AIA Case Study

Premier Dermatology & Skin Renewal Center

Bentonville, Arkansas

Client Control: Consultants to Completion

AIA CASE STUDY

PROJECT ABSTRACT

PROJECT PERSPECTIVES

Protocols: The Web of Decision Making Constituencies: The Client Voice in Projects

Stories: The Episodes of Practice

Ideas: Innovation in Architecture Practice

Measures: Individual, Practice, and Client Measures of Success

Illustrations: The Graphic Overview

PROJECT ANALYSIS

The Client

Business

Design

Delivery

Services

Resources

Table of Contents

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CASE STUDY BUILDING AND TEAM

Premier Dermatology and Skin Renewal Centerwww.premierderm.net

ClientMissy Clifton, M.D.

ArchitectMiller Boskus Lack Architects, P.A.Steve Miller, AIAwww.mbl-arch.com

General ContractorCommerce Construction Inc.Junior Lopezccinwa.com

Interior DesignerMH DesignMelissa Hayneswww.melissahaynesdesign.com

Project Abstract

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University of ArkansasFay Jones School of Architecturearchitecture.uark.edu

StudentsBrendan BoatwrightJeremy GoucherElsa LoAkihiro MoriyaJake NewsumArmando Rios

FacultyBob Kohler, AIAwww.kohlerarchitects.com

Late 2009, dermatologist and owner of Premier Dermatology and Skin Renewal Center, Missy Clifton decided to expand her medical practice located in Bentonville Arkansas. Striving for a world class medical facility that gave the feeling of an up-scale home and not compromising the comfort of her patients, Dr. Missy Clifton began to choreograph the process that would bring her goal to fruition.

For the relocation, a plot of land was purchased in the Fountain Plaza development of Bentonville. This plot was selected based on its active location near the interstate highway, the availability of room for expansion, and the strict building standards of quality set forth by the owners of Fountain Plaza. A relationship was established between Dr. Clifton and Practice Flow Solutions of Norcross, Georgia. The intent of the relationship was for PFS to act as a medical planning consultant analyzing the current flow and operations of her medical practice then to provide an efficient planning diagram of how her new facility would operate.

Dr. Clifton along with her mother as a financialadvisor, and Shelley Fryer as her business

Project Abstract

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manager, began the process of interviewing architectural referrals. The most promising reference was that given by her accountant, whose accounting practice is housed in a building in Fountain Plaza. Miller Boskus Lack, Architects of Fayetteville, Arkansas was the suggested firm. Not only had Steve Miller designed the building that their mutual accountant was housed in, he was also au courant of the strict design standards set forth by both the city of Bentonville and the owners of Fountain Plaza due to the fact that he designed the master plan of the development. Miller Boskus Lack was selected as the design architect for the expansion of Premier Dermatology and Skin Renewal Center.

To ensure the viability and success of this expansion and to maintain control of the process, Dr. Clifton continued to select design and construction members of her team. Melissa Haynes of MH Design was selected as an Interior Design specialist. Dr. Clifton had worked with her previously on her own private residence and was satisfied with both the quality of work and the relationship that had developed.

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Project Abstract

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When searching for a contractor to build, the process lent itself to be that of a standard design-bid-build. Steve Miller provided a list to Dr. Clifton of seven companies that he had worked with in the past. All seven companies provided bids. When the bids returned, Dr. Clifton, in order to maintain control over quality and completion chose to be more critical of the construction process. Interviews between her selection team and the constructors began. After interviewing the lowest three bidding companies, Dr. Clifton chose to work with the fourth lowest bid. This bid was represented by Junior Lopez of Commerce Construction Inc. of Springdale Arkansas. Dr. Clifton chose to approach this process in a way that would ensure not only a finished product but working with an experienced company with a respected background. CCI ensured an economically efficient, a quality product, and a pleasurable relationship building experience. Other client-retained consultants include a Lanscape Architect and an Audio/ Visual Engineer.

In addition to Dr. Clifton’s medical practice, this facility would also house space for lease. 20,000 square feet of collective space was to be designed and constructed. As the economy wavered so did Dr. Clifton’s comfort level with a facility of this size. The amount of space devoted for future leasing was down-sized. Mid 2010, Dr. Clifton’s business ambitions and financial securities led her to the acquisition of a successful, award-winning spa located in Springdale Arkansas. The purchase of East Meets West Spa resulted in positive scope creep and further expansion of her facility into the space devoted for leasing.

