- THE MAGAZINE
Come fall, parents across San Diego County will be able to breath easier knowing that, should their children require critical care, they will have available to them a healing oasis unlike any other in the country.
Built by McCarthy Building Companies Inc. and designed by Anshen+Allen, the new $260 million Rady Children’s Hospital Acute Care Pavilion is the first acute care facility in California to meet the rigorous standards for quality and safety mandated by the Office of Statewide Health Planning and Development (OSHPD) while also achieving the level of occupant health and environmental sustainability needed to earn LEED certified status. Construction was completed June 30, 2010 -- 15 days ahead of schedule -- and the facility will be equipped and staffed to receive patients by mid-October.
California’s Seismic Patrol
OSHPD oversight of California hospitals was born of the 1971 Sylmar earthquake in Southern California’s San Fernando Valley. The 6.6 magnitude earthquake caused several hospitals to collapse, endangering the lives of hundreds of patients and hampering the ability to provide emergency care to the injured.
In 1973, the state Legislature passed the Alfred E. Alquist Hospital Seismic Safety Act, and ever since, all hospital construction has been governed by this legislation. The standards not only help enforce patient safety during the earthquake but also ensure that facilities can continue to function and care for the injured afterward. As a result, OSHPD is responsible for overseeing all aspects of construction for general acute care and psychiatric hospitals as well as multistory skilled nursing homes and intermediate care facilities in California.
Construction oversight of OSHPD facilities adds a heightened level of complexity to already complicated healthcare construction projects in California, which is based on the state’s strict criteria for project inspections as well as reviews and approvals of any and all changes of construction materials or methods.
For the Acute Care Pavilion, Rady Children’s Hospital employed an onsite inspector of record and three field inspectors who were bound to the letter of the law. McCarthy had the integral role of working through all construction issues, developing proactive solutions, documenting every discussion and construction activity, and gaining the confidence of OSHPD inspectors, who visited the site three times a week. Not a single detail of the project could afford to be overlooked, from the drilling operation, which involved the installation of individual 60-foot-deep by 8-inch-wide holes to accommodate seismic tie-down rods, to the torque of each bolt.
Rady Children’s Hospital has been committed to incorporating green practices throughout its operations for many years. So when it came time to expand, it set on a mission to become the largest children's hospital in the state with a world-class LEED-certified facility. Marrying a world where patients and operations are paramount with that of an eco-friendly environment would challenge the project team, but also represent a significant construction achievement.
The new 279,000-square foot Acute Care Pavilion was built on a tight 148,650-square-foot site at the southeast end of the hospital campus, adjacent to the existing Rose Pavilion. Second- and third-floor bridges and a ground-floor walkway connect the existing facility to the new four-story building. The facility’s exterior features a glass-fiber reinforced, precast concrete exterior; integral-colored plaster; storefront and curtain wall glass systems with colored accents; and metal panels, railings and canopies.
Rady Children’s Hospital is the only dedicated child-specific medical center in the San Diego region whose demand for services had outgrown its existing facilities. When equipped, the new Acute Care Pavilion will house a much-needed surgical center with 16 state-of-the-art operating rooms and associated support departments, 84 acuity adaptable medical-surgical beds, a 32-bed neonatal intensive care center, and a cancer center with a 28-bed hematology and oncology unit and a 10-bed bone marrow transplant intensive care unit.
To knowledgeably address the LEED aspects of the project and carry through the facility’s sustainable design in a thoughtful, practical manner, McCarthy employed a dedicated LEED professional, and since the project began in early 2008, 10 of the construction team members have become LEED APs.
Construction execution required rigorous tracking and monitoring to ensure compliance with the credits. The project team took extra precautions at every turn. More than anything, success of the project required trust on the part of the owner that the project team members would work cohesively with OSHPD, the USGBC and one another, always with the hospital’s and patients’ best interest in mind. Tim Jacoby, vice president of facilities for Rady Children’s Hospital, led the collaboration.
