DURANT, Okla.—The campus of the Choctaw Nation Regional Medical Clinic in Durant has been awarded three LEED Silver certifications. The awards were given to Choctaw Nation Health Services Authority and Robins & Morton and James Childers Architects, Inc. for their combined work on the medical center.

The three buildings of the medical center entail a 146,093-square-foot clinic, a 6,108-square-foot health service administration building and a facilities maintenance building encompassing 11,750 square feet. The clinic, which does double duty as the campus’s hospital, houses facilities for outpatient surgery, dental, behavioral health and ophthalmology as well. The health services administration and facilities maintenance buildings are joined to the primary clinic via sidewalks.

Part of the reason for the award was that the healthcare facilities make extensive use of geothermal heating and cooling thanks to hundreds of wells at the property, which were integral to the design wishes of the Choctaw nation. The lobby’s glass is “electrochromic,” meaning its sensors automatically tint depending on the amount of natural light that is entering the building through the windows.

The health services administration and facilities maintenance buildings won the award due to the use of sustainable construction materials in their design, which further helps with energy efficiency throughout.

The three buildings were awarded separate Silver certifications under the umbrella of the LEED Campus program, which allows each individual facility to prioritize sustainability objectives in their award criteria.

“We have been encouraging our clients [to commit] to green building, specifically healthcare and higher education, to consider the LEED Campus program,” said Robins & Morton Sustainability Manager Jackie Mustakas in a statement. “Not only does it reduce duplication of administrative efforts on active projects, it makes it more attractive for future projects to pursue certifications knowing that a series of points is already secured.”

The campus is designed to be a point of healthcare service for some 260,000 members of the Choctaw Nation, as well as members of other tribes living in the surrounding community.

“Any coordination we can do now to motivate future project teams to pursue certification, therefore collaborating as an integrated team, prioritizing positive environmental outcomes and reducing operating costs is worth the effort entirely,” Mustakas added.

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KANSAS CITY, Mo.—An Award of Merit has been given to architecture firm Hoefer Wysocki for its innovative and sustainable work on the Saint Luke’s Multispecialty Clinic – Blue Springs, Missouri.  Hoefer Wysocki was awarded the 2019 United States Green Building Council (USGBC) West North Central (WNC) Leadership Awards in the “Innovative Design, New Construction” category for its work on Saint Luke’s.

The LEED Silver-certified clinic, valued at $11.6 million, was purpose-built for specialized and flexible outpatient care such as imaging, labs and pharmacy services.  According to Hoefer Wysocki, the clinic offers a “flexible floor plan” for its examination rooms, in which specialists can rotate their visits with one patient without reconfiguring the room layout. 

Of particular importance for Hoefer Wysocki was ensuring that the Saint Luke’s Multispecialty Clinic – Blue Springs, Missouri, be a model for sustainability, said Ashley Eusey, P.E., LEED AP, GGP, sustainability specialist at Hoefer Wysocki.

“Sustainability can provide great value to any project,” Eusey said in a statement to HCO News.  “The healthcare industry specifically has a history of extensive water and energy use, so reducing use of these two resources can potentially reduce operating costs.”

Such concerns were ameliorated in the design process with a particular focus on improved stormwater management.  Furthermore, construction waste was hauled away in part to divert solid waste away from landfills.

“Resilient design, which emphasizes adaptability and flexibility, can also decrease future renovation costs as medical equipment, technology and treatment approaches evolve over time,” added Eusey.

Hoefer Wysocki’s sustainability measures at Saint Luke’s included incorporating walking trails throughout the grounds as part of an overall employee wellness program.  What the firm calls “strategic daylighting” will hopefully help with darkness-related mood shifts that can occur during the colder months, and electric vehicle charging stations are also included on the site as well as part of the push for sustainability.

The firm also points out that sustainability development saves money over the long haul and improves both business and the patient experience.  Furthermore, Eusey and Hoefer Wysocki are pushing for more sustainable facilities across the Midwest in this and future projects. 

