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Hospitality Healthcare Economic Trends Aesthetic Dental and Cosmetic Surgery Markets; ..................................................................................... 26 Private vs. NHS ..........................................................................

28 What is the Dental Plan Market Worth ........................................ 29 Market position Brand positioning ............................................... 29 Brand Personality ....................................................................... 30 Level of competitive threat Competitor Review ............................ 32 The MALL - Manchester ........................................................ 32 The Corporate Dental Competitors Info Sources Dunn & Bradstreet and FT.Com Moody and Poors ................................. 34 Competitor Analysis GRAPHIC Created by Natalie Jameson . 34 Integrated Dental Holdings Ltd Majority NHS ....................... 34 Oasis Dental Care Ltd - Sub of Oasis Healthcare Ltd - 40% NHS........................................................................................ 34 Associated Dental Practices - 75% NHS................................ 35 Dr JD Hull & Associates Limited Majority Private ................. 35 James Hull Manchester St Annes Clinic .............................. 36 Services, Service Providers and Products to be Accomodated....... 37 Client Journey Goals: ..................................................................... 27 Customer Journey Process MAP ................................................ 40 Unique Selling Point Diagram Comparing The Standard Dental Experience to Dr Knights Concept ................................................. 44 Space Planning Criteria .................................................................. 45 Room Number and Specialty mix of Dental Treatment Rooms and Conclusions from Interviews ....................................................... 46 What Type of Roles will there be ............................................ 46 How many people of each type of role are to be accommodated? ..................................................................... 46 What major functions will take place in the building? .............. 46 How might the building design enhance or impact occupant interactions? ........................................................................... 46 Project Design Goals Ethos and Approach .................................. 51 Design Goal 1 G1 Create a Healing and Uplifting Environment which highlights the benefits of the Clients Unique Selling Point Within the Design ....................................................................... 54
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Table of Contents
Executive Summary .......................................................................... 4 Project Outline .............................................................................. 4 Use and Occupancy ..................................................................... 4 Client Description of Concept........................................................ 4 Target Market ............................................................................... 5 Buildings Initial Perceived Need and Project Scope ...................... 5 The Design Problem From The Perspective Of The Designers Underpinning Ethos .......................................................................... 7 Healthcare Design ........................................................................ 7 Evidence Based Design ................................................................ 7 Integrative or Holistic healthcare ................................................... 9 Website for this image .............................................................. 7 Healthcare Consumerism ........................................................ 10 Designers Architectural Interest ...................................................... 11 Designers Market Segmentation Preference .............................. 11 Personal Design Outcome Statement ......................................... 11 Scope and Methodology for Design Brief ........................................ 13 Client Needs ................................................................................... 16 The Client Dr Lance Knight ......................................................... 17 The Clients Existing Brands ....................................................... 18 Market Research and Demographic Context of the UK Dental Market and Facial Aesthetics Industries ..................................................... 23 Dental Market Facial Aesthetics Market Research Mind Map ..... 23 Market History ............................................................................ 23 The Celebrity Dentist .................................................................. 24 Todays Aesthetic Dental and Cosmetic Surgery Markets; .......... 25
D e s i

Hospitality Healthcare Healthcare Hot Topic Mind Map .................................................. 55 The Medical Benefits Of Creating A Positive In Reception Experience Upon Arrival. ........................................................ 56 Ulrichs Five Tenets of Healing Design.................................... 57 Ulrichs Five Tenets of Healing Design: ..................................... 57 Acoustical performance ................. Error! Bookmark not defined. AIR QUALITY ............................................................................. 58 COLOUR IN HEALING EVIRONMENTS .................................... 58 Arrival and Discharge - The Reception Effect and Waiting Room Blues 59 THE DESK A HUGE BARRIER................................................ 59 Waiting ROOM BLUESI .............................................................. 60 Consider alternatives to reception check in desks!...................... 61 DESIGN GOAL Create a productive space conducive to producing the most motivated and effective team members by Indentifing and applying The Key Environmental Factors In Productivity In Workspace ..................................................................................... 64 Article How the Brain Experiences Architecture - ........................ 64 GSA Monitors Workplace Basics to Improve Productivity ............... 65 DESIGN GOAL Create a productive space conducive to producing the most motivated and effective team members ............................ 66 Lighting Recommendations ............................................................ 66 DESIGN GOAL CREATE A HOSPITAILITY ENVIRVONMENT USING SPA DESIGN IDEAS .......................................................... 68 Green Spas ................................................................................... 70 Primary experience research of patient Dental Client Journey? ...... 74 The Consultation and Treatments ................................................... 75 Post Treatments Recovery and Discharge...................................... 75 Unique Selling Point The New Customer journey Concept .......... 75 DESIGN GOAL Design Appropriate Environment For Buyers Of The Services................................................................................... 76
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Literary Review - What Are The Primary Attributes and Considerations Made When Choosing A Dental Practitioner? ........ 76 DESIGN GOAL Conclusions /Recommendations - Buyer Considerations And Implications For The Design And Inclusion Of Facilities. ........................................................................................ 77 DESIGN GOAL Design a Sustainable Environment For Buyers Of The Services. ................................................................................. 79 Design Goal Site Analysis For An Environmentally And Contextually Responsive Design ................................................... 80 DESIGN GOAL URBAN CONTEXT ............................................ 81 Manchester Precedents.................................................................. 81 Upper King Street Conservation ..................................................... 82 History ........................................................................................ 82 List of Equipment ) Samples purchase order from In Store Dental Annotated by Dr Knight .................................................................. 92 Design Space Planning ................................................................. 94 Strategy - Target Market Preference Considerations and including Environmental Psychology ............................................................. 96 Target Market Preferences ......................................................... 96 The research strongly suggests that this market demands ......... 96 Color Considerations .................................................................. 97 Word Associated with the Demographic preferences.................. 97 Environmental Psychology and Considerations .......................... 97 Site Survey and Key Considerations .............................................. 99 Existing Space Site Survey ...................................................... 99 Floor plan and initial considerations............................................ 99 Construction And Materials....................................................... 101 For Provision of Dental ............................................................. 102 Site Size ................................................................................... 109 Space Standards ...................................................................... 109 Placement ................................................................................ 109 Signage .................................................................................... 110

Hospitality Healthcare Lighting ..................................................................................... 110 Design and Technical Equipment Requirements....................... 110 Health and Safety ......................................................................... 112 Timeline, Deliverables and Budgetary Considerations .................. 113 Timeline and Deliverables ......................................................... 113 Budgetary Considerations ......................................................... 114 References and Bibliography ........................................................ 115

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Executive Summary

Parking Spaces:

No,

City Centre Location With

Good Transport And Local Car Parks Project Outline Country Region: City: Address: M2 1HE The client outlines that the business will be low volume Client: Surgeon Building Type: Tenant Type : Space Size: 71 Sq Meters & 764.23 Sq Feet Small Cotton Mill Renovation New Maxiofacial Boutique & Office Dr. Lance Knight, Cosmetic Dental high turnover in terms of it business model. Dr Knight estimates that occupancy levels will be circa 25 at any one time. The split is10 staff to15 clients. United Kingdom North West Manchester No 3 Back Pool Fold Manchester Interior Budget Funding: Geographic Limits With Close Proximity , 320k Private Client Funding Building Only

Use and Occupancy

Client Description of Concept The client describes the business as a private members dental and f club.

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a live client as privilege. It is also a chance to build a high profile design scheme that will not only launch my career as a Super prime market celebrities and high earnings clientele who expect the best of the best in dental technology and service. Back Pool Fold is in a current state of neglect offers. Back Pool Buildings Initial Perceived Need and Project Scope Just off of Manchesters Cross Street. The building is situated perfectly for access by the high-end market segment that my designs are aimed at. The clients primary project goals to Fold requires an extensive structural remediation. The project offers the chance to completely design it internally and give it a new phase of life. The building is a typical example of the 19th Century industrial period. It was constructed as a single leaf, load bearing Cheshire brick wall in an English bond formation with plain sash windows. The building is adjoined on two sides leaving two elevations. The existing long south faade is to be retained and restored. The south elevation (most architecturally significant) c13m long and the longest facade faces the alley and is elevation is adorned with a 1930s antique fire escape and antique lights. designer in the city but also help to build valuable local professional contacts.

Target Market

create a private healthcare facility is complimented by a strong desire to retrofit of new technologies and renewable energies into one of Englands historic commercial buildings. Although the building is not listed Back Pool Folds wonderfully is preserved cobbles once led to the one of Manchesters Lost Halls, Radclyffe Halls. (Pevsner 2001) The buildings late 1890s industrial character will give a credible and urban flavour to any scheme it hosts. I see the ability to work on this building with

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Hospitality Healthcare
This is to be renovated. The fire escape gangways are reminiscent of icons in old films that were set in New York City. The windows of the south elevation along the south elevation are currently boarded and are to be replaced. Public access is currently via the west elevation. The West elevation is the shortest at c5.4m, faces the Cross street entrance and is to be fully redesigned.

