COLUMBUS, Ohio—Hammes Healthcare, a leading provider of consulting and project management services, is pleased to celebrate the groundbreaking of The Franklin County Crisis Care Center on behalf of the Alcohol, Drug and Mental Health Board of Franklin County (ADAMH) in Columbus, Ohio.

Hammes has been engaged as the owner’s representative on the project since 2021, supporting ADAMH with planning, design and construction initiatives, including team member selection.
The new 72,000-square-foot center will offer walk-in services, an intake and assessment area, a 23-hour observation unit, inpatient unit, substance use disorder treatment services, medical services, pharmacy, family support services, and administrative services. It will also serve as the preferred location for first responders to take patients in need of mental health and addiction crisis services.

“We are honored to support ADAMH on this endeavor and recognize the positive impact it will have on Franklin County,” said Nancy Connolly, President of Hammes Healthcare.

Hammes Healthcare is a national consulting firm that provides real estate and market strategy, facility planning, project management and development services to the healthcare industry.

NBBJ is the architect on the project; the construction is a combination of Corna Kokosing and Elford.

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Part I of this article focuses on research and how it affects the impact on hospital design, especially facilities geared towards veterans. One such facility focusing on patient-centered design is the Southeast Louisiana Veterans Health Care System Replacement Medical Center, a VA medical center destroyed when Hurricane Katrina devastated New Orleans. Designed by national architectural firm NBBJ with two local New Orleans firms, Eskew+Dumez+Ripple and Rozas Ward Architects, the new four-story, 1.6 million-square-foot campus, dubbed Project Legacy, now serves more than 70,000 veterans in a 23-parish catchment area and across the Gulf Coast with an anticipated 550,000 annual visits.

Read on to see the other elements of the project that made it a success in achieving patiet-centered design for veterans.

Timing

Planning for the project’s successful delivery began during the pursuit process when Clark/McCarthy Healthcare Partners (CMHP), the joint venture that constructed the project, proposed a phased construction schedule. Turning over the project in segments allowed VA personnel more time to commission, activate and move into their new buildings. In 2014, the project’s first building, the renovated and restored historic Pan-American Life Insurance building, was turned over to the VA for its administrative offices. The remaining eight buildings were turned over upon completion, the most recent being the diagnostic and treatment building in October 2016.

To maintain the client’s target date for medical care, CMHP further phased construction to turn over critical portions of the facility before buildings were fully complete. The team turned over the main computer room in the diagnostic and treatment building 10 months before the remainder of the building to allow VA medical center personnel to expedite the installation and activation of much of the campus’ technology infrastructure.

Construction Collaboration

The City of New Orleans and CMHP worked collaboratively on logistics, infrastructure planning, small business outreach and communications, which included working with the Louisiana Department of Transportation. Maximizing opportunities for small, local, disadvantaged, minority-owned and veteran-owned businesses was a CMHP priority throughout construction.

The team’s phased approach allowed subcontracting packages to be divided into smaller scopes that were more manageable for small firms. A typical project of this size would have between 70 to 90 subcontractors; this effort had nearly three times as many. More than $230 million of contracts were awarded to small businesses. The contracting team further increased opportunity for local businesses by hosting two, six-part training sessions to help educate small businesses on federal contracting and construction best practices. Approximately 50 companies completed this CMU Building Blocks program. CMHP also followed up with hands-on construction training and setting up a mentorship program. The result is that local businesses not only understand procurement, but individual tradesmen have developed a trade in coordination with this job.

The Result

Project Legacy, as this medical center is nicknamed, broke ground in June 2010, began accepting outpatients in December 2016 and is opening in phases throughout 2017. This facility sets new standards for VA’s patient-centered care, in a facility that honors veterans’ service and reflects the culture of New Orleans. The campus includes 200 inpatient beds, 370 outpatient exam rooms, 21 procedural suites, ambulatory clinics, emergency and imaging departments, mental health services, patient education facilities, transitional living and outpatient rehabilitation, a central energy plant and two parking garages. The hospital also features a gymnasium, swimming pool, healing gardens, courtyards, and walking paths. The facility is designed to meet the full array of VA missions — education, research and national emergency preparedness and assistance.

