Republic of the Philippines

EASTERN VISAYAS STATE UNIVERSITY

COLLEGE OF ARCHITECTURE AND ALLIED DISCIPLINE
Tacloban City

DES 415 – ARCHITECTURAL DESIGN 7

RESEARCH WORK No. 2

COMMUNITY HEALTH CENTER

Submitted By:

BRENT JARRYD P. LUEGO

BSAR – 4A

Submitted To:

AR. HERVY G. CATILOGO, MSCM

INSTRUCTOR

Date
OCTOBER 28, 2023
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TABLE OF CONTENTS

I. COVER PAGE ………………………………………….……………... i

TABLE OF CONTENTS………………………………...….………… ii

II. INTRODUCTION…………...…………………………………………. 3

III. BACKGROUND OF THE STUDY……………………….……………4

Why are community health center (CHCs) important in

healthcare? .....4

Why are community health centers able to use these funds in such a

timely and efficient manner? ………………………………………………

Community Health

Components…………………………………………..6

Health Center Fundamentals………………………………………………

What community health centers

provide………………………………….8

The Future of Community Health Centers……………………………….9

 Architectural Styles for Healthcare Buildings

…………………………..11

Designing Convenient and Welcoming Entrances………………………

12

Examples of Community Health Centers………………………………..13

IV. CONCLUSION…………………………………………………………17

V. REFERENCES………………………………………………………....18

INTRODUCTION

Community health centers offer top-notch, culturally sensitive medical treatment. At the

local health center, the treatment is given by compassionate staff. They assist you in enhancing

both your physical and mental wellbeing. These are patient-centered, community-based

organizations that offer cheap, easily accessible primary healthcare to individuals and families,

including homeless people, agricultural laborers, persons living in public housing, and veterans.

In places where access to affordable healthcare is restricted by economic, geographic, or

cultural limitations, health centers integrate access to pharmacy, mental health, drug use disorder,

and dental health services. By focusing on the integrated care management of patients with

different healthcare requirements and the implementation of essential quality improvement

techniques, such as health information technology, health centers lessen health inequities.

Primary care also includes sick visits, the identification and ongoing management of

chronic conditions like diabetes and asthma, as well as cancer screenings. Screenings and
examinations that are part of preventative treatment can significantly lower the likelihood that

larger health problems will develop in the future. Even better, preventing problems before they

arise usually costs less money. Compared to an ER visit or surgery, a doctor's appointment and

prescription are more affordable. You can obtain the majority of services in one location on the

same day in order to best guarantee that patients receive the care required for a healthy existence.

This all-encompassing strategy covers dental offices, pharmacies, drug rehab centers, mental

health services, and more. It can offer necessary medical services under one roof rather than

sending patients to various doctors' offices.

BACKGROUND OF THE STUDY

People have a significant influence on your community regardless of how you engage

with your co livings. It might be both good and harmful. There is no other way than as a

community; the same goes for health. The fusion of economics, social obligations, and health

care services is community health. Health hazards and social and economic situations are more

or less comparable among residents of a certain area. Community health is a branch of medicine

that focuses on the health of the populace in a certain region. This crucial area of public health

includes initiatives to assist local residents in safeguarding and enhancing their health,

preventing the spread of infectious illnesses, and preparing for natural catastrophes.

Public wellness initiatives provide access to preventative healthcare, involve individuals

in choosing their own care, and work to save hospital expenses. Population health and

community health are frequently conflated. However, although being related, there are enough

distinctions. While population health uses outcome-driven approaches for the health benefits of a
specific group of people typically defined by attribution, community health refers to the

collective efforts of individuals or organizations for the betterment of the health of a

geographically or culturally defined group of people.

Why are community health center (CHCs) important in healthcare?

