The boom in outpatient facility construction shows no signs of slowing. But these projects are becoming increasingly complex as medical groups and hospital systems demand spaces that can keep up with their rapidly changing strategic and organizational requirements.

February 14, 2013

4. Anticipate greater pressure from clients for you to deliver ‘affordable  elegance.’


To keep costs to a minimum and deliver what the client termed “affordable elegance,” the Building Team for the Everett Clinic’s new Smokey Point (Wash.) Medical Center—ZGF Architects (designer), Coughlin Porter Lundeen (structural engineer), Affiliated Engineers (MEP engineer), and J.R. Abbott Construction (GC)—used tilt-up concrete for the shell of the structure. The move saved an estimated $160,000 in construction and material costs. Photo: Benjamin Benschneider


As if delivering highly efficient, flexible, and patient-focused facilities wasn’t difficult enough, Building Teams can look forward to having clients up the ante on exterior and interior architecture schemes. As healthcare institutions and physician groups compete for outpatient business, they’re increasingly leaning on their facilities to help attract and retain both patients and employees, while keeping budgets tight for designing and constructing outpatient facilities.

To deliver world-class facilities on constrained budgets, Building Teams are getting creative in the selection of materials, finishes, and construction methods.

Take, for example, the Everett Clinic’s new Smokey Point (Wash.) Medical Center. The two-story, 60,000-sf facility was built for around $200/sf—“a budget that is unheard of for this building type,” says Anita Rossen, Senior Healthcare Interior Designer with ZGF Architects, the project’s architect. “Because they are physician-owned, cost was a huge factor. The term their CEO used throughout the design and planning process was ‘affordable elegance.’”

Rossen says the Building Team, which included contractor J.R. Abbott Construction, Seattle, MEP engineer Affiliated Engineers, Chicago, and structural engineer Coughlin Porter Lundeen, Seattle, identified dozens of alternative design and construction approaches and materials and finishes that resulted in more than $350,000 in upfront savings.

The most startling of these was the use of tilt-up concrete construction for the shell of the structure—a construction method that is more popularly associated with big-box stores and warehouses than modern healthcare facilities. The move saved an estimated $160,000 in construction and material costs, according to Michael Sloane, LEED GA, Project Engineer with J.R. Abbott.

“Tilt-panel construction reduced the number of trades involved in the exterior skin, which reduced the number of costly handoffs or transitions,” says Sloane. “It also reduced the number of layers on the exterior from five to two.” That means no metal studs, sheathing, or vapor barrier; just the concrete panel and insulation. Sloane says going with tilt-up saved $8/sf over traditional masonry wall construction.

But how to break up the massing so that the building wouldn’t look like a boxy warehouse? That was the problem before the design team. “We wanted it to feel extremely inviting—a healthcare facility that you would actually want to go to for care,” says Rossen.

To break up the box, the team varied roofline angles and introduced glass curtain wall, storefront windows, wood and metal accents, and vertical reveals in the concrete panels.

To create the “inviting” interior, Rossen says the team brought the concrete panel reveals and exposed wood elements inside to complete the custom, modern look.

Several other “affordable elegance” measures were employed on the project, including the use of mostly off-the-shelf floor tile that was installed in a staggered pattern in the main entry area and stairway for a custom aesthetic; wood-pattern vinyl flooring in lieu of more costly flooring products; and naturally finished local western red cedar instead of hardwoods like ipe or teak.

These are the kinds of low-cost, value-added solutions Building Teams are going to have to provide if they expect to succeed in the outpatient facility market.

To break up the massing of the tilt-up concrete box, the design team incorporated wood and metal accents and vertical reveals in the concrete panels. Using tilt-up cut the number of layers in the building envelope from five to two, thereby saving $8/sf over traditional masonry construction. Photo: Benjamin Benschneider



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