Building strong and green

White Memorial Medical CenterWhite Memorial Medical Center took a proactive approach to meeting strict new building codes. The result is a building that meets those codes and achieves high levels of sustainability and energy savings, as Keith Regan learns.  The 1994 Northridge earthquake that rocked the Los Angeles area left its mark on Southern California. But nearly a decade and a half later, the impacts are still appearing in new buildings erected under the significantly tougher building codes passed in the wake of the tremor. The new White Memorial Medical Center is one of the more proactive and sweeping examples of tapping into federal funds to meet that new toughened code, known as the Section 406 Seismic Hazards Mitigation Program for Hospitals. The White Memorial project will have a price tag of close to $240 million when completed in early 2010. A portion of the cost was mitigated by grants from the Federal Emergency Management Agency (FEMA). The building project also meets many tenets of green and sustainable building construction and is an example of patient-first design, says Al Deininger, vice president of construction and facilities at the hospital. Brought to Los Angeles as part of a three-person turnaround team tapped to improve White MemorialÔÇÖs operations in the 1980s, Deininger has overseen the rebuilding project since it was first conceived in 1998. ÔÇ£Adventist Health is a very compliant organization,ÔÇØ Deininger says, referring to the medical centerÔÇÖs parent company. ÔÇ£Some of the larger hospital systems made the decision that they were so big that the state would never really take the necessary steps to force them to comply with the new earthquake codes. We began right away to make plans to come into compliance.ÔÇØSome time was spent looking at the possibility of upgrading White MemorialÔÇÖs existing structures, but it was quickly determined that the hospital would get more bang for its buck from building new. The project added more than 100,000 square feet to the medical center, but it wasnÔÇÖt designed to significantly increase the number of beds at the hospital. Instead, the focus was on creating a facility that would enable the administration to improve the efficiency and throughput at the hospital, especially in the ambulatory care areas.┬á In fact, patient comfort was a major focus of the entire renovation. ÔÇ£We started with the patient and family first, and we really focused on enhancing that experience,ÔÇØ Deininger says. Visitors quickly notice the difference strolling down the corridors of the inpatient wings. NursesÔÇÖ stations that used to have a prominent spot out in the open have been moved ÔÇ£off stage,ÔÇØ which gives the hallways a much calmer, quieter feel. ÔÇ£The nursesÔÇÖ stations of old had a lot of people and commotion, and all that is behind the scenes now.ÔÇØ The new facility relies heavily on mobile computing, with nurses and doctors using workstations on wheels (WOWs), which can be taken into patient rooms or into special off-hallway areas. Space was also created for equipment rooms and large clean and soiled utility rooms, helping to avoid the clutter that is a frequent sight in many hospital hallways. And overhead paging is kept to a minimum, with staff instead using wireless phones to communicate. ÔÇ£We all know that quiet produces better healing,ÔÇØ Deininger adds. All patient rooms now have built-in couches that can be made into beds, enabling family members to stay close by. Rooms also have individual climate control, which gives patients a feeling of control at a time when they have to trust others with most decisions. Early feedback on the building has been overwhelmingly positive, with the only negative comments coming early on from doctors who werenÔÇÖt yet used to the new facility. ÔÇ£Within a couple of weeks they were on board as well, because of the positive patient and employee feedback,ÔÇØ Deininger says.In addition to being patient-friendly, the project was also meant to be easy on the environment. Scores of green elements were designed and built into the medical center, with everything from chilled water and ice storage to conversion of motors to variable speed settings getting a look. The efforts have paid off. Even though the 348,000-square-foot patient care tower is 100,000 square feet larger than before the project, the hospital is actually paying less for gas and electricity than beforeÔÇödespite price increases. A major reason for the savings is a dual-source central plant system that can run on either natural gas or electricity. Computers are constantly fed current rate information and are able to switch the system to the most efficient option. The building project was overseen by Charles Pankow Builders, which used a modified design-build approach based on designs by Taylor and Associates Architects. It met strict state guidelines for reducing construction waste, with all excess concrete and steel generated on the site recycled. Another key element of the green design is the healing garden, located in the patient care tower. The garden features plants known for their medicinal uses among the predominantly Mexican-American population the hospital serves. ItÔÇÖs a welcoming element to the main entrance to the hospital, where a two-story entranceway and lobby amenities are being built in the final part of the project.The efficiency being sought has clearly been achieved. White Memorial was able to keep its emergency room operating when the nearby Los Angeles County hospital closed its emergency department to move into a new facility of its own. While 13 other hospitals had to close their ERs after reaching saturation, White Memorial kept its ER open. ÔÇ£A big part of that is our throughput efficiency,ÔÇØ Deininger says. ÔÇ£A lot of the credit for that goes to our people, but the building is part of it as well. We set out to give them a facility that would enable them to do their jobs to the best of their abilities, and thatÔÇÖs what we have.ÔÇØ┬á