SAN FRANCISCO—Sutter Health has just announced, as part of its long-term vision to expand services and increase patient access to high-quality care in San Francisco, a $442 million investment in the Mission Bernal neighborhood. Sutter will engage community support as part of building a new, five-story, 129,000-square-foot comprehensive advanced neurological and neurosurgical care complex adjacent to its existing CPMC Mission Bernal Campus hospital at the corner of Caesar Chavez and Valencia streets. The new care complex, planned in partnership with Sutter’s West Bay Medical Group physicians, will officially welcome patients in 2028. This is the first project in Sutter’s larger planned growth strategy for San Francisco over the next five years, which, when combined, will result in nearly a billion dollars in investment dollars across the city.

Mission Bernal Care Complex

The new Mission Bernal Care Complex, built on the site of the former St. Luke’s Hospital, will serve as an advanced, multi-specialty center for comprehensive neurological and neurosurgical care. Services will initially include neurology and neurosurgery as well as high-demand services such as lab, imaging, infusion, rehabilitation and an on-site ambulatory surgery center. Patients will also have access to the latest research and clinical trials. Sutter’s nationally recognized Ray Dolby Brain Health Center and Forbes Norris MDA/ALS Research and Treatment Center will move to the new complex to build on the great work and impact of both centers and organize similar services to better meet patient needs and foster collaboration among clinicians. The care complex will also include underground parking.

“Sutter Health is doubling down on its commitment to make significant investments that greatly expand access to advanced specialty care to meet the care needs of San Francisco residents and the entire Bay Area,” said Warner Thomas, president and CEO of Sutter Health. “We’re proud to invest more than $440 million in the community, planned in partnership with our physician colleagues, to deliver comprehensive neurological and neurosurgical care, notable specialized programs, and all support, diagnostic and ambulatory surgery services in this new state-of-the-art care complex.”

“Our goal is to provide coordinated, comprehensive access to integrated care that merges the expertise of neurologists — who specialize in diagnosis and treatment — with the skill of neurosurgeons and other providers who perform therapeutic procedures. The Mission Bernal Care Complex will create more access to care for patients with neurological conditions and provide them the opportunity to take advantage of Sutter’s award-winning neuroscience treatment and clinical research,” said Dr. Lewis Leng, a neurosurgeon with Sutter West Bay Medical Group.

“Patients will be able to come to this location and visit their specialist, receive diagnostic lab and imaging, as well as outpatient procedures all in one complex. Having all these services under one roof and being able to provide advanced, comprehensive care for patients and their families will create a more convenient, coordinated experience,” said Christina Oh, president of Sutter’s Greater San Francisco Market.

CPMC Mission Bernal Campus Hospital

As part of its long-term vision, Sutter also plans to add two neurological intervention suites to the CPMC Mission Bernal Campus hospital by 2027 to complement the range of specialty care available next door at the new Mission Bernal Care Complex when it is completed. These neurological intervention suites will offer patients the most advanced imaging capabilities available and enable fast detection of stroke and the minimally invasive treatment of life-threatening blockages, aneurysms or blood clots in the brain when time is critical.

Primary Care and Women’s Services Expansion

Finally, Sutter will expand primary care and women’s care services on the Mission Bernal Campus at the Monteagle building (1580 Valencia St.). The space will be remodeled to create a modern, comfortable care environment for patients, including new space for primary care and women’s OB/GYN clinics. Other services currently provided, which will remain at the location, include cardiology, endocrinology, general surgery, orthopedics, podiatry and pediatrics (Mission Neighborhood Clinic). These services ensure a convenient and seamless health care experience for patients and allow for coordination and collaboration among doctors and across care teams. The remodeled space is projected to open to patients in the summer of 2025.

“Sutter has a comprehensive plan to expand our services in San Francisco and our investment in the Mission Bernal neighborhood is vital to ensuring people in this area have increased access to leading-edge health care provided by top-notch physicians,” said Dr. Rob Nordgren, chief medical officer of Sutter’s Greater San Francisco Market. “To achieve this, we also plan to increase the number of physicians and care providers to serve our patients. It’s all about access and reducing wait times for people wanting to make an appointment to see a specialist. Being able to provide more primary care access is key to our future success and our goal is to grow from 40 primary care providers in San Francisco today to 100 by 2030.”

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SAN JOSE, Calif.—Skanska recently completed Sutter Health’s Samaritan Court Ambulatory Care and Surgery Center (Samaritan Court), a three-story, 69,000-square-foot medical office building that allows the client, Sutter Health, to offer patient access to more convenient, affordable and connected care across the region.

