Medical villages feature flexible, adaptable facilities that are designed to accommodate, and anticipate, evolutions in care delivery and technology. They achieve new efficiencies in how space is used, enabling clinical and administrative services to provide multiple functions simultaneously – reducing overall costs.Patients visiting a medical village can benefit in terms of time, convenience, and access. They can connect with multiple providers in one location, accessing both primary and urgent care, lab work, rehabilitation services, and pharmacy, while also attending educational and wellness classes, all within walking distance.E4H Environments for Health Architecture, a nationwide architecture and design firm exclusively focused on healthcare, is at the forefront of this design trend, engaged in many such projects across the country.  E4H’s modular designs focus on creating spaces that can be multi-functional, with maximum flexibility, using the same area, for example, for a rotating specialty clinic one week, and once a month infusion therapy the next week.  Exam rooms are designed to be as uniform as possible, enabling use by any type of provider from psychiatric to cardiology. Likewise, procedure rooms are not dedicated to only one type of procedure, but designed for flexible use. There are shared reception and waiting areas, staff support areas, and bathrooms saving the cost of excess square footage and services. Private offices are minimal, staff work areas are open and collaborative, with areas for private consultation strategically located throughout.   Some examples of E4H’s medical village projects from around the country, supported by these unique funding partnerships, include:In TICONDEROGA, New York, The entire Inter-Lakes Health campus, which houses Moses Ludington Hospital, is being transformed into “a medical village”. This project entails 26,000 SF of renovations, expected to be complete in late 2018. The hospital will include an emergency department, diagnostic imaging, an outpatient clinic, PT/Rehab, Lab, and Pharmacy. and adjacent on the same campus there will be senior housing, a nursing home, adult home, dental clinic, and a primary care center, as well as hospice care and substance-abuse treatment. The $9 million project is being funded in part by New York’s Department of Health. A critical part to the project’s completion is the hospital’s partnership with the University of Vermont Health Network, which will further enable the system to bring all new modern facilities to serve more North Country patients. This collaborative approach to design will allow the system to bring an expanded array of outpatient services to their patients, without expanding the footprint of the hospital.This project is supported by New York State’s major grant program, the Delivery System Reform Incentive Program, aimed at a fundamental restructuring of the healthcare delivery system, and reducing avoidable hospital use by 25% over 5 years. The Harker Heights Medical Pavilion, a three-story, 60,000SF medical office building located on the Seton Medical Center campus in Harker Heights, Texas.  Rendina Healthcare Real Estate, one of the largest full-service healthcare real estate firms in the country, developed the building in joint ownership with the many specialists who occupy offices there.  Patients have access to numerous medical specialties all under one roof including family practice, internal medicine, cardiology, general surgery, orthopedic surgery, neurosurgery, plastic surgery, obstetrics and gynecology, gastroenterology, otolaryngology, nephrology, neurology, oncology, rheumatology, and urology. One of the first such projects E4H Environments for Health Architecture completed was for Dartmouth Hitchcock in Nashua NH. This multi-specialty medical office/ambulatory care building accommodates both primary and specialty care patients in a collaborative environment. Diagnostic testing, endoscopy, MRI/CT, and infusion therapy are provided on site as well as a walk-in clinic for same-day care. Clinical and support programs include pediatrics, family medicine, oncology, internal medicine, gastroenterology, and space for visiting specialists. This 150,000SF space was designed with E4H’s modular approach, creating a Lean environment with extraordinary flexibility for future use. It includes collaborative off stage areas, instead of private physician offices, and saved valuable square footage for clinical space. The design supports this patient-centered Medical Home model where a primary care team, led by the physician, works collaboratively to address the acute, chronic, and preventative needs of patients.The pace of change in healthcare delivery will only increase in the coming years, with new technologies, medical treatments, and certain economic pressures and changes to payment models. Creative public/private partnerships, integrated campus models and design innovations that can readily adapt will be critical to that future. No one can afford to let space sit idle, so increasing flexibility of usage allows healthcare providers to do more with less and improves the patient experience at the same time.Jennifer Arbuckle, AIA, NCARB, LEED AP, Partner, E4H, WillistonJennifer has 27 years of diverse healthcare experience. She has guided many projects from master planning through construction and is a talented planner, architect, and designer. She has worked on projects across New York State and New England, ranging from Children’s Hospitals to Community Medical Centers. She is also the Chair of the Vermont Board of Architects.last_img read more

Posted in xawlvtwz

first_imgGet instant access to must-read content today!To access hundreds of features, subscribe today! At a time when the world is forced to go digital more than ever before just to stay connected, discover the in-depth content our subscribers receive every month by subscribing to gasworld.Don’t just stay connected, stay at the forefront – join gasworld and become a subscriber to access all of our must-read content online from just $270. Subscribelast_img

Posted in ahpxiwjb

first_imgSubscribe Get instant access to must-read content today!To access hundreds of features, subscribe today! At a time when the world is forced to go digital more than ever before just to stay connected, discover the in-depth content our subscribers receive every month by subscribing to gasworld.Don’t just stay connected, stay at the forefront – join gasworld and become a subscriber to access all of our must-read content online from just $270.last_img