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Protocols: The Web of Decision Making

The primary decision chain related to the case was unique because all channels of communication led through the client. To involve herself in the process of project design and delivery, the client hired specialists as her own client-retained consultants, including the architect (Miller Boskus Lack Architects), interior designer (MH Design), medical planning consultant (Practice Flow Solutions), landscape architect, and audio -visual engineer. The client integrated the specialists into a goal oriented team to achieve her vision. Dr. Clifton was always the primary decision maker. Her mother, Lynn Murphy, and Business Manager, Shelley Friar, acted as a support group in her decision making process as evidenced by their desire for weekly meetings with the team of specialists.

In this case the client equated herself with the architect in the web of communication. With this strong client, the role of the architect’s services aimed to satisfy the client’s goals rather than achieve their own design aspirations. Practice Flow Solutions was hired by Dr. Clifton initially to analyze the daily operations of her existing business, in order to produce a functional plan that integrates two programs, dermatology clinic and spa, under one roof.

Project Perspectives

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Constituencies: The Voice of The Client

Dr. Clifton had many goals to satisfy for this to be considered a successful project. She wanted the lobby to have the atmosphere of a home as opposed to the norm, a cold medical facility. Within this pleasant space, she wanted to house multiple programs and leasing spaces. Ideally this project would be located in the overlapping areas of Bentonville and Rogers, near 540 interstate high-way.

The Client, Dr. Clifton, was quick and confident with her decision throughout the design process. She was not a client who would change her mind, which allowed for continuous development. The architect, Steve Miller of Miller Boskus Lack Architects, aimed to please the client. He embraced collaboration with the owner’s consultants, attended weekly meetings, and provided iterations for approval from the client. Boskus Lack Architects assembles a custom design team for every project to ensure the best results, without in house competition. This allows their firm to be specialized and versatile for any clients’ need.


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Client

Practice Flow Solutions Melissa Haynes - MH Design

Steve Miller - Miller, Boskus, Lack

Decision structure of the project


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Stories: The Episodes of Practice

The project revolved around a very decisive client, when issues were presented to her, she was able to resolve the problems immediately. The client’s confidence strived from consultants to completion. Since the beginning, the client knew that she wanted to design an innovative facility that incorporated both a clinic and a spa. Along with that, she also wanted to create leasing spaces that would bring her extra income or allow for future expansion. Originally, the leasing space contained half the square footage of the site; upon further consideration, the overall size of the facility decreased, but the amount of owner occupied space increased.

Original planned division of lease and clinic space

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Ideas: Innovation in Architecture Practice

One of the innovations of the project was taking advantage of new technology and implementing it in various aspects of the building. As stated previously, Missy Clifton is a person who values quality in every aspect. This quality is translated though her decision to install technology that allows each room at the clinic to be individually controlled remotely – whether that be from the receptionist’s desk or a cell phone. Premiere Dermatology was built for the 21st century. Another innovation in the technological aspect of the project was the use of the same centralized system to control the Trane HVAC system with the Siemens controller to merge the best features of two companies. Only recently has it been possible to mix brands of technology such as it was in this case. However, now that these technologies can be combined, an extremely efficient (though complicated) system is in place for the clinic. Fortunately, Missy Clifton was hands-on in going after the proper consultants needed to attain her high standard for these new features for her building. Clifton hired several different and unique consultants early in the process (in this case, a technological consultant) to achieve her personal goals for the project. By doing this, Clifton gained a team of specialized individuals, all of who could work together and maintain the highest standards of quality to accomplish their specified task.

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Fountain in entry foyer


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Measure: Individuals, Practice, and Client Measures of Success

Missy Clifton is not an average client – not for contractors, architects, interior designers, or the several other consultants she hired. Clifton is a decisive person, and when the daunting process of creating her building began, she faced all of her decisions head on, with supreme confidence and decisiveness. Knowing what would make logical sense for the success of her building, Clifton was proactive in hiring consultants of her own, prior to the architect’s involvement. Uncommon as it may seem, Clifton made decisions in a preemptive way, determined to have a successful project with as few complications as possible.