The project’s completion continues Skanska and Sutter Health’s enduring working relationship and further cements the construction firm as a leading provider of healthcare projects throughout the region, and beyond. In addition to leveraging several innovative construction tactics, Samaritan Court marks the first instance in which a general contractor collaborated with all trade partners (mechanical, electrical, plumbing, framing and drywall) on layout strategy and responsibilities simultaneously, done via the use of Dusty Robotics, delivering the project nearly three months ahead of schedule at a cost savings of approximately $3 million for the client.

Located near the border of San Jose and Los Gatos in Santa Clara County, Samaritan Court brings together 34 physicians within Palo Alto Medical Foundation from 12 medical specialties, along with a clinical lab, imaging suite and an ambulatory surgery center, designed to make care more convenient and affordable for patients and providers. The completion of Samaritan Court is a key part of the client’s broader plan to build more than two dozen ambulatory care centers across Northern California over the next four years.

Despite significant project challenges including the COVID-19 pandemic and supply chain delays, Skanska leveraged innovative construction technologies such as the use of Dusty Robotics, virtual punch list, and Takt Planning, to relay efficiencies to all project partners, including the architect/designers, owner, trade partners, and equipment specialists, delivering the project nearly three months ahead of schedule at a cost savings of nearly $3 million for the client. The team used an integrated form of agreement (IFOA), which, throughout the pandemic, helped stimulate creative ideas and planning remotely.

To ensure the project was delivered ahead of schedule, the team focused on rework to determine where improvements could be made to cut rework in half in comparison to projects of similar size and complexity, implementing major changes to the traditional project delivery process. In the goal-setting stage, the project team determined the average number of punch list items on similar projects that could be used as a baseline for measuring rework. The team analyzed historical data from comparative healthcare projects and found the typical project averaged 250 punch list items per 10,000 square feet. Using this metric, the Samaritan Court team altered the process by starting punch list activities during the design and preconstruction phases rather than in the closeout phase when work has been put in place.

Over three hundred conditions were resolved in two months, not counting the many conditions that would have been repeated multiple times. Based on historical data, these items would have caused a delay of up to 30 days and cost more than $100,000 to resolve.

The virtual punch list allowed each stakeholder to review final conditions—furniture, casework and equipment placement, ADA clearances, device and outlet alignment, utility connections and item placements that would require unique finish details—in the building model, ultimately allowing the team to achieve its goal of cutting rework by 50 percent on the project.

Skanska worked extensively with all trade partners specializing in mechanical, electrical, plumbing, framing and drywall, to facilitate a combined layout plan in a first-of-its-kind collaboration and implementation of Dusty Robotics, which offers robot-powered tools to save time and improve results through BIM-driven layouts. Once layout work was complete, a single file was uploaded to Dusty Robotics where a 2-D draft is processed and printed onto the floor. Skanska’s work provided a faster, more accurate and clearer layout that all trade teams could utilize, working together simultaneously to further reduce field errors and relaying an added benefit of time and cost savings to the client team.

Additionally, the project team leveraged the use of Takt Planning, and set an aggressive goal to learn and implement related strategies to have a single schedule for all project partners, including the architecture/design team, owner, trade partners and equipment specialists.

The design team, Boulder Associates, brought the client’s vision to life for a warm, timeless, easy-to-maintain, and inviting space by incorporating warm woods, recessed modern lighting, natural stone and visually stimulating wayfinding graphics into the project’s interior design.

Samaritan Court boasts strong wayfinding throughout the building with local flora and fauna elemental themes assigned to each floor, such as water, pebbles and trees. In collaboration with signage and art consultants, the team added a breakdown of natural elements to assign to each medical practice in the form of graphics, aimed to create an intuitive and self-sufficient overall feeling and orientation in the building for both patients and staff.

Key operational and planning considerations for the design focus on providing patient-centered care by aligning the care model and technology with the built and natural environments to achieve the best outcomes for end users.

Elemental design highlights included:

• Designing the building to have a single entry/exit for patients, promoting clear wayfinding.
• Centralizing reception areas for upper floors at the patient entry points.
• Centralizing waiting spaces on upper floors to allow a variety of clinical services to share seating and maximize efficiency for staff movement.
• Localizing departments to achieve the greatest operational efficiency for the best patient care with ease of access to core modalities including Diagnostic Imaging and Laboratory Services.
• Allowing departmental adjacencies to share point-of-care rooms and support spaces between clinic modules and services.
• Locating the surgery center on the first floor for ease of patient access and discharge.
• Orienting patient care and recovery rooms toward pleasant views of the natural environment to encourage patient recovery.