However, constant vigilance is the key to ensure that things don’t get sloppy, Eusey said.

“Commissioning and metering assist in maintaining optimal performance of building systems [and] continuous monitoring can alert maintenance personnel of performance deficiencies,” said Eusey, who is recognized as a national leader in sustainable design.  “This practice potentially prevents mechanical breakdowns long before they affect utility bills and system performance.

“All of these strategies were incorporated into the Saint Luke’s Multispecialty Clinic design.”

McCownGordon Construction of Kansas City, which served as the general contractor, has built facilities for the Saint Lake’s system of clinics in both Missouri and Kansas. 

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OAKLAND, Calif. – Kaiser Permanente has reached an agreement for a major renewable energy purchase that will empower it to achieve its goal of being carbon neutral by 2020.

With this announcement, Kaiser Permanente, recognized as the leading health care sponsor of the Global Climate Action Summit in San Francisco, underlines its commitment to improving the health of individuals and communities by focusing on climate change.

Kaiser Permanente’s power purchase agreement for 180 MW of clean energy – which is enough to power 27 of its 39 hospital – will enable the construction of utility-scale solar and wind farms, and one of the country’s largest battery-energy storage systems.

The agreement is part of a comprehensive portfolio of renewable energy solutions and greenhouse gas reduction strategies that together, enable Kaiser Permanente’s clean energy future.

“Climate change is here. We are seeing the effects of it in devastating wildfires, hurricanes and droughts already impacting people’s lives,” said Chairman and CEO Bernard J. Tyson. “At Kaiser Permanente, we understand that one of the most effective ways to protect the health of the more than 68 million people in the communities we serve is by ensuring healthy environmental conditions. By investing in renewable energy and becoming carbon neutral, Kaiser Permanente is helping to prevent climate-related illness for people worldwide.

Kaiser Permanente continues to demonstrate its commitment to environmental consciousness in the public health system.

The organization first announced its goal to become carbon neutral in 2020, noting several. These achievements include:

• Reaching a 29 percent reduction in net greenhouse gas emissions since 2008, while increasing our membership by 36 percent.
• Reducing water usage by 12 percent per-square-foot of building space since 2013.
• Opening California’s first LEED Platinum hospital, the Kaiser Permanente San Diego Medical Center in April 2017.
• Hosting California’s first hospital-based renewable microgridat the Kaiser Permanente Richmond Medical Center.
• Issued $1 billion in Green Bonds to fund LEED Platinum and Gold building projects.
• And lastly, joining RE100, California Healthcare Climate Alliance, Ceres Connect the Drops and other climate leadership initiatives.

Tyson also delivered statements during the opening plenary of the Global Climate Action Summit on Thursday, Sept. 13.

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TRAVERSE CITY, Mich. — In April 2016, the Munson Medical Center’s Cowell Family Cancer Center opened its door to the public with the mission to provide quality medical treatment in a serene, nature-infused environment. In 2017, the advocacy group, Less Cancer, recognized the Cowell Family Cancer Center for leadership in cancer prevention efforts. Now, the center has officially hung a new plaque displaying its recently earned LEED certification from the U.S. Green Building Council.

Cowell Family Cancer Center credits this achievement to several green features implemented throughout the facility. These features include a 3,900-square-foot green roof using succulent plants that help reduce storm water runoff, protecting the nearby Kids Creek and the quality of water. The roof was a collaboration project by the Watershed Center and the Grand Traverse Conservation District. Another vital element of the center’s construction was high-efficiency electrical and mechanical systems. Other features encouraging “smart commuting” that include covered bike racks, showers and lockers for commuters and a bus stop also played a part in the LEED certification.

Cowell Family Cancer Center’s Core Value of Stewardship

Munson Healthcare Vice President of Facilities Steve Tongue explained that stewardship is part of the company’s core values, stating that a healthy environment “is a fundamental building block of a healthy community,” according to a statement announcing the certification.

