MIDVALE, Utah – Pointing to the recent devastations of natural disasters including Hurricane Harvey and Irma, Intermountain Healthcare aims to strengthen Utah’s medical infrastructure in acquiring the supplies it needs to face a natural-disaster at its high-tech 327,000-square-foot fulfillment center in Midvale, while also using features that could earn it a LEED Gold certification. For any business, improving your overall supply chain strategy through cheaper costs, more efficient systems, and better fulfillment rates is important but can be life-saving too in the medical industry.

Construction on what is being called the ‘Kem C. Gardner Supply Chain Center’ prepares the facility for earthquakes and severe winter storms, the two most likely natural-disaster scenarios in Utah. The building has been designed to reach high performance in significant areas of human and environmental health, including sustainable site development, water savings, energy efficiency, materials selection and indoor environmental quality.

According to Gordon Slade, the supply chain logistics director, the Intermountain Supply Chain Center building was designed and built to a seismic importance factor of 7.5 on the Richter scale. It is equipped with plentiful medical equipment to get the needed materials to medical facilities within 48 to 96 hours without the assistance of disaster-response agencies.

The highly automated facility orders, purchases, stocks and distributes about 5,000 different types of medical supplies and medications with up to a 30-day supply on hand. More than 2.5 million medical items pass through the center each year, according to a statement.

“The large 327,000-square-foot building was built as if it were six different buildings all very close together [creating physical decoupling of foundations, floors and walls] to reduce the amount of damage that would otherwise occur in a moderate to strong earthquake,” said Slade. “The building is equipped with backup generators and fuel to run them for 72 hours or longer. There is also a Command Center room to coordinate with our hospitals, local, state and federal officials during a natural disaster event. The center is equipped with emergency communications radios, satellite phone and dedicated analog phone lines.”

Intermountain Healthcare strives to create a reduction in costs by purchasing supplies directly from the manufacturer, handling the delivery of products and streamlining processes. “Reduced supply costs come through the self-distribution model the building provides and includes a very high fill rate and accuracy rate to assure our caregivers have what they need to treat our patients,” said Slade.

There are innate efficiencies being achieved with these improvements such as large bulk purchase volumes, including standardization of supply, cost, quality, and outcome-based product selection and procurement. The overall improved availability of supplies will mitigate overnight shipment costs, improve supplier engagement and relationships, supply-chain efficiency and supply continuity (assuring needed supply at the greatest time of need, information, forecast and usage transparency.) Lastly, it will provide the ability for suppliers to see demand, warehouse automation and a reduction in labor costs as well as a dedicated transportation fleet, creating highly reliable and efficient deliveries.

“While the supply chain center does provide cost savings, its value is in the support of our clinicians and patients for improved quality and outcomes,” said Slade.

The building also has design features that incorporate LEED Gold certification aspects. While the building has not acquired such certification, it features several LEED design elements such as an LED lighting upgrade throughout the entire building, 55 kW solar panel array on the roof top, electric pool car with charging stations, direct access to public transportation and the light rail located at the corner of the campus, being built on land reclaimed from an EPA superfund cleanup site, an interior designed for daylight harvesting, xeriscape landscaping and recycled materials during construction.

The mainly automated center employs approximately more than 50 workers, according to a statement. Peggy Lee, a communications executive for Intermountain HealthCare’s supply chain operations, explained that the organization also equips distribution employees with the proficiency to maintain all of the center’s services, even if the robotics break down in the event of a disaster.

“We have this beautiful automation, and people [balance] to ensure we would be fully operational [in the event of a natural disaster],” Lee said.

The close proximity of the supply center to both Intermountain Healthcare facilities and traffic arteries will ultimately bolster medical workers in the event of an emergency, and will set a model for other centers to develop highly prepared storage and relief centers for their communities.

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McGatha and his team examined various roofing materials that would help achieve certification objectives and decided on cool roof materials – highly reflective materials that stay cooler in the summer sun compared to traditional roofs. These kinds of materials can be installed by many firms, including Daniel Nicholas Roofing, and can also help reduce energy costs, improve occupant comfort, cut maintenance costs, increase the life of the roof and contribute to the reduction of the heat-island effect.

PVC, TPO and Cool-Metal Roofing

McGatha and his team worked with a local Duro-Last representative to choose a white, 40 mil PVC sheet ASTM D4434, Type IV, fabric-reinforced membrane, ideal for flat and low-sloped roofs.

PVC has been around for awhile, McGatha says. Modern PVC materials are shown to have no negative environmental qualities. Half of the materials come from recycled components. Its a good product and has durability.

