Engineering Inc. - September/October 2008 - 26

A Model Hospital One of the most design-conscious hospitals in the world is Rikshospitalet University Hospital in Oslo, norway. The $500 million, 1.4 million-square-foot facility with 585 beds has emerged as a model for much of the world. It includes skylights, floor-to-ceiling windows, painted glass, soft lighting in place of fluorescents, fountains, art, textiles, gardens and a panoramic view of nearby fjords. a renowned pediatrics and maternity wing includes vibrant colors, a play area and a bed for parents in each child’s room. Waiting rooms include television sets, pianos, computers and game tables. The upshot? Since opening in 2000, Rikshospitalet University Hospital has doubled the number of patients it accommodates (and received superior ratings) while lowering turnover, absentee rates and overall costs. In a 2004 New York Times article, architect arvid Ottar described it as “a humanistic hospital: built by humans for humans.” profitable baby delivery business. By the early 2000s, many hospital executives began to realize that a homespun touch paid dividends. Today, the list of amenities includes comfortable single rooms with nice views, soft lighting, nearby gardens and many of the amenities of home—including wireless Internet access, home theater and entertainment (including high-definition flat-screen televisions), video games and a more diverse and appealing menu. Tony Monk, who specializes in health care design and is the author of the book Hospital Builders, believes that the trend is all about “dollars and sense.” He argues that people who enter a facility are vulnerable and the environment can sometimes make or break their recovery. And there’s growing medical evidence to support the notion. But the evolution of medical facilities also is about creating a better environment for health care workers and stamping out infection. It’s no small matter. The Center for Health Design, a Concord, Calif.–based nonprofit organization that promotes the idea of “healing” hospitals, estimates that capital spending on health care facilities will rise to $25 billion annually in 2010—up from $15 billion in 2006. 26 eNGINeerING INc. september / october 2008 The organization reports that much of the additional outlay for upgraded facilities—typically $12 million for a $240 million, 300-bed facility—is recouped through reduced infection rates and better patient recovery. Researchers also say that better facilities attract top-tier physicians and other health care workers. “It creates a better environment for everyone,” says Mercy’s Gilbert. But turning that concept into reality can sometimes prove daunting. Designing and building a new facility—or retrofitting an existing one—can take years and involves complicated architecture, design, engineering and project management skills. Success requires new ways of thinking and a high level of communication and cooperation among construction partners and subcontractors. “Medical facilities are extremely complex,” explains ACEC Vice Chairman James Duncan, chairman and chief engineer at Seattle-based Sparling, which specializes in hospital construction. “A typical project requires detailed knowledge and expertise in an array of systems and technologies.” The engineering expertise required for health care facilities is among the most challenging in the industry. Hospitals typical project requires detailed knowledge and expertise in an array of systems and technologies. JaMES DUnCan SPaRLInG A require tight integration among a variety of systems—including electrical, lighting, computer networking, voice communication, HVAC and medical equipment. “It’s no longer feasible to operate each system using separate wiring or cabling,” Duncan says. “Space planning and design elements must enter the process from the very beginning and influence a project throughout the planning and construction phase.” Moreover, he says, designers must create adequate spaces and pathways for future equipment—including information technology (IT) systems. And those subtle differences can make or break a contract. Sparling typically works with clients to identify the focal points for projects. Like most companies providing design or engineering services, it increasingly relies on Building Information Modeling (BIM) software to fully explore options. “3-D drawing development is becoming common,” adds Grant Schmidt, senior engineer and market segment leader for health care at KJWW Engineering Consultants in Rock Island, Ill. “It is an important tool in understanding the scope of a project and conducting what-if scenarios. It helps an organization minimize the price of construction and avoid excessive change orders.” Valoree Eikinas, principal and director of building systems for Raleigh, N.C.–based Mulkey Inc., says her firm does not yet see a critical demand for BIM in the health facilities sector, but clients do expect firms to work quickly and design with an eye toward the future. “The ability to design at a fast pace and design in future expectations is key in the health care field,” she says. “Hospitals exist for many years and evolve rapidly as technologies evolve. The engineering team needs to be able to design systems capable of evolving with them.” Trading Spaces The trend to rethink the notion of hospital space—as well as patient rooms—is gaining steam the world over. Health care facilities in North America, Europe and beyond are looking to make hospitals feel and look more like home. Driving the trend is the

Engineering Inc. - September/October 2008

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