Barbara Hesselgrave 2016-01-08 15:10:39
Nearly a century ago, legislation enacted by President Woodrow Wilson founded a basic training facility for American soldiers preparing for World War I. Named Camp Benning, the post was located just outside the capital city of Columbus, GA. Following the Armistice, the post was renamed Fort Benning in 1922. But this was just the first step toward a number of changes that transformed the facility from an Infantry training school to an installation that included several outdoor and indoor recreational facilities. The biggest change however, was spurred by military concern that the disastrous casualty rate of the Great War—believed to be a result of inadequate training—must never be repeated, which led to Lt. Col George C. Marshall initiating a significant overhaul to military training and education in the late 1920s, later known as the “Benning Revolution.” Over the next several decades, Fort Benning evolved from a basic training facility to become the home for armor and paratrooper training, and consolidated the programs from other training facilities to create what is today a post that is a medium-size city. Yet by 2009, this growing city supporting a population of over 110,000 people comprised of soldiers, their families, civilians, retirees, and others was in desperate need of a new hospital. Plagued by inadequate water supply, failing air conditioning, power outages, and plumbing nightmares, the old hospital was clearly on its last legs, and even those were shaky at best. “We were in a 60-year-old facility that was being held together with duct tape and baling wire,” says Tim West, electrical engineer at the new Martin Army Community Hospital (MACH), Facilities Maintenance Branch. West explains it was not a matter of fixing the old but starting from scratch to create a new, energy efficient facility that he says “provides services to three states—Georgia, Alabama, and Florida—with an eligible beneficiary population of nearly 83,000.” West says that the process of building any military facility is initiated through the US Army Corps of Engineers, under the auspices of the Department of Defense (DoD) where he and colleague Darrel Maples, the Corps HVAC guru who handled the mechanical engineering aspects, first began working on the project. Both West and Maples later transitioned from the Corps to helm the new hospital’s facilities management maintenance Branch. The primary objectives were to bring the post’s healthcare into the 21st century, both clinically and structurally, which became the task of a huge team of contractors, engineers, architects, and interior designers who met—and in fact exceeded—the stringent requirements of the first-ever design/build hospital developed by the DoD. A Natural Healing Environment With today’s hospital health delivery evolving toward fewer and shorter in-patient stays, the facility reduced its bed size from the previous 100-beds to 84-beds, but Maples says there still are more than 30 outpatient specialty clinics that take up 300,000 square feet, which is just a bit less than half of the total MACH footprint of 750,000 square feet. Even from the outside, the new hospital, named after the late Major General Joseph I. Martin, imparts a sense of serenity and peacefulness. Built on a 50-acre parcel and surrounded by a natural wooded environment, the hospital’s main structure includes two clinic wings with a connecting bridge at one end in an open rectangle shape. In between these two wings the structures are joined visually with a lush landscaped area complete with trees, shrubs, flowers, and a serpentine waterway that traverses its length, terminating in a series of small falls and a pond. Outpatients and visitors can walk, sit and relax on these grounds. These clinic wings attach to the hospital through a Grand Concourse that is the main entrance to the facility. From a distance the overall appearance blends nature with function. “Our concept was to build into the natural slope of the site, and thereby minimize the size and height of the buildings,” says Maples. “There’s a terraced feel, with lots of levels and differing roof levels,” which he says are enhanced by roof gardens. “Three of these roof gardens are on different levels and they are installed to basically reduce the heat island effect and reflect solar energy. Where we don’t have those we have TPO (thermoplastic polyolefin) membrane,” he says. “Everything was chosen for low maintenance and maximum efficiency, while all our colors and surfaces were selected to enhance the healing environment,” which he says includes the interior aesthetics and all the artwork which was chosen for a “water-based theme.” However, the largest and signature piece of artwork is a massive commissioned wall art that acts as the focal point for their four-story atrium. This modernist installation features a representation of a jump tower augmented by small, colored, semi-globe structures attached by wires from the ceiling that echo the parachutes of the servicemen undergoing paratrooper training at the renowned Fort Benning “jump school.” From the full-scale design down to the smallest interior fitting details, every aspect of the project was chosen and installed toward optimizing the energy efficiency of the building and its systems, all toward the goal of achieving LEED Silver Certification. In fact, West says that the Army now requires all their building projects must meet LEED silver objectives. Energy Efficiency From the Ground Up Kim E. Shinn, PE, LEED Fellow, CxA, BEMP, Principal and Senior Sustainability Wizard at TLC Engineering for Architecture, comments on his role with the Turner Construction side of the project. Since they were pursuing LEED from the project outset, he says they were able to “program” in many credits within the budget and actually achieved LEED Gold certification.” Current Federal regulations prohibit spending additional monies above what is budgeted for anything higher than Silver level certification. He