PVC materials arent the only cool roof materials available on the market that are ideal for flat, low-sloped roofs and used by TrueWorks Roof Repair and other roofing services. At Kaiser Permanentes new Modesto Medical Center in Modesto, Calif., building designers opted for Firestone Ultra Ply TPO (thermoplastic polyolefin) .060 membrane.

Rather than following LEED-certification guidance in their selection of roofing materials, the planners used the Green Guide for Health Care a self-certifying tool for healthy and sustainable building design, construction and operations written specifically for healthcare organizations.

The healthcare provider has installed more than 100 acres of TPO material on rooftops at its various facilities, according to Tom Cooper, national manager of sustainable building design and research with Kaiser.

It became Kaiser Permanentes design standard eight years ago, Cooper says.

Metal roofing materials, where the secret to achieving coolness and energy efficiency is in the materials reflective coatings, can be paint or granular systems.

There is a misconception that metal isnt cool, but when were talking about cool metal roofs, were usually talking about a family of different products like steel, copper, aluminum and zinc and different solar-reflecting coatings on those materials, says Scott Kriner, president of Green Metal Consulting, who also serves as technical advisor for the Metal Initiative.

Cool metal roofs are ideal for steep-sloped, low-rise buildings with small wall surfaces that are less than four stories, Kriner says.

In addition to the environmental benefits metal offers, it also has aesthetic benefits with color and texture choice for visible steep-sloped roofs. On high-rise buildings, where the roof is not visible, the metal will likely be flat and in a natural finish or painted white.

Above sheathing ventilation installation techniques, where metal panels can be raised slightly off of the deck to create a chimney effect, can boost some of the energy efficiencies of the roofing material.

Cool Roof Maintenance

A cool roof, regardless of materials used, must be kept clean in order to support the materials ability to reflect solar heat.
Metal roofs can self-clean for the most part, but not entirely. Many people are using metal as roofing on commercial buildings and their own homes because it easy to maintain and very sturdy, to find more information and have a browse at what’s available, check out somewhere like www.aluminiumwarehouse.co.uk. Rainwater runoff on sloped metal roofs can help to remove dirt and debris. Paint coatings and most natural metal surfaces keep mold and mildew away.

With regard to a metal roofs maintenance, it is good practice to inspect the roof and remove things that accumulate on the roof, such as tree branches, leaves or debris, Kriner says. There will also be a continual need to maintain good flow in gutters, downspouts and drains. Its also good to check the caulking, sealants and flashing around penetrations.

Like any other roof, cool roofs can be vulnerable to accidents and foot traffic. Duro-Lasts product literature warns that the roof not be used for storage. Inclement and extreme seasonal weather patterns can also impact maintenance.

There is thermal movement with metal roofing in extreme heat, but concealed clips that fasten to the support structure allow for unimpeded movement of the metal panels, Kriner says.

McGatha and his team at Dayton Childrens took precautions against punctures in the roof membrane by adding walk-off mats for technicians who need to access the roof. They also installed ice guards.

Since the roofs initial installation, facility workers have tweaked the flow of the walk-off mats and added more ice protection.

You have to design your facilitys roof with sensitivities to your specific geography and climate, but its hard to anticipate ice and walking patterns. McGatha says. You cant just [install the roof] and forget about it.

McGatha says the cost of the PVC cool roof at Dayton Childrens Outpatient Care Center was only slightly more than the cost of a traditional roof. He anticipates a return on investment will come from reduced utility expenses and wear and tear on the roofs sub-structure.

From Kaiser Permanentes perspective, installing a TPO cool roof has no impact on first costs, Cooper says. However, the organization has seen a 10 percent savings in energy expenses.

Installation cost estimates can range from $70 to $650 for every 100 square feet of for metal roofs, compared to $110 to $200 for membrane-roof materials, Kriner says. In addition to energy and life cycle cost savings, some states and local municipalities offer cool roof tax rebates and incentives.

Taking Another Direction

Cool roof materials arent necessarily always the right choice for every hospital. Facility layout and design may influence the choice of roofing materials.

Phoenix Childrens Hospital is currently in the midst of an expansion and chose a highly efficient roofing ballast and insulation, instead of cool roof materials, to keep heat gain at a minimum.

Cool roofs are typically, if not always, comprised of a high-reflective paint or reflective materials the idea being that they reflect the sun/heat away from the building, says Dave Cottle, executive director of planning design and construction for the hospital. The use of such materials on the lower level roofs of our facility would reflect up into patient rooms and increase the heat gain into the rooms. On the higher roofs, there are safety issues, because it would reflect into the flight path of helicopters trying to land on the helipad.

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