In this HEALTHCARE DESIGN.11 conference preview, Bryan Brinkman of B4 Architects touches on brief points of the design process for the Livingstone Accident & Emergency Unit (A&E) in Port Elizabeth, South Africa. Although the design and construction process of the center was fraught with technical hitches and setbacks, the former design team of Brinkman Ndayi McAll was able to deliver a facility that not only met a tight deadline but also satisfied the needs and desires of a variety of clients for one project.

Brinkman will be presenting the full session, “Accelerated Construction of a State-of-the-Art A&E Unit in South Africa,” from 9 to 10 a.m. on Monday, November 14, 2011, in Bayou E. He shared some of his thoughts with Shandi Matambanadzo, Associate Editor, HEALTHCARE DESIGN magazine.

Tell us about the timeline that you were working with and what needed to be accomplished for the Accident & Emergency Unit at Livingstone Hospital?
Bryan Brinkman:
With South Africa hosting the FIFA 2010 Soccer World Cup, which was due to commence in early June 2010, Port Elizabeth was one of the successful cities which had bid to be a venue for the hosting of eight matches, including a quarter-final and the third-fourth playoff. The city had written into its hosting agreement that it had to provide a new A&E as the condition and capacity of the existing units did not meet FIFA’s minimum standards. When the client appointed the consultant team for the project we had a little over 20 months to design, document,
and construct the project. While initial projections indicated that the project would require 18 months to construct, procedural delays in decision making and procurement ultimately forced the construction program to be reduced to 12.5 months which required that the construction period be accelerated to achieve completion by June 7, 2010.

In designing the unit, what were the key areas of concern?
The key areas of concern was to provide sufficient space for the unit (the existing trauma unit was very cramped), clear and well-defined circulation and relationships between departments and high levels of security (due to previous gang-related violence). Furthermore the client wished that the standard of finishes in the facility raise the bar in terms of the standards prevalent in South African Public health facilities.

Were there any unexpected challenges? How did you overcome them?
There always are in a project. Despite a lot of discussion around development of the brief having taken place during the design phase, there remained differences in opinion between the institution’s staff and senior health departmental officials over the composition of the X-ray suite for the new facility which re-surfaced during construction requiring the addition of another digital X-ray suite when construction of the structure was well advanced. This necessitated some rapid replanning and on-site adjustments to the steel-reinforced concrete structure to accommodate
the changes. The biggest challenge, however, was the late inclusion of a two-bed infectious diseases isolation area which FIFA revealed they also required as part of the facility. This unit was designed and built within five months in time for the tournament.

Some of the things mentioned about the project were the high standards in energy efficiency, durability of finishes, best practices, and budget adherence? Can you expand on that a little, especially the energy efficiency?
A key requirement of the master planning proposal, which had been underway for Livingstone Hospital prior to the design of the new A&E, was identification of best practicesboth in terms of finishes and energy efficiency models. The consultant team spent four months during the master planning conducting research, visits to precedents and presentations to the client and implementing agent (Department of Public Works) which culminated in various standards being agreed to. Regarding energy efficiency care was taken with orientation of the building and it›s components to limit solar heat gain while the electrical systems prioritized energy-efficient lighting with sensordriven activation. While the overall mechanical design intends to utilize various heat recovery systems to pre-heat hot water supply and limit energy wastage through heat loss, some of the components of this are to be installed in a later phase.

Can you give brief highlights as to what HCD.11 attendees can expect to hear at the conference?
The presentation will outline the background to the project, the design process, and an overview of the construction and the consultant-contractor relationship in order to ensure that the construction proceeded with the minimum of delays. There will also be a photographic overview of the completed facility with commentary of original decisions made based on reviewing usage a year later, including review of certain assumptions made by both the client and design team in light of actual occupation practices.

For more information, follow the conference Twitter updates at #HCD11 or visit us on Twitter: #HCD11  Follow us on Twitter: #HCD11    F Fl