adds the project was awarded LEED Gold in August 2015. Shinn explains that the Energy Independence and Security Act (EISA) of 2009, requires that “Federal facilities must be built to use 30% less energy, than if that building was designed and built to the minimum requirements of the national building energy code,” which he says was ASHRAE Standard 90.1-2007 at the time of their contract award. Nonetheless, Shinn says they exceeded that 30% threshold and were able to reach an estimated 40% of energy reduction against the EISA benchmarks. This would be challenging for any garden-variety project, but especially so for hospitals as their energy use profile is significantly different from office or residential. “The hours of operation are essentially 24/7/365, and are dominated by the internal energy consumption such as high air-flow rates for clinical spaces, medical equipment, lights, the occupants; all this is fairly constant year-round and not influenced by climate,” says Shinn. In fact, they discovered unexpectedly how climate can affect major energy decisions. In the pre-proposal modeling stages he says they learned the code minimum insulation values were very good; so good in fact, that by adding extremely high wall insulation to the walls and roof they saw it would actually cause an increase in energy costs. “The heat generated by high internal loads of the lights and equipment was being held in during Georgia’s relatively mild spring and fall, causing the air-conditioning energy to increase.” What they did learn was that the most important element of the architecture with respect to energy consumption turned out to be not the walls and roofs, but windows and curtain wall. Most of the highest performing energy conservation measures, Shinn says, “turned out to be control-related; that is, being able to reduce lighting, temperature settings and air flows during times when spaces were unoccupied, which cost the project very little.” Maples adds that they selected walls constructed of pre-cast concrete which were conveniently available from a manufacturer right outside of Atlanta; a bonus, since buying local “within 500 miles” is another LEED credit. He describes the precast as having an insulated board sandwiched between the outside which is a smooth, sandstone appearing surface, and the inside concrete which was to receive interior surfaces and would not show. Heating, Cooling, and Critical Backup Power Maples says that the RFP stipulated steam as the source of heat energy from the central plant but that the contractor proposed a “value engineering change that instead proposed hot water.” He says hot water has fewer maintenance problems and steam, it was pointed out, can be costly in the long run with leaks, steam traps and requires constant vigilance “from full-time maintenance people to make sure you have a tight system.” The hospital now runs on the three heating hot water boilers, rated at 400 boiler hp each. Still, there was a role for steam and while hot water serves most of their needs, Maples says that two small steam boilers, rated at 100 boiler hp each, are in use to create plant steam for humidification, high level disinfection for washers, sterilizers, the kitchen, and for the loading dock. The Central Utility Plant supplies all of the hospital utilities in an innovative fashion, as Maples explains. “We have a utility trench coming into the hospital, and all the utilities, heating, domestic, natural gas, chilled water, fire protection—all of those are fed from the detached central plant, and they come through this trench to a mechanical room and distributed through a set of risers. “What was unique about our project was that a lot of hospital interstitial space, that is the space above the finished ceiling where you typically run a lot of utilities, always presents access and maintenance issues. You’re always having to pull ceilings apart, or get into patient or clinic rooms causing downtime and inconvenience. So what we said was, ‘let’s take a whole floor and consolidate that space, and have a whole 16-foot height and dedicate a complete floor to all of our systems.’ So they picked a floor, and now it all goes through huge chases that go up and down, and the maintenance people love it because they can easily get to everything.” Having enough backup power is also critical, and West says that the Army mandates they have enough power to run 100% of the designed load for a minimum of four days in the case of a utility failure. “We installed three emergency diesel engine generators each rated for 1,750 kilowatts to meet the facility emergency load demands and ensure that the hospital can run ‘business as usual’ across each of the three branches of the emergency power system, which include the life safety systems, critical patient care systems, and the critical equipment loads.” In addition, West explains that the emergency power system was designed to allow for adequate future growth as additional emergency load requirements are introduced within the new facility through new equipment purchases and renovations over the coming years. The equipment branch includes air handling equipment, mechanical equipment, and “anywhere there are pumps, fans, and motors, these must be provided with power. You have to maintain an environment of care anywhere there’s patient care in the hospital, and if you have a utility failure, you have to provide enough power to keep it operational.” West says the diesel backups provide 5.25-MW emergency service power, “So it’s really a small power plant on its own,” which he says is supplied by two, 25,000-gallon underground diesel fuel tanks that are double walled and encased in leak protection systems. And just for perspective, West cites 1 MW as equivalent to one million watts of energy, so the hospitals’ standby emergency power system is capable of supplying more than five million watts of backup power, which would be enough electrical energy to simultaneously operate more than 160,000 32-W T8 fluorescent