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The Design Problem From The Perspective Of The Designers Underpinning Ethos

Evidence Based Design EBD has become relevant in the Healthcare Architectural and Design field in an effort to improve patient and staff well being,

Healthcare Design Most healthcare facilities are recognisable as organized, clean, and functional environments that enable health practices to be carried out easily and efficiently. However, a number of healthcare

patient healing process, stress reduction and safety. Evidence-based design is a relatively new field of study. According to The Centre for Health Design, the field borrows terminology and ideas from several disciplines including Environmental,

facilities do not take into account how design may affect patient welfare. I believe the role of interior design has an integral part to play in effective wellbeing and the control of stress, which is an internal reaction to external factors. I was inspired to research the subject for my final major project that would provide a platform to showcase my concept of Healthcare Hospitality. The concept of Healthcare Hospitality is a culmination of various emerging issues in the field of healthcare design. Three current hot topics in the field of healthcare design are:-

Psychology, Architecture, Neuroscience and Behavioural Economics. Through exploration and understanding of this topical question I intend to create a healthcare interior environment that promotes uplifted spirits and promotes healing. According to the Academy of Architecture for Health, a healthcare environment is therapeutic when it does all of the following: 1. Supports clinical excellence in the treatment of the physical body. Supports the psychosocial and spiritual needs of the patient, family, and staff.

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Hospitality Healthcare
2. Produces measurable positive effects on patients

clinical outcomes and staff effectiveness.

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Integrative or Holistic healthcare The practice of Integrated Healthcare involves the use of

conventional and alternative/complementary medical therapies in conjunction with each other.

This is why we have seen an influx of dental spas offering massages etc with conventional treatments.
Website for this image Integrative Health Care: Some Considerations. By Joel Proctor, MS, Dipl. sacredtree.com

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Healthcare Consumerism The future of healthcare is based on a demand-control model with economic forces similar to those that affect the all other purchasing behaviours. Clearly, health and healthcare are not the same as

purchasing other goods and services; however, certain mega trends have been impacting our economy and service industries that have a parallel in healthcare. Basically healthcare consumers have a choice and we need to employ retail design techniques to ensure they choose us.

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Designers Architectural Interest


My architectural interest is specific to the retrofit of emerging technologies and renewable energies into Britains large stock of commercial and residential housing stock. I describe this as breathing new life into the old, whilst building a bridge to the future. Through the adaptive reuse, rehabilitation, preservation and modernisation of an historic areas building, Back Pool Fold, in the King Street Conservation Area, this project aims to continue Manchesters successful urban legacy of breathing new life into the architecture, which represents the historic. In accord with this tradition, the design program seeks to prepare this historic areas building for the next 50 to 100 years of service. It also intends to demonstrate the value of integrated design that balances the needs of the buildings historic significance with current needs and emergent issues; balances aesthetics, cost, and reliability; creates environmentally responsible and

superior workplaces for highly talented healthcare professional; and gives public expression to our societies values today.

Designers Market Segmentation Preference Through my student career degree I have enjoyed creating high end, luxury and creative schemes. My primary focus has been to design spaces that are proactively conducive to the clients achieving their personal or professional objectives. My designs have been either targeted at the forward thinking professional or for the highly demanding affluent resident.

Personal Design Outcome Statement I have a vested interest in the discipline of healthcare design. This has driven my ambition to create something in Manchester, which encapsulates my design beliefs in this field. Whilst studying I have worked within this field for four years as a stakeholder and business consultant. My background is in corporate banking and through the commercial and economic

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awareness gained in that market I have recognised an opportunity to provide a holistic design and business

consultancy service to healthcare and cosmetic aesthetics professionals. By fully researching and completing the project it will serve as a viability test for the business concept of providing design and business consultancy to this market. I aim to capitalise on the opportunity of having a real healthcare client and developing a space into a commercial high-end dental boutique. This

project provides the perfect showcase for future design projects.

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Hospitality Healthcare

Scope and Methodology for Design Brief


The brief has been developed following the undertaking of thorough research and evaluation of all relevant areas

Manchester, construction team, structural engineer and the course supervisors. Key brief and design details were outlined and included in the brief. The requirements of the client are vital to the success and the functionality of the end product.

associated with this design. Structure and layout of this document was considered to develop a professional, consistent and definitive document. The final brief not only covers information in relation to the client, the existing building and proposed designs schemes, the target market and key areas that provide underpinning background for the design team to work to, furthermore, it offers a clear timeline of events and important deadlines that are to be worked to in a professional manner. Decisions and developments have been made based on the research and continued revisions during meetings with the client Dr Lance Knight the clients for the RIBA stage one up to planning consultation with the clients Architects AFL in

The brief is underpinned by relative issues in the UK Healthcare and Cosmetic Aesthetics market, integrated Healthcare Design, Building Regulations, Design Against Crime, Sustainable and Renewable design, medical specific legislation, health and safety, Conversation Area Issues and Crime, relevant building regulations etc and accessibility. It is imperative that design must comply with the guidelines set by HTM0105 in 2009 by the Department of Health. The published document HTM 01-05

decontamination guidance for dental practices has been instrumental in the design. The regulations are focused in particular at primary care dental practices in

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Hospitality Healthcare
the U.K. and are designed to ensure that all dental practices meet essential quality requirements and best practice standards set by the Department of Health. This document has provided strong background knowledge, however, ongoing research and development of ideas are key to the progress and this will continue throughout. More detailed information in relation to the contents of the design, fixtures, fittings, structure and materials will be provided in the subsequent documentation. The design will aim to utilize the clients existing businesses to plan the surgery spaces and to gain an idea on process. The brief has been prepared via the following process: A desktop study of books, journals, websites, The Clients Strategic and Financial Plans A review of the clients key processes and procedures. Research into precedent designs for: Dental Surgeries High End Hospitality Markets Sources such as interviews with the clients board and staff, meeting with suppliers to the dental industry, books, Green Build exhibition, online journals the Internet and course related handouts have been observed to ensure the brief covers all the areas that are important, to provide both the client and the designer with a concise and informative manuscript.

A review of the competitive market. A study of the target audience

magazines:-

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Hospitality Healthcare
A study of the environmental factors of

Healthcare design

PLUS

Designer Inspiration Visits A Spa in particular Sustainable Spas Discussions with Instore Dental and Ultimate smile spa key staff. Creation of the Brief and supporting documents including a A Project Plan, Weekly Team Briefing Minutes, schedule of proposed works and a timeline All sources are included within the research document.

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through discussions with the client as well as a review of the clients marketing materials, business plans, strategic plans

Client Needs
THE OWNERS GOAL IS TO SET A NEW PARADIGM IN PRIVATE DENTAL and FACIAL AESTHETICS.
People Place To attract and retain the best in class of dental professionals. The place is one which is to have an highly desirable location which meets the prestigious brand image in development, accessible location with good transport links for all stakeholders. Product Dental and Facial Aesthetics Primary Market wants Secondary Market - Maintenance and standard dental needs Price Top End Price Point - Caters for specialized needs and

including long term missions and visions amongst other reporting sources on the further education market.

To design for a client it is imperative to fully understand their world and their customers/audiences world. A full understating of Dr Lance Knight business, its clients, its market position is required in order to provide a

comprehensive design platform. This has been is achieved

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offering (c.200 Sainsbury & >1,000 Tescos). Many opportunities to expand outside of core relationships exist. A millionaire by 27 years old Lance is the founding member of the first dental company to launch in Sainsbury & Tesco, has commissioned the conversion of a Manchester mini mill as the premises for a new concept in general and aesthetic dentistry. The project will include the brand development and business plan for this new entity. Currently this young dental group has the two entities catering for two distinct market segments. The new entity will be developed as an extension to the high-end brand, Ultimate Smile Spa. Dr LK has and his board have developed their two brands Instore Dental (ISD) and Ultimate Smile Spa (USS) portfolio to date via organic growth, i.e. not acquisition. The company is 2.5 years old with 7 surgeries and is now in the coveted position of having the right of first refusal on new sites Sainsburys and Tescos dental units. Target supermarkets with pharmacy The need for the construction/renovation project for has arisen out of the ambitions of Dr Knight to continue to shape the face of UK dentistry via a new high-end dental company.

The Client Dr Lance Knight

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Hospitality Healthcare

The Clients Existing Brands

In-store Dental (ISD) Ultimate Smile Spa (USS) Extension of Ultimate Smile Spa

Provides full range of dental services within Supermarkets

Premium brand dental

Offering Facial Aesthetic

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spa still some national health clients Target mass market underserved by NHS & local providers Caters for wants rather than needs market Quality service at reasonable prices Specialist centre of excellenc e Specialist centre of Caters wants rather than needs market for but has as well as Cosmetic Dental Services

excellence and Dental Training

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centre

Clear & transparent pricing

Higher price point than ISD

Higher end price point than ISD. Dental club membershi p fees will be paid for additional members benefits. Essentially like healthcare plan out middle with the

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man insurer.

Convenient locations with parking and high footfall

Private and National Health Patients

Private and National Health Patients

Availability (8am till 8pm including weekends)

Availabilit y (8am till 8pm including weekends )

Availability (8am 10pm including weekends) till

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Market Research and Demographic Context of the UK Dental Market and Facial Aesthetics Industries

"the roots of conventional medicine, including Rene Descartes work in 1641 work led to what is known as the Cartesian Split. This is basically a clear delineation between body and mind and surgery procedures in Western (allopathic) medicine can be traced back to the famous Rene' Descartes."