Conclusion

By linking health care construction and design strategies with key desired outcomes, such as reduced health care–associated infections, fewer falls, increased energy savings, better patient satisfaction and increased market share, the discussion at the design table is no longer about the first costs of health care facility design or about meeting immediate facility space needs but about the role of the physical environment in supporting the mission of the organization in providing high-quality care. This is a positive trend that will affect the quality of health care facilities being built in the years to come.

Barbara Wagner is senior vice president with Clark Construction Group – California, based in Irvine, Calif.

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More than $200 billion has been spent over the past decade on U.S. hospital construction. To increase the likelihood of designing facilities that function well for patients and staff, and are cost-effective, hospital administrators and facility planners are drawing on evidence-based design to increase the likelihood that new facilities will generate the expected outcomes. Forward-thinking health care organizations, architectural firms and construction companies know that the built environment plays a key role in treating illness, especially if that environment uses patient-centered design. To that end, many are conducting focus groups with patients and staff with results that greatly influence the design and features of a hospital.

Importance of Research on Design

Research can help facility professionals, architects and hospital administrators make more informed facility decisions. For example, in 2006, researchers at Texas A&M and Georgia Institute of Technology identified more than 600 studies demonstrating the impact of hospital design on outcome measures, including reductions in staff errors and stress as well as the amount of pain experienced and medication required by patients. Their conclusion was two-fold: First, there is more than sufficient evidence from the scientific literature to guide current hospital design; and second, using that information to improve hospital design does have a significant impact upon patient and staff outcomes. However, what may have worked in 2006 to help in the design process is now being taken a step further with the use of focus groups.

Information garnered from facilitated focus groups provides patient input and guides the design of a truly patient-centered facility. In order to best meet the needs of patients, focus groups should be used to identify what is of critical importance to them in the design.

Designing hospitals to be comfortable and accessible benefits more than just patient-satisfaction rates. This approach to design helps make patients partners in their care, and high levels of patient engagement make them more likely to follow up with their doctors, continue their medication and maintain healthy living practices, which also provide quantifiable outcome results. Additionally, this methodology allows hospitals to be designed with maximum adaptability and flexibility in mind, to accommodate changes and provide for future growth. Another benefit for the health care facility is that by listening to both patients and staff and applying their feedback into the design helps in both recruiting and staff retention.

Looking at New Orleans

After Hurricane Katrina devastated New Orleans and destroyed the previous VA medical center there, national architectural firm NBBJ collaborated on the Southeast Louisiana Veterans Health Care System Replacement Medical Center with two local New Orleans firms, Eskew+Dumez+Ripple and Rozas Ward Architects. Together, the team set out to design a new four-story, 1.6 million-square-foot campus to serve more than 70,000 veterans in a 23-parish catchment area and across the Gulf Coast with an anticipated 550,000 annual visits. Building from the ground up gave everyone the opportunity to reimagine what a veterans hospital should be.

To begin figuring out this specialized patient population and its health care needs, the design team engaged experts in other domains, including a quantitative psychologist/industrial designer with a focus in disability studies and a clinical psychologist. The architects and the client also recruited veterans as research participants, including men and women of different age groups and backgrounds, such as homeless veterans, those who lived through the trauma of Hurricane Katrina, 20-somethings who had served in Iraq and Afghanistan, and 80-year-olds who fought in World War II.

Overall, the research effort included more than 100 veterans, 180 VA hospital staff from Louisiana (many of whom are veterans themselves), 70 hours of observation and 600 pages of notes. From these immersive and interactive activities, the design team distilled several major insights that informed the design priorities of the project, which continued through the end of 2011.

Challenges & Unique Construction Requirements

A major challenge was designing the facility to withstand potential future natural disasters. Designed and constructed for maximum resiliency, the medical center can remain fully operational during a major storm or natural disaster. The plan quite literally overturns the conventional organization of hospitals, moving the emergency room and essential utilities above the 20-foot flood line and filling lower levels with less mission-critical features.

