It would be reasonable to assume that increased use of glass and daylighting in healthcare facilities these days would have a major impact on MEP calculations and design. However, SSR's Jonas McBride notes that “today's high-tech, high-efficiency glass usually exceeds the energy code and has virtually no impact on MEP.” McBride's architectural teammate on the SAMMC project, RTKL's Barger, agrees, noting that the U.S. Army clients preferred a glass façade for the new expansion rather than replicating the brick structure, with deeply inset windows of the 1992 parent structure. RTKL Lead Designer Eurico Francisco explains, “The use of glass allowed for a lighter, more welcoming expression of the architecture. In addition, our clients were aware that the more glass and natural light you have in a facility, the faster the healing process. Although you still have to be cognizant of building orientation and the need to minimize heat gain, modern glass technology has addressed issues that concern MEP design.”
One feature of the new Army medical center has pushed MEP design in an unconventional direction, notes Barger: “a continual interstitial level throughout each floor (figure 3). This is something virtually unheard of in private construction because of initial costs.” Explains RTKL Project Manager Alan Sneed, “The MEP interstitial space has approximately six to seven feet of clear space and typically allows for nine-foot ceilings in the occupied spaces below. Sandwiched in between the two is a separate zone for lighting fixtures, air diffusers and cabling. The building is 19.5 feet floor to floor altogether.” The great advantage of this? “It adds a great deal to the long-term flexibility and adaptability of the structure,” says Barger. “It allows for ready adaptation of new technologies and for important upgrades over time without ever disrupting patient care.”
The floor-to-floor height of SAMMC is 19.5 feet, with a nine-foot lay-in ceiling below the seven-foot interstitial building space. Without this space, future MEP maintenance or renovation projects would require disruptions to patient care as workers would have to access the plenum through the ceilings of clinical areas
Addressing private clients' cost reservations, SSR's McBride says “our government client had a certain design philosophy and wanted interstitial space that would be clean and flexible without intruding in the sterile environment below”-especially important as the medical center is heavily involved in burn care. Though it indeed added costs-the designers' current estimate is at about $50/sq. ft.-Barger notes that “we had the building structure to support this, and it resulted in approximately three to four feet of additional skin per floor.”
One feature of the new Army medical center has pushed MEP design in an unconventional direction…
In whichever direction future MEP design proceeds-more flexible interstitial areas, more tightly designed plenums or right-sized mechanicals-everyone agrees that the overall design process will never be the same. “Folks running hospitals these days are being required more and more to deliver value for the dollar, and they're expecting the same discipline from their project delivery teams,” says Walter P. Moore's Seckinger. Colleague Kurtis Young adds, “Healthcare providers are generally serial builders. They're always starting up new projects while, at the same time, hearkening back to previous projects and looking for ways to improve.
“This is why integrated project delivery (IPD) has found a natural home and momentum in the healthcare field,” Young continues. “We have a ‘perfect storm’ today of LEAN methodology, IPD and BIM all impacting project delivery strategy. We're still in early days, and there are wide disparities in levels of sophistication among clients and lots of education is needed. But we're all being asked to do more with less, and IPD-while no panacea-can be a great tool to help us achieve this. The upside potential has never been greater.” HBIHealthcare Building Ideas 2010 Winter;7(1):18-21