In that same statement, other sustainable efforts at Munson Healthcare were underlined. These efforts include the Paul Oliver Memorial Hospital staff in Frankfort, Mich., voting to pay 25 cents more for takeout items packaged in compostable containers made from corn; using a purple-container disposal program for pharmaceuticals to ensure that “active substances” are disposed of properly and do not contaminate the environment through the water and/or soil; and installing a new boiler plant, lighting upgrades and water conservation measures at Manistee Hospital. The estimated annual energy cost savings are more than $100,000 annually.

In addition to critical medical treatments, the center offers life-affirming health and wellness services that treat the whole body and mind to promote physical, emotional, mental and spiritual healing, according to the organization’s website. The cancer center also provides individualized supportive care, including a spa-like health and wellness suite offering services ranging from yoga to meditation and massage.

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AUSTIN, Texas — The Dell Seton Medical Center at The University of Texas at Austin, a project from the facility management companies of Medxcel and Ascension, was recently recognized for green design and construction methods, receiving high honors after opening in May 2017. The 517,000-square-foot facility in Austin, hosts 13 operating rooms and 211 beds, securing a new health care innovation zone in downtown Austin with sustainability leading to its core value.

Dell Seton continues Ascension’s legacy of green building leadership, with this being the third LEED certification for Ascension Texas, according to a statement. Dell Children’s Medical Center of Central Texas previously received two LEED Platinum certifications. Ascension also holds two Austin Energy Green Building five-star projects. In the program’s 26-year history, only six commercial projects have been awarded five stars.

Michael Argrir, CEO and president of Medxcel, explained the many design features that were implemented, which created an exemplary environment for patient healing and the education of future healthcare practitioners, thus leading to the facility’s achievement of LEED Gold and 4-Star Austin Energy Green Building certifications.

For example, interior courtyards and adjacent University of Texas (UT) campus greenspace provide verdant areas to patients, associates and visitors. Drought-tolerant native and non-invasive adapted plants are 100 percent irrigated with condensate water collected from the building’s air handling units. Additionally, innovative vegetated bioswales control stormwater quality into Waller Creek in order to protect and treat rainwater that flows directly into Lake Austin. Water-efficient plumbing fixtures and equipment help reduce domestic potable water use by more than 35 percent as compared with a typical hospital.

Other sustainable features of the hospital include environmentally desirable materials and products with recycled content that were regionally extracted and manufactured, along with FSC-certified wood, rapidly renewable materials and avoidance of chemicals of concern. Low VOC content materials were used for all interior and exterior adhesives and sealants, paints and coatings. Agrifiber products and batt insulation with no added urea formaldehyde are also utilized. Furthermore, more than 80 percent of the construction waste was diverted from landfills.

These features, among countless others, are what led DSMCUT to achieve this immense feat. The decision to place the project in the urban location of the center of downtown Austin on the University of Texas campus played a major factor in the sustainable features that set DSMCUT apart. Due to this location, associates and visitors have excellent access to public transportation. In addition, the hospital encourages the use of alternative transportation by providing bike racks and parking priority to hybrid and alternative-fuel vehicles as well as to employees who carpool. The hospital installed nine electric vehicle charging stations in the parking garage to supplement the other sustainable transportation initiatives that the project implemented.

Though initial costs of implementing these sustainable design features were higher than that of a less sustainable project, the long-term effects of these initiatives will help to counter other costs and will benefit the patient care and caregivers.

For example, DSMCUT is making noticeable progress through mitigation and resiliency programs, investing in energy efficiency and renewably-generated electricity. As most can likely assume, energy and electricity are mounting costs for hospitals. By offsetting these through sustainable practices, hospitals can actually save money and have the unique opportunity to address climate change.

The hospital also helps counterbalance water costs by reducing water use through water-efficient plumbing fixtures like low-flow faucets, shower heads, toilets and urinals, and efficient process water systems such as sterilizers, kitchen dishwashers and ice machines. The courtyard and street plants are native, drought-tolerant species irrigated with reclaimed condensate water from the building’s air-handling units.