According to data published by HRSA regarding health center performance, 62.89

percent of health center patients in 2018 were of an ethnic minority. CHCs offer critical care
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services to underserved communities. These services include:

 Delivering high quality and comprehensive primary and preventative care regardless of

patients’ ability to pay

 Offering supportive services such as health education, language translation, and

transportation

 Operating under the direction of patient-driven boards of community-based

organizations, including public and private non-profit organizations and tribal-and faith-

based organizations

 Developing and providing systems that respond to the unique needs of diverse,

underserved areas and populations

 Meeting compliance standards as described by the Health Resources and Services

Administration’s (HRSA) Bureau of Primary Health Care (BPHC)

Why are community health centers able to use these funds in such a timely and efficient

manner?
 These patient-directed, neighborhood-based clinics are frequently able to identify health

problems sooner and develop successful community-based solutions before others even

comprehend the underlying dynamics. Since their founding in the 1960s, these crucial suppliers

have acquired these talents. At more than 8,000 locations, these health facilities currently provide

care to over 20 million people, including 941,000 seasonal and migrant farm workers and 1

million homeless people. The law that established these facilities stipulates four requirements

that must be fulfilled: 6

They must be located in or serve a high-needs community. These medically underserved

areas are defined as having a high percentages of people living in poverty, areas with few

primary care physicians, higher than average infant mortality rates and high percentages of the

elderly.

They must provide health care to all, regardless of ability to pay. All community health

centers must commit to providing services for everyone, with fees based on a standard a sliding

fee schedule that adjusts charges for care according to income.

They must provide comprehensive health care services. All community health centers also

must offer a broad range of “enabling” services to support the delivery of consistent, affordable

health care.

They must be governed by a community board. All community health center boards must

be comprised of a majority (at least 51 percent) of health center patients who have the authority

to oversee the operations of the center. These powers include approving budgets, hiring and

firing chief executives, and establishing general policies.

Community Health Components

Community health care professionals assess how social and economic status-related

elements, such as poverty, nutrition, water availability, conflict, crime, and transportation

services, have an influence on the population. They also determine what improvements are

required and how the community's health and education services connect to people's lives. The
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following are crucial elements of community health:

 Identification of significant public health issues, such as social and environmental

influences impacting healthy living, within the same geographic region.

 Developing an intervention strategy to resolve urban infrastructure shortages, such as

setting up community health centers, mobile clinics, and services for outreach. In order to

promote life changes, inform people about the importance of medical treatment and safe

lifestyles.

 Ensuring the availability of essential medical services like screenings, therapy, and

counseling.

 In case emergencies cost reduction of expensive treatments and hospitalizations.

 Advocating to state and federal officials for better treatment for at-risk communities.

 Works alongside other neighborhood groups to discuss the emotional, physical, cultural,

and social features of the city, including housing, nutrition, and transportation.

Health Center Fundamentals

 To promote the health of those with limited resources, health centers receive federal grant

money through the Health Center Program. Some health facilities are given financing to

concentrate on particular groups, such as homeless people and families, migrant and seasonal

farmworkers, and those living in public housing. There are additional medical facilities that

fulfill all requirements of the Health Center Program but do not obtain funds from federal

awards. Look-alikes for the Health Center Program are these. Medicaid, Medicare, private

insurance, patient fees, and other sources make up the vast bulk of the operational budgets for
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health facilities. The following are the Health Center Fundamentals:

 Deliver comprehensive, culturally competent, high-quality primary health care, as well as

supportive services such as health education, translation, and transportation.

 Provide services regardless of the patient’s ability to pay and charge for services on a

sliding fee scale.

 Develop systems of patient-centered and integrated care that respond to the unique needs

of diverse medically underserved areas and populations.

 Private non-profit or public entities, including tribal and faith-based organizations that

operate under the direction of a patient-majority governing board.

 Meet requirements regarding administrative, clinical, and financial operations.

What community health centers provide

These health facilities must offer a comprehensive array of medical treatments, frequently

going above and beyond what other healthcare facilities like hospitals or outpatient clinics can.

