The topic of human health and its consequential relationship to the built environment is not a foreign subject to gb&d. And although we continue to chronicle the unprecedented growth of the medical industry’s bold sustainability efforts, there have been specific, extraordinary patterns in their approach to using design as a tool to advance patient care that begged for a return to the focus of this exact segment. Over the next nine pages, Vincent Caruso revisits the healthcare sector to document the medical design innovations that have begotten since we last left off, including Gundersen Health System’s latest zero-carbon-footprint addition, The Northeast Georgia Medical Center’s healing biophilia, and the groundbreaking innovations found at the upcoming Well Living Lab.
GUNDERSEN LEGACY BUILDING
To many residents in southwest Wisconsin, Gundersen Health System is hardly an unfamiliar organization. For more than a century, the nonprofit has provided a myriad of medical services across multiple specified facilities on a vast campus that spans 160 acres. Gundersen has long earned a revered status within its field for being among the first to begin experimenting with incorporating environmental sustainability in forging its infrastructure. Even before 2011, when construction commenced on the Legacy Building, Gundersen’s most recent addition, the campus had already garnered four LEED accreditations. It was with the introduction of the Legacy Building, a component of a broad campus renewal project by Gundersen, where sustainability served as the foundation of the facility, rather than vice versa.
The six-story Legacy Building was built as an addition to the existing hospital, designed with the intention of expanding care services ranging from emergency and critical care to pediatrics. As lead architectural designer Matt Sanders of AECOM, the design team behind the project, tells us, “Portions of the existing building were retooled to accommodate new program elements,” while others were transported to varying corners of the newly constructed Legacy quarters. For example, “the existing Surgery Core was redesigned as the location for the new Interventional Radiology Labs, Hybrid Operating Rooms, and Catheterization Labs, and the existing Neonatal Intensive Care Unit (NICU) was converted to new Labor Deliver Rooms.” This design was intended to enhance navigation and cooperation between facilities, while seizing the opportunity to increase sustainability, too.
“Gundersen has gone above and beyond,” as Camille Helou puts it. Helou, vice president and director of healthcare at Kraus-Anderson Construction, points out that through adapting the colossal, 450,000-square-foot Legacy Building, “very high goals for sustainability and energy independence” were set and followed, to ultimately reach a zero carbon footprint in 2014. Two important elements that facilitated this enviable energy performance were the quality of the building envelope and sophistication of the geothermal heating system.
To implement the geothermal system, Helou says, 156 production wells were drilled 400 feet beneath the hospital parking lot surface and kept at a 48-degree temperature. To determine whether heat or cooling is needed, a 300-ton geothermal heat pump circulates water throughout the system, acting as a moderator. During the cooler seasons, energy is transferred to the building from the underground pump to disperse heat, while during the warmer months, the heat is pulled from the building and routed to the wells. “It is Gundersen’s largest energy-saving component,” Helou emphasizes, “saving 70 to 80 kBtu (British thermal units) per square foot annually.”
What’s more is that these goals were approached from the philosophy that the efficiency of the building is best pursued with human health in mind. “Patients’ and guests’ experiences are enhanced by sustainable features such as improved air quality, daylighting, and abundant thermal windows that capture sun energy,” Helou recounts. Research that supports the psychological benefits for access to hearty amounts of daylight have been confirmed in innumerable studies, and the Legacy Building has responded accordingly. Helou illustrates, “Windows and access to daylight have been shown to reduce depression, pain, and agitation in patients,” not to mention the picturesque views of the Mississippi River outside.
Inevitably, there are bound to be areas of any building where natural daylight is unable to reach. However, by employing “energy-saving light fixtures that produce light closer to the spectrum of natural daylight,” Helou and his team were able to reproduce the experience to the best effect money can buy. The Legacy Building is set to be the Gundersen Health System’s fifth building to receive a LEED certification.
WELL LIVING LAB
What if there was a way to unobtrusively conduct experiments on human beings in real time for maximal accuracy? And what if the aforementioned behind-closed-doors laboratory was just in the next room over from the scientists at hand? The concept behind the Well Living Lab, a joint project between Rochester, Minnesota-based Mayo Clinic and WELL Building Standard originators Delos, aims to answer those very questions—and a heap of others related to human health and wellness.
The idea was hatched in September of 2014, when it became clear that the two parties, who have a history of collaborative projects, shared an interest in exploring the relationship between the indoor environment and the natural human condition. Also based in Rochester, the Well Living Lab clinic has been designed almost as something of a “human ant farm” and is equipped with monitor technologies of the highest caliber. According to EPA studies, Americans spend an average of 93% of their lives indoors, and the aim of this project is to study human beings in the habitat in which they spend this significant plurality of their lives.
“We started from scratch,” says Dana Pillai, executive director of the Well Living Lab. “The space was formerly an office.” And what was once just an office is transforming into an “experimental” space that has modular capabilities, allowing it to be reconfigured to take the form of a variety of settings—including an office, a classroom, an apartment, a hotel, etc. A “back of house” was also included, where Mayo and Delos professionals can observe what is taking place in the main area, where consenting volunteers will be housed and monitored via inconspicuously furnished, highly advanced sensor technologies. “What we want to figure out is if we can prioritize the kinds of effects environmental factors have on people’s behavior and work performance,” Pillai says.
