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
| May 5, 2011
Hospitals launch quiet campaigns to drown out noise of modern medicine
Worldwide, sound levels inside hospitals average 72 decibels during the day and 60 decibels at night, which far exceeds the standard of 40 decibels or less, set by the World Health Organization. The culprit: modern medicine. In response, hospitals throughout Illinois and the U.S. are launching "quiet campaigns" that include eliminating intercom paging, replacing metal trash cans, installing sound-absorbing flooring and paneling, and dimming lights at night to remind staff to keep their voices down.
| Apr 14, 2011
USGBC debuts LEED for Healthcare
The U.S. Green Building Council (USGBC) introduces its latest green building rating system, LEED for Healthcare. The rating system guides the design and construction of both new buildings and major renovations of existing buildings, and can be applied to inpatient, outpatient and licensed long-term care facilities, medical offices, assisted living facilities and medical education and research centers.
| Apr 13, 2011
Virginia hospital’s prescription for green construction: LEED Gold
Rockingham Memorial Hospital in Harrisonburg, Va., is the commonwealth’s first inpatient healthcare facility to earn LEED Gold. The 630,000-sf facility was designed by Earl Swensson Associates, with commissioning consultant SSRCx, both of Nashville.
| Apr 12, 2011
Mental hospital in Boston redeveloped as healthcare complex
An abandoned state mental health facility in Boston’s prestigious Longwood Medical Area is being transformed into the Mass Mental Health Center, a four-building mixed-use complex that includes a mental health day hospital, a clinical and office building, a medical research facility for Brigham and Women’s Hospital, and a residential facility.
| Mar 17, 2011
Perkins Eastman launches The Green House prototype design package
Design and architecture firm Perkins Eastman is pleased to join The Green House project and NCB Capital Impact in announcing the launch of The Green House Prototype Design Package. The Prototype will help providers develop small home senior living communities with greater efficiency and cost savings—all to the standards of care developed by The Green House project.
| Mar 14, 2011
Renowned sustainable architect Charles D. Knight to lead Cannon Design’s Phoenix office
Cannon Design is pleased to announce that Charles D. Knight, AIA, CID, LEED AP, has joined the firm as principal. Knight will serve as the leader of the Phoenix office with a focus on advancing the firm’s healthcare practice. Knight brings over 25 years of experience and is an internationally recognized architect who has won numerous awards for his unique contributions to the sustainable and humanistic design of healthcare facilities.
| Mar 11, 2011
Renovation energizes retirement community in Massachusetts
The 12-year-old Edgewood Retirement Community in Andover, Mass., underwent a major 40,000-sf expansion and renovation that added 60 patient care beds in the long-term care unit, a new 17,000-sf, 40-bed cognitive impairment unit, and an 80-seat informal dining bistro.
| Mar 11, 2011
Research facility added to Texas Medical Center
Situated on the Texas Medical Center’s North Campus in Houston, the new Methodist Hospital Research Institute is a 12-story, 440,000-sf facility dedicated to translational research. Designed by New York City-based Kohn Pedersen Fox, with healthcare, science, and technology firm WHR Architects, Houston, the building has open, flexible labs, offices, and amenities for use by 90 principal investigators and 800 post-doc trainees and staff.
| Mar 11, 2011
Mixed-income retirement community in Maryland based on holistic care
The Green House Residences at Stadium Place in Waverly, Md., is a five-story, 40,600-sf, mixed-income retirement community based on a holistic continuum of care concept developed by Dr. Bill Thomas. Each of the four residential floors houses a self-contained home for 12 residents that includes 12 bedrooms/baths organized around a common living/social area called the “hearth,” which includes a kitchen, living room with fireplace, and dining area.