Dental Market and Facial Aesthetics Market Research Mind Map

Renes work set the standard still widely practiced today for doctors to concentrate/specialise, in most cases, in isolation, on specific organs/body areas. Although todays dentist has official doctor

status and has to complete five years of basic training prior to practicing, this wasnt always the case. The practice of conventional dentistry was initially unregulated. In fact it used to be carried out in Market History The Cosmetic Dental and Facial Aesthetics Industries came from well-meaning and humble beginnings. They are subcategories of conventional medicine. According to Caroline Young the author of Integrative Health: A Holistic Approach for Health Professionals, dental barbershops until the 1400s (British Dental Association Archives). Sir John Tomes and Sir Edwin Saunders drove through

dental industry regulation and legislation with the Dentistry Act of 1878. (British Dental Association Archives) This validation as a profession was expedited in the very early years with the expansion

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Hospitality Healthcare
of the middle classes wanting healthier and more natural looking smiles, like the rest of the world. The development of the skills required in cosmetic dentistry and facial aesthetics came during the WWII where the men were left very exposed and record numbers of war wounds and disfigurements occurred. (Backstein and Hinkek 2005) The military surgeons developed groundbreaking skin graft and reconstruction procedures that are still at the root of techniques today. After the war, a lack of patients for these new skills drove the surgeons to start actively marketing. They aimed their efforts much like today at the affluent middle aged, middle classed women who were mostly finished with raising families. It seems that not much has changed and that even then they were playing on womens insecurities, for what could these women possibly have to offer but to look pleasant and please their men by looking youthful if their children were now grown up? This incessant encourage of the media for us to look like the star we see the media had continued today. The dental market has evolved to Perpetuating our desire to recreate lives through our looks is our obsession with celebrities. This was born with TV and went from strength to strength through the Video recorder Hollywood into our homes and now the Internet means that everyone can be a celebrity. If we are not busy trying to make ourselves a celebrity via You Tube or on some terrible talk show (enter Jeremy Kyle and Jerry Springer) or launching E-list careers on Big Brother or other fly on the wall reality shows, we are arriving at a clinic clutching a clip from a womens magazine saying can I have lips like Scarlett Johansson, Cheryl Coles Teeth, cheeks. Weber makes a strong case that the desire to conform is omni present in our society. She says , Ashlee Simpsons nose or Natalie Portman's market that is synonymous with the celebrity glamour lifestyle a large number of the population aspire to be part of.

The Celebrity Dentist

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Whether this desire expresses itself via physical appearance or home decorating, the individualized self is the result of a transformative journey toward a model of excellence doctor in a position of trust, power and influence in our society. The suggestion that elective surgery is a lifestyle choice, i.e. a way to live your life, sends shivers down the spine. However with the industry contributing billions to the economy there is certainly proof that a number of people, primarily women are choosing this as a way of life.

embodied by experts or celebrities (Weber 2009) With the wave of reality TV and be star shows came the creation of billions for TV networks via the plethora of makeover TV shows. We have created a new bread of celebrity. The dentist and the cosmetic surgeon. Dr Knight is in this category.

Todays Aesthetic Dental and Cosmetic Surgery Markets; The Markets are described as purely elective, a lifestyle choice undertaken to enhance physical appearance, improve self-esteem and boost confidence. Read online at

http://www.nhs.uk/news/2009/11November/Pages/plastic-cosmeticsurgery-botox-filler-warning.aspx Its difficult to decide what is most concerning, that this quote was taken from an article on the NHS website or that is was made by a

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The Uk public underwent 36,542 operations in 2010. (BAAPS 2010) 94% percent of the clients were female of which 67% were married According to Mintels report, Cosmetic Surgery - UK - June 2010 the UK Cosmetic surgery market is worth in excess of 2.3 billion pounds read online at (BAAPS 2010). This markets astounding growth trends are mainly

Economic Trends Aesthetic Dental and Cosmetic Surgery Markets;

made driven by non-surgical procedures like Botox and Derma fillers and chemical peels (MINTEL 2011).

http://oxygen.mintel.com/sinatra/oxygen/display/id=480789. The industry has seen a whopping 17 % rise from 2009 (Mintel). Mintel estimate that by 2015 the market will equate to circa 3.6 billion pounds.

Closely associated to the cosmetic surgery market is the cosmetic dentistry market. The cosmetic dentistry sector forms a seminal part

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Hospitality Healthcare
of the larger maxillofacial elective aesthetic market. According to the Office of Fair Trading, UK market for dental services was worth 7.2 billion in 2010. Forecasts suggest this could grow to 8.2 billion by 2014 with much of the growth coming from the private market. They also state that spending in this part of the primary care dentistry market was split NHS 40% and 60% private provision. Read Online at http://www.oft.gov.uk/news-andupdates/press/2011/99-11. The governments latest dental contracts have discouraged dentists from carrying out anything other than the most basic reactive treatments leaving many clients frustrated and dissatisfied with the care they receive. Both clients and Principals are leaving in droves to the Private Sector. Dentists are falling behind on their Unit of Dental Activities UDAs and Units of Orthodontic Activity UOAs targets PCT's have started to act against target breaches financial threats and penalties. Practice valuations have been driven as high as 5x EBIT with the The government estimates there are currently over 2 million people that wish to register with an NHS dentist that can not find a surgery willing to take on new clients . Additionally thousands of clients are leaving the NHS in search of shorter notice private dental appointments nearer their home. Web searches for dentistry are now breaking all previous records and dentists are addressing their web presence, overall branding and marketing; influx of funded and acquisitive PE firms and corporate groups. Sales of dental membership schemes and interest-free finance facilities have reached record levels; with punitive

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Hospitality Healthcare
New business models have emerged for the delivery of dentistry treatment coordinators, care nurses and hygienist/therapists taking a more active role in the clients customer service experience. The growth in cosmetic procedures continued to has drive Jongh,and Aartman, site in the article . (2008) Preoccupation with ones appearance: A motivating factor for cosmetic dental treatment? British Dental Journal, Market growth will likely be perpetuated by

our societies infatuation with our appearance In addition our desire to remain young grows ever stronger as the traditional markers of entry to adulthood of completing school, leaving home, starting a career, marrying, and having children continue to move to older ages.

change and growth in the market.

Private vs. NHS NHS spending estimated at 3.3bn (58%) with spending on Private dentistry estimated at 2.4bn (42%) Private spending peaked at 2.5bn in 2007/08 prior to the recession Image from http://www.harleyaestheticsdundee.co.uk/images/dermal.jpg Growth within the private sector projected to continue at a stronger The prospects look rosy for the industry as it is a market that is based on our obsession with self. Leading Psychologists De rate than NHS (21% private versus 12% NHS) as a result of public spending cuts to reduce the UK budget deficit; increasing cosmetic and recent funding increases to NHS from central government

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consciousness; and negative impact of 2006 dentistry reform. Source: Laing & Buisson Dentistry UK Market Report 2011, Dentistry Market Development Report 2010 MBD UK Linked to Private Members Clubs and High end Aesthetics Spa Exclusive with unique benefits

What is the Dental Plan Market Worth Total dental plan market (covering capitation, dental insurance and dental cover from cash plans) estimated to be worth 665m in 2009 Spending on plans increasing at twice the rate of self pay private spending during the 2000s only available to members

Source: Laing & Buisson Dentistry UK Market Report 2011, MBD UK Dentistry Market Development Report 2010

Market position Brand positioning High Value price point Quality service and added Value Brand vision Private Members Club Precedent Shore ditch House

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Precendent t In a former tea warehouse in the part of town where the City meets the East End you'll find the latest and largest off-shoot from Soho House founder Nick Jones. This swanky 6.5m members-only

It appears that the three most critical factors in creating an optimal healing environment in a spa venue are (1) a dedicated caring staff at all levels, (2) a mission driven organization that will not compromise,

bar/restuarant club is home to media hipsters who want to see and be seen. With members willing to pay 700 a year to be part of the crowd and only 1,000 memberships available - all now sold - exclusivity is key. The group's other 'houses' - Soho House, Babington House, The House in New York - all share the same cool, minimalist wood and glass interiors. Added extras this Shoreditch branch comes with include bowling alleys, cowshed spa, gym and, the biggest draw, a heated rooftop pool - where Calvin Klein bikinis are de rigeur, naturally.

Excerpts from Article The Ranch leadership aimed to show that

a physical facility (environment) would play a role in promoting optimal


Brand Personality The Spa as a Model - As an Optimal Healing Environment Precedent Study - Canyon Ranch Tucson Arizona What Dr Knight hopes for is to create a brand which is understood for people to feel really good about themselves on the inside and the outside . This an environment which aims to help people to there let their best feelings come out. This value should be reflected in the interior design .

healing. Elaborately detailed landscaping plans were implemented with a vision of a future campus that would provide a stress-free environment and assist people in the healing process. The buildings on the Ranch were set to create small pockets of privacy, one building from the other. All buildings were designed to be one story, and to maximize views of the surrounding mountains. Roads throughout the Ranch were closed to vehicular traffic, no streetlights were erected, and night lighting was at ground level. Good design on its own cannot heal, but it can make science work better. Lighting, offices, public and private spaces, finishes, wall

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coverings, acoustics, outdoor seating areas along the meditation path, and water artwork have all been designed to impact positively as people try to change their lifestyles. Just as in the delivery of health programs, one size does not fit all. Ulrich makes this case very clear in his thoughts on the effects of interior design on wellness. A difficult but important challenge for designers is to be sensitive to such group differences in orientations, and try to assess the gains or losses for one group vis-a-vis the other in attempting to achieve the goal of psychologically supportive

design.http://www.samueliinstitute.org/news/172SIIB/version/default/part/AttachmentData/data/Frost.pdf

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Level of competitive threat Competitor Review


This is always dependent on the number of same market

co m pl et e control over what is given to the client even if the labs let then down. . The

segmentation practices in the local vicinity. Apart from the corporate multiples ,there are two other high end dental practices in the vicinity. Dr Knight owns one of them Ultimate Smile Spa There are other the Mall .

surger ies

The MALL - Manchester


The Mall are selling comfort and modernism Pretty Generic

dont look anything special

Attributes They also dont highlight anything regarding healing and complimentary additional benefits to make them stand out from the crowd. The Mall do have their own lab. Cost efficient but I dont really see this as adding any value to the client except perhaps the control of the supply chain. This is not an issue though as the dentist has

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Integrated Dental Holdings Ltd Majority NHS
1996 Incorp. by third-generation dentist David Hudaly. Over the past four years IDH has opened 30 new NHS dental practices and made 50 practice acquisitions

The Corporate Dental Competitors Info Sources Dunn & Bradstreet and FT.Com Moody and Poors

Competitor Analysis GRAPHIC Created by Natalie Jameson

IDH, HQ is Bolton, circa 1.5 million patients, c700 dentists and 200 practices with c1,700 employees. KEY focus is PCT and (DoH) - NHS but they do offer private dental care as well. Split unknown. T/O /FYE 05 66m Full accts not yet filed Merrill Lynch paid LGV 300m for IDHs shares in Feb 08, nearly double what LGV paid two years earlier. Funding Mix of Debt from Syndicate Bank of Ireland, Barclays and RBS.

