This Issue

Healing Hospitals

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By Mary Grauerholz

HDR Inc. designs an Army Medical Center with sustainability and wellness in mind.

The global architectural firm HDR Inc. was in the middle of designing a new military hospital in Fort Belvoir, Virginia, in 2007 when news broke about substandard conditions at Walter Reed Army Medical Center. The news that some of the U.S. Army’s wounded veterans were being treated in a moldering, dilapidated setting launched an investigation and a directive from Congress that both hospitals be transformed into “world-class medical facilities.”

“We were right in the middle of the design process with the Department of Defense on Fort Belvoir. It was quite a firestorm, a tumultuous time,” says Jeff Getty, RA, LEED AP, an architect in HDR’s Arlington, Virginia, office.

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When combined with environmental and financial benefits, the SROI net present value of HEPA filtration and hydrogen peroxide vapor cleaning increases the total benefits to roughly $38 million and $121 million, respectively.

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Top: Jeff Getty,. lead design architect of the Fort Bliss Hospital Replacement. Middle: Mark Meaders, sustainability manager for HDR. Bottom: Erin McMillan, HDR project architect.

While conditions at the Walter Reed facility, then located in Washington, D.C., developed into a scandal, there was a very positive result that would direct the design of military hospitals going forward.

“It certainly awakened a lot of people in the Department of Defense to a lot of things they weren’t cognizant of,” Getty says. “There’s a great sensitivity now to treating these folks [wounded soldiers] with great care.”

Today Getty is the lead design architect of the Fort Bliss Hospital Replacement, a $1 billion project that will replace the current hospital, the William Beaumont Army Medical Center at Fort Bliss. The new medical center, in El Paso, Texas, will embrace the highest principles of healthcare architecture: a patient-centered, world-class complex that incorporates U.S. Green Building Council (USGBC) Leadership in Energy and Environmental Design (LEED) guidelines and evidence-based design (EBD), as well as a Sustainable Return on Investment (SROI) philosophy. An original HDR concept, SROI estimates the value of a project by assigning a monetary value to every cost and benefit, including economic, social, and environmental.

By weighing the effect of every aspect of military hospitals on patients, their families, medical staff, and the environment, the Fort Bliss facility will be a paragon of healthcare settings for treating active soldiers, veterans, and their families. Scheduled to open in 2018, the hospital will showcase sustainability, smart technology, and energy-saving features in a visually comforting, patient-centered setting.

In summer 2018, HDR plans to apply for LEED Silver certification in two areas: LEED for Healthcare for the center’s hospital and clinic, and LEED for New Construction for ancillary structures, such as the administration building and the central utility plant.

Mark Meaders, LEED AP BD+C, a sustainability manager in HDR’s Dallas office, says that HDR’s effort toward sustainability and design—putting people and the planet first—is based on a simple but hard-hitting mantra: “Our resources are not infinite. With the exception of the sun’s energy and wind, they are finite.”

Meaders is leading the Fort Bliss project’s sustainability efforts for HDR, an award-winning global firm with roughly 1,500 employees. HDR has examined countless components that will create a state-of-the-art Fort Bliss medical facility, featuring 127 inpatient rooms with smart room technology and plenty of natural light.

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The goal of HDR’s Fort Bliss project team is to design a world-class medical facility in support of our veterans and their families.

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HDR employed a leading-edge strategy to identify products with reduced toxins for the project, helping to avoid toxic chemicals such as heavy metals, phthalates, and perfluorinated compounds. The principle of material transparency—requesting that building product manufacturers disclose the materials in their products—provided a great assist.

“HDR, as well as many design firms, is placing a big focus on health and wellness, material transparency, and minimizing, or eliminating, chemicals of concern,” Meaders says. Options are much more plentiful today, he adds, than when the design started in 2010.

HDR’s holistic approach is focusing on sustainable building materials with recycled content and certified wood, and materials from regional sources. Many inpatient rooms will be equipped with ceiling-mounted lifts and rubber flooring, to ease physical stress for patients and medical staff. Inpatient rooms will be cleaned with a hydrogen peroxide vapor system to eliminate pathogens like the MRSA bacteria, avoiding the use of toxic cleaners.

Energy-efficient measures will be featured throughout, including high-efficiency centrifugal chillers with variable speed drives, and passive energy reduction through reflective roofing systems and shading devices on exterior windows.

Another exciting component is the addition of eight simulation labs, including an operating room, and seven classrooms, all aiding in research and staff education. “Research is part of world-class design,” says Erin McMillan, an HDR project architect who has been helping to execute Getty’s vision. “The simulation areas will show whether a premise of design actually panned out.”

The U.S. Armed Forces has been a significant partner in making strides for sustainability and patient-centered care in a truly world-class setting, Meaders says. “The military has a big focus on energy and water efficiency and independence, resiliency, climate impacts on design, and other factors,” he says. “I believe this project is an excellent example of such efforts.”

Locating technology, materials, and other strategies that are cost competitive—one aspect of SROI—is imperative, Meaders says. But the SROI concept goes much further to determine the real cost of each part. SROI analysis converts to dollars all relevant incremental social, environmental, and financial impacts of a structure, including air and water quality, waste reduction, and human health, as well as financial impact (such as the cost of labor).

“All the analysis that went into the SROI measures was unique and forward-thinking,” Meaders says. “I have not worked on another project that has performed that level of analysis.”

A geothermal energy system was not pursued after a 6,000-ft test well showed the water was not hot enough for the planned system. Likewise, a plan for a reclamation plant to clean wastewater for irrigation and other nondrinking uses also was not feasible.

Grounds will be planted with natural grasses and indigenous plants, instead of a traditional grass lawn, creating a beautiful desert landscape under a breathtaking open sky. Drought-resistant trees will dot the site, measuring more than 16 million square feet, as well as native shrubs, perennials, and succulents.

Two overarching goals have guided the project, Getty says. “The first one is to improve the lives of patients to make better outcomes and better care,” he says. “The second is to improve staff satisfaction and health. It’s all about caring for patients and staff.” Inherent in that philosophy is, Getty adds, “being a responsible steward of environmental concerns and protecting resources.”

Meaders concurs that the environment must take center stage in the Fort Bliss project. “It is our duty and responsibility to manage and conserve natural resources for future generations,” he says. “It is also our responsibility to leave the Earth a better place than when we got it from our parents and grandparents.”