Healthcare Design - March 2021 - 30

In Focus

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of building new against organizational needs.
Ultimately, this process showed that through
modernization, the hospital could get nearly
everything it wanted at about half the cost of
building new.
Moving forward, the team used a phased approach to keep some existing buildings while
adding new structures. EYP developed a tool
to walk hospital management and contractors
through each of the 34 phases and outlined a
plan to keep the hospital operating while renovations took place. One of the first steps was to
free space on and around the site to make room
for the renovation work, resulting in a new
parking deck built across from the hospital and
staff offices consolidated and relocated. Additionally, the lab was moved to create room for
a new main lobby. After the new expansion was
built, the intensive care unit and some of the
dining spaces were moved into the new tower
during renovations.
Throughout the construction process, the
team was cautious about what was being shut
down to ensure the hospital remained fully operational. EYP updated the phasing plan every
week with an eye on user experience and adjusted the schedule in response to cost savings,
program changes, unforeseen conditions such
as weather events, etc. At times, the pandemic
caused delays of equipment delivery and labor
because no one could come onto the site, also
creating the need to revise the timeline.

standards might be the best solution. If the organization is reacting to
growing volumes and needs to expand beyond the capacity of its current
site, then a new building may better suit its needs.
EXISTING CONDITIONS

If a phased renovation is chosen, the next step is a systematic and thorough documentation of existing structures by the entire design team. This
process will provide a deeper understanding of how an organization uses
its current buildings, how the facility can operate during construction,
and what's needed to support future care needs.
An assessment of the existing facility should include an in-depth analysis by engineers of mechanical, electrical, plumbing, fire protection, and
energy-efficiency systems. For example, this process should evaluate if
the central utility plant needs an upgrade to support the renovation. During the discovery phase, it's essential for the project team to physically go
into the building to document the space. Even during COVID-19, when
visitations are restricted, this process can be feasible by limiting staff; visiting during off-hours, nights, and weekends; and using safety protocols
such as wearing personal protective gear. Technology can also aid this
process. For example, using 360-degree image-capture technology, the
team can take a complete image of the facility that can be referenced at
any time throughout the project, reducing the need for additional facility
visits and the amount of time spent in the building.
The full project team should also be involved in building documentation and assessment to understand the facility's current workings as well
as compare notes, point out issues, and identify areas of concern. Existing
materials are also evaluated to determine what's outdated and needs replacement. For projects involving a construction manager (CM) as constructor or CM at risk, it's advantageous to bring that member on board
during the discovery phase to provide insight into constructability issues.
It's also crucial to understand how the current building works within
the context of the campus and surrounding areas, such as parking structures and emergency department accessibility.
Another important step is conducting a master plan exercise with the
owner to outline existing and projected patient volumes and services. It
can be helpful to do a comparative analysis of peer organizations, as well.
The process analyzes what the organization has today, compared with its
goals and industry best practices. Years later, leaders can come back to the
report to ask if goals were met and better understand where to go next.

SHARED VISION

The critical decisions that hospital owners contemplate-how to stay competitive, maintain
compliance with updated regulations, and rise
to current standards of care and safety-can
all be met by modernizing an existing hospital. However, making the decision to pursue a
renovation in place of building new requires a
strong partnership between the design professionals and contractor, and a deep understanding of the building and the organization. All
team members must be on board with the plan
and work collaboratively to address issues that
inevitably surface to achieve a shared vision for
a new project. 

C A S E S T U D Y: C H I L D R E N ' S H O S P I TA L N E W O R L E A N S

Children's Hospital New Orleans is undergoing a 400,000-square-foot
expansion and renovation within a 600,000-square-foot combined inpatient and outpatient facility. The multiphased modernization project,
currently under construction and expected to be completed by fall 2021,
will take approximately seven years, from master planning to completion, incorporating 34 distinct phases. During modernization, the hospital will remain fully operational.
EYP Architecture & Engineering was hired in 2015 and worked closely
with the hospital's management team-and in collaboration with the
community, clinicians, and CM at risk-to evaluate the existing structures and develop a thorough understanding of hospital operations and
aspirations. Early consideration was to build an entirely new building. A
basic conceptual massing study and visualization renderings were conducted to get an idea of what the new building would look like, as well as
provide a cost estimate based on square footage and the pros and cons

MARCH 2021

David A. Deis, AIA, LEED AP, is managing principal
and senior project director at EYP Architecture & Engineering (Atlanta). He can be reached at D D E I S @
E Y P A E . C O M . Matthew Chalifoux, FAIA, is senior historic preservation architect and senior principal at EYP
Architecture & Engineering (Washington, D.C.). He
can be reached at M C H A L I F O U X @ E Y P A E . C O M .

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Healthcare Design - March 2021

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