Oasis Dental Care Ltd - Sub of Oasis Healthcare Ltd - 40% NHS
1996 Incorp., 1999, four practices, 2000 12 practices AIM listing, 2001 Acquisition 23 further practices ,2002 Acquisition of Ora Dental Grp

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10 practices, 2003 Acquired Dencare Mgmnt. Grp Ltd 38 practices , 2007 Dec 2006 grown to 120 Oasis Oasis HQ is Norwich, Circa c551 dentists and 140 practices circa 1400 employees T/O split 64% Midlands & Nth , 6% Central, 29% South. T/O 90m PBT, 4.6m , Neg Net Worth of 21m Focus Split 40% NHS 60% Private, Duke Street Capital bought Oasis for after a bidding war with ADP for c 79million, Funding mix of Equity and Debt from Barclays. KEY focus is 75% PCT and Dep.of Health (DoH) - NHS but they do offer private dental care as well. Split unknown. HQ is South of England , nr Surrey, T/O /FYE 05 18m Full accts not yet filed Neg Net Worth 7.3m Aims to hit t/o in re region of 40million by Nov 2007 but accts not yet filed. In March 2007 EAC, now called Milestone Capital, sold their investment in ADP to the management and Kaupthing Bank, for an undisclosed sum.

Associated Dental Practices - 75% NHS


Third Largest UK Dental Group. Founded in 1985. Provide NHS

Dr JD Hull & Associates Limited Majority Private


Dr Hull founded the group in 1987 with its first dental practice in Newport, Wales. JHA now operates 48 dental practices across the UK Sold a share to Hutton Collins in 2006 in a deal that valued the business at c85m when t/o was 21-23m HQ London - T/O 28million, PBT 3.2m Land and Buildings 3.2m Cash 1.8M.Net Worth Neg 1.9m -

dentistry with over 110 practices serving 800,000 patients Starting as a single dental practice, 2000 had 14 practices based in the south. In early 2002 sold to VC - European Acquisition Capital and subsequent acquisitions growth to a total of 56 practices by February 2007. By this stage the group had reached sufficient scale to be profitable and self-funding.

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Jdh Holdings Ltd its Ultimate Holding Company has a Positive Net Worth of 7million

James Hull Manchester St Annes Clinic


Really there is only James Hull to consider a threat . let look at there permises in Manchester . They paractie in

Manchester is St Anns dental Practice. It is in the same location Knight as Dr

Ultimate

Smile Spa Clinic

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Services, Service Providers and Products to be Accomodated


A full and detailed understanding of the clients has been gained via primary research with the client team and two key suppliers of the clients and reference to the Metric Handbook and the Whole Building Design Guide. The following specific services and care /service providers will need to be accommodated. General dentistry: The diagnosis, treatment, and management of the overall oral health care needs of patients, including gum care, fillings, crowns, veneers, bridges and preventive education. Periodontics: The dental specialty that involves

Periodontal disease is a major cause of tooth loss in adults. Endodontist: A dentist specializing in diseases of the tooth root, dental pulp, and surrounding tissue. "Orthodontics dental and dentofacial that orthopedics: The

specialty

involves

correcting

malocclusions, or bad bites as a result of crowded, missing or extra teeth, or jaws that are out of alignment. Treatment includes the use of braces,

retainers, headgear, and other appliances" Oral and maxillofacial surgery: A specialty of dentistry that includes dentoalveolar surgery and the diagnosis and correction of diseases, injuries, and defects of the mouth and jaws. Cosmetic Dentistry

preventing gum (periodontal) disease an infection of the tissues surrounding and supporting the teeth.

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Hospitality Healthcare
Exodontist: A dentist specializing in the extraction of teeth. Prosthodontics: The area of dentistry involving the diagnosis, treatment planning, rehabilitation, and maintenance of patients with complex clinical "Pediatric dentistry: An age-defined dental specialty that provides preventive and therapeutic oral health care for infants and children through adolescence" Oral hygiene treatment room (OHTR): A room similar to a dental treatment room (DTR) that is used by the dental hygienist to treat patients

conditions. These patients have missing or deficient teeth and/or oral tissues that can be rehabilitation

Client Journey Goals:

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Functionality Equipment and Layout of a dental facility is extremely specific. The minimum circulation requirements for the nurses and doctors must be respected to ensure the correct application of treatment techniques can be applied. THE FOLLOWING APPROACH WAS TAKEN TO IDENTIFY THE REQUISITE STANDARDS AND TO UNDERSTAND TYPE OF SPACES THEY HAVE IN THE CURRENT PRACTICE.: 1. Worked out what the client would like to be the optimum client experience to be 2. Created a process map of ideal customer experience to overlay the program on. 3. Discussion with client to understand of minimum space requirements to see if feasible in proposed facility 4. Client Journey Process flowchart 5. Annotated floor plans from the existing surgeries doc ref 6. Visual Study of dental surgery images and floor plans and summarize list of types of spaces. 7. Meeting with dental equipments supplier Henry Schein to ascertain space standards of typical spaces (standard dental equip and costs 8. Review WBDG website for dental facilities standard templates and sizes attached

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Customer Journey Process MAP

I created these process maps for the client to define what he want the process to be to support the client experience. Interviews were held with Dr Lance Knight Clinical Director, Mr Scott Jameson MD , Mrs. Kirsty Beresford Practice
Program Manager Ultimate Smile Spa, Miss Philipa Knight

Practice Manager Instore

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Unique Selling Point Diagram Comparing The Standard Dental Experience to Dr

Knights Concept
Once the clients customer was

excellance

framework

established a comparison was made to understand how this is unique. Several meeting were held

with the client to ascertain what the customer journey is in his existing practices and what he feels is unique about his new business concept. Dr Knights explanations of what his USP are the diagram bulleted list .

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The Long Program

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Room Number and Specialty mix of Dental Treatment Rooms

Space Planning Criteria


The criterion has been developed on the basis that that modern facilities are essential to provide comprehensive dental care. Interview with Client and Team Annotated floor plans from the existing surgeries doc ref Visual Study of dental surgery images and floor plans and summarise list of types of spaces Meeting with dental equipment supplier Henry Schein to ascertain space standards of typical spaces (standard dental equip and costs Review WBDG website for dental facilities standard templates and sizes attached

and Conclusions from Interviews

What Type of Roles will there be How many people of each type of role are to be accommodated? What major functions will take place in the building? How might the building design enhance or impact occupant interactions?

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Involvement of interested parties in the definition of the scope of work prior to the design effort.

Project Design Goals Ethos and Approach


The effective management of the process is dependant like anything, a really well thought out and tested plan. In architecture this is particularly important. This excerpt is from the Whole Building Design Guide read online

Emphasis on gathering and analyzing data early in the process so that the design is based upon sound decisions. Efficiencies gained by avoiding redesign and more redesign as requirements emerge during architectural

In the 1980s and 1990s, some architectural schools began to drop architectural programming from their curricula. The emphasis of the Post-Modern and Deconstruction agendas was instead on form-making. Programming and its attention to the users of buildings was not a priority. Now, several generations of architects have little familiarity with architectural programming and the advantages it offers:

design.
http://www.wbdg.org/design/dd_archprogramming.ph p Date Accessed October 2011. By setting goals during the programming stage Back Pool Folds clients strategic aims have been considered in conjunction with the responsibilities that come with re-visioning a historic area building and the values and attitudes of our society today. These are then imbedded in the process of concept design development and through to completion

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The goals have been set inspirationally and realistically with due diligence to check their feasibility of application.

The GSA Program Goals Matrix

This is an example of a The GSA (General Services Administration) Program Goals Matrix in Facilities Standards for Public Buildings, P100 indicates critical Program-System relationships that must be addressed within Building Systems Programming Directives to designers. http://www.wbdg.org/images/perform_req_2.gif

I think this a really effective and succinct way to keep the project goals in mind when designing. I will create design one .

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Design Goal 1 G1 Create a Healing and Uplifting Environment

which highlights the benefits of the Clients Unique Selling Point Within the Design
What are the topics of Healthcare Design that should be considered to create an uplifting and healing environment? In the west we can see a rise of conventional surgical and non surgical procedures increasing in line with Integrated health care therapies. http://www.integratedhealth.org.uk/home.html Integrated Healthcare is CONVENTIONAL and COMPLEMENTARY medical therapies together. Integrated health is a key constituent of EVIDENCE BASED DESIGN. Holistic Approach for Health Professionals ,Cindy Coopson . Integrative Health:

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Healthcare Hot Topic Mind Map


Created by NJ with Text to Mindmap www.text2mindmap.com/

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The Medical Benefits Of Creating A Positive In Reception Experience Upon Arrival.
This website discusses the medical benefits of waiting room design. http://crockettstudio.wordpress.com/2011/02/26/positive-distractions-inthe-waiting-room-design-opportunities/Recommendation for Reception Area.

