The Future at Fort Bliss
HDR employs sustainable practices and evidence-based design for the new William Beaumont Army Medical Center in El Paso, Texas.
Owner: U.S. Military
Cost: $966 million
Total Square Footage: One million-plus (including eight structures that support inpatient care, specialty outpatient care, and administrative staff)
LEED rating: Potenial Platinum
There’s a new day dawning for patients who will be admitted to or staff who will work in the new William Beaumont Army Medical Center at Fort Bliss. The $966-million complex, due to open in 2016 at the U.S. Army base in El Paso, Texas, is shaping up to be a visually stunning structure that embraces the principles of sustainable and evidence-based design, energy conservation, and green construction while offering cutting-edge, patient-centered care. Think smart-room technology, renewable energy, use of the least toxic materials, natural light, and soothing interiors.
The facility is expected to set a new bar in patient care and employee satisfaction—perhaps like no other hospital in the world—thanks to a partnership between the military and a team of creative designers from HDR, an award-winning global architectural firm. Together, they are melding the best strategies in hospital construction and patient care: evidence-based design (EBD), Leadership in Energy and Environmental Design guidelines (LEED), and the military’s new gold standard for medical facilities, “World-Class design.”
“It’s absolutely exciting; it’s going to have a lot of ‘firsts,’” says Major Bryan Walrath of the medical complex, whose patients will be the 90,000 soldiers, family members, and retirees that are expected in the rapidly growing Fort Bliss area. Major Walrath, a program manager for the U.S. Army Health Facility Planning Agency and the project overseer, says the hospital will go a long way to support the “unprecedented growth” at Fort Bliss.
Barbara A. Dellinger, an HDR vice president, says the new hospital, a cluster of six major structures linked by healing gardens and a labyrinth, will push boundaries in almost every way. “Everything about these new buildings involves a change in practice,” says Dellinger, an expert in EBD, a theory that emphasizes the importance of using credible data to influence the design process. “People think EBD is related to just buildings,” Dellinger says. “It does begin with the building, but the building allows the entire culture to change so that care can be delivered in a patient-focused way.”
“This is a huge cultural change for the military,” Dellinger says. “‘Austere but adequate’ is a quote the military used in the past. World-Class design has changed that since it is now well established that the “design can substantially affect the efficiency and effectiveness of making correct and timely diagnoses; the ease and accuracy of administering appropriate care; the attitude and morale of patients, visitors and staff; the culture of the organization, and an environment that promotes the healing process.” (Achieving World Class, Defense Health Board, 2009, p. B-2.)
Energy and water conservation are paramount. Engineers are currently analyzing how to drill a deep test well to determine if the geothermal water can be used for heating water in the facility. Grounds are being designed to create a healing environment and will be planted with natural grasses and indigenous flowers.
“The government wants to save resources; we’re trying to save as many natural resources as possible by square footage,” says Susan Donkers, a project manager in sustainable design services at HDR, who is pursuing the LEED for Healthcare certification with her colleague, Jean Hansen, HDR’s sustainable interiors manager. As Donkers says, “It’s a design challenge.”
Add HDR’s concept of Sustainable Return on Investment (SROI) to the other project cornerstones, and it is bound to forge new ways of thinking about health and wellness. SROI determines the full value of a project by giving a monetary value to every cost and benefit—economic, social, and environmental. In other words, sustainability and conservation do more than save green resources; with the right planning it can save money and increase morale. Russ Manning, a senior health system planner for the Department of Defense, says that SROI had added an exciting aspect to the project. “SROI has helped us ensure we focus our resources on the most effective sustainable approaches to the project,” he says.
Since the project will apply for LEED for Healthcare certification, which has new and more intense focus on the building’s finishes and components, Dellinger’s team has called on the expertise of Jean Hansen, HDR’s sustainable interiors manager to look at the chemical composition of nearly all elements of the building and to steer away from toxic chemicals and substances such as formaldehyde, heavy metals, halogenated flame retardants, phthalates, perfluorinated compounds (PFCs) and added antimicrobials. Paint will be high quality, with low or no VOCs to meet indoor-air requirements. Rubber flooring will be used where possible. It is less toxic, quieter, provides more foot and back comfort, and rubber floors also will not require waxing or stripping. In regards to the hospital furniture, Hansen is examining the chemicals and substances in the materials and finishes, recycled content, country of origin, and whether wood is certified by the Forest Stewardship Council (FSC). It’s good ecology, but also good for humans. As Hansen said, “It really needs to tie back to health.”
World Class Design
There are many strategies for achieving World-Class design. Hansen’s research assists also in guiding several of them, including acoustics and safety. “We’re designing it to be quieter, for a healing environment,” she says. “We’re thinking holistically.” Highly absorbent ceiling tiles as well as flooring surfaces are being specified. Ceiling-mounted patient lifts will ease stress on the bodies of both patients and medical personnel and help reduce injuries. All patient rooms are private, with space for family members, thus further supporting the theory that healing is faster when families can assist patients during their stay in the hospital. “The patient room is so much more about the patient now,” Hansen says.
“The overarching goal is to provide a safe, calm environment in which people can heal,” Dellinger says. The use of positive distractions is employed frequently, and includes views to nature and the gardens or the Franklin Mountains. Finishes, both exterior and interior will include native stone, as well as colors, patterns, and textures that are akin to the culture and geography of the area, and spacious windows allowing abundant light deep into the buildings. The sustainability philosophy extends to post-construction agenda. Maintenance will be as toxic-free as is possible.
Though many of the strategies have been assumed to help healing, it has not been easy to measure the intangible aspects about them until HDR developed Sustainable Return on Investment. As HDR’s Dellinger says, “If a nurse injures her or his back, the medical leave can be quantified, but how do you measure the frustration, anger, and stress on them and their family?” Many of the intangibles can start to be quantified.
Blending World-Class design, evidence-based design, and sustainable design guidelines, and underscoring it all with Sustainable Return on Investment, is a natural fit, says HDR’s Dellinger. These strategies are expected to lead to improvements in patient satisfaction, safety, infection control, and preservation of resources. “It’s the triple bottom line,” Dellinger says: “save money, preserve the environment, and increase morale for patients and employees. It’s a win-win-win.”
Projected Sustainable Design Metrics
- 35 percent potable water use reduction
- 60 percent energy use savings (BTUs, excluding receptacle and process loads)
- 37 percent energy cost savings
- 14 percent renewable energy compared to annual energy cost
- 36 percent potable water use reduction
- 60 percent energy use savings (BTUs, excluding receptacle and process loads)
- 40 percent energy cost savings
- Eight percent renewable energy compared to annual energy cost