Experience the Dell Seton Medical Center at The University of Texas in 360° video:

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The hospital’s green strategy has situated the institution to gain a certified level of recognition in the U.S. Green Building Council’s and Green Business Certification Inc.’s LEED program this past July, according to a statement.

The design of the hospital’s $450 million headquarters, which opened last September, granted the opportunity to create a campus that would advance from top to bottom on the environmental efficiency of the old building. The 650,000-square-foot-structure was expected to use 12 percent less in utilities than comparably sized hospitals — an efficiency goal that hospital officials said they are already exceeding.

“It’s a smart business decision to save energy,” said Stanley Hunter, the project director for the hospital’s master plan program, in the Stamford Advocate. “If you think about it from the very beginning, it’s not costing more.”

The hospital’s exterior echoes the emphasis on sustainability, with terracotta panels covering the lower part of the building. The terracotta is more energy efficient than brick, because it does not trap and transfer heat into the building, which results in less energy needed for cooling. With a similar objective, the new building’s roof is white, so it reflects rather than absorbs sunlight.

Lowering the use of energy helps to produce a more comfortable environment, hospital officials said, with the new building’s control system turning down the lights on patient floors at night to create a quieter ambiance while also using less wattage.

“With that type of control system, you automatically have both the advantage of a better patient experience, plus energy savings,” Hunter said to the Stamford Advocate. “It’s a win-win.”

The approximately 35,000-square-foot Central Utility plant, which opened in January 2014, also helps maintain energy-cost savings. A tunnel lined with utility tubes and wiring leads to the heart of the hospital’s energy-conserving operations, designed to serve the new buildings more resourcefully than its former hub. Running on natural gas, the boiler and chiller is monitored digitally to make sure it is only expending as much as energy as possibly needed.

“We used to burn No. 6 oil,” said plant operations supervisor Terence Brady. “But it’s not cost-effective and not the green synergy we’re trying to promote.”

Hospital officials said they maintain a close watch over the plant’s systems, which work at prolific rates, according to a statement. One boiler produces almost 13,000 pounds of steam per hour.

“We’re constantly having [the boilers] tested for their efficiency,” said Michael Smeriglio, the hospital’s executive director of facilities management in the Stamford Advocate. “We have an optimization package, which controls the motor — it’s reading the temperature and flame output and reading the amount of gas going in. We’re not using more than what we need.”

On the hospital’s third level, the exact conservation principles apply in the 40,000-square-foot mechanical floor. Air handlers use “variable speed technology” motors that spin as fast as necessary. If less air is needed, the motors slow down to save energy.

However, data on the new building’s total utility output and costs was not immediately available.

Approximately 980 healthcare projects are certified nationwide, while 1,835 are waiting to earn certification. Connecticut has 270 LEED-certified commercial properties and another 364 waiting for certification. Across the U.S., about 64,500 projects are certified or working towards certification.

“One of the main tenets of LEED is human health and the belief that buildings can have an impact on our health,” said Theresa Backus, a technical specialist in the building council’s LEED department. “We believe buildings that are designed to be more sustainable are healthier buildings.”

Stamford Hospital officials envision applying other innovations when they become financially possible. The Central Utility Plant could accommodate a co-generation system, which would recycle utility emissions. Heat byproducts, for instance, could be reused to warm up boiler water.

“You’d using less energy to warm up the water in boilers,” Smeriglio said in the Stamford Advocate. “We’d want to use every waste product off the co-generation.”

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PHILADELPHIA — The University of Pennsylvania in Philadelphia held a groundbreaking ceremony for its new hospital on May 3. The new “Pavilion” will be located on Penn Medicine’s West Philadelphia campus — located at the former site of Penn Tower — where it will house inpatient care for the Abramson Cancer Center, heart and vascular medicine and surgery, neurology and neurosurgery and a new emergency department. Completion of the new pavilion is expected in 2021.