Incorporating positive distractions in the design of medical spaces, including the doctors office waiting room, is one of the five key tenets of healing design that Texas A&M Professor Roger Ulrich proposed as a result of a study he published in 2004 in The Lancet. Ulrichs research showed, in part, that attractive surroundings that included views of nature, paintings, flowers, etc. had a beneficial effect on the recuperation rate of hospital patients. Patients that had access to positive visual stimulation recovered three-quarters of a day faster and needed less pain medication than patients that did not have such similar visual stimulation. Ulrich( 2004)

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Ulrichs Five Tenets of Healing Design
2. and TV) 3. A greater sense of control in a clients environment. (A Positive distractions. (Calming and Inspiring - Art Music

Who is Roger Ulrich and what are his healing environmental principles and how can they be applied to the design of the new facility?
Roger Ulrich, PhD, is perhaps the most cited and influential evidence-based healthcare design researcher in the world. His studies have been lauded for their scientific rigor, and his findings continue to be readily implemented by healthcare managers, clinicians, design practitioners, and policy makers in the United States and abroad. Without question, Ulrich's work has directly impacted the design of many billions of dollars of hospital construction, and improved the safety and health outcomes of patients across the globe.

two individual private suite for use, which can be booked for overnight stays and personalised to order) 4. Social support spaces. (We will provide spaces for friends

to come with friends as supporters, silent or otherwise.) 5. Reduction or elimination of environmental stressors

including.

Adequate space
Should be provided in public areas and waiting rooms to avoid

We will employ evidence based design approaches such as

crowding;

Ulrichs Five Tenets of Healing Design: 1. Access or connection to nature. (Features which bring an

Odors
Odours that are objectionable or medical can create stress.

oasis feel to the urban environment)

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Way finding;
the built environment should provide clear visual cues to orient patients and families, and guide them to their destination and return. Landscaping, building elements, daylight, colour, texture, and pattern should all give cues, as well as artwork and signage

AIR QUALITY
100% outside air where climatic conditions allow.

COLOUR IN HEALING EVIRONMENTS

Lighting Issues
Appropriate lighting systems; lighting can be a stressor that alters mood, increases stress, disrupts daily rhythms, and modulates hormone production (J. Roberts, Ph.D.) Provide lighting that supports natural circadian rhythm; Provide natural day lighting where possible, or bright white lights (400600nm) in the daytime. Ensure absolute darkness in the evening; for night time movement only red lights (650-700nm) should be present in the rooms. (J. Roberts, PhD

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Receptionist asks you to indentify yourself Be nice of they knew me.? They hand you a form oh joy! be nice if didnt have to fill a

Arrival and Discharge - The Reception Effect and Waiting Room Blues

form manually

THE DESK A HUGE BARRIER The classic dental experiences includes coming in to face a wall of desk, which is a psychological barrier between yourself and the practice straight away it adds to you unconscious feeling of being slightly at their mercy. , With a receptionist sat behind it in a barrier which screams you and us are not equal. Not, come in lets catch up and

collaborate to meet your needs . What happens at reception -

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Even though these are some fairly nice ones here . They are still very much you just wait for your fait until we are ready for you. It seem the reception desk in terms of priority is the normally the biggest item in the place. Should it be the other way around? The customers should feel like they are the most important person there and the environment should look like it is for them. There is some good research in this area on Positive Distractions to consider along with my own opinions on them as a dental consumer, but lets start with my own perception of waiting rooms. Good or bad. I dont like the thought of waiting and I also do not know anyone who else likes waiting. So why do we still approach these as designers with that in mind. I question the need for them a customer! If business gives me an appointment time why cant they be ready for me when I arrive? Now I realize that just in time booking in of people is not Waiting ROOM BLUESI I hate the whole concept of waiting and believe that those reception areas should an integral part of the client experience and positively influence the outcome of the treatment. Avoiding the design aspects of the furniture Wipe clean pleather seats which are uncomfortable not tactile and are normally too close to the next person for comfort. If your are lucky there may be a TV could have a TV or Radio on. It isnt normally what you would chose to watch. really that There are normally people sat in reception looking

uncomfortable thumbing through outdated magazine in some cases.

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Hospitality Healthcare
Can we take payment and sell extra in some other way other than people having to stand at the desk? We aim to immediately put the client in a relaxed mood because they wont be in the frame of mind of being stereotypical dentist waiting room sat around looking at people leaving people holding their face. Its a spa like hospitality and environment where you are feeling like are in for a pleasant experience. Even though IPAD Technology used for Form Completion Also eradicate the need for storage of hard copy forms. NB This is possible as electronic signatures are now acceptable in medical history forms.

Consider alternatives to reception check in desks!

http://www.arx.com/industries/digital-signature-for-healthcare Try to avoid reception asking existing customers their name. Also we want to be able to quickly build a rapport with new potential customers name Really there should be some sort of id system that the customers use to unlock the door, which let the practice know so they could be invited in by name. What happens if someone walks up by just passing trade? I think even then some sort of signage or touch window touch screen

you might not be. Refreshments are offered and then you are escorted to your private area where the consultants and your team will come and discuss with you in private you'll need and eat in the meantime waltzed you all waiting you can sit and relax and have interesting refreshments watch the television yeah really just get yourself in a positive frame of Consider how we meet and greet people and check them in? Consider alternatives? What technology could be used?

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system a mobile Text us you details and some one will personally greet. http://www.electronics-sourcing.com/uk/

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museum. http://www.shockmd.com/2009/07/13/architecture-and-

DESIGN GOAL Create a productive space conducive to producing the most motivated and effective team members by Indentifing and applying The Key Environmental Factors In

neuroscience/ The task is to Indentify The Key Environmental Factors In Productivity In Workspace genreally the spcifically for a clinic.

Article How the Brain Experien

Productivity In Workspace
Currently the building is an empty shell . The design team have the opportunity to create the optimum working environment for the client. Careful consideration of what goes into creating a great feeling building will halp to set the design goals for this area . Buildings also need to respond to the functional needs of the occupants, and users need to be provided with adequate lighting, well-modulated heating and cooling systems, structural soundness, and public safety provisions. These requirements can vary according to the type of building, a hospital has other requirements than a

ces Architect ure

Ligh t Ther mal Com fort

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Acoustics Windows Acoustic Privacy Separate ducts for the heating

GSA Monitors Workplace Basics to Improve Productivity

and coo ling to sav

In the Article isuggests that the key factors which improved the workers environment and threrefore theeir productivity were, Light Natural daylighting Good Artificial Daylighting where daylighting not available Reconfigurable - Adaptable and flexible workspaces. Good accessable plug sockets for workers. Lamps for task lighting

e ene rgy and

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Hospitality Healthcare

incorporated into the external envelope or glazing

DESIGN GOAL Create a productive space conducive to producing the most motivated and effective team members Lighting Recommendations
Natural light is generally preferable to artificial lighting. Explore strategies for increasing the natural lighting to the building In designing office buildings, careful consideration should be given to the quantity of glazing and its orientation. It is important to be able to control glare. Ideally the means to control lighting admission should be

systems. Ambient lighting should be provided at an appropriate level for the tasks being undertaken. It is helpful if ambient light levels can be controlled on a zonal basis around the office. It may be beneficial to reduce ambient levels (for example to 200 Lux) supplemented by individual task lighting at the desk. Ambient lighting might be designed to suit the viewing of computer screens, with much brighter task lights for reading small print in documents.

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Wherever possible, lighting solutions should correspond to individual needs. Older staff particularly appreciate the ability to personally control artificial light sources.

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DESIGN

GOAL

CREATE

HOSPITAILITY

outcomes and competing for valuable staff.

ENVIRVONMENT USING SPA DESIGN IDEAS

The physical organization, attention to the quality of the public experience, and carefully orchestrated wayfinding could greatly reduce the confusion and stress that usually describe a trip to the hospital. So

http://www.healthcaredesignmagazine.com/blogs/cmahan/hospitality-hospital-site-design Hospitality in Hospital Site Design October 3, 2008 by CMahan PRINT SHARE

what does this actually mean for the site design?

It means that the same attention to detail will be important in the site, as well as the interior spaces. In resort development, a common axiom says that the first five minutes of a guests experience dictates how the

A recent HEALTHCARE DESIGN survey showed that more than 51% of those polled believe new hospitals should incorporate design ideas from spas and hotels. I am reminded of an article I read some time ago by architect Adam Kerner, who pointed out that the words hospital and hospitality share the same Middle English root, hospitale.

rest of the stay will be perceived. The sequence of arrival, from accessing the site and parking the car, to how one is received, processed, and directed, are integral to that experience.

It means creating gardens in visible areas of a building or campus so patients can have contact with nature, proven in many studies to improve recovery time and reduce stress for patients and staff. It suggests that the addition of resort-type amenities such as water features, fireplaces, and outdoor furniture upholstered in rich fabric will

I am fascinated by this semantic relationship and believe that there are many lessons to be learned from the hospitality industry, not just for pampering patients and families, but for delivering positive patient

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be more common. We may see more hospitals with desirable sites that have views to a beautiful natural landscape.

Creating a resort setting for staff and families could include exploring previously undeveloped areas of the site such as a rooftop, where privacy and quiet may be more achievable than in standard waiting rooms or staff lounges.

I am interested to hear to what degree this design approach might be incorporated in new, or even existing, facilities.

