The hurricanes that swept through Florida in the 1990s, starting with the massive Hurricane Andrew in 1992, were our first warning. But what really started the process for Memorial Regional Hospital in Hollywood, Florida, was a Category 1 hurricane-the least powerful hurricane of all-blowing in windows and tearing off exterior panels in 2005. This was of great concern because not only is this a 690-bed community hospital, operating 24/7, but it is a refuge for hospital staff and their families, as well as some local police. It was obvious that something had to be done to better secure this facility.

Memorial Regional Hospital was actually a combination of several buildings on campus that had been constructed during every decade since the 1950s. Some exteriors were masonry, some were made up of concrete panels, some had metal stud exteriors-there was virtually every building type, and none of it was compliant with current codes.

It turned out that a local dealer for STO, an exterior insulation system using synthetic stucco, had the idea of reinforcing the existing STO product for purposes of hurricane protection. Therefore, the existing hospital could be protected by encapsulating the entire building in EIFS panels using this material. It incorporated three layers of reinforced mesh that added tremendous tensile strength to the material far beyond the typical STO application. Subsequent tests showed that a façade made up of this material could withstand winds of 200 miles-per-hour-a limit that was recorded only because the testing equipment stopped at that number.

What added to the appeal of this material was that the STO application had great flexibility for construction-it could be applied to all the building types that made up the hospital. It could be applied adhesively or mechanically to masonry, fastened by exterior metal studs to concrete panels, or supported by a new metal stud system outside the existing one for metal frame construction.

There were design benefits as well. When completed, the entire building was clad and appeared as a single design element for a more contemporary, upgraded look. Also, the variable thickness of the foam insulation, varying by as much as 6 or 7 inches, allowed for the creation of reveals and other exterior details that added complexity to the design. STO also has a color palette, which enabled us to introduce the hospital's colors, using their blue around the campus with stripes around the parapets and in the hospital's logo.

Window installation was another interesting facet of this project. Working completely from the outside, we installed replacement windows that were just as hurricane-resistant as the curtainwall. Meanwhile, the existing patient room windows were left on the inside, which created a shadow box ledge that patients could use for flowers, photos, or what have you. These inside windows are removed when patient rooms are vacant. By doing this, certain rooms at a time, instead of all at once-there are still rooms where the inside windows haven't been removed yet, but which still look fine because the ledges are finished and were planned for-we've been able to avoid taking entire wings of the hospital off-line. In the medical office building nearby, though, we were able to do this on nights and weekends.

Fortunately, Mother Nature hasn't tested the façade yet-there have been no significant hurricanes in the area since the project was completed. We have done random tests of areas of the façade with water jets, just to make sure, and the system has come through with no problems.

Also important were steps we took to do the construction. We did everything we could to make the process as unobtrusive as possible. Working almost entirely from the outside helped with this, and outside of that work area there was a screen to hide workers from view. Also, workers parked off-site, using a shuttle to the work site, and meals and bathroom facilities were available outside. In general, the workers were kept separate from patients, visitors, and staff, which was highly important. We were still able to upgrade the safety and security of the hospital in a major way. HD

For further information, contact Charles A. Michelson, AIA, LEED AP, Principal, Saltz Michelson Architects, Fort Lauderdale, Florida, at phone 954.266.2700, fax 954.266.2701, e-mail cmichelson@saltzmichelson.com, or visit http://www.saltzmichelson.com.

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Based on an interview with Charles A. Michelson, AIA, LEED AP, Principal, Saltz Michelson Architects, Fort Lauderdale, Florida

Healthcare Design 2009 May;9(5):16-18