Healthcare Design Magazine Feature: Ochsner Health Offers Lessons In Converting Big-box Retail To Healthcare

By Brooke Bilyj | May 22, 2024

Ochsner Medical Complex – Clearview, Metairie, Louisiana

A former Sears department store in the suburb of Metairie, La., just outside of New Orleans, presented Ochsner Health (New Orleans) with an enticing opportunity to expand its footprint into a new market.

Ochsner had redeveloped other former retail buildings in the past, but this project—its largest retail conversion yet—posed bigger challenges and even greater potential to bring a broad mix of medical services into an underserved market.

“Retail locations offer us great opportunities because they’re set up to have easy access for the communities they serve,” says Chris Blackwell, assistant vice president of facilities planning at Ochsner Health. “This location was ideal because of the high traffic and ease of accessibility,” being conveniently located right off Interstate 10, a major transportation artery leading into New Orleans.

Ochsner Medical Complex – Clearview was envisioned as the region’s premier outpatient facility with 22 primary and specialty care clinics, an ambulatory surgery suite with eight operating rooms (ORs), and a 10-bed inpatient unit for overnight stays. Dubbed a “super clinic” because of the breadth of healthcare services housed under one roof, the 202,000-square-foot facility opened in February 2023, three years after planning began.

Grace Hebert Curtis Architects designs a flexible outpatient facility

Ochsner partnered with Grace Hebert Curtis Architects (GHC; Baton Rouge, La.) to overhaul and optimize the existing space while planning for future flexibility and expansion.

After designing a similar clinic together in Baton Rouge from the ground up, the challenge here was overlaying the same efficiencies into a space that wasn’t initially designed for healthcare.

Because redevelopment was less expensive than new construction, Ochsner decided to take advantage of the existing two-story building—adding a third level and transforming the big-box store into an outpatient facility. “You have to approach retail conversions with a mindset of adaptability,” Blackwell says.

“You’re not going to find a location that perfectly fits your model of building ground up, so you have to maintain your standards while also being adaptable to use retail locations when they become available.”

Updating building structures to support healthcare environments

Converting the boxy retail space into an efficient ambulatory facility posed challenges, starting with the structure’s existing column grid of 26 feet by 26 feet. “If we were starting from scratch, we’d do a 30-foot-by-30-foot grid,” Blackwell says, “so the column spacing wasn’t ideal.”

For example, the smaller grid system limited the options for the orientation of the second-floor ORs, which as a result had to be sized a few inches larger than Ochsner’s standard rooms. The grid also dictated the layout and placement of clinic pods throughout the facility. However, the existing structure did offer lofty ceiling heights of 17 feet, creating spacious first-and second-floor layouts that allowed ample room for mechanical systems.

Originally constructed in 1968, the former store was a windowless rectangle with a dark, boxed-in interior. “The footprint of the building was another challenge,” Blackwell says. To address this, the project team removed a corner of the building to gain access to the center and bring more natural light into the interior by exposing more north- and east-facing facets with the addition of extensive windows. “We gave up almost 25 percent of the existing square footage to provide easier accessibility,” Blackwell says.

The cut-out corner also creates a more prominent entrance, including a covered drop-off space between the existing parking lots and a landscaped plaza that offers pedestrian access. “The landscaping and traffic flow are designed to calm patients down,” says Gary J. “Jimmy” Hebert Jr., associate principal and architect at GHC. “We try to make them feel comfortable and relaxed before they walk through the door.”

Other improved access points include a drive-through pharmacy and a covered pick-up area in the back, where patients leave after surgery without going through the main lobby. “Being an outpatient hospital, everything was built around convenience and ease of use,” says Andrew Hancher, Ochsner’s assistant vice president of clinic operations at Clearview.

Planning a clinic pod layout

The new Clearview facility houses a variety of clinical programs including women’s services, men’s health, behavioral health, neurology, gastroenterology, cardiology, ophthalmology, and comprehensive pain management.

Fitting all 22 clinics, eight ORs, and various work areas into the existing grid was a complicated puzzle that Hebert compares to playing the Tetris video game. The goal wasn’t just fitting the pieces together, but also enabling future growth and flexibility as services evolve over time.

