Resilient Hospital Design in Joplin - Model for the Future?

First it was just a slogan "resilient design" but now we see the first civilian such buildings come online. This NPR story about the rebuilt new Joplin, Missouri hospital now complete is indicative. See also architect's information below:

Klaus Philipsen, FAIA

“This is hallowed land that no longer belongs to Mercy but to the story of Joplin, of residents enduring a massive disaster by coming together to rebuild and move forward, “ We hope new uses of the campus can weave together as sort of a healing quilt for the city.” Gary Pulsipher, president of Mercy Hospital Joplin. 

audio of the NPR story:

The full-on storm hardening done at Joplin added up to about two-and-a-half percent of the total construction cost, or about $12 million. But Guenther says in less storm-prone areas, the job can be done for 1 percent or less.

MELISSA BLOCK, HOST:

For people throughout the Midwest, spring means the start of tornado season. When natural disasters strike, like tornadoes or hurricanes, hospitals have to be able to survive. From member station KCUR in Kansas City, Alex Smith reports on how hospitals are trying to strengthen their defenses against disaster.

ALEX SMITH: Shortly after one of the worst of tornadoes in U.S. history, Joplin, Mo., resident Brandon McCoy described what he saw during the storm.

(SOUNDBITE OF ARCHIVED RECORDING)

BRANDON COY: Standing on the sixth floor, I was trying to help a lady out of some debris. And you look outside and just - everything's gone - everything. And, you know, nobody knew what happened.

SMITH: One-hundred-fifty-eight people died as a result of the massive tornado in May 2011, and the property damage was catastrophic, particularly for St. John's Medical Center.

NORMAN MORGAN: What you're looking at is basically a brick building that's halfway out of the grade right now.

SMITH: Nearly four years later, Norman Morgan of the Dallas-based HKS architecture firm shows off the distinct features of Joplin's new hospital. It's covered in concrete and brick paneling, and many of the windows are built to hold up in 250-mile-per-hour winds. Outside you can see the roof of an underground bunker where the generators and boilers are housed out of the reach of danger.

ROBIN GUENTHER: To also provide essential community services as the most resistant or significant buildings in communities.

SMITH: Robin Guenther is a principal with Perkins and Will architecture firm. She co-authored a recent report for the Department of Health and Human Services describing how hospitals can better withstand natural disasters. She says that in many cases hospitals may need to be rebuilt from scratch, particularly on the coasts where flooding is a risk.

GUENTHER: Those hospitals actually need to be built upside down, meaning all of their key equipment should not be in the basements or undergrounds. It needs to actually be on the roof.

SMITH: The full-on storm hardening done at Joplin added up to about two-and-a-half percent of the total construction cost, or about $12 million. But Guenther says in less storm-prone areas, the job can be done for 1 percent or less. Despite that relatively low cost, prevention is a tough sell.

GUENTHER: We increase the level of strength of a building, wall or roof based on a disaster that causes damage, not before it happens.

RON MARSHALL: Having grown up in Kansas and being a native of Kansas, I think we've all learned to respect the power of tornadoes. And I don't think there's any skepticism that it couldn't happen to any of us.

SMITH: Ron Marshall coordinates hospital preparedness for the Kansas Hospital Association. Here at St. Francis Hospital in Topeka, he says they're focused on improving preparation strategies.

MARSHALL: We'd all love to go out and build a new tornado-safe hospital, but in today's reality of economics and health care, that's unfortunately not easily an option.

SMITH: More pressure for storm-proofing could be coming. Hurricanes Katrina, Sandy and Ike lead to some of the biggest insurance payouts in U.S. history. And worries about future losses may lead insurers to insist on new building requirements. For NPR News, I'm Alex Smith in Kansas City.

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Here some more info about the hospital from the architect's website:

High-impact, laminated glass was incorporated throughout the facility along with protected evacuation routes.

Connected to the hospital by a 450-foot underground tunnel is a 30,000-square-foot central utility plant containing all mechanical, electrical and plumbing systems. To protect critical hospital systems, the utility plant was built halfway below ground to limit exposure to the elements. The generator system will enable the hospital to operate for 96 hours if power is lost. 

From architect's webpage

Demolished in the May 22, 2011, EF-5 tornado – the deadliest tornado in the U.S. since 1947 – the new Mercy Hospital Joplin is set to open its doors to patients on March 22, 2015. The $465 million (total project cost), 205-private room hospital replaces the former St. John’s Mercy Regional Medical Center.

In addition to setting the standard in tornado readiness at the hospital level, the project was completed under budget and in less than half the time it would have taken for a comparable facility.

“From the first few moments after the tornado tore through Joplin, staff from McCarthy and HKS were on the ground to offer immediate assistance,” said McCarthy Building Companies, Inc. President and Chief Operating Officer Scott Wittkop. The team of construction manager McCarthy, architectural firms HKS, Inc. and Archimages, and MEP Engineer Heideman & Associates joined together to assist Mercy in any way necessary.