The new, 16-story, 1.5 million-square foot facility has a budget of $1.5 billion. The design and construction of the project is a collaborative effort between multiple firms. PennFIRST, an integrated project delivery team in Philadelphia is completing the planning and design process for the new hospital with global health care design firm HDR, as well as the international architectural firm Foster + Partners. BR+A is the engineering designer, with construction management experts L.F. Driscoll in Bala Cynwyd and Balfour Beatty Construction in Dallas, also on the project. Additionally, Penn Medicine’s clinical and facilities experts are part of this collaborative team, as well as the input of patients and related family advocates.

The design team had the minimization of patient stress on the forefront of building design for the new facility, with a goal of maximizing patient care and treatment, according to Troy Parks, senior communications specialist at HDR. As such, the hospital is designed to divide into smaller “neighborhoods” to provide a greater sense of community, and create a warmer feeling overall for the hospital. Plentiful daylight and landscape views will be present at this new facility, with the intention of optimizing the health and wellbeing of its occupants, according to Parks.

The new Pavilion will have 500 new private patient rooms and 47 operating and interventional rooms. These patient rooms were designed with “long-term flexibility” so that they can adapt and change over time with “minimal impact to the building fabric,” according to Parks. The rooms are designed in such a way that they can transform from intensive care related needs to a standard room as patients recover over time. Additionally, all private patient rooms have a uniform design to maximize patient care, and include a private bath and a comfortable area for family members and visitors. Telemedicine technologies will be installed into each of the rooms to maximize patient and staff communication, as well as to make “multi-nodal” physician consultations possible.

The new hospital design includes a number of environmentally sustainable features, with LEED certification being pursued for construction of the new facility. Some of these sustainable features include the reuse of water, optimized access to daylight, 100 percent outside air, outdoor green space available building occupants and visitors, and overall high performance building envelope and mechanical systems. Additionally, the surrounding landscape was designed to create pedestrianized routes and landscaped gardens and plazas to enhance not only the patient experience, but also to enhance that of the surrounding community.

The new Pavilion is being designed with a network of public bridges and walkways that will not only make movement around the campus pleasant and easy, but will link the new facility to the Hospital of the University of Pennsylvania and the adjacent Perelman Center for Advanced Medicine. This network of walkways also easily leads building occupants to the local train station.

“As the nation’s oldest teaching hospital, the Hospital of the University of Pennsylvania is rooted in a history of firsts going back nearly 150 years,” said Ralph W. Muller, chief executive officer of the University of Pennsylvania Health System in a recent statement. “Now, with the Pavilion, we’re poised for the next 100 years of advances in patient care,” said Muller.

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CHESTERFIELD, Mo. — St. Luke’s Hospital in Chesterfield held a dedication ceremony on Jan. 23 for its new outpatient services building after its completion in December 2016. The new facility was constructed to accommodate the growing needs of outpatient healthcare services on the hospital’s west campus and to provide flexibility for future department growth within the building.

The 106,000-square-foot, five-story building had a budget of $40 million. The architects on the project were BSA LifeStructures in St. Louis, with general contractor McCarthy Building Companies, also in St Louis. The new outpatient Center Building adjoins with St. Luke’s Mr. and Mrs. Theodore P. Desloge, Jr. Outpatient Center, and provides additional space for new physician offices as well as the expansion of St. Luke’s physical therapy and cardiac rehabilitation services. Additionally, the nutrition wellness and diabetes center, anticoagulation clinic, wound care and hyperbaric medicine services have all relocated into the new outpatient buildings since the completion of construction in January.

“The dedication of St. Luke’s new outpatient services building is a significant event for St. Luke’s Hospital and health care in our region,” said Christine M. Candio, RN, president and chief executive officer at St. Luke’s in a recent statement. “As our community grows and changes, we work to stay ahead of patient needs by continuing to provide convenient access to the highest quality care and services possible.”

