Health Care Construction 2008

New software is designed to take less time and money getting a project off the ground

By Robert Carlsen

When the California Building Standards Commission in November approved plans to use HAZUS software to reclassify the earthquake risks in hospitals, engineers and designers hailed the move as a cost- and time-effective way to upgrade the state’s facilities.

The CBSC’s actions amended the rules for implementing SB 1953, the state Hospital Facilities Seismic Safety Act, which was signed into law in 1994 with a 35-year timeline to ensure all California hospitals meet immediate occupancy standards for a 500-year earthquake by 2030. The CBSC action permits the use of HAZUS, a methodology that was creatively adapted by the Office of Statewide Health Planning and Development.

The original method, as applied by hospitals, required seismic repair or replacement of nearly 1,000 of California’s hospital buildings, but the  HAZUS method is “not only more accurate in assessing a hospital’s risk of failure in a 500-year earthquake, but it also saves the state billions of dollars in repairs that do not need to be completed until 2030,” says Chris Poland, president and CEO of Degenkolb Engineers of San Francisco.

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The Hazards U.S. Multi-Hazard, or HAZUS-MH, is a nationally applicable standardized methodology and software program that estimates potential losses from earthquakes, hurricane winds and floods. HAZUS-MH was developed by the Federal Emergency Management Agency under contract with the National Institute of Building Sciences.

The California Hospital Association says that prior to this change all hospital buildings deemed to be at risk of collapse in an earthquake had to meet new seismic standards by Jan. 1, 2013, or be closed to patient care. An April 2001 report by OSHPD found that nearly 40% of California’s hospital buildings were in this category.

This assessment, however, was made in the late 1990s using what is now considered to be outdated and inadequate technology.

The CHA says that by conducting a more accurate re-evaluation of hospital buildings using the sophisticated HAZUS modeling technology, it is projected that at least half of the buildings will be found to pose a much lower risk than was originally estimated. These buildings will be reclassified into a lower-risk category – and will have until 2030 to meet the state’s highest structural requirements for earthquake safety.

Those buildings that remain in the high-risk category according to the HAZUS methodology must meet the new hospital seismic requirements by Jan. 1, 2013, or face closure.

Spearheading the HAZUS program is OHSPD’s Facilities Development Division. Deputy Director John Gillengerten says HAZUS has major players Sutter Health and Kaiser Permanente “pretty excited. They can now focus on buildings with the highest risk,” especially those located near major earthquake faults.

In the earthquake prone Bay Area, Kaiser currently is constructing a $250 million Vacaville facility and has recently completed the $450 Antioch Deer Valley project.

Besides increased accuracy, HAZUS can be used in a phased design review system.

Gillengerten says the pilot project for HAZUS use is the $312 million Palomar Medical Center West facility in Poway. Construction began late last year on the 52-acre, 800,000-sq-ft building.

While prior to HAZUS, the review process took between 12 to 18 months to complete, this Palomar Pomerado Health project was able to shave at least six months off the process. Structural designs were reviewed in phases as the design progressed, which helped catch and fix errors and omissions in the initial design process, Gillengerten says.

Plan review comments were incorporated early into the design process, rather than revising a finished design, which would have required extensive rework of the drawings.

Carl Scheueman, director of regulatory affairs for Sutter Health, says the healthcare firm currently has 14 project applications to use HAZUS submitted to OSHPD, many of which are located in the Bay Area.

Even though HAZUS will not benefit all healthcare projects in the state, especially those already under way, it will at least prod firms and organizations to get things done, says Bruce Nelson, vice president-business development, health care, for McCarthy Building Cos., which is currently involved in a dozen health care projects in the state.

“Unless the firms are working on a specific business plan to upgrade their facilities anyway, this at least gives them the opportunity to postpone some of the work,” Nelson says.

Shaking Up Earthquake Safety

Mills-Peninsula project first in state to use innovative seismic technology

By David Silva

Builders of the $528 million Mills-Peninsula Medical Center in Burlingame hope that one of its innovative systems will never be tested.