Catherine Mahan, FASLA is President of Mahan Rykiel Associates Inc., a landscape architecture, urban design and planning firm specializing in healthcare design with offices in Baltimore, Maryland and Hong Kong. She has lectured nationally on the benefits of restorative/healing gardens in a healthcare environment.

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Green Spas

green

spas

provide

healthier

experience.

Green spas are more relaxing - By putting aside the stressors of modern life including noise, pollution, toxins and waste green spas are able to offer a more balanced and relaxing experience.

Green spa treatments are more effective - Synthetically derived skincare products may produce quick results, but they might also cause damage. Natural treatments are gentler and help ensure long-term health and beauty.

Green spas put the body in harmony with nature - Green Green spas are naturally healthy - By eliminating toxins in their skin care products and in their spas environment, spas are attuned to the rhythms of nature as well as the rhythms of the human body. When nature and body are in

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harmony attractive.

humans

feel

healthier,

stronger

and

more

Green spas are good business - Although up-front costs for some greening programs may be high, they usually pay for themselves and start to provide savings within one to two years. For example: investing in low-flow shower heads and toilets will cost up front, but the savings in water use will continue well into the future.

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Primary experience research of patient Dental Client Journey?


Created by NJ on

Prezi July 2011 I think to understand what is unique you need to understand what the standard is. CHARTS the experience of my dental patient experience

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The Consultation and Treatments

Post Treatments Recovery and Discharge

Unique Selling Point The New Customer journey Concept

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DESIGN GOAL Design Appropriate Environment For Buyers Of The Services. Literary Review and What Are The Made Primary When

also raised some questions about dental surgery and other similar medical services. A review of study made by a Two respected lectures in Marketing at the University of Sydney, Sydney, Australia, the primary attributes considered by consumers when choosing a dental practitioner, or subsequently evaluating the quality of service can be grouped into three general categories: (1) Those related directly to provision of the core service offering itself, e.g. quality of service, professional

Attributes

Considerations

Choosing A Dental Practitioner?


In order to design an appropriate solution it is important to have an idea of why people go to the dentist. A brief literature review was undertaken to answer this question. Although nobody would describe going to the dentist as a pleasure the dental industry has been working hard at trying to address the main objections and fear factors that people have with regard to the dentist. The findings made significant the importance of separating the regular buyer from the irregular or occasional buyer, As Dr Knights concept is about creating frequent users through the development of a dental club

competence, attitude of dentist and the support staff, methods of pain control, etc. (2) Those concerned with aspects other than the core service offering, e.g. location, parking facilities, office atmosphere, etc. (3) Consumers may also base their decisions on the reputation of the dentist and the use of advertisements. The perceived reputation could be brought about through wordof-mouth recommendations from friends and family or

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through advertising.Wang, Zhengyuan; Janda, Swinder; Rao (1996) Andrus, D. and Buchheister, J. (1985 in Major factors affecting dental consumer satisfaction", Health Marketing Quarterly, In general people have the expectation that regular check ups will minimize any pain or inconvenience from our teeth and,

DESIGN GOAL Conclusions /Recommendations Buyer Considerations And Implications For The Design And Inclusion Of Facilities.
I divided the motivations of the two types of buyers in to two segments to be considered. 1) Frequent Elective cosmetic or vanity users of dental services

unfortunately, when our teeth get damaged. Increasingly, dentists have added cosmetic and "semi-cosmetic " services such as cleaning, polishing and colouring to the range offered. People will accept a certain amount of discomfort in order to have more attractive teeth are more likely to be frequent visitors whereas those who merely want to know their teeth are OK will visit less often. Cosmetic dental work buyers might also be more concerned about the environment in which the work is done as well as issues such as the aesthetics of the facility and the brand associations convenience, location and opening hours. 2) Infrequent

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Users (most of them) a trip to the dentist is viewed with certain trepidation and, in some cases, outright fear. This concern might underlie the importance of competence, professionalism and methods of pain control To encourage infrequent users to come more often a non-dental aesthetic would be the way forward. Ie we need to give the customer a reason to go other than for their teeth which they. Dental co are doing this with Spa like atmospheres but are offering this as an add on to the treatment. It would seem appropriate to go one step further suggestion is that we have a facility that

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DESIGN

GOAL

Design

Sustainable

Environment For Buyers Of The Services.

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Design

Goal

And

Site

Analysis

For

An

Environmentally Design

Contextually

Responsive

NJ 21/12/12

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DESIGN GOAL URBAN CONTEXT


The design and orientation should be consistent with existing and planned development patterns and nearby uses. These materials should reign supreme in this design scheme. Aim to keep a truth of materials

Manchester Precedents
There is a beauty and simplicity of the architectural pallet employed when considering the re-visioning of a historic building. .

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Hospitality Healthcare

water supply for the town for over 200 years. There was also

Upper King Street Conservation

a reservoir close to where Norfolk Street is now.

The buildings exterior should be consistent with existing local design guidelines. In this respect we have used the King Street Conservation Guidelines as a benchmark.

History

In medieval times this part of Manchester was open fields to the south of the village of Manchester. There were springs here which provided a supply of water, giving rise to the names Fountain Street and Spring Gardens. In 1557 a pipe was laid to carry the water to the market place near the present location of the Old Shambles. This was the principal

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DESIGN GOAL 1) To achieve Legal and Regulatory standard compliance and demonstrate exemplar standard of training and qualifications for all clinical staff . or dentists who are constrained by the rules of sterilization and cross infection control. This is an area to consider in its design. Design Goal Recommendations Use Regulatory Restrictions our Competitive advantage Regulatory Restrictions Competitive advantage to highlight Proof that the financial contribution to the economy is a noteworthy one the government are planning a tax levy on Botox and other similar non surgical procedures. The government is claiming that Botox holds no medical gravitas. This seems a grey area as the health benefits of some procedures are subjective and down to the individual, i.e. who are the government to make judgments on the psychological health benefits of non-surgical procedures? It would seem more useful if the government provided a strong regulatory environment instead of prioitising revenues. This would provide more effective safe and balanced industry for the patient. Currently beauticians can administer a number of treatments in non-sterile environments. This is a contradiction to the rules governing doctors DESIGN GOAL 1) To achieve best practice HTM01/05 design standards Decontamination guidance for dental practices In 2009 the Department of Health published document HTM 01-05 decontamination guidance for dental practices. The regulations are focused in particular at primary care dental practices in the U.K. and are designed to ensure that all dental practices meet essential Visible clinicians qualification should be placed in view in the interior. Consider where to place these. Perhaps the surgery? or in the welcome lounge?

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quality requirements and best practice standards set by the Department of Health. The aims and objections of HTM 01/05 are about providing safe environments for clients and staff within this industry : Recognition of the difference between cleaning, disinfection and sterilisation. Implementation of Practice procedures and policies. Understanding of maintenance, testing, storage and disposal. Understanding Equipment. Operating safely and practically within the law and the British Dental Association guidelines. the importance of Personal Protective Recognition and minimization of cross-infection. Not only does the legislation set out the rules for the management of potential contaminates , it also sets out guidance for the dental environment , interiors and architectural design of spaces and fixtures and fittings. The regulation set two dates, which are important. The initial review date for minimum standard was set for 2011. The second benchmark is for 2015 where best practice must be achieved. According to the British Dental Association the a dentist best practice is the one with higher standards in infection control. The best dental practice continuously makes efforts for improvements in premises and equipment, changes in dental practice management for safest and best treatment of patients in clean, healthy and noninfectious environment. The Quality Care commissionwww.cqc.org.uk/ , are currently

reviewing practices across the country now. There will be some who

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Hospitality Healthcare
will be given statuary instruction for corrective actions and environment/practice alterations, which will be required in order for a practice to be compliant. Figure 4: Elevation of double decontamination practice room, best

HTM01/05 Precedent Diagrams to review the interior elements of compliance with HTM01/05 Richard Mitzman and Geoffrey L Ridgway discuss the impact that HTM 01-05 illustrates the effect it will have on the design of dental practices in the figures 1-6.UK Dental Market

Figure 1: Minimum decontamination room to be compliant now Figure 2: Single decontamination room compliant now Figure 3: Double decontamination room best practice in Private Dentistry

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screen and HTM01/05 No longer Acceptable To date, one solution has been to plan a decontamination area in (or in an alcove off) a back of house staff corridor. Whilst this was far more satisfactory than found in many practices, particularly those that had the steriliser in the surgery ,this no longer complies with the guidelines in HTM 01-05. The reason for this is that it is possible for contaminated, dirty instruments to be carried through the clean zone of the possibly an etched glass sliding pivoting door. are See two or

examples of such adaptations.

decontamination area. This now obviously has to be addressed and most dentists also find themselves in a situation where their practices do not conform to the practice. Many of the existing decontamination areas can be adapted to comply with the insertion of a floor to ceiling etched glass guidelines, let alone best

DESIGN GOAL 2) Recommendations for Best Practice

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Hospitality Healthcare
HTM01/05 Design With a new interior fit out we have the opportunity try and be 100% best practice compliant. We will have an instrument washer/disinfector, in a pass-through formation The instrument washer/disinfector should always be in the dirty area; the steriliser in the clean area. The washed instruments then have to be carried through to the clean area to be inspected and packed. The biggest difference for the best practice decontamination areas is that the dirty and clean areas have to be divided into separate rooms each with a door and individual air supply and extraction. It can be seen that the space requirement is of at least eight square metres (86sqft). Most existing dental practices will not have this spare space and will need to alter their layout, even possibly lose a surgery (usually a minimum of 10 square metres).