The new outpatient center possesses a number of features designed to improve the overall patient experience, care and services, according to Ellen Post, interior designer at BSA LifeStructures. A single-loaded corridor creates a wayfinding element with multiple entry points, shortening the distance patients would travel while exposed to the outdoors, with large windows in the corridor allowing natural light to enter the clinic spaces. A number of design elements balance the physical and stylistic connection between the adjacent Mr. and Mrs. Theodore P. Desloge, Jr. Outpatient Center and the new outpatient center according to Post, such as an indoor walkway that allows patients, visitors and staff to travel inside, between the buildings.

“The interior and exterior design language of the Desloge Outpatient Center drove the aesthetic of the new facility,” said Carter Haas, designer at BSA LifeStructures. “The design embraces the natural fall of the existing topography, enabling a partial basement level to accommodate mechanical systems and a service and delivery zone.” The location of the partial basement and the distance from the street shapes the location of the core and main canopy drop-off at the new building, according to Haas.

Overcoming structural challenges in connecting the two outpatient buildings was one of the biggest obstacles that the design team faced on the project, but in the end these goals were achieved successfully, according to Haas. In an effort to improve overall efficiency and communication for the project, iPads and advanced construction software — including BIM 360, NoteVault and Bluebeam applications — were utilized by McCarthy and its design and construction team.

The new outpatient building is seeking LEED Core and Shell certification, and is currently being reviewed, according to Corey Black, project manager at McCarthy Building Companies. The new building is energy and water efficient, according to Black, and generated minimal construction waste throughout the duration of the project. The new facility integrates sustainability through the use of healthy, regional materials, and bioretention basins to slow and treat onsite stormwater runoff. Additionally, the building implemented CO2 emissions reduction and improved indoor air quality.

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Cost estimating can make or break a project — and ensures that no surprises will arise come bid day. Continuing to cost estimate throughout the construction process can further guarantee that projects stay on budget and that facility owners are given timely information about system life cycles.

Healthcare Construction + Operations News recently spoke with Paul Whitson, AIA, LEED GA, senior vice president and regional health care leader in HOK’s St. Louis office to gain some insight on cost-estimating during the design and construction of major projects.

Q: How often do you use cost estimating while designing a project?

Whitson: Almost always. It’s essential in understanding how many square feet are needed for a project and how much it will cost. On a project for the University of Colorado in Colorado Springs, we are using it in the early programming stages for the school’s Sports Medicine and Performance Center. We have teamed with a construction manager who will use cost estimating to accurately identify constructability issues and deliver the best outcomes for the school.

Q: How does the cost estimating process differ between specific project phases?

Whitson: Ideally, it should reduce costs from concept to the construction document phase. At the concept phase, more allowances are made in estimating for the unknown. But as project planning advances, refinements can be made as site issues and layout become better known. There are generally two big changes in project phases: when you move from unit-costing to systems-costing and when unforeseen contingency costs become clearer. In each case, as the unknown aspects peel away, the costs should go down. Essentially, the more that is known, the better for accurate cost estimating.

Q: How can cost estimating help facilities save money and stay within budget?

Whitson: [Cost estimating] can help in two ways. First, it is a great benefit in setting benchmarks to make the best use of capital on the project and keep it within budget. But it also provides valuable information for that next project, where it can be used to predict future costs for similar projects or an added phase. We use technology like Revit and BIM to model systems early in the project. The model gives team members a better understanding of how all facets of the project fit together and overcomes conflicts to avoid having to make costly changes later on in the project.

Q: How can cost estimating help in the maintenance/operations of the building once a construction project is completed?

Whitson: That’s part of the system costs, and in general proceeds with the understanding of the first cost versus the operating costs over the life of the project. There may be cheaper HVAC systems, but their cost must be viewed over the long term. A more expensive system can provide greater value in efficiency and energy conservation over the life of the system.

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