This means that in addition to offering thorough primary health care, they also provide specialty
care (such as orthopedic, cardiac, or podiatric care), dental, and mental health services, as well as

"supportive services" like nutrition education, translation services, care coordination and case

management, transportation to and from health care facilities, and outreach initiatives to help

find qualified patients. Additionally, it implies that the care is provided in languages that are
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widely spoken in these areas and is culturally acceptable.

Community health centers customize their services to match the unique requirements of

their communities thanks to the community board's influence and dedication to holistic

healthcare. Because of this, 89 percent of health centers offer interpretation and translation

services on-site, 79 percent offer weight-loss programs, 91 percent offer case management

services, and 89 percent have services available to assist patients in finding other programs for

which they may qualify.

Studies repeatedly demonstrate that the treatment given by community health centers

helps patients achieve better health outcomes. Additionally, patients at these facilities are more

likely to identify a regular source of treatment and express satisfaction with their interactions

with healthcare professionals. One of the reasons why treatment provided by community health

centers is less expensive and eventually saves money for the larger health care system is that they

place a strong emphasis on primary care and offer extra supportive services.

The Future of Community Health Centers

More Access into the Community. The primary location for healthcare is no longer

regarded to be hospitals. Younger generations are finding it more convenient to look for

community health centers and clinics nearby their homes and places of business. The
"retailization of healthcare" enables patients to access non-acute treatment in a clean and

hygienic setting. As convenience and accessibility are becoming crucial factors for patients,

several retail developers are including healthcare purposes in their malls. Community health

centers are combining various services into a single clinic, such as urgent care, dentistry, vision,

family health, wellness, mental health, pharmacy, and geriatric care, in an effort to become more
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convenient.

Healthcare institutions were struggling with bed constraints, PPE shortages, and crowded

waiting areas earlier this year. The answer for delivering COVID-19 testing to a larger audience

was drive-through testing facilities. These drive-through testing facilities could continue to

operate after the pandemic for other uses like giving flu injections or even other immunizations.

Drive-through help pharmacies provide accessible healthcare. Drive-through facilities are a

common feature of many bigger retail pharmacies, such those operated by CVS and Walgreens.

This idea is also gaining greater traction from other businesses like Target. Future community

health clinics should be designed with drive-through services in mind to provide more

convenient care while preserving social distance and infection control.

Future of Waiting Rooms. The waiting areas of healthcare facilities have transformed

into foci of extreme hygienic and anti-viral/anti-bacterial measures due to the COVID-19

circumstances. Some clinics have constructed two waiting rooms: one for ill patients and one for

healthy patients. The majority of institutions no longer use waiting rooms by asking people to

wait in their cars until they are called inside their appointments. Future waiting rooms may

change greatly in size and layout due to the growing usage of AI, tele-health, and smart

biometric measures. Smaller waiting areas and lobby areas might result from the increased use of
computerized "self-check-in" procedures. Healthcare institutions may profit from allowing

patients to check in from their cars and/or outside vestibules, thus lowering the requirement for 11
inside check-in areas.

Revised HVAC Systems. In a world where there are airborne diseases, HVAC systems

will be essential to building design in the future. We are building an HVAC system that makes

use of UV lights embedded within the ductwork for one of our ongoing projects with a FQHC

(Federally Qualified Health Center). The UV sunlight rapidly destroys germs, bacteria, and

viruses as air flows through the duct. Although these kinds of devices have been available for a

while, more institutions are implementing them in an effort to encourage hygienic and anti-viral

spreading behaviors. Additional HVAC system concerns include raising the amount of filtration

in the machinery to remove dust and allergens in addition to germs and viruses.

Architectural Styles for Healthcare Buildings

The range of architectural designs for healthcare facilities is enormous. Each institution

employs a distinct blend of architectural characteristics to serve the surrounding populations,

from tiny specialty offices to massive hospitals that treat thousands of patients every day.