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Sketch

Designers Sketch of the HTM0105 Process Details of a Dental Equipment Supplier meeting to understand the functional

requirements of A dental Business

The sketch was created in a meeting held on the 30th of Sept with Henry Schein sales consultant. Henry Schein are a worldwide dental equipment supplier.

Richard Firth,
Equipment Sales Specialist

Henry Schein Minerva Dental 0797112 8049


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Hospitality Healthcare
DESIGN GOAL - Flexible Appropriate Work space and Equipment Configurations AS per Ultimate Smile Spa and Instore Dental Discussion held Summer 2011 When Discussion were held with staff of Ultimate smile spa they advised that thfollw medical needs, modes of treatment, and will workload continue to expansion than tight and highly specific ones Be served by modular, easily accessed, and easily modified mechanical and electrical systems Where size and program allow, be designed on a modular system basis Be open-ended, with well planned directions for future

change, the clinic should should Follow modular Email From Richard Firth with standard surgery facilities

concepts of space planning and layout Use established

Email from Richard firth and copy of dental layout. chair layout based on standard size surgery of 3m

standard room sizes and plans as much as possible, rather

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DESIGN GOAL 3) To achieve Flexibility and Expandability

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List of Equipment ) Samples purchase order from In Store Dental Annotated by Dr Knight

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Design Space Planning


Development reviews to address these issues.Maintenance professionals should be included in Schematic and Designthis space must be able to accommodate the loads and use of this equipment.by the Facility Manager; scaffolding should be avoided. The flooring materials

hours public use.appropriate, designers should strategize security design to make monumental interiors, atria, and other grand spaces suitable forhigh volume of pedestrian traffic. Areas such as cafeterias, auditoria and exhibition halls should be located near the lobby.WhereSince the lobby also serves as the collection point for all employees entering the building, it shall be designed to accommodate theThe main lobby should accommodate visitors by providing information facilities, waiting areas and access to vertical transportation.. The lobby should be clearly visible from the outside, both day and night.Entrance Lobbies and

withinother appropriate equipment can be used to access these elements where approvedcleaning of light fixtures and servicing smoke detectors (if provided). Portable lifts ordesign, as well as maintenance andatria must be addressed duringcladding) of multi-level lobbies orceiling surfaces (glazing andof the interior and exterior wall andAccess, maintenance and cleaningfurther details. of this chapter forBuilding LobbyDesign Issues Affecting Security,Chapter 8 and the section onsecure side of the lobby. Refer toqueuing space on the future nonturnstiles. Also allow for adequatecheck, metal detector andinclude an identity check, bagfuture security station that maysecure side to accommodate asecure area, with space on thedivisible into a non-secure andspace shall be planned to beEven in non-secure buildings, lobbyafter

Atriaattractive graphics should be provided to assist visitors with directions.elevated approaches that require steps, but need to be coordinated with overall approach to provide building security. Clear andApproaches must be well-lighted and designed to direct the visitor to the entrance. Grade level approaches are preferred overdesign.A canopy, portico, or arcade should be used for weather protection, and to emphasize the main entrance or enhance the buildingtraffic. All public entrances shall be accessible to physically challenged individuals.. The main entrance to a Federal building must be conveniently located for

Program

Hospitality Healthcare
vehicular and pedestrianEntrances and Vestibulesoriginal finishes and compatible in form, detail, and scale with original design.lobbies, and the permanent corridors at each floor level. In historic buildings, new materials should be commensurate in quality withPublic spaces are those accessible to the general public. They include entrances, lobbies, stairways, public elevator and escalatorPublic SpacesRooms designed for video teleconferencing or training should have a minimum clear ceiling height of 3000 mm (10 feet).avoid excessive loading of vertical transportation and to provide immediate egress for large groups of people.the tenant. If such spaces are grouped to form a large training or conference facility, they should be located near the ground floor to. Individual training and conference rooms may be located within the building to best suitTraining and Major Conference Roomsto structural floor.Where ADPThe access flooring of ADP areas shall be level with adjacent related spaces and must always be level with the landings of elevators, for additional essential electronic facilities requirements.Fire Protection Engineeringused elsewhere in the building. ADP areas are almost exclusively associated with main frame computer equipment. See Chapter 7,. ADP spaces require access flooring over a plenum space, even if access floors are notAutomated Data Processing (ADP)

Areasreconfiguration flexibility.mm (7 feet 6 inches). Enclosed offices should have the same ceiling height as adjacent open office spaces to allow futurefeet). The clear ceiling height of private toilets and small closets, which are ancillary to other office spaces is a minimum of 2300The clear ceiling height of individual office rooms not exceeding an occupiable 14 m2 (150 square feet) is a minimum of 2400 mm (8The clear ceiling height for office spaces is a minimum of 2700 mm (9 feet) for spaces that are larger than 14 m2 (150 square feet).exposed system solutions that maintain full ceiling clearance and allow ornamental surfaces to remain exposed to view.space containing vaulted ceilings, oversized windows, or similar features, consideration should be given to

accommodate ADP facility expansion. The floor levels of access flooring should be constant throughout the floor.areas occupy 33 percent or more of a floor, the entire floor, including internal corridors, shall be designed with raised access flooringthat serve the ADP facility. Ramps shall only be used where it is impossible to adjust the level of the

Program

Hospitality Healthcare
thoughtfully designed,maintaining full clearance at windows and

Strategy

Target and

Market

Preference Environmental

grouping systems, as necessary, to minimize the reduction of ceiling height. In officeceilings in standard office space within historic buildings should maintain the original ceiling height to the greatest extent possible,changes. In historic buildings, however, original ceilings in significant spaces should remain exposed to view. New suspended. Above all, the general office space should have a uniform ceiling height to provide flexibility for future floor planCeiling Heightopen and airy atmosphere. It also encourages interaction between individuals and work groups.techniques, heating and cooling to the working areas. This approach can be adapted to a larger building depth and still present anencouraged. It has a higher degree of efficiency and flexibility, and provides easier distribution of natural light and daylighting. The open plan approach (with a very limited number of ceiling height partitions for offices) isClosed Offices Versus Open Plan3.2 Space PlanningPublic Lobby space Incorporating music lyrics, phrases and symbols are tools of connecting with this audience and will appeal directly to their characteristics and identity. The research strongly suggests that this market demands The design development stages should be influenced by imagery from genres such as music, film, technology, celebrity or iconic symbols and art and design imaginations of the visitors. as these are known to capture Target Market Preferences

Considerations Psychology

including

Program

Hospitality Healthcare
Connecting music trends with fashion, graphics and the use of colour in advertising will create an instant awareness and recognition. pacedTechnologyCelebrity TrendCoolConnectedSavvy Color Considerations Research shows that current colour trends bold, block, shiny, metallic, iridescent appeal to this market Key colours are bright yellow pink, red, green and blue which appeal to this market. Environmental Psychology and Considerations The following graphics & print influences should be considered:The designed space will evoke positive emotional state but also a The use of graphics inspired by editorial prints, band publications such as posters or album covers, sense of place, connection and wellbeing through application and techniques gained in the following areas: The designer will use interactive and engaging design concepts, which appeal to the Visual, Auditory, and The team will consider creating a character or characters as research shows that a highly appealing character can create more awareness than a human alternative. cultureMusicVisualsOn-

Word Associated with the Demographic preferences

magazine covers and typography that compliments the image have been successful with this target market. Aim to use striking, and thought provoking imagery and text.

Kinaesthetic learning styles of the audiences.

Program

Hospitality Healthcare
The space, flow and movement of the stand will be proactively considered. The use of colour and its effect on emotion and mood will be employed in conjunction with the knowledge gained in the target market research. The use of understanding how different people view patterns, designs and collections of objects will allow the finished design to potentially please and stimulate the viewer positively. The designer will use interactive and engaging design concepts, which appeal to the Introvert- Extrovert, Sensory Intuitive, Thinker Feeler, Judger Perceiver personality types.

Program

Hospitality Healthcare
Research also near a

Site Survey and Key Considerations

suggests that being corner intersection of an is

positive more

Existing Space Site Survey The site is Manchester Central Convention Complex. It is an awardwinning conference and exhibition venue, in the heart of the city of Manchester.

as the stands appear

spacious than those flanked on either side and traffic naturally flows in direction. The designers your

Floor plan and initial considerations Initial thoughts on the position for the 2009 stand eg number 78, is that is preferable to being near the entrance as lot of visitors seem

will attend the 2010 your Design Future

Manchester exhibition The team have designed a standard questionnaire to assist with gathering site and audience qualitative and quantative data. This

to walk into the middle of an exhibition to get their bearings and before they begin to interact.

Program

Hospitality Healthcare
data along with consideration of their design concept will enable them to make informed final location recommendations.

Program

Hospitality Healthcare

Construction And Materials Where possible materials choices will be in line with the clients statement and objective to produce surpluses in the their operations to achieve a sustainable future. The design interpretation of this will be to re-use materials where possible and to make conscious decisions regarding the materials which are also in sync with what the target market preferences are. Health and Safety and Maximum weight restrictions will be in line with the

Program

Hospitality Healthcare
supply power only to the dentist chairs.

