- Opened in December 2025, UCI Health’s 357,000-square-foot hospital in Irvine, California, stands as one of the first all-electric acute care hospitals in the U.S., achieving an energy use intensity of 115 (well under the national median of 400-plus) while on track for LEED Platinum certification.
- By orienting 80 percent of patient rooms toward the neighboring San Joaquin Marsh Reserve and pairing biophilic design with bird-safe glazing, the design team turned the surrounding wetlands into an active part of the healing experience.
- A shared surgical “megafloor” linking the hospital and its ambulatory care center centralized sterile processing and pushed operating room efficiency to nearly 80 percent, outperforming industry benchmarks by 10 percent.
Situated adjacent to the 300-acre San Joaquin Marsh Reserve, UCI Health’s new acute care hospital in Irvine, Calif., stands as a testament to the organization’s decarbonization goals. Opened in December 2025, the 357,000-square-foot facility is one of the first all-electric acute care hospitals in the U.S.
“How can you not embrace a story of sustainability when you’re right next to the marsh?” says Brian Pratt, who was associate vice chancellor and campus architect at the University of California, Irvine (UC Irvine; Irvine, Calif.) during this project. “We considered this location to be a real differentiator, so the design needed to honor the marsh, not only as a resource and an inspiration but as part of the healing story of patient care.”
Although UCI Health operates a large hospital offering emergency care, imaging, and cancer treatment about 13 miles away in Orange, Calif., traffic on the 55 freeway often forced long travel times for patients coming from Irvine. According to Pratt, bringing these services closer to University of California, Irvine’s (UCI Health-Irvine) main campus presented a “once-in-a-lifetime opportunity to change the landscape of healthcare in Orange County.”
UC Irvine sets new standard for sustainability
The 7-story hospital connects to the adjacent 5-story Chao Family Comprehensive Cancer Center and Ambulatory Care Center (ACC) through a ground-level “surgical megafloor” that accommodates both inpatient and outpatient procedures. Above the surgical floor, an outdoor plaza links the main entrances into each building. Inside, the hospital features a 20-room emergency department on the second floor, administrative spaces on the third, and 144 universal patient rooms across the remaining four floors.
Building on UC Irvine’s longstanding commitment to sustainability, UCI Health signed a Climate Pledge in 2022 aiming to achieve net-zero greenhouse gas emissions by 2050. Although energy-intensive healthcare facilities qualify for exemptions from UC Irvine’s overall carbon reduction goals, the system’s leaders decided early on that the hospital would set a new standard for sustainability. UCI Health – Irvine is on track to be the 24th LEED Platinum building on the UC Irvine campus and the sixth LEED Platinum hospital nationwide.
To achieve its vision, UCI Health partnered with CO Architects (Los Angeles) for architecture and interior design, along with Hensel Phelps (Greeley, Colo.) as general contractor, while also collaborating with multiple trade partners and consultants.
“We put a flag in the ground and said, ‘We’re going to be the first ones to lead the way, and we’re going to embrace the problem-solving and collaboration that need to occur,’” Pratt says. “It takes a profoundly different approach to pursue such a game-changing project.”
Outlining energy goals for UCI Health – Irvine
While UCI Health wanted the new acute care hospital to be as energy efficient as possible, the project didn’t set out to be all-electric from the start. Initially, the health system planned for electric HVAC systems but assumed that more energy-intensive processes like humidification, sterilization, and cooking would still require gas, Pratt says. But as the design-build contractors began sourcing energy-efficient equipment to minimize the facility’s energy use intensity (EUI), they realized that total electrification was actually feasible.
“When you electrify services like sterilization and humidification, you eliminate an incredible amount of distribution piping and equipment that needs to be maintained, which created significant savings over time,” Pratt says. “By reducing those lifecycle maintenance costs, our engineers were able to demonstrate a 3.4-year payback by going all-electric, which is a blink of an eye when you’re designing a building to last a hundred years.”
Pratt says the healthcare organization spent close to two years negotiating with the local public utility provider, Southern California Edison, to ensure that they would have the resiliency, clean power, and sheer capacity needed to build an all-electric hospital. “Once we cleared that hurdle, we had to focus on minimizing our carbon footprint,” he says.