lightbulbs. “But really, we’re almost never operating at 100% of the capacity of the emergency power system, so we could supply emergency power a lot longer than the four required days should that ever happen,” he adds. Spending More to Stay Cool for Less The cooling capacity for the nearly 750,000-square-foot facility is provided from “three large 1,200-ton centrifugal chillers with matching cooling towers about 45 feet high,” says Maples. The hospital uses condensate recovery from air handlers to help achieve LEED certification; Maples describes how this works. “There are 17 air handling units on the third [maintenance] floor and large fans blow air across the coils, then when the water drops out that condensate is collected and pumped back to the central energy plant and used in the cooling for reuse.” He says it's like collecting the water that drips from an air conditioning window unit, and then sending it back to be reused, but on a massive scale, of course. Lighting is also a huge energy consideration, and they chose a “very sophisticated dynamic lighting system,” says West. “The hospital building itself was aligned with natural daylighting, and the system is sensitive to the daylight and ambient light, interacting to automatically dim when light is not needed. A lot of natural light is harvested and the system is also programmed with tiers so that during off-hours a lot of areas can cut back to a certain lighting percentage.” He describes the lighting as a mix of energy-efficient electronic ballast fluorescent, a lot of CFL and a lot of architectural LED. While the project was a fixed price contract, they demonstrated that by using energy-efficient, but more costly, fixtures, the tradeoff would benefit costs in the long run. However, the majority of these energy saving strategies are not obvious to visitors and staff. They just know it feels comfortable and looks good. Which is the intent of good design, says Stephanie Cox, Interior Designer and Initial Outfitting Project Manager for US Army Health Facility Planning. Outfitting From Carpets to Carts “Interiors for hospitals have very specific requirements: they need to have surfaces that resist microbes and are easily cleaned, the environment needs to be safe for patients and staff, it needs to be inviting and comfortable to offer a healing environment. These requirements are then compounded by unique needs of government facilities for sustainability, long-term durability, and added strength for protection against terrorism. Finding the balance and providing a facility that meets these requirement and the needs of all types of users was a challenge that the entire delivery team made their mission,” explains Cox. In terms of equipment and furniture purchases Cox says, “We tried to focus on LEED requirements where possible, and sometimes changes in technology standards were already helping to make that happen. Items that had constant use like refrigerators were easy choices to specify Energy Star-Rated models early in the project. Many furniture manufacturers now offer a variety of products that are GREENGUARD certified and use 100% post-consumer recycled content, so it was easy to specify those products for the new facility.” One aspect that made a difference in people’s comfort and behavior is the Design Team’s use of a wide-open stairway in the main concourse, rather than a closed-in claustrophobic stairwell that is typical of many older facilities. This has prompted people to choose taking the stairs over elevators on a regular basis. “By designing the grand staircase in the main concourse we've opened up the space so you have a sight line to both Clinic Buildings and the Hospital Building.” The Design Team also used drop down natural wood ceilings near elevators and artistic touches such as colored canvas canopies in the Dining Area to provide people with defined areas to gather and add acoustic comfort for spaces that could feel too large and open. A Test Run to Fine Tune the Design Cox says they ran scenarios called “Day in the Life” to educate staff on how to use the building before it opened by inviting all departments to test their current building knowledge and current operating procedures. “It’s very hard to expect staff to continue normal operations in the current facility and think about every scenario or opportunity that could take place in the new facility at the same time. “The Transition Team ran these exercises to see how people used pathways and procedures; for example, getting a patient from A to B to C, would they remember that pathway in an emergency and under a stressful situation? That’s what we wanted to see. These exercises gave us the knowledge to know where to fix things, whether it was something operational or construction related that caused deficiencies or inefficiencies. Staff members were also encouraged to share the positive as well, so other departments could learn from a success story.” Cox cites how some staff found chairs in a waiting area placed too close to a railing on a floor elevation could allow a child to fall over it, so the layout was immediately amended to prevent a tragic accident before the hospital even opened for business. The best part of the project however, Cox says, is installing art and choosing a palette of colors and artwork conducive to feeling good in the space. “We want patients and staff to feel good while they are here. Colors, textures, layout, and artwork can make all the difference, sometimes without someone actually knowing it.” “We chose photographic art to use in corridors and unique fine art for certain public places such as reception desks, waiting areas, and main hallways. The commissioning of the ‘jump tower’ in the main concourse was designed to reinforce the mission and purpose of the post while adding a touch of whimsy and visual interest in a place where stress can quickly overtake you,” she says. In one case, materials from the old building became art in the new facility. “We salvaged the stained