One Nineteen Health and Wellness Center in Birmingham, Ala., might be associated with St. Vincent's Hospital, but one look around the striking 154,600-sf facility reveals this is not a traditional healthcare building.
A 15,000-sf, state-of-the-art fitness center with 28 flat-screen monitors is located just beyond the building's circular lobby. An indoor running track wraps around overhead. Off to one side is an 8,300-sf spa. A 23-meter, six-lane lap pool is located elsewhere in the building.
Designed by Nashville, Tenn.-based Earl Swensson Associates, One Nineteen reflects St. Vincent's realization that to succeed in the wellness market, it had to sell the concept of a healthy lifestyle—a holistic approach to wellness that integrates fitness and medical components in a facility special enough to attract private members.
That business strategy is critical, says Brad Earl, VP of HLM Design-Heery in Philadelphia. "Wellness centers are retail businesses, and the engine that drives them is that out-of-pocket retail dollar," he says.
As a result, hospitals are challenging Building Teams to create standalone wellness centers offering supervised exercise programs, weight loss support, rehabilitation, and nutritional guidance. The facilities target baby boomers and older generations, people seriously out of shape, or those exercising for the first time—in other words, people who would not likely cross-shop traditional chains like Gold's Gym or Bally Total Fitness.
Medical components are the gotta-have-it fitness features offered by wellness centers. Clients expect a full range of treatment, including diagnostic evaluations, lifestyle management, and physician supervision. Clinical spaces have to accommodate these functions.
At One Nineteen Health and Wellness Center, approximately 30,000 sf of the building's almost 155,000 sf is occupied by medical office space, says architect Ron Lustig, AIA, ISHC, principal design architect at Earl Swensson Associates.
Medical components will play even greater roles in wellness center design, predicts Joan Whaley, VP of Healthcare in the San Diego office of HMC. She says that commodity medical services, such as X-rays, CT scans, and MRIs, will continue moving from the hospital to the wellness center. "It's a lot cheaper for hospitals to do those things in a wellness center than in an acute care hospital," she says.
Wellness centers also need to be dynamic spaces with a sense of energy and excitement that makes members enthusiastic about their treatment.
"We wanted everyone to walk in and see activity," says Lustig, who placed high-tech cardiovascular equipment and the second-floor running track within view of One Nineteen's lobby.
HLM Design-Heery's Earl follows a "wet and dry" approach to ensure his buildings motivate.
The wet program includes an aquatic center with a large, multiple-lane lap pool, a warm-water therapy pool, and a large whirlpool. The dry area includes a cardiovascular area and strength training fitness floor; several activity studios that are flexible enough to accommodate Pilates, aerobics, or yoga classes; and a running track. Locker rooms should be easily accessible to either area.
A beefed up HVAC system is required for aquatic areas, says George Myers, senior project architect in the Dallas office of Marshall Erdman & Associates. "There's so much humidity [in these facilities] that without an adequate HVAC system, there are very real concerns about slipping and falling," not to mention mold buildup, he says.
As for lighting, Myers' advice is to open spaces to the outside to capture natural light—gaining all-important views of nature in the process. Opening interior spaces allows light to filter throughout the building. When planning artificial light, Myers recommends a combination of overhead light and indirect light, which is especially important in areas where members will be stretching or exercising while lying on their backs.
However, leaving spaces too open can contribute to another major problem, higher noise levels. Myers recalls being shown photos of one such facility. "It was very impressive architecturally, and there was this aerobics room with high ceilings and great views of the Rocky Mountains," says Myers. "But they couldn't use the room because nobody could hear anything in there and the space didn't work and was useless."
His recommendation: use low ceilings in areas where members will have to listen to instruction or converse with staff members.
The spa area is where wellness centers can get a healthy dose of luxury.
"Think sensible luxury," advises Judith Singer, Ed.D., president/co-owner of Health Fitness Dynamics, Pompano Beach, Fla. Singer, whose firm specializes in resort-based spas, was on the team for One Nineteen.
Customers are going to want the trappings of luxury, but can do without the over-the-top ornamentation, says Singer. "When people go to a health spa, they want to feel good and be surrounded by comfort. At the same time, you're going there to see results, not gold-plated fixtures."
Spas currently occupy less square footage than fitness areas, but expect the gap to close over the next few years, says HMC's Whaley. "Spas are becoming so much more important, and I'm seeing much more attention to them in wellness center programs," she says. "Your mental wellness affects your physical wellness. The interface between beauty and health is very real."
Wellness center spas exemplify the holistic approach to treatment through massage, facials, skin care, body treatments, and other methods of relaxation and rehabilitation. Many centers use spas to promote alternative therapies—acupuncture, aromatherapy, and meditation.
Chicago-based Loebl Schlossman & Hackl designed an entire wellness center spa based on alternative medicine. The Integrative Medicine Centre in Geneva, Ill., utilizes feng shui concepts to create a soothing 5,000-sf facility with eight treatment rooms, meditation rooms, movement room, support areas, and shower areas.
A small boutique or a few display shelves next to or near a spa allows members to purchase lotions, creams, or other accessories to continue their treatment at home. But avoid building full pro shops with clothing and other gear. "Healthcare institutions have to avoid crossing that retail line for fear of alienating patients," says Abigail Clary, senior associate principal at Loebl Schlossman & Hackl.
Wellness centers need multipurpose spaces that allow them to promote healthy lifestyles beyond physical fitness.
One Nineteen has an elaborate cooking demonstration kitchen where members can view culinary presentations and learn more about healthy eating habits. The kitchen is equipped with closed-circuit televisions—a feature highly recommended by both Earl and Myers—to allow everyone a clear view, not just those lucky enough to have seats up front. The demonstration kitchen Earl designed for the Robert Wood Johnson Hamilton Center for Health and Wellness in Mercerville, N.J., had 45 seats, so supplemental televisions were necessary.
Healthy cafés are also becoming part of the wellness agenda. Members can buy healthy snacks and drinks during their visits and purchase meals they can enjoy outside the facility. Myers says that the café is more of a convenience than a profit center. He recommends outsourcing it, if possible.
Because clients often find motivation from one another, quiet gathering areas where they can relax and socialize outside the busy fitness zone are important. Size is less of an issue with these spaces; it's more about comfort. In some instances, gathering spaces are large atriums with water features. Other times the areas are well under 1,000 sf and have comfortable sofas and chairs placed around a fireplace.
Education is crucial to lifestyle change, and wellness centers need meeting rooms to accommodate learning programs. The number of classes offered will dictate how much space is required, but Earl tends to be generous with meeting spaces. The 90,000-sf Robert Wood Johnson Hamilton Center has 20,000 sf of educational space. "You normally don't do that much, but they run 300 classes a week," says Earl. "They've seen their market share go up purely as part of the wellness center programs."