Reducing the project’s energy usage required finding the right electric-powered equipment to meet the building’s needs. “We thought we would have to develop a whole new system, but we were able to utilize readily available equipment,” says Brian Maximuk, operations manager at Hensel Phelps (Irvine, Calif.). “It was just aligning the right equipment in the right combination and sequence to meet the requirements of a healthcare facility.”
Using heat recovery chillers in healthcare facilities
For example, a critical technology that enabled UCI Health – Irvine’s all-electric facility was a dual-purpose HVAC system that captures heat generated during the refrigeration cycle to simultaneously produce chilled and hot water.
Although widely used in Europe, these heat recovery chillers are less common in the U.S. Pratt attributes the “incredible expertise and tenacity of Hensel Phelps and the design team” for enabling the sourcing of this equipment, which also created momentum within the broader industry. “Because we’ve demonstrated that it’s achievable, not only are other hospitals following suit, but equipment manufacturers are following along too, so there are more heat recovery chillers on the market now.”
However, this equipment presented another challenge: space. “We had to pay attention to the footprint, because electrical equipment requires more space, plus additional utility infrastructure, like routing conduits,” Maximuk says.
The engineers’ answer was a freestanding 31,848-square-foot central utility plant “to make all the puzzle pieces fit,” putting backup generators and mechanical equipment on the roof and even adding a 60-foot extrusion to accommodate the air stacks required for the heat pumps.
Relative to the total area of each facility, the hospital’s energy efficiency measures 115 EUI while the ACC measures 62 EUI — well below the national medians for healthcare facilities reported by Energy Star, which exceed 400 and 100 EUI, respectively.
Site strategies for new hospital projects
The initial request for proposal (RFP) positioned the hospital away from the marsh, instead placing the central utility plant nearest to the wetlands. When developing the initial design concept, Hensel Phelps’ previous operations manager questioned this placement, recognizing the marsh as the site’s defining feature. He proposed moving the hospital and the ACC south, orienting the buildings so that 80 percent of the rooms would have views of the landscape.
“Overall healing is more than just medicine; it’s the experience the patient has when they can embrace nature instead of feeling like they’re in a hospital,” Maximuk says.
To accentuate these views, the design team also added several outdoor terraces to bring patients, staff, and visitors even closer to the marsh. For example, on the fourth floor of the ACC, patients receiving infusion therapy can sit outside, immersed in the sights and sounds of nature.
“When you’re inside, you just get the view, but there are so many other sensory benefits an outdoor terrace can offer that contribute to the healing power of biophilic design principles,” says Gina Chang, principal and healthcare team lead at CO Architects (Los Angeles).
Beyond visual connectivity, “the marsh became a touchstone for many decisions because we wanted to be good stewards of the environment,” Pratt says. “Even the arrangement of the buildings and the selection of the glass are based largely on preventing bird strikes.”
For example, designers minimized expansive surfaces of reflective curtainwalls utilizing a custom vertical frit pattern on the glass along with horizontal sunshades to break up the flat façade. This approach improved energy efficiency, reduced solar heat gain, and provided a bird-safe design, Maximuk says.
To optimize the shading mechanisms, the design team leveraged machine learning to balance views, glare, solar heat gain, constructability, and cost. “The marsh was a constant inspiration and challenge,” Chang says. While orienting the buildings to maximize marsh views increased the solar heat gain, the team focused on the healing patient experience. “We made the decision to prioritize views first and then figure out solar shading to support that,” she says.
The high-performance unitized curtainwall, strategic glazing, shading design, and positioning of the buildings to shade each other achieved an 85 percent reduction in overall solar gain, according to CO Architects.
Creating a surgical “megafloor” to maximize operational efficiencies
UCI Health’s original RFP envisioned a skybridge connecting the acute care hospital to the neighboring ACC, which opened in 2024. After several discussions with UCI Health leaders during the design bid competition, the teams at Hensel Phelps and CO Architects proposed moving the connection down to the ground level, creating a shared surgical “megafloor” between the two buildings.
Not only did this free up space above the first floor to provide an outdoor plaza overlooking the marsh, Maximuk says, “but it also created operational efficiencies, where high-risk outpatient procedures could be directly transported to the inpatient hospital if needed.”
Spanning 167,105 square feet, the megafloor combines inpatient and outpatient surgical services with 15 standard operating rooms, five interventional procedure rooms, four advanced multispecialty interventional suites, and 64 flexible pre- and post-operative rooms.
