Health Care Projects Designed to Speed Cures

By Lucy Bodilly

The newest health care projects in Portland and Seattle are following some of the latest construction and health care trends: lean construction digital imaging and sustainability.

At the Swedish Orthopedic Center general contractor Sellen Construction Co., and architect NBBJ both of Seattle used BIM extensively and were able to complete the project in 19 months.

Turner Construction and ZGF, both of Portland, planned around a constricted site, and put into place an award winningmechanical system.

Mortenson Construction and architect whever built an facility used strictly for outpatient care which includes one of the most advanced digital records systems in the area.

Providence Medical Center

Providence Portland Medical Center’s campus master plan included an expansion and seismic upgrade of the central utility plant, a newly constructed 900-space parking garage as well as the new $204 million Cancer Center. The central utility plant in the 490,000-sq.-ft, 11-story building won a national award from the American Society for Healthcare Engineering for teamwork and planning.

Originally built in 1947, the old physical plant served the entire Providence Portland Medical Center campus. The new cancer tower had to be built where it stood, forcing Turner to completely relocate it.

New chiller, electrical, generator, and pump rooms were built on the lower level of the existing garage, which was then seismically upgraded.

Emergency and utility power, chilled water, heating hot water, domestic water, natural gas, and all medical gasses were replaced and the existing systems were transferred to the new equipment. “To tie-in the new systems, we had to turn the power off 100 times for the new hookups,” said Molly Nichols, Turner’s superintendent. “And at that, we were only allowed a two second delay.” This required thorough and exhaustive testing over a period of 12 weeks before all systems were safe and fully operational. Three new 2-megawat generators and two new 30,000-gallon underground fuel tanks were also installed, requiring rerouting of a the major electrical feeds to the hospital and final tie-in of the generators and associated switching gear.

Providence Health & Services conducted both energy and eco-charrettes to brainstorm design strategies and to build commitment and vision within the design team and community. Through partnership with PGE’s Dispatchable Standby Generation,Providence is able to feed power back to the grid during peak demand without losing power to its campus. PGE has access to 400- kilowatt hours per year from Providence.

The new Cancer Center includes a number of other energy-efficient design strategies and sustainable technologies that will deliver substantial annual operating savings. State-of-the-art mechanical elements include a 100 percent outside air system with high accuracy airflow terminal units. These units minimize the risk for spreading infection. A plate and frame heat exchanger waits until outside temperatures are 50 degrees or below to utilize the cooling towers alone for cooling, leaving the chillers idle for several months out of the year, which is a huge energy savings.

A new and improved air handler unit, called Fan Wall Technology, is also used.

In lieu of large house centrifugal fans, this newer technology utilizes an array, or wall, of axial fans to increase fan efficiency and reduce horsepower related to redundancy. It also solves major maintenance issues by allowing individual fan replacement even while the air handler units are operating.

“In order to have the air-handling units arrive in time to meet our aggressive schedule, we pre-purchased them through Turner Logistics,” said Dan Gemme, Vice President and Operations Manager of Turner’s Portland office. “In addition to the air handling units, major mechanical, plumbing and electrical equipment (transformers, switch gear and automatic transfer switches, bus duct, chilled water pumps, condensate pumps, a boiler and three chillers) were prepurchased in the same manner.”

New seismic solution

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As an essential facility, the Cancer Center is designed to 50 percent higher seismic requirements than typical buildings in the area. Challenged by the program, schedule, and necessary alignment between the new and existing buildings, structural engineers from KPFF, Portland, determined steel plate shear walls (SPSW) were the best seismic solution. Although seldom used in the United States, fabrication of SPSW is simpler with fewer walls required and tests show that they are among the best-functioning systems under seismic conditions.

Meticulous pre-planning made the erection process go smoothly. With an aggressive construction schedule, nearly 7,500 shop drawings were reviewed in just over 18 weeks. One of the biggest challenges was setting trusses that spanned the existing and fully operational boiler room. Each truss was divided into thirds and set in place on supports, bolted up, and welded prior to the removal of temporary supports.