Posted in jycywmjo

first_imgJamaican investors celebrated a recent Bloomberg report showing that the Jamaica Stock Exchange (JSE) has the highest growth rate in the world for 2015. Such numbers reveal a thriving Jamaican business sector and a viable emerging economy. But, though improving accessibility to the market for foreign investors did much to boast growth, the JSE still saw low engagement from the Diaspora – nowhere near what our community’s share of the market could be.Many in our community have not taken advantage of investing in Jamaica through the JSE. The lack of participation also hints at a broader problem – the low number of savings and investment portfolios in our communityGranted, it’s difficult for the majority of the Diaspora to invest or save when, according to a 2014 survey, disposable income averages less than 5 percent. This hardly leaves sufficient excess funds to save or invest. However, the same survey shows a large percentage of the community spending heavily on unnecessary consumption goods, made evident by high credit card balances, which severely minimize the ability to save.Some people may argue that interest rates offered by banks and other financial institutions in South Florida are so low, that it does not encourage savings or investment. However, the Diaspora risks weakening its empowerment if it’s not accumulating significant investment capital, particularly capital that can contribute to the expansion and viability of its business sector.It’s disappointing that after some 45 years of our community’s steady growth to over 350,000 residents, the community does not own a major financial institution. Thanks to tight regulations set by the Florida Office of Financial Regulation, there are major challenge in establishing a community bank owned and operated by the Jamaican Diaspora. Fewer community banks have opened in South Florida since 2010 – but the window has not been closed to future enterprises.Despite signs that a significant percent of the community overextends themselves in the consumption of material goods, the Diaspora is far from being financially depressed. It shouldn’t be difficult to source investment capital for either a community bank or a credit union owned by the collective South Florida Diaspora.Even without a steady investment source, several small businesses have developed in South Florida’s Jamaican community. Entrepreneurship is definitely not lacking. Their expansion, however, may be limited due to the lack of reliable investment sources. Although the region’s economy has seen significant improvement since the 2008 market crash, commercial and community banks still maintain tight restrictions on business loans. Enterprising individuals have initiated limited loan portfolios to help small business, but this source of funding is more the exception than the rule.Jamaica’s Diaspora in South Florida is desperately in need of such initiatives. We need to find alternatives to the scarce capital available outside the community.This proposed financial institution won’t materialize overnight. It will take time to ensure the institution meet state requirements, and is organized to minimize potential risks. But it would be encouraging to at least see deliberate planning begin to create such an institution. The failure of so many promising businesses in the community because of insufficient capital is frustrating and wasteful.A viable Jamaican-owned financial institution within the Diaspora could grab the attention of Jamaican investors. Some of the excess capital generated by investors on the JSE, should it continue its buoyancy, could be redirected to the business community in the Diaspora.The success of the JSE, its investors and listed businesses, is yet another example of the resilience of Jamaicans. This resilience needs to be displayed in the budding business community among the Jamaica’s Diaspora.last_img read more

Posted in xyybvouo

first_imgOWINGS MILLS, Md. — The Ravens began preparations for their Week 15 contest against Philadelphia without their top cornerback on the practice field.Jimmy Smith was not present for Baltimore’s Wednesday walk-through as he recovers from a right ankle sprain suffered in Monday’s loss to New England. The 2011 first-round pick left the game late in the first quarter and did not return, but head coach John Harbaugh has offered no clarity on his status for Sunday’s game or beyond.“I really don’t want to get into that, to be honest with you,” Harbaugh said. “I don’t really see any purpose to get into that. Thanks for asking.”Should Smith not be able to play against the Eagles on Sunday, the Ravens would likely turn to Shareece Wright to start opposite rookie Tavon Young. Slot cornerback Jerraud Powers practiced on a limited basis despite leaving Monday’s game with a concussion.Reserve defensive back Anthony Levine (toe) and linebacker Terrell Suggs were absent from Wednesday’s practice. Suggs received a veteran day off.Tight end Crockett Gillmore (hamstring) made his return to practice on a limited basis after missing his sixth straight game. Rookie guard Alex Lewis (ankle) was a full participant after practicing on a limited basis last week. He appears poised to return against Philadelphia after missing four consecutive games.Third-year wide receiver Michael Campanaro was officially promoted to the 53-man roster on Wednesday and is expected to be in the return specialist mix with veteran safety Lardarius Webb, according to Harbaugh. The Ravens waived four-time Pro Bowl returner Devin Hester on Tuesday.“That was a little bit of a tough move just because we have so much respect for Devin and the effort he’s put in,” Harbaugh said. “I told him I feel like we didn’t get the job done. We didn’t do enough to make the return game productive enough to make it worthwhile.”The Eagles were without top receiver Jordan Matthews (ankle) and veteran running back Darren Sproles (concussion) during their Wednesday practice.The Ravens will wear their black jerseys for their home finale on Sunday. They own a 15-6 all-time record when wearing their alternate tops and are 12-3 under Harbaugh.Below is the full injury report for Wednesday:BALTIMOREDID NOT PARTICIPATE: DB Anthony Levine (toe), CB Jimmy Smith (ankle), LB Terrell Suggs (non-injury)LIMITED PARTICIPATION: TE Crockett Gillmore (thigh), CB Jerraud Powers (concussion)FULL PARTICIPATION: G Alex Lewis (ankle)PHILADELPHIADID NOT PARTICIPATE: G Allen Barbre (hamstring), WR Jordan Matthews (ankle), RB Darren Sproles (concussion), OT Halapoulivaati Vaitai (knee)FULL PARTICIPATION: G Brandon Brooks (illness), TE Brent Celek (stinger), WR Dorial Green-Beckham (abdomen)last_img read more

Posted in vlpnbmjn