“It was just the right thing to do,” said Norman Morgan, AIA, HKS principal-in-charge. “This project was meaningful on many levels. It wasn’t only about a facility, it was about people – a community suffering from loss and devastation. Our job was to give them hope – give them back their hospital. This rebuilding effort became part of the healing process for the community.”

After the group assessed the damage, Mercy made a promise to the community to rebuild the hospital by early 2015. With this upcoming opening, the team has delivered on this promise, providing a safe, state-of-the-art healthcare facility for Joplin and the surrounding communities it serves.

The new 890,000-square-foot facility includes a nine-story hospital patient tower and five-story clinic tower. It houses units including medical surgical, critical care, women’s/children’s (labor, delivery, recovery and postpartum rooms), neonatal intensive care, behavioral health and rehab.

Unprecedented Speed
“Speed of delivery was of the utmost importance,” stated Mercy’s John Farnen, executive director of strategic projects. “It took a truly collaborative effort to design and construct this hospital so quickly.”

Ryan Felton, McCarthy project director, explained, “This replacement hospital is opening just 46 months after the tornado hit Joplin, which is approximately half the time you would normally anticipate to plan, design and construct a similarly sized hospital.”

“A standard design schedule is typically eight and a half months,” Morgan said. “To meet the fast-track Mercy Joplin schedule, McCarthy began construction just three months after starting design. We worked as a seamless team with our client located in Joplin and their corporate offices in St. Louis as well as McCarthy and our many consultants. A Revit model allowed us to update changes just in time with the team. And, an astute and nimble client made working through the process efficient as well as rewarding.”

In order to move quickly, Mercy, HKS and McCarthy utilized Building Information Modeling (BIM) to avoid potential issues later in the field. Prefabrication also enabled McCarthy to accelerate the construction. Headwalls and restroom walls for all patient rooms currently built out were constructed in a warehouse and installed later in the construction process.

Safety and Resiliency
As national companies, both HKS and McCarthy had prior experience designing and constructing storm-resistant facilities in coastal regions. The new hospital incorporates many resiliency elements to help withstand another natural disaster and provide a safe environment for patients, staff and visitors.

“The team used lessons learned from the disaster and experience working in coastal regions to design and build a safer, more secure facility,” Morgan said. “For example, we designed protected evacuation routes, incorporated high impact glass and protected critical systems throughout the hospital.”

Critical areas of the hospital, such as the emergency department and intensive care unit, have windows rated to withstand 250 mph winds. High-impact, laminated glass was incorporated throughout the facility along with protected evacuation routes.

Connected to the hospital by a 450-foot underground tunnel is a 30,000-square-foot central utility plant containing all mechanical, electrical and plumbing systems. To protect critical hospital systems, the utility plant was built halfway below ground to limit exposure to the elements. The generator system will enable the hospital to operate for 96 hours if power is lost. To create ease of access to the new hospital, McCarthy also built new entrance ramps, exit ramps and interchanges for the Missouri Department of Transportation, as well as a new road leading up to the facility.

“The new Mercy Hospital Joplin exemplifies teamwork, commitment and innovation,” Felton said. “We are so proud to be able to deliver this world-class facility to the Joplin community. It’s more than just a hospital. This project represents hope, and it has been an honor to be a part of it.”

About HKS, Inc.
HKS is ranked among the top healthcare architectural firms in the world by Modern Healthcare and BD World Architecture. Operating from 26 offices worldwide, HKS focuses on innovative healthcare design, process and delivery. The firm’s award-winning healthcare architecture includes 2,000 unique projects representing 80,000 beds and 184 million square feet. HKS projects have garnered numerous awards and coverage in worldwide publications. The firm’s healthcare specialists are highly respected international speakers.

About McCarthy
McCarthy Building Companies, Inc. has been setting the industry standard in healthcare construction for over a century. Ranked the largest healthcare builder in America by Modern Healthcare, McCarthy has constructed more than 800 significant healthcare facilities and renovated thousands more. McCarthy offers its clients the full range of construction delivery methods – construction management, general contracting, and design/build – whether for one individual project, a sustaining work program or a system-wide facilities program. With national headquarters in St. Louis, McCarthy also has full-service offices in San Diego, Sacramento, San Francisco and San Jose, Calif.; Phoenix; Las Vegas; Albuquerque; Dallas; Houston; Atlanta; Collinsville, Ill. and Kansas City, Kan. McCarthy is 100 percent employee owned.

About Mercy
Mercy is the fifth largest Catholic health care system in the U.S. and serves millions annually. Mercy includes 35 acute care hospitals, four heart hospitals, two children’s hospitals, three rehab hospitals and two orthopedic hospitals, nearly 700 clinic and outpatient facilities, 40,000 co-workers and more than 2,000 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has outreach ministries in Louisiana, Mississippi and Texas.

- See more at: http://www.mccarthy.com/news/2015/03/06/new-mercy-hospital-joplin-opens-in-record-time/#sthash.3jWrKyrv.dpuf

Resilient Hospitals article