Faced with the complexities of value-based payment models and the uncertainties surrounding healthcare reform, the nation's healthcare delivery systems are taking the long view of their operations.
“They're looking at everything from organizational structures, staffing, and services, all the way down to the cost of building and operating a facility,” says Mike Zorich, PE, LEED AP, Client Executive with engineering firm IMEG.
Case in point: Boston Medical Center's multi-year campus consolidation will trim its footprint by 60 beds and 329,000 sf, saving $25 million a year in operating costs.
See also: Top 160 Healthcare Architecture + AE Firms - 2018 Giants 300
See also: Top 90 Healthcare Engineering + EA Firms - 2018 Giants 300
See also: Top 105 Healthcare Construction + CM Firms - 2018 Giants 300
Academic medical centers are also modernizing. The IPD team for Sutter Health’s California Pacific Medical Center, San Francisco—which includes SmithGroupJJR, Boulder Associates, and HerreroBOLDT—is building two replacement hospitals, closing an existing campus, and converting another one from inpatient to outpatient care.
“We are quickly transitioning from patient-centered to patient-driven care,” says Heather Chung, EDAC, LEED AP, VP/Health Studio Leader, SmithGroupJJR. “Patients are changing what it means to be accessible and convenient and are shaping what healthcare providers deliver.”
“The healthcare market continues to reach further into communities and away from the traditional hospital for many front-line services,” says IMEG’s Zorich. “Healthcare buildings used to be designed for more than 50-year life spans, but many of the smaller off-campus outpatient facilities are now looking at 20 years or less.”
An emphasis on reducing costs and improving efficiency is fueling the use of Lean construction and prefabrication.
Prefab helped Skanska shave more than $200,000 in construction costs off a 444,000-sf hospital expansion at the University of Virginia Health System, Charlottesville. “Laser scanning identified opportunities for the prefabrication of materials alongside critical in-place infrastructure that could not be interrupted,” says Andrew Quirk, Senior Vice President and National Director of Skanska USA’s Healthcare Center of Excellence.
AEC firms are also stepping up the use of VR and AR tools. “Not only can VR and AR help our clients understand department layouts, adjacencies, workflows, and finishes during the design process, but clients can continue to use these tools to maintain and operate their facilities more efficiently,” says Mike Stapf, Vice President, Design Integration, McCarthy Building Companies.
doubling down ON RESILIENCE, collaboration
Resilience is guiding the design of healthcare facilities, particularly in regions vulnerable to extreme emergency events. “Healthcare facilities need to maintain services during and after extreme events, and this drives priorities in a very different direction than before,” says Pat Bosch, LEED AP, Design Director, Perkins+Will, Miami.
In South Texas, P+W is leading the expansion of Christus Spohn Hospital Corpus Christi–Shoreline, a pilot project using the RELi rating system. RELi helps project teams plan for hazards and emergencies that could cut power and heat or compromise a building’s functionality.
The hospital's leaders recognized the facility's role as a regional command center in the event of a natural disaster or terrorist threat and as a place of refuge. "They identified resilient design as a top priority," says Julie Frazier, Associate Principal, Perkins+Will, Dallas.
Masonry skin, impact-resistant glazing, and galvanized exposed metals will protect the 10-story structure during extreme events. If HVAC systems are knocked out of service, reflective roof surfaces will minimize heat gain; sun-shading devices will filter natural sunlight on patient floors. Several days' provision of food and water will be stocked.
Another new healthcare design trend: translational medicine, which brings researchers and clinicians under the same roof to hasten discoveries that accelerate individualized patient treatments.
“Just as the AIDS epidemic needed a new way of thinking, cancer care and clinical care in general need a new way to take advantage of advanced technology and research methods to deliver innovative, personalized care and treatment for their patients,” says Hank Adams, AIA, ACHA, EDAC, Global Director of Health at HDR.
Transdisciplinary integration is breaking down the physical and organizational barriers that have traditionally separated these areas, to speed up the development of life-saving therapies.
“The merging of patient care, education, and science into one contiguous platform is the future of academic medicine,” says Scott Rawlings, AIA, FACHA, LEED AP, Director of Healthcare with HOK.