For Provision of Dental

BWIC with M&E works Builders Works Hoardings and Demolition Retain for reuse 3No Spotlights. Disposal to Weee Regs Skips & Waste removal 40 Yrd White melamine hoarding complete with Signage "Instore Dental Coming Soon" Door complete with Digi Lock. Remove toilet and walls to create Plant Cupboard. Remove existing Ceiling and Lighting to skip. Chase out and make good to floor and walls to take Power as drawing SK03. Chases reuired to bury conduit to floor sockets to 1 217.60 540.40 540.40 435.20 Make Good Locally and Fill existing walls Paint with 1 mist coat walls to shell Alterations to toilet to form plant room. Allow for new doubel doors c/w ventilation grille for new Compresor and Suction machines 1,426.40 Walls

1,001.00

1,001.00

1 1 700.00 700.00

130 130 1

6.80 491.40 1,312.80

884.00

Program

Hospitality Healthcare
New Ceiling Plaster board lay in ceiling:-1 3,024.00 Supply and Install Single Glazed Shopfront Allow to refinish existing Shutter to Ral 9001 Make good and Decorate Opening and Flooring bulkhead to concession entrance.

Polyfloor Prestige PUR 1830 Clove - inc latex screed and DPC if required. Floor to be tested prior to installation Vinyl skirting (to be left loose for installation after the walls have been installed)

2,881.90

M&E 1 67.85 Strip out Strip out A/C Ventilation, review equipment 488.75

Protection (polythene and cordex) Windows Supply and install Replacement Windows to front and side elevations

239.20

for reuse / ensure services retained for fresh air ventilation.

Program

Hospitality Healthcare
Power and Data Retain Existing mains board and relocate to Dirty Area at High Level. 1 402.50 strip out to be retained. Refurbish as

required. Supply and Install Illuminated Fire exit sign 2

Lighting Install of electrical as below Install new Lighting layout as Drawing SK03 Merton Light fitting 600x 600 Concord Decade 24 1 1 5,068.05

Plumbing Provide 22mm Mains Cold water feed onto new Dental Area at high level above the ceiling located above in the Plant Room. Provide 100mm SVP to the rear left corner of the area existing SVP to be removed and floor penitration sealed. 1,120.00 308.00

Modula 4 x 24 T16 Lay-in ref 2041863 Supply New Emergency Fittings Concord Decade Modula 4 x 24 T16 Emergency Lay-in ref 2041864 Install 3 No Downlighters retained from the 1 3hr Integral 7

Provide termination for the waste from air conditioning cassette unit in the ceiling void. 3/4 Boss to the SVP all other connections by air conditioning engineer.

262.08

Program

Hospitality Healthcare
H&V Supply and Install a Heat Recovery unit to provide fresh air ventilation and extract stale air connected to the existing ventilation and extract system Supply and install new smoke detectors as Supply and Install new Split AC system to 3 no surgeries and Reception area. Install new Call points as Clarkson's Design Review existing 2 cassette system, heating, Ventilation and Fresh Air for reuse. Design and develop best system possible to include reuse of existing equipment. Allow to clean and service any existing equipment used. Ensure gasses are compatable with current regulations. Clarkson's Commission Sprinkler Make safe and plug Sprinkler heads for the duration of the works. 352.80 0.00 4,480.00 3,444.25 Cable, Boxes and Carriage Cost for Fire Alarm links to Extract / Supply air units 1,032.86 64.40 31.92 6,325.00 Clarkson Design 185.14 1 2,875.00 Fire Alarm Disconnect Existing smoke detection for the period of site works and swap out of ceiling. Install new bells as Clarkson Design 149.80 352.80

Program

Hospitality Healthcare
Design and install new sprinkler system in line with the new surgery layout. 0.00 Signage Bulkhead Sign 4500 x 700 x 5mm Diabond spray painted to RAL1955C with Instore Intruder Alarm Possible works to intruder alarm. Telephones Reroute existing phone services back to DP on Wall Testing and Certification Documentation and Project Management 281.75 534.75 0.00 Foamex Flag signs 350H x 750 mm 30mm 0.00 143.75 returns c/w double sided solvent prints and fixing brackets. Applied vinyl's "Dental Services" to Double Sided Totem @ 150mm Cap Height Applied vinyl's "Dental Services" to Store Directory Adjacent front doors @ ??mm Cap Height Installation @ Sainsbury's, Merton Out of Hours. 1 560.00 4 70.28 4 70.28 1 224.00 Dentist applied solvent print logo and vinyl's affixed to bulkhead with split batons 2 756.67

Program

Hospitality Healthcare
Building Regulation Approval 1,658.50

Preliminaries

Project Manager/IDM Day foreman Night Foreman Cost Manager Compliance with CDM Site surveys H&S requirements Insurances

1.0 5.0 0.0 1.0 0.5 0.0 0.5 0.5

360.00 408.00 450.00 720.00 270.00 900.00 360.00 310.30 Contract Works

Program

Hospitality Healthcare
Preliminaries

Total

Program

Hospitality Healthcare
W al l 60 0 m

Site Size The stand must be contained within a 3mx6m space. It must not exceed 2.5 meters, which is to the top of the stand i.e. to include signage space. Please note This height size can be increased if required through the venues application process.

Fur nit ure Source: Metric Handbook Section 5:30 Design basics: Building and Movements

Wheelchair users will be considered, in particular the Space Standards The following space standards will be considered in the design. Access according to the Metric Handbook (Littlefield. D, 2009. space required to allow for accessibility to all areas. According to the Metric Handbook a wheelchair turning circle is 1500mm.

Metric Handbook: Planning and design data, Architectural Press: Oxford) Areas that need to conform are - space between a wall, either Placement Consideration of the placement of objects is paramount in our design therefore:Adults eye level = 150 cm Childrens eye level = 120 cm (approx.)

permanent or temporary is required to be 600mm

Program

Hospitality Healthcare
Optimum placement will be in the middle, which is at eye level. This will be appropriate those in wheelchairs as well. Sculptures will need to be elevated on plinths or platforms to raise them off the ground so that they can be seen at a comfortable height. Artwork needs to be displayed at a consistent and Lighting All lighting design should consider glare as an issue along with other ambient and environmental factors of lighting at this type of event. The key criteria for the provision of lighting systems for temporary exhibitions is flexibility. This is flexibility in light direction, light levels, and positions for additional power or additional lighting. The design and placement of objects will consider groups or grids of work for placement of items. Design and Technical Equipment Requirements To ensure the appropriate space is apportioned for housing role Signage Signage will take into account the clients corporate style guidelines where appropriate and required. It is possible to reuse the new 2010 exhibition stand or elements of it. specific equipment; Signage will employ techniques and principles as per the design strategies target market influences.

comfortable height, We will keep space between any artworks or displays consistent and measured accurately:

Program

Hospitality Healthcare
Consider graphics and the form they will take (storyboards, Posters, light boxes etc) Display cabinets. Pc's, plasmas etc Literature racks, carrier bag hooks etc? Student work display for each of the six AME subjects, including elevated plynths or display cabinetry for breakable or delicate art pieces Electric Power Points Computers - Previously Used 6 Macs and one laptop with CAD or similar for interior design walk-throughs if required.

Seating has been mentioned as desirable. Research suggests Storage space for marketing aids/materials/merchandising Secure storage for personal belonging Any specialist lifting or handling equipment for heavy items? Anything which 'hangs' from the ceiling (banners, stand elements etc) Adequate Presentation and Circulation Space for Staff that people often feel intimidated by seated exhibitors. They may feel as if they are interrupting the staff taking a break. The key objective is to interact and recruit. Therefore the most effective situation is staff taking regular breaks to remain rested, refreshed and approachable. NB this can be reconsidered if the client feels this is imperative.

Program

Hospitality Healthcare

Health and Safety


The venues key documents which will be considered in the design process and along with our detailed health and safety research documents are as follows: Exhibitor Manual, Specifications and Deadlines, Code of Practice for Exhibitors Additional Electrics Order Form, Additional Items Order Form, Audio Visual Order Form,IT/Internet Order Form Health and Safety General Risk Assessment, Additional Risk Assessment These are all available online at

https://www.ucasevents.com/ucas/frontend/reg/tOtherPage.cs p?pageID=249080&eventID=517&eventID=517

Program

Hospitality Healthcare
Research file, annotated sketchbook, journal, drawings etc Attend Design Your Future event Nov10 Complete user survey and site evaluation Timeline and Deliverables Notebook of initial ideas and written design brief w/c 1st Presentation informal brief to client w/c 8th November 2010 space planning, visuals. Samples/materials/finishes/ H&S Design team share individual conceptual design ideas with each Other in the format of A3 inspiration boards/sheets. w/c 8th November 2010 approvals, equipment requests November 2010 Proposed model including costings and final proposed scheme drawings for mock up w/c 6th December 2010 w/c 29th November 2010 Design development - drawings, models, written report, digital walkthroughs, Prior to finalising design concept. w/c 29th November 2010

Timeline,

Deliverables

and

Budgetary

Considerations

Formulate initial design concepts themes/concepts character, function, aesthetics, sensory experience w/c 22 November 2010

Construction testing actual design up to and including Presentation / submission /implementation w/c 10th January 2011

Program

Hospitality Healthcare

The following expected by the client as a minimum:Transparent Research and Design Development Process Ongoing Evidence to demonstrate our thinking and approach as a team Ongoing

Budgetary Considerations Although a specific budget is not required we will approach all expenditure with prudence and all costs will be documented.

Program

Hospitality Healthcare

References and Bibliography

Andrus, D. and Buchheister, J. (1985, "Major factors affecting dental consumer satisfaction", Health Marketing Quarterly, Vol. 3, Fall, pp. 5768. Bush, R.P. and Nitse, P.S. (1992, "Retail versus private dental practices: do the patients differ?", Journal of Health Care Marketing, Vol. 12 No. 1, pp. 3947. Sanchez, P.M. and Bonner, G.P. (1989, " Dental services advertising: does it affect consumers?", Journal of Health Care Marketing, Vol. 9 No. 4, pp. 27-

Program

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