glass window inserts from the Chapel in the old building and used them in the new Chapel area. Most of them were in good shape, but a few needed repairs before they could be reinstalled. The artist was able to reinvent these pieces to match the style of the new facility while maintaining their integrity. It turned out better than we imagined and looks beautiful.” Spectacular Achievement of the 90-Day Miracle Looking back at the project that virtually consumed his existence for five years, veteran project manager Marty Miller of Turner Construction Company says nearly everything that came out of the request for proposal (RFP) on paper. It became the Martin Army Community Hospital, and, in reality, originated in the planning stage of what he calls the “90-day miracle.” “We had been following the legislation budgets and we knew an RFP was in the works for a new hospital, so we were ready for it when they announced it. We had our teams lined up in the wings ready to go. However, this project was the Army’s first ever firm-fixed price, design/build hospital replacement project with no bridging documents, so we did not really know what to expect.” And, he says, this challenge was further compounded by the massive 4,700-page RFP “that filled several four-inch-thick notebooks,” but did not include any sketches, nor floorplans of any sort. “We were literally starting from scratch with a blank piece of paper. “The narrative specified the adjacencies they wanted; for example, they wanted radiology near the emergency room, and they also wanted it near the surgery suite. It also had a description of how the facility should integrate with the site, how operation and energy functions should perform, and how all of it should reflect army values of strength and character. And the contract was to have a fixed dollar value to do all this.” Miller says they only had 90 days to review this massive document and respond with a written proposal, plus the elevation drawings that identified the specific rooms and functions. The first thing his team did was to define a mission statement, “to serve our brave soldiers and their families,” he says, and then “during the design process we had a LEED plan and scorecard from day one.” “Our LEED plan then went through the schematic design, creating the building blocks in terms of shape, and we ran energy simulation models on the various designs to help us determine an optimal solution to design problems.” By starting with the end goals in mind he says this steered the team of architects and engineers to maximize value so “from a gross to net square footage there was not much wasted space.” Miller says as they got on a roll, they had some surprising discoveries. “What we found more important than the insulating qualities of the walls and precast were the windows, 90% of which have views to nature. We selected a very high performance spectrally selective glass that allows in light but rejects the infrared heat. And the more glass we put in, the more it reduced artificial lighting and this had more impact than the heat gain from using more glass. Our energy model allowed us to study this as we never had before.” As the artificial lighting load was reduced, Miller says, “We began to see these synergies that allowed us to produce the design which achieved a LEED gold at no extra cost.” Other energy considerations included their concept of “don’t make more of something than you need.” For example, Miller says a hospital needs certain air changes per hour per room type, but to get that air change “you over-condition the room, then have to put in a heat coil to bring the temperature back into the comfort zone, and it’s a tremendous energy waste.” By maneuvering the chill water to a higher temperature, they reduced the over-cooling and saved energy and cost. Another energy-saving surprise came from noise reduction efforts. Studies report noise as a big factor on patient recovery and satisfaction so to produce a quieter atmosphere Miller says they slowed down the air handlers. “Instead of pushing air 500 feet per minute, we slowed down the fans and made the ductwork larger and an interesting thing happened. It became quieter, it reduced fan horsepower and allowed air to be in air-cooling coils longer, and this reduced the static pressure across the coils. We slowed our variable speed pumps [VSP] pumps down, and as we did this, it moved the energy needle a lot.” Years Later, the New Award-Winning MACH After years of work, the ribbon cutting to celebrate the final finish of the Martin Army Community Hospital came on November 8, 2014, and included impressive dignitaries such as Congressmen who helped secure the needed funding, local town mayors, and descendants of the eponymous Martin family, says USACE’s Alan Bugg, who recalls the ceremony. However, the ribbon cutting was just the beginning for the medical and administrative staff tasked with preparing for the first patient, who Bugg says was admitted just days later on November 17, 2014. Bugg says in late 2015, nearly a year later, fine tuning adjustments are still taking place, and there is one remaining change order to add, “an uninterrupted power source for the MRI.” All the principals from each of the MACH participating teams are in consensus that while this was probably the most challenging and demanding project of their career, it is one they are exceedingly proud of. Bugg says, “After being in the construction business for 32 years this is the best one I’ve worked on,” and he praises the work of other contributors. “The hospital team did a really great job, and we won a USACE project delivery team award of the year. The patients, staff, and visitors who come into the facility are amazed by how much it doesn’t look like a typical hospital. With nearly all the clinical rooms facing the creek and the woods, you just don’t have any sense this even is a hospital.” Barbara Hesselgrave is a writer specializing in environmental topics.
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