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OAKLAND, Calif.—Architecture firm HED and general contractor Herrero Builders of San Francisco have jointly announced the completion of the South Wing Renovation of the Alta Bates Summit Medical Center hospital campus in the San Francisco Bay city of Oakland. The expansion was necessary due to an ever-increasing population throughout the East Bay and a greater need for MRIs and guest services on the existing campus itself.

The announcement said that HED worked alongside client Sutter Health on a master plan for facilities management that required seismic upgrades in the earthquake-prone Bay Area and repairs that had been long delayed on crucial maintenance items.

The project entailed 37,000 square feet of renovation to the facility’s ground floor, which was the second in a series of upgrades engaged in as part of the master plan developed by HED for Sutter Health. Unveiled in 2018, the facilities master plan “organized and sequenced” over 70 individual tasks necessary across the medical campus over the next decade.

“As we looked at the varied needs across the campuses, we knew one thing clearly—we never wanted to undergo a renovation project in the same space twice,” Shurid Rahman, project manager with Sutter Health, said in a statement. Rahman added that the healthcare firm’s plan was to “make these renovation disruptions as minimal as possible” while the healthcare facility remained open for business.

The ground-level renovations came with a price tag of $30 million for upgrades to the South Wing of the Alta Bates Campus building. This included an expanded suite specifically for MRIs to address what has been described as a “growing stroke problem” in the East Bay. The new MRI suite replaces a trailer that warehoused the facility’s machine prior to this expansion.

Furthermore, the campus’s food program was updated to be better able to serve a larger contingent of patients and visitors, as well as give staff and visitors and patients an “elevated dining experience.” The old kitchen and cafeteria date from the 1980s and thus were in need of a modern update.

A doctor’s lounge was also added for the hard-working healthcare professionals at the site to have a break area.

“The interior renovation of this building incorporated a complete reconfiguration of uses to adapt to the changing needs of the Sutter Health organization,” Brett Paloutzian, principal of HED, said in a statement. “Through our integrated partnership with Herrero Builders and Sutter Health, we were able to deliver this complex renovation project utilizing LEAN construction principles and met Sutter Health’s goals for the project’s schedule and budget.”

The construction and design firms’ LEAN Integrated Delivery Process was utilized to fashion the doctors’ lounge, cafeteria and MRI suite inside the campus’s most-visited buildings.

In addition to its San Francisco offices, architecture firm HED has other California locations in Los Angeles, Sacramento and San Diego. Herrera Builders opened in San Francisco in 1955, and its portfolio includes seismic upgrades, tenant improvements and brand-new construction.

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SAN FRANCISCO — A brand-new flagship hospital for Sutter Health — the California Pacific Medical Center (CPMC) — opened its doors to patients in March, serving as a hub for Sutter Health’s inpatient and outpatient services citywide.

The 1,015,000-square-foot hospital encompasses 11 patient floors (plus two-stories of central utility plant located above,) 274-patient beds, 20 labor and delivery rooms, and 418 parking spaces.

The California Pacific Medical Center (CPMC) Van Ness Campus hospital ultimately reimagines what an urban medical center can be, with dynamic architecture that knits the civic realm to 21st century health care and provides a beacon for health and wellness in the city.

Located on a full-city block at the major arterial intersection of Van Ness Avenue and Geary Boulevard in downtown San Francisco, the hospital was designed to enhance the urban fabric as a 12-story contemporary glass, metal and stone tower reflective of the high-rise buildings of the city’s nearby Financial District.

According to Kent Hetherwick, principal and project manager for CPMC Van Ness, SmithGroup, the hospital design offers patients, visitors and staff rich daylighting, expansive views across the city from all patient rooms and a roof-top courtyard garden.

Inside the hospital, each floor is themed to a natural element — earth, flora, water, light and air — with sophisticated finishes, colors and the use of super graphics to reinforce the concept of the floor and help orient people in the building. Lighting design throughout the hospital enhances healing and helps to clarify wayfinding in the large facility.

The new hospital was also built in response to California’s 2030 deadline that all hospitals must be capable of remaining operational after an earthquake. 

To achieve this, the new facility uses two novel approaches to strengthen the structure against seismic vibration: 120 viscous wall dampers absorb vibration without the need for superstructure, the first time this technology has been used in a hospital in North America; and the building’s glass curtainwall uses four-sided structural silicone sealant that is higher performing in a seismic event than a traditional clip-in curtainwall system.

The patient bedside is prioritized in the design as the most meaningful space in a patient-centered environment. 

Each room is designed for bedside care delivery, bringing services like X-ray to the patient in order to increase patient safety, comfort and wellness.

A family zone is integrated into each room with dedicated space for them to participate comfortably in the care of their loved one — in some rooms the banquet couch even converts to a cot for family to stay within the room.

Additionally, each floor has multiple family room spaces for visitors to step away to unplug and relax.