Swedish Orthopedic Institute

Sellen Construction and NBBJ collaborated closely to complete the $140 million Orthopedic Institute in downtown Seattle. Broadway on Seattle’s First Hill. Five years in planning including three years in design and construction, the project team used BIM to help design and build the facility co-currently.

The 372,000-square-foot Swedish Orthopedic Institute (SOI) has 11 stories – with five floors devoted to patient care, two for medical offices, and four of underground parking.

SOI is closer to the birthing suite model, where families can be with the patient in a natural environment. Patients will have access to extensive clinical education and rooms that feature wireless Internet access, DVD players, flat-screen televisions, and room service-style food service.

The unique environment will also allow patients to get up, move around, exercise and socialize with others during recovery, not stay isolated in their rooms. NBBJ followed the latest trends in health care design, by protecting patient privacy maximizing comfort ith the use of a central corridor. The only access between patient rooms and surgical areas is through the corridor, which minimizes exposure between the public and patients. It also allows all medical necessities, to take place privately.

The design also helps patients by providing color-coded molding, making it easy to tally distance. Benches for resting, and interesting artwork and etched glass will temper recovery.

Swedish has 54 active orthopedic surgeons on staff, many of which were heavily involved in the vision for and design of the new facility. “We worked met with everyone at least once a month,” says Kristina Ryhn, principal architect from NBBJ.

Two conceptual ‘spine sculptures’ were commissioned for SOI, based on the theme of mobility. Julie Speidel of Seattle designed a large-scale piece in basalt stones with bronze inlays that is an artistic interpretation of a spine when viewed from above. And artist Debbie Young of Ellensburg, Wash., created 10 four-foot by four-foot panels out of terrazzo from the former building on site that resembles a spine.

Group Health Outpatient Facility

Mortenson Seattle turned the keys over to the $120 million state-of-the-art Group Health Bellevue Medical Center, The fourstory, 190,000 sq ft medical center will be home to the largest multi-specialty practice in East King County with 125 physicians representing more than 25 medical specialties. The “signature facility” of Group Health reached substantial completion two weeks ahead of schedule and is comprised of four stories of below-grade parking and four stories of above-grade clinical and medical office space.

Group Health is charting new territory in health care with completion of the facility. All Group Health members who need inpatient care following surgery will be transferred through a tunnel to Overlake Hospital, which shares the same campus.

The structure is airy; a design element which has been found to lower stress, create calmness and contribute to better health outcomes.

“We are thrilled with the success of this project,” said Michael Harder, General Manager of Healthcare for Mortenson Construction Seattle. “Our experienced healthcare team, along with our project partners, delivered a cutting-edge facility on-time and on-budget in an extremely tight marketplace” Many sustainable elements were added to the Group Health Medical Center, such as: individual thermostats to monitor thermal comfort; the use of fully sustainable and renewable Lyptus hardwood; energy efficient occupancy sensors, photocells and dimming ballasts to reduce electricity; and a white EPDM roof to reduce solar heat gain. The ceilings were also raised to 10 feet to allow more natural light in and reduce the use of artificial light. A complete flush of indoor air was also performed before movein to remove contaminants from the construction process.

Designed specifically around the needs of their patients and housing the latest in technology and medical equipment, the facility will include offices for physicians in primary care and more than 25 specialties, diagnostic imaging, operating rooms for day surgery, oncology services (including an on-site infusion room that provides chemotherapy) and 24-hour services for acute care and emergencies. To nurture physician-patient relationships, larger exam rooms feature a curtained changing area, couch for patients or family and special lighting for exams or consultations. Each room provides access to computers and Group Health’s clinical information system, allowing patients and doctors to review medical records together, helping patients make better-informed decisions. An “on-stage”, “off-stage” design throughout the medical center keeps public areas calming, comfortable and focused on patient needs. In the off-stage zones there are separate staff entrances, elevators, corridors and workspaces to promote collaboration among physicians and staff.