The shared surgery platform reshaped the entire complex, driving efficiencies in sterile processing, patient flow, and OR turnover. “It changed the game for the layout of the whole complex,” Pratt says.
A key decision was centralizing the sterile processing department (SPD) as part of this megafloor. “We were able to upsize the SPD in the ACC to support both buildings and reduce the size of the SPD in the hospital, which was a big savings from a cost and space standpoint,” Maximuk says.
To optimize how the centralized SPD would serve the surgical megafloor and how patients would move from pre-op through the ORs to recovery, CO Architects turned to AI-generated computer simulations.
Designed like a video game, with clinicians modeled as characters, the simulations played out a full year of use, comparing traffic patterns and room assignments to identify the most efficient flow.
That intelligence gave UCI Health’s surgical leadership the insight to develop an innovative assembly-line model for sterile processing: an extra-wide sterile core with two aisles of shelving, allowing staff to efficiently choose instruments and equipment for each procedure.
As a result, the ORs at UCI Health – Irvine are currently operating at nearly 80 percent efficiency, performing 10 percent better than the industry benchmark. “That has profound impacts, not only on enhanced patient care,” Pratt says, “but also the obvious business benefits that come with that efficiency.”
How can project teams enhance patient experience through design?
By embracing the adjacent marsh as an inspiration to enhance the patient experience while protecting the environment, UCI Health – Irvine achieved its goal of creating a healing destination in the nation’s first all-electric hospital. Throughout the project, thoughtful design decisions optimized care while minimizing the site’s carbon footprint to set a new standard for sustainability.
“The intangibles that come from the vistas over the marsh, along with the tangible measures of OR efficiency and all-electric sustainability, come together to make this facility greater than the sum of its parts,” Pratt says.
Brooke Bilyj is a freelance writer and owner of Bantamedia (Cleveland) and can be reached at [email protected].
UCI Health – Irvine project details
Project location: Irvine, Calif.
Completion date: December 2025
Owner: UCI Health, University of California, Irvine
Total building area: 357,000 sq. ft. (hospital); 223,000 sq. ft. (comprehensive cancer center and ambulatory care building; 31,848 sw. ft. (central utility plant); 1,340-space parking structure
Total construction cost: $1.3 billion
Cost/sq. ft.: Not disclosed
Architect: CO Architects
Interior designer: CO Architects
General contractor: Hensel Phelps
Engineers: WSP and tk1sc (MEP/IT, lighting, LEED), Degenkolb (structural), Stantec (civil), Newson Brown Acoustics (acoustical)
Builder: Hensel Phelps
Medical equipment planner: Mazzetti
Acoustical Vibration: Colin Gordon Associates
Landscape Architect: Ridge Landscape Architects (RLA)
Signage: SKA Design
Interior design/furniture/audio visual: CO Architects
Laboratory/pharmacy planning: CO Architects
Disabled access: USAccess Consultants
Food service: Webb Foodservice Design
Material handling/vertical transport: St. Onge Company
Geotechnical: Langan
Façade access: Olympique Façade Access
Carpet/flooring: Daltile, Corradini Corp., Patcraft, ShawContract
Ceiling/wall systems: 9Wood, Armstrong World Industries
Doors/locks/hardware: Assa Abloy, Cookson Door, Enclos, Gildor Automatic Doors
Fabric/textiles: Designtex; Concertex, Ultraleather
Furniture—seating/casegoods: Allseating, Bernhardt Design, Carolina, Davis Furniture, Global Furniture, Integra, Janus et Cie, Keilhauer, Kwalu Furniture, OFS, Stance Healthcare, Teknion, Terra Furniture, Wieland Healthcare
Surfaces—solid/other: Corian, Formica, Wilsonart Engineered Surfaces
Exterior cladding: ORCO, Enclos, National Ready Mixed Concrete Company, California Sheet Metal
Seismic Joints: CS (Construction Specialties), MM Systems
Roofing: Letner Roofing Co.
Glass: Viracon
Cabinetwork and custom woodwork: ISEC
Paint: Sherwin-Williams
Elevators: Otis Worldwide Corporation
HVAC: Multistack
Plumbing fixtures: American Standard
Project details are provided by the design team and not vetted by Healthcare Design.