Overall, the planning, design, construction and business have all been a major success. The project was completed on time (allowing extra time for the additional work) and on budget. The project had a dedicated team of carefully chosen individuals, all of whom have excellent reputations. The architect, Steve Miller, of Miller Boskus Lack, has a long-standing reputation of delivering quality projects that meet the specifications of the client. Miller strives to give his clients what they ask for so that they will come to him again for repeat business. In fact, Miller Boskus Lack was recommended for the project by Missy Clifton’s accountant, shared by Steve Miller. Miller not only designed the master plan for the office park, but he

also designed several of the completed buildings. Missy Clifton’s building would be the sixth building Steve Miller did for the complex. As per Clifton’s request, Miller designed the building to be a unique structure, featuring a large glass curved front wall. This had been predetermined by Clifton and was evident in the drawings provided by Practice Flow Solutions of Norcross Georgia. PFS was one of the client’s consultants involved early on in the process, prior to Steve Miller. Retained by the “super-client” Missy Clifton, PFS is a company that examines how an office functions and then supplies a plan based on their findings. This led to the functional success of the very complex plan, integrating both doctor and spa offices. Another consultant that the client was smart to include early in the process was interior designer Melissa Haynes. Clifton knew exactly what she wanted her office to feel like. She decided early on that creating a warm home-like environment would be the best way to relax her patients. Clifton hired the interior designer early in the process to ensure that she would achieve the desired look and feel for the office and spa. Clifton’s idea of creating a doctor’s office to be more like a home is one of the driving points that made the project successful. In addition, the early involvement of Haynes helped unify all of the consultants – another advantage to having a proactive client like Clifton.

After Steve Miller became involved, it was time to pick a contractor. In this case, the contractor also

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Master Plan of Fountain Plaza


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played a significant role in the success of the project. Commerce Construction Company lived up to its stellar reputation by completing the project on time and on budget. It is interesting to note that Commerce won the bid, despite being the forth lowest. It was their reputation and honesty with the client that won them the job. As a company, Commerce does not tend to do bid projects, however, by explaining their bid to Missy Clifton, they gained her trust as a dependable company that centered itself on responsibility to the client. A smart move on Clifton’s side, as it was later learned that some of the earlier contractors went bankrupt. In the long run, being an educated and involved client like Clifton saved a lot of headaches for her and all of her consultants.

It can be said that Missy Clifton was the principle in maintaining the quality of the project, and therefore, she is the one most responsible for the extreme success of the building. Without her swift (yet cautious) decision-making, the proper architect,

builder, interior designer, etcetera, might not havebeen chosen. For that matter, Clifton’s ability to be decisive may have very well influenced all of her consultants to work at their most efficient levels. A great amount of the success of the project is certainly owed to Missy Clifton. Similarly, architect Steve Miller was fortunate to have a quality-centered client, which helped to create a smooth and successful project. Miller alluded to wanting more clients as knowledgeable and involved as Clifton. This suggests that one of the most important aspects in a project is the relationship between client and architect. There must be a level of respect and understanding that has to be met in both directions. Ethically, this project was right on track. With the high number of well-respected consultants, little was to go wrong – all the more praise to Clifton for investing in the proper people. Though the project was not to be specially recognized architecturally, it did have a goal to stand out among the other building in the complex, which it successfully accomplishes.

Final plan

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Interior rendering

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Illustrations: The Graphic Overview

The most important drawings representing the project are the renderings. Steve Miller brought the project to life when he showed Clifton the renderings of the front façade of the building. The main rendering showed the large curving glass wall that Clifton was adamant about including as the main feature. This also illustrated to the client how the building would stand out from a typical spec structure. The renderings and the built project look nearly identical, indicating that Miller maintained the design ideas through construction. The photographs of the exterior are the most telling of the success of the project. The interior photographs of the front curved wall are also an indicator of the success of the interior designer, Mellissa Haynes. Though the project did not rely on physical models, the renderings were conclusive enough to convey the essence of the building.

Facade iteration studies

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The Client

The client in this case is Dr. Missy Clifton, owner and operator of Premier Dermatology and Skin Renewal Center. Dr. Clifton proudly had her hand in all decisions made in the project down to the detail. This was the first building project that Dr. Clifton had taken on but she proved very prepared to take on the process.

Once Dr. Missy Clifton decided to go with a new construction building for her expanding business a consulting firm, Practice Flow Solutions, was hired to observe her daily practice and collect data. Practice Flow Solutions observed the activity of Dr. Clifton and her employees going as far as timing the procedures and meetings that took place in Premier Dermatology’s everyday practice. From this data a basic plan was generated.

Dr. Clifton then chose Miller Boskus Lack through a personal reference who knew that the architects had a portfolio of work including: numerous medical facilities and the master plan of the site that was chosen by Dr. Clifton. The plan that the consultants produced was passed over to Miller Boskus Lack at this point.

