Hospitals can’t move with the latest green technology and trends the way other commercial and residential buildings can. Disruptions in service and unexpected downtime at a major hospital or in a critical environment can very quickly turn into a life-or-death situation. Their HVAC, plumbing, electrical, controls, security systems and more have to be nimble. Success demands expertise on a few fronts, including, but not limited to aesthetics, energy savings, retrofitting, collaboration with multiple trades and energy storage.

Here’s proof in the form of an active project at Harris: a healthcare facility right in the middle of a bustling downtown area is adding a new ten-story build to their campus. Sustainability is a priority, but they need to be able to draw more energy when needed to minimize downtime and provide extra security in emergency situations (like another pandemic). So, what’s going in their walls?  

A total energy recovery wheel: Return air from the building goes through the top or one side of the wheel. As it spins, outside air, be it warm or cold, exchanges heat. So, for example, in the summer, hot air from the outside would get pre-cooled by, say, a 72-degree return coming to the wheel from inside the building. This building has 11 units totaling about 700,000 CFM, recovering air from all over, even kitchen and sterile processing. 

High air change air delivery in operating rooms: To support better surgery outcomes, the operating rooms have 66 air changes per hour. Only the minimum amount of outside air required for ventilation and dehumidification comes from a central air handling unit, with most of the air changes recirculating through fan coils adjacent to the operating room. This avoids turning an enormous amount of air over at the central air handling unit, eliminating the greater pressure drop due to longer, larger duct runs. The end result is lower energy cost (even with the higher than typical air change rates), reduced airborne contaminants and an expected reduction in rate of infection. 

“Pandemic ready” options on two floors: A solution that came out of master planning from the COVID-19 pandemic, this option allows the building to fully exhaust these two floors when in pandemic mode, enabling the prioritization of health and safety above energy efficiency when necessary. Otherwise, the HVAC system is in normal, energy efficient mode. This is an essential consideration in hospitals and other healthcare facilities, but can also apply to commercial buildings outside the healthcare market. 

Domestic heating, water and steam metering: Metering helps create understanding about where energy usage is really happening so changes can be made during commissioning, operation and recommissioning down the road. 

A winter cooling system with dry coolers: This facility recently put in a new central utility plant designed to be drained and offline during the winter, running off outside air when temperatures got low. However, this new build would involve operating rooms and data rooms, so year-round cooling became necessary. This added dry cooler system is basically a giant coil on the roof that rejects heat into the air, eliminating the need for refrigerant compressor energy to make chilled water. The result? Essentially free cooling through the winter months. 

Extension of the campus chilled and steam loop: Having a single loop fed directly from the central utility plant around the entire campus will allow the facility to feed from both directions, helping accommodate shutdowns, equipment failures and many other issues. Running this loop off a single source with newer equipment coupled with good controls strategies will boost efficiency and make the system less intrusive and less expensive to operate. 

Three separate domestic water systems for cold, hot and recirculating water: Because the building is 10 stories, having a system that serves the bottom third of the building, one that serves the middle and one that serves the top eliminates the problem of over-pressurization. What that means is there’s no need to add booster pumps to depressurize water before sending it back down to lower floors, lowering energy use and increasing the longevity of piping, etc. 

Stand-alone and backup systems for data rooms: With a wealth of systemwide data infrastructure stored in these rooms, preservation of that data and, therefore, the equipment storing it is paramount. So, the data rooms have their own stand-alone system, as well as an emergency backup that the system immediately swaps to in the unlikely event that the chilled water goes out on site. This backup system actually pulls in cool air from the hallways, something we have not seen yet, in our experience!

An entirely uncommon grease interceptor for their full commercial kitchen: A grease interceptor in general is required by code, but this facility invested in a hydromechanical grease interceptor. Far more expensive than your basic iteration, this piece of equipment is more effective at trapping grease before it has an opportunity to get into the sanitary sewer system. 

A question on the minds of contractors looking at this list might not be the what so much as the how. 

Planning is paramount. The further ahead we’re able to plan, the better we can model and the more we can prefabricate and the more effective our installation will be. This project, for example, is using block scheduling throughout. What that means is that each has a specific window to complete work in before the next team comes in for theirs. There’s no option for delaying. You have to meet your commitments. This project is also on an active site. With zero space for material storage and lay down, deliveries must be scheduled right to the exact moment the material is needed. 

None of the above can be accomplished without effective and frequent communication both within our teams and beyond them. Work on projects like these cannot be completed in silos. For example, nine out of 10 floors for this build need to tie into the adjacent, existing building. That means all but one planned level have floor-to-floor height constraints that can’t budge, which has to be communicated effectively to architects who may want to see the ceilings lowered. The design has to marry the new building to the old one, with BIM playing a crucial role making sure ductwork, piping and electrical are correctly fitted into the ceiling space we have. 

Everyone working in this industry understands that the best contractors in the world are only as good as the teams they’ve built to get the work done. So, we can’t understate the significant challenge posed by ongoing labor shortages in our industry. You can’t meet commitments like block scheduling if you don’t have teams of people who are completely on task throughout. You won’t be able to come up with an on-the-fly solution for a just-discovered issue onsite if you don’t employ quick thinking problem-solvers. In a major urban area this is going to go beyond a nice job posting offering work on some of the biggest, coolest projects around. No, to remain competitive today, a contractor has to also be a reliable, high-quality partner to the community as well as local labor unions and organizations. 

Projects like these are likely to increase in complexity as environmental regulations continue to change alongside building design aesthetics and never-flagging advancements in technology. Delivering on expectations is about how well we’re able to coordinate with all the other cooks in the kitchen, manage expectations along the way, mitigate risk and pivot on a dime. Success isn’t just found in Plan A, it’s in the contingencies and the teams; expert knowledge, quick minds, curiosity and lateral thinking are almost certain to win the day. 

Getting it right means striking the right balance. For the hospitals looking to be sustainable and safe, that balance is between access to more energy while regularly using less. For the contractors bidding on that work? It’s being able to do more with less, without slowing down.

Jon Hegge, senior manager, business development and preconstruction with Harris, is a licensed professional engineer with a background in technical sales, design engineering and preconstruction. He has extensive experience in leading MEP system design and project management for complex projects across diverse markets and regions.