On the fifth-floor birthing center, a large family waiting area overlooks an accessible open-air courtyard garden to provide family members a comfortable place to pass the time while they await the arrival of their newest addition.

Both the comfort and efficacy of staff is another key consideration in the design. Planning of the new hospital sought to improve workflow and enhance patient care by eliminating literal and figurative boundaries between hospital departments.

For example, the adult and pediatric emergency departments share an adjacency with the imaging department to ensure quick and accessible treatment.

As for technological advancements, The Real Time Location System that tracks equipment, assets, patients and key staff members to improve patient safety, streamline staff workflow and eliminate “hunting and gathering” activities, and support equipment preventative maintenance and calibration requirements is incorporated into this facility.

“The electronic wayfinding system that allows patients and visitors to navigate through the building using the digital wayfinding and/or an app on their ‘phone, reducing frustration and improving patient satisfaction,” said Phil Crompton, Principal, Vantage Technologies.

The wireless system which has overtaken wired connections as the primary method for accessing information in the building, providing improved access to electronic medical record data for staff and connections to work and home for patients and loved ones.

The CPMC Van Ness Campus hospital is also designed to achieve LEED Silver certification (which is currently pending review by USGBC as of March 2019), and the sustainable measures employed improve the health and wellness of occupants as well as conserving resources. 

The new hospital uses 14 percent less energy than an average hospital of its size.  All patient rooms receive direct natural daylight, so energy use from lighting is reduced. Further, nearly all of the hospital’s lighting is LED dramatically reducing energy use for lighting.

A 100 percent filtered outside air system enhances the interior air quality while being a lower-energy ventilation system for the hospital. The hospital’s five green roofs total 25,000 sf and are planted with native vegetation that filters rainwater for irrigation, saving 180,000 gallons of drinkable water annually. Low-flow plumbing fixtures are used throughout the hospital to reduce day-to-day water usage.

Abatement and demolition of the former building on the site began in approximately July 2013. An emergency structural shoring contractor came in to ensure the building was fully safe and supported. Shoring and excavation were fully completed approximately November 2014, and construction for the building began in December 2014.  The hospital admitted its first patients on March 2, 2019.

Sutter Health leveraged an integrated project delivery (IPD) for the CPMC Van Ness Campus hospital, with three contract signatories on the Integrated Form of Agreement (IFOA):  the owner, Sutter Health; the architect, SmithGroup; and the general contractor, HerreroBOLDT (a joint venture of Herrero Builders and The Boldt Company).

“There is a sentiment echoed by many project participants that integrated project delivery process was very conducive to this successful project, and I would agree,” said Hetherwick. “This delivery method increases collaboration, bringing together all team members together in a co-located space and under an Integrated Form of Agreement—the client, architect, contractor and risk partners agree pool their profits with the goal of sharing risks and savings.”

Hetherwick continued explaining how this fosters a one-for-all-team attitude to be as efficient as possible and deliver the project with the best value back to the owner.  Everyone is invested in the process and the project’s success, leading to greater collaboration and feedback during design and construction that minimizes unknowns and conflicts and eliminates value engineering after design completion.

“The result is that this project ended with a contingency balance of approximately $20 million to be shared between IFOA members, came in under its original project budget, and was delivered on time,” concluded Hetherwick.

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This project marks one of the first major renovations since the Landmark Medical Center was founded in 1988. The hospital provides health care services for more than 175,000 patients on a yearly basis.

“We are excited to see the completion of this outstanding facility,” said Tony Cavallaro, president of JACA Architects, in a statement. “We are proud to contribute to the overall quality of care provided by the Landmark Cancer Center, and hope that Landmark patients will benefit greatly from the considerations designed within the center.”

To incorporate a more sustainable design, Landmark Medical center replaced an outdated exterior storefront and installed, larger, more heat reflective windows, according to a statement. A new, energy-efficient HVAC system was also installed to heat and cool the building.

Designers also incorporated large windows and used natural light to help facilitate a calmer and more healing environment, according to a statement.

In order to make patients as comfortable as possible during their stay at Landmark, designers included individual lighting controls, video controls and Wi-Fi in each room. Additional accommodations were included for families who are spending the night.

One major challenge JACA faced was developing a design that matched the floor plan of other facilities located on the Rehabilitation Hospital of Rhode Island’s campus. During the design process, architects were able to maintain the majority of the patient room layouts and plumbing features while creating the enough space for different departments in the hospital.

According to a statement from JACA, the project cost over $3 million to build and design and construction began in fall of 2015.

JACA Architects has been involved in large-scale construction projects since 1991. They specialize in designing medical and senior-living facilities as well as health care centers.

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