Sky-high healing

Six takeaways from the first-ever high-rise healthcare seminar

On April 26th, 2016 the city of Chicago hosted a unique event as both healthcare and high-rise building professionals gathered to share notes at the Chicago Committee on High Rise Buildings (CCHRB) High Rise Healthcare Facilities for the 21st Century seminar. VOA’s Doug King, who serves as the CCHRB chairperson for high-rise healthcare moderated the event and kicked-off the presentations with an overview of the topic at hand. The session featured five presentations followed by a Q&A moderated by King touching on themes related to planning/design, elevators, building systems, building enclosures, and healthcare facility codes/guidelines. Here are six aspects of high-rise healthcare design that really resonated with me.

    With the industry shifting towards the goal of promoting health and wellness on a daily basis, urban healthcare facilities may begin to look more like community centers providing retail, restaurants, and other amenities at the ground level. Urban hospitals frequently become campuses with interconnecting bridges or tunnels for continuous flow through a live city.
    Much like a city, hospitals often see occupancy schedules running nonstop. It is harder to determine peak times in a hospital versus that of an office building which traditionally sees a rush at lunch, 9am, and 5pm. This 24-hour schedule results in more complex building system and elevator system designs.
    A critical element in healthcare is access and wayfinding for multiple categories of visitors, staff, patient types, research and education groups who must reach locations for loading docks, clean or sterile supplies, waste/soiled disposal, parking, drop-off, helipad, and more.
    In large healthcare facilities, organizations can merge clinical, research, and educational elements of their comprehensive care practices under one roof, resulting in “use integration” of a single building.  If shared floors between uses are desired, it can be a challenge to seamlessly connect these functions while minimizing core and utility pathways such as mechanical shafts, stacked electrical and IT closets and elevators.  A larger floor plate may be needed which could be limited in an urban setting.  It is also important to integrate the additional MEP spaces usually required in a hospital due to system redundancy and systems unique to healthcare (filtered water supplies, nurse call, dedicated OR air handlers and more).
    The world’s tallest hospitals only reach 400-500’. The conference audience wondered why. Is this height limitation a reaction to the market in major cities, splitting services between multiple buildings? Or were there other concerns about applying tall or supertall methodologies for the healthcare building type?  Mehdi Jalayerian (from ESD Global) offered one explanation from the building systems perspective.  He noted that once a building surpasses 400-500’, it takes on “a whole new high rise design philosophy” requiring smaller vertical zones to isolate larger pressures.
    Hospitals are often compartmentalized to comply with life safety measures related to the spread of smoke and fire. This concept also benefits high rises by limiting the stack affect (when warmer air inside migrates upward, drawing cooler outside air in) within separated zones through the height of the building.  A big concern with high-rise hospitals is patient evacuation during an emergency.  Some believe elevators should be used for evacuation while others insist that no evacuation at all is best because patients can remain safe within a fire or smoke-proof compartment.These are just a few of the questions raised at this thought-provoking seminar.

High-rise healthcare is far from a topic that’s been exhausted.

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