Prior to even starting construction, during the early stages of conceptual design, architects

must give great consideration to the building's exterior design, layout, and placement. The

outside architectural designs that are most successful for healthcare facilities include:

Organic Design. The structure appears more pleasant to guests when it melds into the

surroundings. In order to eliminate clear borders and encourage free-flowing mobility, the

building's design and color should complement its surroundings. Examples include the curving
exterior with a glassy, metallic finish that HMC Architects created for the Torrance Memorial

Medical Center on the Californian coast to resemble ocean waves.

Accessible Location. The community depends on healthcare facilities, thus they should

be situated in handy locations. This entails situating the structure as near as feasible to public 12
transportation and include features like safe bike racks and pedestrian walkways.

Daylight-Facing Windows. The structure should be positioned at the ideal angle to let in

enough of natural sunshine during peak operating hours or to screen specific building portions

from direct sunlight during the hottest hours of the day. The length of a patient's stay is

decreased and staff productivity is increased by exposure to sunshine.

Open Public Access. Providing a few public areas where community members can

congregate promotes goodwill and encourages the community to seek medical attention when

necessary. The community may take use of the natural scenery and streams. The hospital serves

as a community hub and is utilized for more than just emergencies.

Designing Convenient and Welcoming Entrances

When they visit hospitals and other medical institutions, many people experience anxiety.

This could be as a result of their associations with unpleasant previous events, such illness or

injury. When they arrive at the building's door, their nervousness frequently starts. Some

patients' anxiety is so bad that they completely miss crucial doctor's visits.

However, patients and visitors find healthcare facilities significantly less threatening

when they are designed in a more hospitable architectural style. Creating accessible entrances
that seem bright and open is one of the finest ways to help patients and visitors feel more at ease.

To achieve this, architects should:

Create a main point of entry. It is less stressful and perplexing for patients and guests to

check in when there is only one reception area. When a visitor enters Torrance Memorial

Medical Center through the main door, they are greeted by the reception desk. It gives them 13
comfort to be greeted by a smiling face.

Offer multiple check-in options. Patients who suffer from social anxiety may benefit

from self-check-in kiosks and staffed reception desks since they have more options.

Make the entrance highly visible from the outside. Employ rows of trees at to draw

attention from the walkway to the front door. Awnings that pointed toward the entryway were

also employed to direct guests inside.

Let in more light. Skylights, floor to ceiling windows, and big glass doors give entrances

a brighter appearance. Additionally, it gives them a peek inside before they go inside, which can

reduce their fear.

Design deep entrances. The entrance hall has to be large to seem less cramped.

Install comfortable furnishings. Patients and guests are encouraged to unwind by the

variety of seats and tables scattered throughout the foyer.

Include soothing artwork. A front entryway feels less sterile and barren when there is

art present, particularly images or paintings of the natural world. It gives the lobby a homey,

cozy appearance.
Examples of Community Health Centers
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Whittier Street Community Health Center

It is a six-story, 80,000 square foot structure building that accommodates a variety of

outpatient clinics and support services for healthcare. Urgent care centers, pediatric, internal

medical, dental, OB/GYN, counseling services, office buildings, and retail space were all part of

the architectural concept.

The clinic's award-winning architecture has a glassy facade that gives visitors a peek of

what goes on inside, but only the patients can fully comprehend how the structure enables

medical staff to provide all-encompassing treatment using the "medical home" approach. DHK

created a happy, peaceful interior that reflects the variety of the neighborhood. It suits our

customer well and is an excellent example of organized complexity and elegant organization.

Figure 1.
Whittier
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Du Noon Community Health Centre, Cape Town, South Africa

Cape Town's Du Noon Community Health Center was finished in 2013. The Western

Cape Provincial Government ordered the construction of the new hospital, which services the

neighborhood as well as a group of recent settlers from the Du Noon informal settlement, who

lacked proper health facilities.

A new public health prototype was thoughtfully designed using natural light and air, a

strong circulation system of streets and assembly areas, intelligible super-graphics, and garden

courts. With a densified layout that is basically a city block divided by internal roadways and

interrupted by a number of courts and squares, the architect exposes his urbanist roots.