Working in accordance with LEED 2.1, the project team is on track to receive 31 of the 25 points needed for LEED certification. Since beginning the application process for this project, the USGBC has rolled out the LEED 3.0 for Healthcare rating system, which is likely to make it more enticing for hospitals to seek certification since the requirements are more specific and applicable to healthcare facility issues.
The Art of Healing
The project team has earned an Innovation in Design credit for the introduction of a series of healing gardens that utilize sustainable design principles and embrace the hospital’s healing arts program, which was originally developed in 1993 in conjunction with the Rose Pavilion construction. The program seeks to enrich the experience of patients, families and staff via works of visual and performing arts and through healing gardens that draw on artists’ talents to transform normally lackluster courtyards into whimsical outdoor retreats.
In synchronicity with the hospital’s healing arts program, the new Rady Children’s Hospital Acute Care Pavilion provides an environment focused on the needs and imaginations of children – one that is also intended to help relieve the stress of families with sick or injured children. Central to the theme of the building is the “River of Life,” manifested through an immense, four-story mineral panel that incorporates a kinetic lighting system, which radiates a rainbow of vibrant colors through the front entry curtain wall. A mosaic tile version of the "River of Life" flows from the mineral lobby wall, out the front door, and into the first-floor landscaped courtyard, which serves as one of several healing gardens.
Called "Carley's Magical Gardens,” these landscaped courtyards were designed through the collaboration of local artists T.J. Dixon, Kim Emerson, Albert De Matteis and James Nelson. The first-floor garden off the main entry, intended for parents and siblings, sets the stage for the whimsical themes experienced throughout the facility.
Located on the second floor off the hematology and oncology unit, the primary healing garden features a giant tiled bird with a place for patients to deposit their wishes, which staff will later collect to better understand the children’s wants and needs. A life-size bronze figure of a young girl sitting at an 8-foot-long table is the centerpiece of the second-floor healing garden and provides a place for organized activities and family gatherings. Other whimsical objects include a mosaic tile and concrete tree playhouse, privacy bench, performance stage, and interactive garden screens and gates. A divided basketball playing area accommodates both regular and immune-deficient patients.
On the third floor is another landscaped bamboo garden with a rubber-surfaced playing area for patients and a retreat area for staff. A vast ground-floor outdoor terrace, strictly for staff use, features large Jacaranda trees, light posts and bike racks.
The Design Treatment
The Rady Children’s Hospital Acute Care Pavilion’s energy efficiency level is 23 percent better than ASHRAE 90.1, utilizing the LEED energy cost budget methodology. This was achieved by incorporating the following sustainable design features:
- occupancy sensors in operating rooms to reduce the ventilation rate by 60 percent when unoccupied, yielding a 45 percent annual energy savings;
- variable frequency drives on air handling unit motors to adjust the fan speed due to filter loading; carbon dioxide monitoring for high-occupancy areas to reduce ventilation rates based on the number of occupants;
- a supply-air temperature reset strategy, which saves energy by adjusting air temperatures based on load;
- a 24,000-square-foot cogeneration plant that provides free heating and high temperature water and contains two 700-ton natural-gas-fired absorption chillers; and
- variable frequency drives on cooling tower fans and hot water pumps.
The project also utilizes recycled and locally obtained steel, concrete and other building materials; low-VOC-emitting paints, glues, carpet and wood; water-efficient landscaping; abundant daylighting; and a dedicated bicycle storage area. A reflective concrete "cool roof” system helps minimize heat gain and control rainwater run-off; painted steel screens conceal rooftop mechanical systems.
Nearly 80 percent of the construction waste materials at the jobsite were recycled. The project team went above and beyond the LEED requirements by declaring the entire hospital campus a “no smoking” zone. A thorough 14-day flush-out of the building was performed upon construction completion.
Working next door to the existing Rady Children's Hospital and observing daily trauma greatly affected the minds and hearts of the construction team members, who were inspired by the passion and commitment of the Rady Children’s Hospital staff to bring this project to life. After all, this was no ordinary construction project. It was a life-saving mission on behalf of parents and their children.