The 450,000-sq-ft facility should remain standing and operational in the event of a catastrophic earthquake.

The hospital, which is located less than 2 mi from the San Andreas Fault, is the first in California to employ base-isolation seismic technology. Isolators - layers of steel and rubber vulcanized to form single units - were placed under each of the 176 columns holding up the structure. Combined with a system of sliders and dampers, the isolators should enable the hospital to withstand a magnitude-8.0 earthquake by displacing seismic pressure into the ground and allowing the building to move up to 30 inches in any direction.

“You have to build a low wall structure around the building to allow it to move around 30 inches in all directions,” says E.J. Saucier, project executive for Turner Construction Co., the project’s Oakland-based general contractor. “You’ve also got all the challenges in how the building’s mechanical and engineering systems hold up in their connections. Visualize a sanitation line: You have to have a pipe connection that allows the building to move and still be functional.

“To allow this, the connectors have a flexible pivot that allows it to move 30 inches in any direction. You have to do that with your water line, fire line and electrical connections.

Further mitigating possible seismic stress on the building are friction pendulum bearings, a key component of the base isolators. In the event of a strong earthquake, the building would slide on the bearings in a gentle pendulum motion.

As designed by project architect Anshen + Allen of San Francisco, the six-story medical center will feature 243 patient beds, healing gardens, walking trails and an attached office building for physician specialists.

Work began on the project in September 2006 and should be completed in the first quarter of 2010. An adjacent 809-space parking garage - designed by International Parking Design of Sherman Oaks - was completed in January 2007.

A facility that incorporated cutting-edge seismic principles was one of the key demands hospital officials placed on Anshen + Allen. Another was that the design must product a medical center that did not appear cold and institutional.

“The owners wanted to instill public confidence in a high-tech facility that also had a non-institutional feeling when you walked through the door,” says Anshen + Allen principal Todd Tierney. “The existing hospital now is a two-tower white behemoth and is dated. You have to take a bank of elevators to get to the top floor.

“In the new hospital, a great deal of effort was made to make sure that the moment you walked through the front door, you knew clearly where the elevators were. More effort was made to make sure that the back elevators were all centrally located to minimize the amount of time it takes staff to get where they’re going.”

Laying out the facility in a way that maximized convenience for patients and hospital staff was a key driver in Anshen + Allen's design, Tierney adds.

“We worked a great deal with hospital officials to follow their lean operational principles,” he says. “For example, we needed to configure the acute-care bed floors to minimize the travel of nurses so they could spend more time with patients. The owners wanted ‘super-floors,’ where the surgery, imaging and emergency departments converged so that they’re immediately adjacent to each other.

“We’re trying to blur the lines between surgery and imaging. We’re trying to break some of the boundaries of ‘this is my department, this is your department.’”

The Project Team

‘Ambient Experience’

St. Joe’s new cancer center transforms patient’s treatments

By Greg Aragon

With the help of a $10 million donation from Roy and Patricia Disney, Providence Saint Joseph Medical Center is building a new $46 million cancer center across the street from its existing 498-bed hospital campus in Burbank.

“Saint Joe’s has been our family’s hospital literally since its inception, and we can’t imagine a more meaningful project to which we can lend our names and financial and moral support,” says Roy Disney, nephew of Walt Disney and former vice chairman and director of the Walt Disney Co.

Officially named the Roy and Patricia Disney Cancer Center, the 57,500-sq-ft, four-story facility was designed by Pasadena-based SWA Architects and is being built by St Louis-based McCarthy Building Cos. Inc.

When complete in January, the free-standing facility will offer comprehensive cancer treatments, including radiotherapy, diagnostics and planning, nutrition and yoga, acupuncture, rehabilitation, and hi-tech conferences. 

The building will also feature a Radio-Frequency Identification system by Johnson Controls, which will allow physicians and staff to quickly access patient records from a variety of secure locations throughout the facility.

The controls can additionally be programmed to recognize a card carried by patients that will trigger room preferences based on their individual desires.