To solve this puzzle, the project team evaluated clinic pod layouts from other Ochsner locations and similar healthcare facilities throughout the country using input from providers. Collaboratively, they developed a standardized pod design consisting of four centralized nurse stations surrounding a central supply space. The staff and supply areas are encircled by a ring of 22 exam rooms of approximately 100 square feet each, plus a pair of larger treatment rooms of about 215 square feet each—all sized and oriented to fit the existing grid.

The pods are arranged so the outer bays of exam rooms can be shared or shifted between neighboring clinics by simply swapping out the exam beds and any specialized equipment. “Each pod is expandable in two directions, and nearly any type of clinic can fit into that pod,” Hebert says.

Similarly, the second-floor perioperative suites are strategically arranged as adjacent pods with operating rooms along the east side of the facility, surrounded by support space and flanked by smaller bays containing four endoscopy labs, four pain management suites, and two heart catheterization labs, which are also used for interventional radiology. These suites share 42 pre- and post-operative rooms, plus 10 inpatient beds.

“It’s very convenient for our nurses and care teams because they’re not walking long distances to take care of patients,” Hancher says.

Standardizing the pre- and post-op rooms also enables flexibility as volumes fluctuate. Normally, different procedural functions might be segregated into different areas of a hospital, Blackwell explains, “but that was a lesson we learned from other locations: to cohort all the pre- and post-rooms together, so they can flex with the demand on any day.”

Adaptable design for room to expand

The adaptable design has already enabled flexible growth since the facility opened. For example, Ochsner decided to consolidate a small satellite location nearby, relocating its obstetricians and gynecologists into Clearview’s OB/GYN clinic.

To free up additional space near the women’s center and imaging lab on the first floor, Ochsner moved the plastic surgery clinic upstairs, leveraging critical adjacencies with the surgical suite while avoiding any renovations.

“If we’re not doing a major renovation to move a department, then the design is working in the way we intended,” Blackwell says. “If we need to move a clinic, we just need to move their equipment.”

To accommodate the future demands and planned growth of the facility, the design team also extended the existing building by adding a third floor, where they reverted to standard ceiling heights of 9 feet, and the potential to add a fourth level. The expansion strategy required strengthening the existing structure with several supports, including diagonal bracing that the designers incorporated into the placement of walls, doors, and windows.

To further support the additional floor load, the designers added an interstitial space above the existing roof, raising the third floor by about 4 1⁄2 feet.

“That interstitial space ended up helping with the ventilation and mechanical systems for the ORs, rather than running them through the third floor,” Hebert says.

The building also includes shell space for two additional ORs, another MRI and CT (currently being built out), and an extra clinic pod on the third floor.

Blackwell is already getting requests to develop the shell space, and as Ochsner designs and renovates other facilities, providers are asking if their clinics can be laid out like Clearview.

“That’s a good indicator that the staff is happy, because other locations are hearing about it and wanting to mimic the functionality,” he says

Brooke Bilyj is a freelance writer and owner of Bantamedia (Cleveland) and can be reached at brooke@bantamedia.com.

Project details for Ochsner Medical Complex – Clearview

Location: Metairie, La.

Completion date: February 2023

Owner: Ochsner Health

Total building area: 202,000 sq. ft.

Total construction cost: Not provided

Cost/sq. ft.: Not provided

Architect: Grace Hebert Curtis Architects LLC

Interior designer: Grace Hebert Curtis Architects LLC

General contractor: Broadmoor LLC

Engineer: Duplantis Design Group PC (civil), Morphy, Makofsky Inc. (structural), YKMH Consulting LLC (electrical and mechanical)

Art consultant: Where Y’Art Works

Art/pictures: Where Y’Art Works

AV equipment/electronics/software: Ochsner

Carpet/flooring: Mannington

Ceiling/wall systems: Conceptional Surfaces, Designtex, USG

Doors/locks/hardware: Schlage, Ives, LCN, Rite, Cookston, Kawneer

Furniture—seating/casegoods: Ochsner, Gator Millworks

Handrails/wall guards: Inpro

Headwalls/booms: Skytron

Signage/wayfinding: Ochsner

Surfaces—solid/other: Corian

Wallcoverings: Designtex

For an expanded list, visit HCDmagazine.com. Project details are provided by the design team and not vetted by Healthcare Design.