“Leading institutions are finding that focusing superspecialties into one building that combines clinical care, trials, research, and education enables them to quickly translate basic research findings into prevention and treatment and to enhance patient care,” says Rawlings.
Related Stories
| Jan 21, 2011
Research center built for interdisciplinary cooperation
The Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, in Houston, the first basic research institute for childhood neurological diseases, is a 13-story twisting tower in the center of the hospital campus.
| Jan 19, 2011
Biomedical research center in Texas to foster scientific collaboration
The new Health and Biomedical Sciences Center at the University of Houston will facilitate interaction between scientists in a 167,000-sf, six-story research facility. The center will bring together researchers from many of the school’s departments to collaborate on interdisciplinary projects. The facility also will feature an ambulatory surgery center for the College of Optometry, the first of its kind for an optometry school. Boston-based firms Shepley Bulfinch and Bailey Architects designed the project.
| Jan 19, 2011
New Fort Hood hospital will replace aging medical center
The Army Corps of Engineers selected London-based Balfour Beatty and St. Louis-based McCarthy to provide design-build services for the Fort Hood Replacement Hospital in Texas, a $503 million, 944,000-sf complex partially funded by the American Recovery and Reinvestment Act. The firm plans to use BIM for the project, which will include outpatient clinics, an ambulance garage, a central utility plant, and three parking structures. Texas firms HKS Architects and Wingler & Sharp will participate as design partners. The project seeks LEED Gold.
| Jan 10, 2011
Michael J. Alter, president of The Alter Group: ‘There’s a significant pent-up demand for projects’
Michael J. Alter, president of The Alter Group, a national corporate real estate development firm headquartered in Skokie, Ill., on the growth of urban centers, project financing, and what clients are saying about sustainability.
| Dec 17, 2010
ARRA-funded Navy hospital aims for LEED Gold
The team of Clark/McCarthy, HKS Architects, and Wingler & Sharp are collaborating on the design of a new naval hospital at Camp Pendleton in Southern California. The $451 million project is the largest so far awarded by the U.S. Navy under the American Recovery and Reinvestment Act. The 500,000-sf, 67-bed hospital, to be located on a 70-acre site, will include facilities for emergency and primary care, specialty care clinics, surgery, and intensive care. The Building Team is targeting LEED Gold.
| Dec 17, 2010
Arizona outpatient cancer center to light a ‘lantern of hope’
Construction of the Banner MD Anderson Cancer Center in Gilbert, Ariz., is under way. Located on the Banner Gateway Medical Center campus near Phoenix, the three-story, 131,000-sf outpatient facility will house radiation oncology, outpatient imaging, multi-specialty clinics, infusion therapy, and various support services. Cannon Design incorporated a signature architectural feature called the “lantern of hope” for the $90 million facility.
| Oct 18, 2010
World’s first zero-carbon city on track in Abu Dhabi
Masdar City, the world’s only zero-carbon city, is on track to be built in Abu Dhabi, with completion expected as early as 2020. Foster + Partners developed the $22 billion city’s master plan, with Adrian Smith + Gordon Gill Architecture, Aedas, and Lava Architects designing buildings for the project’s first phase, which is on track to be ready for occupancy by 2015.
| Oct 13, 2010
Prefab Trailblazer
The $137 million, 12-story, 500,000-sf Miami Valley Hospital cardiac center, Dayton, Ohio, is the first major hospital project in the U.S. to have made extensive use of prefabricated components in its design and construction.
| Oct 13, 2010
Hospital tower gets modern makeover
The Wellmont Holston Valley Medical Center in Kingsport, Tenn., expanded its D unit, a project that includes a 243,443-sf addition with a 12-room operating suite, a 36-bed intensive care unit, and an enlarged emergency department.
| Oct 13, 2010
Hospital and clinic join for better patient care
Designed by HGA Architects and Engineers, the two-story Owatonna (Minn.) Hospital, owned by Allina Hospitals and Clinics, connects to a newly expanded clinic owned by Mayo Health System to create a single facility for inpatient and outpatient care.