“We are working with Phillips Lighting to do something called the ‘Ambient Experience,’” says Dan Bise, SWA project manager. He says that the technology mixes colored LED lighting with music and video projection in patient rooms.

To make the “experience” work, Bise adds that patient rooms will be painted white and the walls curved so they “almost disappear like a movie set.” Colored LED lighting can then be projected throughout the rooms

“Patients can feel like they are in the clouds or in a forest, or they can choose from a number of themes that transforms the environment and takes [their] minds off the cancer treatment going on,” he says.

Other features designed to help comfort patients include large water features in the front of the building, in the lobby and on the second floor in the form of a water garden.

Located on a square site, the project is within 8 in on two sides of an existing parking structure and mere feet from an occupied medical office building and another under-construction medical building.

“The biggest construction challenge we face on this project is the limited accessibility,” says Mike Tuohy, project director for McCarthy. “Our footprint is about 21,000 sq ft and the [construction] site about 25,500 sq ft, so we only have 5,000 extra sq ft that is not covered by building and we have to maintain access to the surrounding structures during construction.

“It’s going to take a lot of planning and communications with the facilities adjacent to us to get this job done.”

Totaling about 900 sq ft, the cast-in-place concrete vaults are independent structures built inside the steel moment-frame building. Each vault requires a wall thickness of around 3 ft to contain radiation.

The Project Team

Owner: Providence Saint Joseph Medical Center, Burbank
General Contractor: McCarthy Building Cos., Newport Beach office
Architect: SWA Architects, Pasadena

Growing Upwards

Bakersfield Memorial adds new patient tower

By Robert Carlsen

Already the largest medical facility in the city, Bakersfield Memorial Hospital is growing even further with the addition of a new $84 million tower.

The idea for a new city hospital began with a citizen campaign formed by civic leaders and healthcare professionals in the early 1950s, which resulted in the 112-bed Greater Bakersfield Memorial Hospital in 1956 at its current location at 34th and San Dimas Street. It was funded through a nonprofit association and operated as a community-owned institution.

In 1995, BMH choose Catholic Healthcare West as its partner since it shared the hospital’s nonprofit, mission-driven philosophy. Local support also helped fund numerous construction and expansion projects through the years, but new technology along with seismic safety realities led to this newest addition.

Redwood City-based Rudolph and Sletten was chosen as general contractor on the West Tower project and Los Angeles-based Perkins + Will came aboard as the architect.

The project takes a one-story building adjacent to the main hospital and adds four stories along with 24 new beds to the Intensive Care Unit, 60 private general medical care rooms and 30 private post-partum rooms for moms and babies. The tower expansion makes it possible to upgrade technology throughout the hospital to include facility-wide wireless monitoring of patients.

In addition, the Emergency Department is being expanded to include a new eight-bed Heart and Stroke Center.

Julie Dobyns, Rudolph and Sletten’s senior project manager, says the work so far has involved more than 30 subcontractors and, at times, up to 260 workers.

“Our main challenge was tying in every floor to the main hospital building,” says Dobyns. “The original building had a basement level, so we went in and did some seismic upgrades there. We also added two elevators.”

Upon completion in November, BMH will house a total of 381 licensed acute care beds. A new nursery will be located on the second floor of the new tower and a third floor ICU will connect to the main hospital.

Planning for the new 72,000-sq-ft tower began in 2003, says Bill Schmalz, principal architect at Perkins + Will.

“The original plan was go up to seven floors,” he says. “But because of updated code requirements, the most allowable at the time of construction was four floors.”

“The facility was designed to the standards of the late 1980s, but we designed the room standards of 2009-2010. Additionally, we had to upgrade the moment connections to accept additional floors.”

At a cost of $736,000 each, the “smart beds” in the new tower will be able to provide continuous monitoring of critically ill patients, according to the hospital.

The Project Team

Owner: Catholic Healthcare West, San Francisco
General Contractor: Rudolph and Sletten, Redwood City
Architect: Perkins + Will, Los Angeles

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