With quality being the primary concern for Dr. Clifton, a decision was made for Miller Boskus Lack to produce a short-list of contractors to be solicited for the job. Dr. Clifton, in an attempt to find the best team with the same vision, interviewed the contractors two at a time starting with the lowest bidder. The two lowest bidders did not fit the part so the next two lowest bidders were interviewed, with the fourth lowest bidder being chosen for the job. Quality for Dr. Clifton was the primary concern, with all other issues taking a back seat, including budget.

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Business

Miller Boskus Lack is a small firm focused on providing the best experience for the client. The mission statement of the firm seconds this thought, “We operate under the principle that service to the client is the foundation of architecture and interior design.” In dealing with a client such as Dr. Clifton, a woman who her employees say is very decisive and “knows what she wants” being client centered offers an advantage to this firm because they can work with the clients wants and needs but still find the room for creativity that all designers long for. Miller Boskus Lack formed out of an older firm that originated in 1954, continuing the reputation of great design balanced with cost and client needs.The firm has the flexibility to work on a number of different projects going from the scale of master planning to a single family residence. To quote the firm profile “Projects designed by the firm include: commercial buildings, health care facilities, shop-ping center, restaurants, educational facilities, churches, industrial buildings, and exclusive cus-tom residences.

Design

The plan of the project created by the consulting firm Practice Flow Solutions was mostly adhered to by Miller Boskus Lack with the addition of the retail spaces and growth of the spa portion being the moments of freedom for the firm to exercise their design expertise. The shell of the building was conceived of entirely by Miller Boskus Lack with the approval by Dr. Clifton. Prior to the design of the exterior Dr. Clifton was asked what buildings she admired and was asked to provide examples via car rides with the architect and pictures. From this joint research between architect and client a series of designs were generated and presented to Dr. Clifton later arriving on the final product.

The focus for Dr. Clifton was to make a high quality building that made a statement about her business as being different than other medical buildings. The main move was to create a curved glass wall to mark the entry. This South facing façade created the opportunity for the architects to design the exterior shading and roof line through a series of iterations that explored different options.From these many iterations the final façade design was arrived at by the firm and approved by Dr. Clifton.

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Detail of spa

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Delivery

The specific project delivery method implemented in the project consists of Design-Bid-Build project. Since the beginning, Dr. Clifton was a very proactive client. She hired different consultants to ease the process. The first consultant to be hired was Practice Flow Solutions Practice Flow Solutions specializes in creating medical planning consult, which tries to solve the problems between patient, staff, and doctor workflow. Practice Flow Solutions delivered an efficiency analysis to Dr. Clifton, along with a space planning report.

Through different reference, Dr. Clifton hired Steve Miller, the architect from Miller Boskus Lack Architects. After receiving the spatial plan from Practice Flow Solutions, Steve Miller took charge in creating the building envelope. They provided multiple sets of iterations for Dr. Clifton to choose from. Upon coming to a decision, they requested multiple bid estimates from different contracting companies.

Dr. Clifton received 7 bids, which were highly recommended by Miller Boskus Lack Architects. In order to choose and hire a contractor, she went through a process of elimination by interviewing each bidder. Along with interviewing each bidder, she researched their previous built work and contacted each reference they had. After this process, she went about choosing the fourth lowest bidder, Junior Lopez, with Commerce Construction. The client said she had a gut feeling, which made her confident with her decision.

Having set up contracts with Steve Miller as the architect and Junior Lopez as the construction manager, she also hired Melissa Haynes as the interior designer. Dr. Clifton made a smart choice by bringing in Haynes early on in the project; by doing so, she was able to get started on the building portion of the project. Since the beginning, Dr. Clifton was in control and knew what she wanted, making this a smooth sail through the decision-making to come with the construction phase of the building.

As the project begun to take life, only a few problems emerged. The project consisted of three major change orders, one of which the architect took full responsibility of. The other change orders were placed by the client for the betterment and benefit of the project in response to the future expansion of the clinic and spa. As the project began and the structure was being erected, the architect and the structural engineer noticed that the structure was a bit to short. After reviewing the drawings, the architect and structural engineer fixed the structure to accommodate the design of the building; the architect and the structural engineer financially compensated this mistake.