These factors include things like lighting, shading, temperature, and humidity. Experimenting with these variables will allow the clinic to gauge how their subjects’ overall happiness and general satisfaction fluctuate. Unlike the traditional model of simply surveying participants, Pillai and his team “can tie in their personal health information with the environmental conditions and their subjective responses to the environment.”
Though the development of the space is still technically in its preparation stages, the team is aiming to commence the series of tests and experiments by spring. However, the Lab has in the meantime, with Centerbrook Architects and Planners handling the design, managed to already register to pursue both LEED and WELL Building Standard certifications. Net zero is also on the team’s radar, though they view that as one component to a larger equation that too often goes ignored. “The ideal home in our view is one that uses minimum resources to give the best experience to its occupants, and I think we have a setup now to quantify that,” Dr. Brent Bauer, medical director of the Well Living Lab, expounds.
Inching toward completion, the means to achieving this are beginning to manifest. “We’re learning how to make big complex systems communicate with each other and to create algorithms to generate them,” he says. In the next couple months, however, Dr. Bauer foresees the Lab learning things more extraordinary than they could have ever thought. Ultimately, the goal is to improve people’s performances at work by making the interior environment better. “Making people healthy and promoting their well-being,” says Pillai, “is how to make a workplace number one.”
NORTHEAST GEORGIA MEDICAL CENTER BRASELTON
The Northeast Georgia Medical Center (NGMC) Braselton is unique for a variety of reasons. Most immediately apparent is the unconventional design and ambiance of the physical structure housing it. The main entrance and lobby break continuity with the rest of the building, fashioned in the form of an expansive, tubular-shaped protrusion, encompassed by a largely glass façade, and capped by a spherical summit resting on an angle to tinge the otherwise sylvan setting with a streak of modernism. The halls of the medical center are carefully balanced by the rustic charm of wooden panels that line the walls and the support of smoky brick columns. But the recent opening of this new facility has been met with praise for more than just its physical appearance. NGMC Braselton is also not only exceptional because it was the first hospital that has been built in Georgia during the past 20 years, but because of the ways in which it sets itself apart from the rest that have preceded it.
Patrick Thibaudeau, vice president-sustainable design at HGA Architects and Engineers (HGA), the architectural and engineering firm behind the project, explains that the team began by “trying to figure out what healthcare of the future should be like and then put a building around that.” The conclusion they arrived at, in collaboration with the client and MEP engineers Perry Crabb, was to go beyond simply “building green” to reduce negative consequence, and assemble a structure that actually benefited human health and the environment.
The remote site of the hospital was a key component in influencing its design. Tranquil and rich with vegetation, HGA envisioned a medical center that could connect its guests to the natural environment that engulfs it. Big open spaces, healing gardens, and patient room placement all designed to capture striking views were among the ambassadors between visiting guests and the great outdoors. In ruminating on the possibilities, the geothermal capabilities soon became apparent to Thibaudeau.
“Our target was to get this hospital to do something that has only really been talked about in a couple of places and achieved in even fewer,” he says, highlighting a ground source heat pump that was installed at the site. The pump system is a “hybrid,” which means that it uses the best of two different systems and its requirements also permit the installation the luxury of being ultimately more cost-effective than comparative models. “Hospitals use a lot of energy,” Thibaudeau explains. Most existing hospitals in the area perform at an EUI (energy use intensity) of 236, a formidable waste compared to NGMC Braselton’s design goal of 100 EUI. That amounts to about a 60% reduction in energy waste compared to other regional facilities (Energy Star Target Finder database).
In building at a far-removed location, ample space for installing complex heating mechanisms comes with the territory, but neighboring infrastructure is something that’s lacking. This means that the site remains considerably darker, which enabled the design team to employ “dark sky lighting” fixtures to reduce light pollution and any other potential disturbances that could come with being the sole glaring beacon in the middle of an otherwise lightless expanse. If it weren’t for dark sky lighting, Thibaudeau points out, light would trespass into other properties, which in addition to disturbing fellow residents, could also disrupt the habits and patterns of animal life. As Thibaudeau illustrates, less than 5% of all the total light lumens on the site emanate upward from their source, meaning that “at least 95% of the lumens point down and stay on the premises of the site. Thereby, the area is kept close to its predevelopment state in terms of lighting.”
Aside from the project’s impressive lighting, an effort to minimize the water consumption was marked by the installation of a “purple pipe” water irrigation system. “Our project partners, civil engineers Kimley-Horn Associates and landscape architects HGOR, did a great job coming up with a plan to percolate rainwater right there in the site as much as possible without disrupting the local water cycle,” recalls Thibaudeau. As a result, the site is able to function entirely independent of the need for potable water consumption, which speaks to HGA’s general architectural philosophy on the project: “Instead of asking if we can get to zero, let’s start there,” Thibaudeau says. It’s a maxim that proved favorable for NGMC Braselton, as the building holds the 2015 award from ENR Southeast for Best Healthcare Project and is presently in the final stages of submitting for LEED 2009 HC Gold certification. The whole project was a group effort where integrated teams collaborated very closely to set bold targets and then worked with the client to achieve them.