The design and construction also had to meet the VA’s antiterrorism security requirements. The shatterproof-glass façade does double-duty by protecting occupants from the impact of an explosion or the 129 mph winds of a Category 3 hurricane. This facility blazes a new trail in terms of how to create a resilient facility and how to integrate that with the VA standards for physical security.

Stay tuned for Part II of this article by Barbara Wagner, senior vice president with Clark Construction Group – California, based in Irvine, Calif.

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The facility was constructed by Clark/McCarthy Healthcare Partners (CMHP) — a joint venture of the two national firms, Clark Construction Group LLC and McCarthy Building Companies Inc. — in partnership with local companies Landis Construction and Woodward Design+Build. The project’s lead architect was Studio NOVA, a joint venture between San Francisco-based NBBJ and locally based Eskew+Dumez+Ripple and Rozas Ward Architects.

Part of an expanding medical district, the facility is located on a 34-acre campus adjacent to the new University Medical Center New Orleans, Louisiana State University Health Science Center and Tulane Medical Center. The veterans medical center alone makes up a unified nine-building campus that includes the restored Pan-American Life building, which serves as the U.S. Department of Veterans Affairs’ (VA) administration building as well as a new diagnostic and treatment building, inpatient building, outpatient building, transitional living facility, central energy plant, patient parking garage and staff parking garage. Later this year, the CMHP team will complete construction of the ninth building, a new research building being constructed as part of the historic Dixie Brewery building.

The complex is organized around a central concourse that links atriums opening into large program blocks subdivided into smaller buildings, according to a statement. These are separated by green courtyards designed to have the same look and feel of the French Quarter. In total, the veterans medical center houses 200 inpatient beds, 370 outpatient exam rooms, 21 procedural suites, eight operating rooms, adulatory clinics, emergency and imaging departments mental health services, patient education facilities and outpatient rehabilitation services. It also features smart classrooms and conference rooms that are updated with the latest technologies such as integrated cameras in the operating rooms and robotic surgery.

To prevent future natural disasters from affecting the facility, it is designed to remain fully operational during a major storm and contains enough provisions and accommodations for up to 1,000 staff and patients for five days, according to a statement. Plus, critical health care functions are located at least 21 feet above the base flood elevation. The campus also includes an emergency transport heliport and boat dock.

“Our team applied lessons learned from Hurricane Katrina to create a resilient hospital infrastructure with an efficient, patient-centered design that will serve up to 70,000 veterans from throughout the region,” said Steve Maslen, project executive of CMHP, in a statement.

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“We are excited to be able to begin this next phase as it means that we are getting that much closer to this project becoming a reality,” said Scott H. Perra, president/CEO of MVHS in a statement. “Both companies have extensive local and international experience, with projects in New York and around the United States as well as in many cities abroad. The companies are committed to working with our local businesses whenever possible to complete the project.”
NBBJ and Turner have extensive experience working together and have completed more than $2.6 billion in projects, many which have focused on health care.

Planning for the hospital, which will be located in downtown Utica, began back in 2014. The new hospital was originally set to be an 830,000-square-foot facility at a cost of $573 million. However, the new cost projection is $480 million for a 750,000-square-foot facility.

“Planning a project of this magnitude occurs in several stages over the course of years,” said Perra, in a statement. “In late 2014, we developed estimates based upon preliminary design concepts. We continue to perform studies and evaluations to further refine the project as we advance through the phases of the development process.”
In addition, the original concept included 430 inpatient beds, while now the revised plan calls for 400 beds.

The project will also include a 24-bed in-patient “shell” that could be finished and used at a later time, if needed, according to an article by local news outlet WBIX. That decision alone saves more than 15,000 square feet of new construction and adds to the overall savings, according to WBIX.

MVHS will be involving the community throughout the design and construction process since it will impact those in surrounding areas. A completion date has not yet been set but project team members and MVHS will update the public as plans progress.

For more information about on project, visit MVHS’ website.

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