The State of Maryland has been experiencing a significant psychiatric bed shortage for several years. To help meet the demand, JBC was contracted by the University of Maryland Medical Center (UMMC) as Construction Manager. Nick M., Paul F., Nick G., Greg G., Jason F., and Royer Z., worked alongside architecture firm, Inquiry | Architecture + Design, to build out 14,000 SF of space for a new 16-bed Child & Adolescent Psychiatric Unit on the 11th and 12th floors of the hospital. This renovation included a full gut of 12,000 SF of space within the unoccupied 11th floor West Wing and 2,000 SF of selective renovation work within the occupied 12th floor West Wing. The new unit houses 16 patient rooms, a welcoming and airy nurses’ station, dining room, conference rooms, group activity rooms, two sensory rooms, and two seclusion rooms.

“Working as a team was the only chance we had of completing this project. The complexity, expected level of quality, and the unprecedented number of challenges on this project required the efforts of all of us. Here in the office, Paul F., Nick G., and I were often all working on unrelated tasks to support the field and keep the project moving. In the field, Greg G., Jason F., and Royer Z. were focused on different areas and trades to push the schedule as much as they could. Jason spent weeks working a later shift to get the flooring installed and protected ahead of the following day’s activities. Greg focused on the MEP and drywall work on the 11^th-floor and navigated us through existing conditions and design challenges. Roy focused on the 12th-floor work and allowed Greg and Jason to keep their focus on the 11th-floor work.” – Nick M., Senior Project Manager

Innovative Safety Measures

Every aspect of this project was constructed with safety in mind, as the well-being of patients and staff would be imperative to the unit’s success. In design, the focus was safety over aesthetics, which meant quality control efforts on our part focused largely on the proper installation of materials, ensuring their safe use in occupancy. JBC worked with the design team through the submittal process to ensure the proper doors, windows, and finishes, specified due to their safety rating and approved use in psychiatric spaces, were used. Anti-ligature, tamper-resistant materials, and shatterproof glass were key elements of the materials used. On this project, Nick G., Assistant Project Manager, “learned the most about ligature points and building with safe materials, as well as the importance of quality control.”

All doors in the unit were hung with anti-barricade hinges, allowing staff members to open the door from the outside if needed. Caulk used throughout the unit is pick-resistant. All patient rooms are located on the exterior walls of the unit, so impact-resistant windows were installed into each room in front of the building’s existing exterior windows. The furniture and chairs are extremely heavy and sit on wide bases versus individual legs. Throughout the unit, anti-ligature elements were installed, including specialty door handles and bathroom fixtures.

Why this Project is Special

The Child & Adolescent Psychiatric Unit goes beyond simply providing a space for patients in need of treatment but provides them with a space that helps to minimize psychological stresses and encourages the use of de-escalation measures taught in treatment. The warm paint colors, nature-inspired artwork, cozy furniture, and padded chill-out coves were all selected to provide a welcoming, non-clinical space for patients. What was built was a space that does not sacrifice quality or safety yet deviates greatly from the ‘institutional’ feel of psychiatric spaces of the past. These design elements also support UMMC’s commitment to incorporating an “on-stage, off-stage” method of care to patients.

The admissions process is, understandably, a stressful and anxiety-provoking experience for the patient and family. Therefore, the entry was designed to feel comforting and airy. As you enter the unit, the nurse’s station is inviting, with comfortable chairs arranged just as any other doctor’s office’s waiting room would appear. Also special to this project is the artwork. Blue and green paint colors throughout the patient rooms and common areas combined with hand-drawn artwork on the walls with inspirational messages set a positive tone for the unit. The artwork was designed especially for this space, by a local Baltimore artist, Annie Howe, and serves as a de-escalation tool for children. There are hidden animals in the artwork, so if a patient becomes agitated, a staff member can redirect their attention to the artwork and ask them to focus on finding animals instead of the trigger that caused their agitation.

The common area’s design for children and adolescents proves to be unique and thoughtful. On the children’s side of the unit, patients exiting their rooms step onto what is called a “front porch area,” a comfortable space where they can spend their day and interact with their peers or play independently. The floors and ceilings were designed to differ from the rest of the hallway, distinguishing the space. On the adolescent side, there are “getting ready stations” complete with sinks and mirrors for adolescents to get ready for their day, supporting a healthy and positive self-image.

Each of these elements supports the mental well-being of patients, better allowing them to receive the care they need while looking and feeling their best in a secure yet warm setting. However, it was the construction team that had to take these visions and design intents and make them a reality. Each of the elements previously discussed, required coordination amongst the trades and attention to detail on everyone’s part. From the comprehensive submittal process to the meticulous installations, to the thorough quality control efforts – the entire team’s diligence ensured a safe, quality space. The success of this project is a testament to what can be accomplished when experts work together and communicate effectively.

To read more about this project, visit WBAL TV and the Baltimore Sun.

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