The Medical University of South Carolina (MUSC) in Charleston is in the first phase of a 20-year master plan that will transform, expand and upgrade its downtown campus to meet the needs of a growing and aging South Carolina population. Total project construction costs are approximately $207 million for Phase 1, which includes the development of a four-story diagnostic and treatment building, a seven-story patient hospitality tower, a garden conservatory that connects the two buildings, and a central energy plant.
Joint venture partners BGKS — Brasfield & Gorrie, M.B. Kahn and SMG — received the notice to proceed in October 2004, and Steve Mann, senior project manager with BGKS, states that the site preparation work and infrastructure improvements were critical to getting the project under way. This work included demolishing a former clinic and two four-story wings of MUSC's Wellness Center, relocating an existing street, and extensive relocation and upgrading of utilities.
In order to have a site large enough for the 640,000-square-foot facility, MUSC had to acquire Doughty Street, which ran through the middle of the project. Owned by the Veterans Administration, MUSC signed a 99-year lease with the VA through the Enhanced Use Leasing program. This program allows entities such as MUSC to lease land from the federal government at low cost on a long-term basis. Because Doughty Street was an active thoroughfare, it was relocated to the other side of the patient tower and renamed Ralph Johnson Drive.
The utility work proved to be one of the most challenging aspects of the job. "For about a three-block area, we rerouted a great deal of the utilities," says Mann. "We broke the project up into multiple phases. We have hospitals surrounding this new facility, and we couldn't shut all of the roads down at one time. So, each phase was constructed in coordination with all the existing hospitals: tear a phase up, take the old utilities out, put new utilities in, get the road surface back down, the traffic back on it, and move onto the next phase. We moved around this building and down to the central energy plant performing this multiphase process, which is typical on an urban project."
The central energy plant plays a critical role for the Phase 1 facility, as well as for future expansion plans. "The central plant can expand over time, so if this building's needs change or other hospitals are built in the general area, they can feed off that same central plant," says Dennis Frazier, administrator for Facilities & Capital Improvements at the Medical University Hospital Authority. The central plant will, in fact, accommodate all three phases of MUSC's expansion program.
Another utility challenge was an inoperable storm water pump system on-site. Charleston sits only a few feet above sea level. At high tide, the rivers and harbor back up into the storm water system. If there is any measurable rain at high tide, the site and everything around it goes underwater. BGKS demolished the old pump station and installed a new multimillion-dollar pump station that can pump out the area in less than an hour.
The water table and poor soil also created challenges during pile driving. Over 2,000 12-inch square precast piles were driven to an average depth of 105 feet to support the weight of the hospital.
"While we were doing excavations, several times the site went totally underwater," says Mann. "We had a great deal of mobile pumping capacity on the site. It's literally the ocean flooding, and until it goes down you can't pump it anywhere. It's a geographical issue of this area."
Charleston's geography also played a critical role in the design of the facility, which had to be built to withstand floods as well as potential hurricanes and earthquakes. In the event of high water, the building was designed so that everything related to patient care is above street level. In order to withstand any hurricanes or earthquakes, the hospital was designed with seismic codes that are not much different than in California.
"There is a lot of diagonal bracing through the building," says Greg Soyka, associate principal with LS3P Associates, one of the architects assisting NBBJ on the project. "There are expansion joints between the patient tower and the conservatory and an expansion joint in the diagnostic and treatment building as well. Earthquakes love irregular shaped buildings; they can damage them very easily. What we tried to do is break the big irregular footprint into a number of components separated by these expansion joints."
The expansion joints allow the sections of the building to move incrementally, relative to each other. "One could move to the north and the other could move to the south. They could move opposite or toward each other. The joints have the resiliency or elasticity to take that kind of movement," says Soyka.
This ability to move during a natural disaster has also been built into the mechanical, electrical and plumbing systems as well. This increases the ability of these systems to remain intact to provide electricity, heating, air conditioning, and water in an emergency.
Additional backup systems have also been added to the facility to either allow the primary MEP systems to operate or replace them if necessary. The diesel tanks that fuel the central plant can go seven days without a refill. In addition, there is on-site water storage for fire protection systems. In the event of a seismic event that would disrupt the city's water supply, there is a 90,000-gallon holding tank beneath the hospital.
"If there's a fire right at the seismic event or three days later, we have enough water in storage to serve the fire demand," says Soyka.
In addition to the holding tank, there is a trailer-mounted water tank that is tapped into MUSC's existing deep well — 900 feet. This mobile tank can be filled when needed and then plugged into the hospital and central plant to supply water primarily for toilet flushing and cooling tower make-up.
"If there's a natural disaster, people are going to need health care. Plus there are people already in the hospital," says Soyka. "We've really given a lot of thought to this huge investment and being able to remain functional in the aftermath of a natural disaster."
Preparing for a natural disaster included extensive testing of the hospital's signature feature — a 185-foot-tall curved glass curtain wall that is reminiscent of a sailing ship and forms the façade of the patient tower.
"In a hurricane, you must maintain the integrity of the building envelope," says Greg Soyka. "As soon as the envelope is punctured — a broken window, a pulled out door or a hole in the roof — that allows a pressure differential to build up inside, and the building ends up almost exploding."
The challenge then is to ensure that any windborne debris that might hit the glass will not shatter it. A PVB plastic interlayer between the panes of glass will help keep each panel intact in its frame if it is broken or cracked. To test its strength, a mockup of the curtain wall was tested at a facility in Miami.
"They shot a 2×4 from a cannon at it and marbles," explains Soyka. "They held the frame and racked it — holding the bottom still and moving the top to form a parallelogram. They sprayed it with water and ran an airplane propeller against it. Then they repeated all of the tests again.
"We learned a lot and did end up making some modifications where the wall tied into the roof at the top."
The glass panels are bordered with aircraft aluminum. Using a 100-ton crane, TSG lifted the panels, set them down in clips and bolted them in place.
The new hospital at MUSC moves away from the typical institutional design features often seen in health care facilities. The exterior of the new buildings reflects Charleston's past with brick masonry facades, punched window openings, a limestone colonnade, and a garden entryway, while the design of the curved glass curtain wall, a nod to the city's nautical past, brings the building into the future.
The conservatory brings the garden inside and offers lush vegetation and natural light for patients and visitors. It also serves as the main entry from both the arrival garden and the pedestrian bridge, which links to the parking garage.
The 156 patient rooms offer "healing hospitality" with private, spacious rooms that offer magnificent views of downtown Charleston and the Ashley River. Families will find plenty of room to visit patients comfortably and privately. The corridors are wide and feature custom lighting, soft colors and wood accents.
Finally the building will house the Heart & Vascular Center, nine operating rooms, a Chest Pain Center, and the Digestive Disease Center with integrated information technology systems and specialized equipment for vascular surgery. Cutting-edge technology will be a highlight of the center, which will also house outpatient clinics to accommodate more than 100,000 visits a year.
Construction on the project will be substantially completed by November 2007.
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