In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject. Bryan Jones is a director at Shepley Bulfinch (Houston). Here, he shares his thoughts on resilient design, incorporating music into healing environments, and the opportunities—and challenges—of turning former retail spaces into healthcare facilities.

1. Countering risk through resilient design

We’ve seen how important it is for hospitals to be able to withstand natural disasters and recover quickly from them. Understanding a facility’s risks and utilizing resilient design gives healthcare design teams and project owners the power to make wise decisions. When Hurricane Ike hit Galveston, Texas, in 2008, flooding impacted over 1 million square feet of the University of Texas Medical Branch’s (UTMB) campus. Afterward, UTMB evaluated its system vulnerability and established new elevation criteria, including relocating essential systems like generators above the second floor of buildings and adding wetproofing and flood doors in limited areas to provide protection of assets and quick response recovery from future flood events.

2. Adaptive reuse

As real estate and construction costs continue to rise, healthcare providers are looking to maximize their capital investments by renovating existing building stock—including former retail sites—into hospitals, medical offices, and clinics. Healthcare planning and design teams often need to address issues specific to these sites to bring these spaces up to code for use as a healthcare facility, such as ensuring that the existing construction type classification is suitable for healthcare occupancy. In addition, the building envelope and roof must meet current energy code requirements, and mechanical and electrical systems will most likely need to be replaced.  Consideration should also be made for improvements to the site conditions to enhance the patient experience.

3. Artful healing

Incorporating the arts into healing environments can involve more than paintings and sculptures. Studies show that music can trigger the brain to release chemicals that distract the body from pain, and researchers also have found that the emotions patients experience while listening to music can have a healthy effect on blood vessel function. Project teams should promote early discussions with clinicians and administrators to determine how and where to incorporate audio and visual enhancement to the patient experience, as well as any therapeutic or treatment technologies.

4. Beyond the big room

Having design and construction team members work together in the same space for all or part of a week can lead to faster delivery and significant savings in time, dollars, and efforts on projects. However, an effective collocation process requires more than a room filled with schedules, sticky notes, and whiteboards; it requires an environment and culture of multidiscipline stakeholders with a common goal of project success. For the Banner University Medical Center Tucson project, a 700,000-square-foot addition that will replace much of the existing hospital, the project team of Shepley Bulfinch, GLHN architects, DPR and Sundt construction companies, and Affiliated Engineers, Inc., as well as major sub-contractors, created a “one-team” approach. Weekly check-ins and report-outs from representatives of each consulting firm, construction trade, architect, and owner provided timely updates to critical issues requiring input or coordination from multiple partners. The team also set aside time for valuable team-building activities to strengthen camaraderie and have some fun together.

5. Adopting sustainability

Throughout my career, I’ve observed the evolution of sustainability in healthcare. One of my favorite resources in college was Design with Climate: Bioclimatic Approach to Architectural Regionalism by Victor Olgyay. Published well before the LEED rating system existed, this book instilled sustainability and energy conservation as basic design principles that I apply to every project. When LEED was first introduced, it was very difficult to apply to hospitals, but as designers, we continued to apply responsible practices towards energy conservation and environmental stewardship. Today, I’m encouraged by the newest version of LEED, which considers the complexities of critical 24-hour facilities and identifies the target metrics to align with the common goal of sustainable architecture.

Bryan Jones, AIA, LEED AP is a director at Shepley Bulfinch (Houston). He can be reached at