Due to its location in an industrial region, the building makes use of features such a

concrete frame, tall lightweight steel roofs, chimney stacks, and vented roofs to provide

ventilation. The availability of health facilities in informal settlements is essential for surviving

in the tough urban environment. The public areas are spacious and well-lit, and whenever

feasible, natural ventilation is employed. Illiteracy and cultural difference are accommodated by

using supergraphics, color coding, and the facility's native Xhosa language for wayfinding.
 16
Figure 2.
Du Noon

Community Health Centre, Raikot, Punjab

Architect: Sarbjit Singh Bahga, Chandigarh

The Community Health Centre is a model for the smallest 30-bed hospital that is

technically feasible. Every square inch of the plinth space has been saved intentionally in order

to reduce building costs to a minimum. The fact that the hospital was completed with a built-up

area of 1520 square meters rather than the 1800 square meters required by the Indian Standard

Institute for a facility of this type indicates the effectiveness of the design. Nevertheless, none of

the necessary functions have been reduced. This was accomplished by optimizing room sizes and

minimizing repeated placements of certain elements, such as stairs, restrooms, nursing stations,

registration desks, etc.

 In addition to the aforementioned, the overlapping of some places has significantly

decreased the overall gross area. For instance, the registration, record, and sluice rooms

connected to the testing laboratory have cleverly made use of the headroom space under the

higher steps of the ramp and stairs. The majority of the wet sections have been vertically piled,

and service pipes are effectively placed in shafts, which further reduces construction costs.

17

Figure 3.
CONCLUSION
Community

Greater accomplishments for the citizens of healthy communities, which are

characterized by enhanced health and quality of life, may be fostered by improved and shared

understanding of the importance of community health. In order to achieve the shared goal of

enhancing health, the community health expresses the requirements of the community and

emphasizes the finest public health research, advancements, and consequences.

Community Health Centers play a vital role in providing accessible, affordable, and

quality healthcare services to underserved and vulnerable populations. In conclusion, these

centers are essential components of the healthcare system, and their significance cannot be
overstated. They serve as a critical safety net for those who might otherwise struggle to access

medical care, thereby improving public health and reducing health disparities.

In conclusion, Community Health Centers are a cornerstone of public health

infrastructure, delivering care where it is most needed, promoting wellness, and reducing

healthcare disparities. Their continued support and expansion are critical to improving the

overall health and well-being of communities.

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REFERENCES

Architects, H. (2019, July 3). Architectural Styles for Healthcare Buildings: A guide | Ideas |

HMC Architects. HMC Architects. https://hmcarchitects.com/news/architectural-styles-

for-healthcare-buildings-a-guide-2019-06-21/

Choudhary, S. (2021). Community Health and Its Importance. Primary Health Care: Open

Access, 11(2), 1–2. https://doi.org/10.35248/2167-1079.21.11.365

Definitive Healthcare. (n.d.). Definition of Community Health Center (CHC).

https://www.definitivehc.com/resources/glossary/community-health-center
Du Noon Community Health Centre by Martin Kruger Architects Urbanists. (2016, July 29).

Architizer. https://architizer.com/projects/du-noon-community-health-centre/

Kirsten. (2021, February 10). What is a Community Health Center? Community Health and

Dental Care. https://ch-dc.org/community-corner/what-is-a-community-health-center/

Sgpa. (2020, October 13). The Future of Community Health Centers - SGPA Architecture and

Planning. SGPA Architecture and Planning. https://www.sgpa.com/the-future-of-

community-health-centers/

The importance of community health centers. (2010, August 9). Center for American Progress.

https://www.americanprogress.org/article/the-importance-of-community-health-centers/

What is a Health Center? | Bureau of Primary Health Care. (2023b, May 1).

https://bphc.hrsa.gov/about-health-centers/what-health-center