Although the project seemed to go smoothly, there was one thing the client was not pleased about, the carpet. Originally, Dr. Clifton had chosen a sample of woven carpet brought to her by Haynes, which was approved for installation. Once the carpet arrived to the site, it was not the same as the sample shown to her, therefore, they decided to call the carpet manufacturing company to see if the sample and the carpet ordered were comparable. The carpet manufacturer assured Dr. Clifton that this carpet would wear the same as the provided sample and would work in public and high traffic areas; with this in mind, she approved the installation of the carpet. After the carpet was installed, it did not meet Dr. Clifton’s standard of quality; the carpet was fraying at the seams where the installer had cut it and the woven pattern was not straight. The carpet installer was not compensated for the installation process due to the poor installation job applied on the wrong carpet. The carpet installer took the problem into his own hands since he was the one who ordered the wrong carpet but also blamed the carpet manufacturer for having faulty carpet. Although the installer took blame of the problems and did not get paid, he placed a lien on the building. In order to resolve this problem, the carpet installer is suing the carpet manufacturer, but has also agreed to get the carpet on the clinic and spa replaced with a sturdy tile carpet.

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Despite the minor problems presented in this project, the project delivery was successful. According to the architect, this has been one of the best projects he has worked on regardless of the minor problems encountered. The success of the project delivery was in response to the good communication skills presented between the client, architect, interior design, and construction manager. Dr. Clifton requested weekly meetings to be held between everyone involved with the project; giving this the strength of a good project.

Initial schematic space planning diagram provided by Practice Flow Solutions

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Services

The services provided in this project went above and beyond the expectations of a normal client. In this case, Dr. Clifton went above the required services to ensure the success of her project by hiring all the consultants for the project since the beginning. After having found a site that met her two requirements, which were being located next to an interstate exit and having a pasture and serene feeling, she hired Steve Miller as the architect. Miller had also designed the master planning for the lot where the site was located, the Fountain Plaza.

Exterior

Although most of the interior spaces were predetermine by Practice Flow Solution, Steve Miller designed the exterior envelope of the project. The clinic and spa is located with a north-south orientation and a south facing façade covered in glazing. The south facing façade posted problems with the amount of light and heat coming into the building; therefore the architecture required some kind of shading device. This was accomplished through a serious of brise soleil that wrapped the front façade and a serious of electronically operated shading curtains that are placed in the inside of the glazing.

Prior to the start of the designing phase of the project, Miller and Dr. Clifton drove around the area where the project was to be located and took inspirations of the surrounding building. There was one project in particular where she wanted to have the same material palette; this building was the Bank of the Ozarks located adjacent to the lot the clinic and spa was to be built. The Bank of the Ozarks had a base that consisted of a rustic stone and a combination of a beige color brick with glass façade, along with wood as the underside of the roof in various part of the project. Dr. Clifton was interested in how the materials met each other, the rusticated base with the juxtaposition of the glass and the underside of the roof. Through the combination of these materials, Miller came up with the design that is currently built.

Miller also got to build a pavilion located on the East side of the building. The pavilion was designed in response to zoning issues; by law if there is a certain amount of green space, it is required that they have exterior sitting area like a picnic table or a bench. The client and the architect responded to this issue by placing a pavilion that would allow people to enjoy the being outside and the view to the fountain. The pavilion was also built as homage to Dr. Clifton’s father. In the future, this space will be used as part of the clinic and spa as an exterior therapeutic area and will serve as a doublefunction, as a space to hold events and parties.

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Project Analysis

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Brise Soleil of Premier Gazebo of Premier Dermatology & Skin Renewal Center

Bank of the Ozarks- used as client desired precedent

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Interior

Practice Flow Solutions designed the interior spaces after having done a space efficiency analysis. They predetermined the amount of space and the organization of the space required to work efficiently in the clinic and spa. They triangulated the space between the offices and the space between each procedure room. Through hiring Practice Flow Solutions, they were able to deliver a service that would allow the clinic and spa to work fluidly.

Dr. Clifton also hired Melissa Haynes from MH Design as the interior designer for the project. For the interior, Dr. Clifton took inspiration of one of her favorite places to visit, the beach. This idea resonated in the multiple water features found throughout the project and the color palette chosen for the interior of the project, the aqua blues and the beige sand.

Another concept requested by Dr. Clifton was that the interiors look comfortable. This was accomplished by creating a home-like feeling into the project. Haynes placed furniture in the foyer that resembled a living room. Along with this idea, Haynes also designed the light fixtures that were going to be hung from the tall ceilings located in the entryway that would compliment the curved wall.

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Patient room

Entry Foyer

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Resources

Resources:Team collaboration was one of the most important resources to this project. Dr. Clifton worked along with Lynn Murphy, her mother and advisor, and Shelley Fryer, her business manager, to make decisions in response to the project. Through their help, they were able to set up a team of architect Steve Miller, construction manager Junior Lopez, and interior designer Melissa Haynes that would collaborate to make this a successful project.

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AIA Case Study

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