Gerald Spencer, P.E. has more than 50 years experience serving as the Engineer of Record responsible for the design and construction of the MEP portions of more than 1300 building construction projects since 1968 including more than 30 years of preparing forensic engineering reports. Gerald Spencer, P.E. has also been providing licensed professional engineering expert opinion and testimony concerning HVAC, electrical, plumbing, cryogenics, ventilation, construction contract compliance, construction cost  estimating, construction contract acquisition, construction contract administration, and other construction matters for attorneys with  since 2001.

medical health care facilities

We have extensive experience as the AE or record for military healthcare projects, including planning, interior design, space evaluation, programming, and medical equipment planning for healthcare projects. 

1. MASTER PLANNING FOR HEALTH CARE FACILITIES:Master Plan Documentation for healthcare facilities should be considered to be a flexible document that must change with changing technology and changing healthcare requirements. This is true is all master planning.

1.1. Strategic Planning and Functional Programming for Medical Facilities is required to plan facilities in advance of need to meet patient and medical research requirements.

1.2. Strategic medical facility planning for large scale projects usually involves a phased funding over several years.

1.3. We believe “user involvement” is essential to effective medical facility planning.

1.4. From our earliest assignments, we have been called on to serve both large and small medical facilities.

1.5. Medical facilities are more complicated than most other facilities.

1.6  Medical need to establish a Comprehensive Business Plan (CBP) that defines realistic construction funding availability forecasts to coincide with the forecast of projected phased construction cost cash flow requirements of the programmed facilities.

1.6.1.  Master Site and Facilities Planning (MSFP) in conjunction with the definition and construction cost of facility construction at each phase is adjusted to correspond with the CBP. The MSFP is adjusted to agree with the CBP. Changes in the CBP require changes in the MSFP. The CBP and the MSFP is seldom a static document, but a constantly document changing according to Patient Load, Procedure Emphasis, Patient Illnesses, Technology Improvements & Innovations, Income, expenses, and many other factors that change constantly. The medical health care managers and the facility managers must correspond regularly for strategic planning and functional requirement programming documentation.

1.6.2 Documentation of your ideas is necessary for the dissemination and review of ideas for future facilities is normally discussed and defined prior to appplication for funding, Most projects are not completely funded entirely at one time. Funding can be erratic, so that multiple contingency facility operating options throughout the planning phases must be available. The facility planning must be phased to coincide with projected capital funding availability. With the rapid pace in the advancement of medical technology and demands for better healthcare, medical facilities have become highly complex. A medical design specialist is almost necessary for the planning, coordinating and success of any large healthcare facility project.activity will occur onsite with your management, board members and physicians. By this approach, time is saved and decisions are more clearly understood and likely to “hold”. Users become more knowledgeable and supportive of the project results. There are no surprises in our approach.

1.6.3  We are your team to keep you aware of project direction at all times.urban and rural hospitals with complex development problems balancing clinical program, facility and financial priorities against competitive and regulatory realities.educational capacity expansion might only involve extending hallways and adding more classrooms along the hallway. As Medical facilities are expanded to increase patient treatment capacity, one area designated for two functions might have one of the functions relocated and the remaining function capacity expanded to take over the vacated space. This might mean remodeling particular areas of a medical facility several times before the ultimate master plan is constructed.

2. INFECTION CONTROL: Patients who come to medical facilities are highly susceptible to infection. They require special considerations in the design of mechanical systems and require isolation from other patients and visitors- One of the prime areas where patients are acutely sensitive to infection is burn centers. Virus and/or disease sites where patients' immunity is compromised, special consideration to both architectural and MEP (mechanical, electrical & plumbing) design are essential. Our team of design specialist have, collectively, over 20 years of experience in the area of infection control in medical facilities. Early on in the programming and planning process it is important to involve the staff that is responsible for maintaining infection control throughout the hospital. Their involvement provides the design team not only current information on the existing hospital's approach to infection control but also if the areas that are planned to be renovated have had a history of infectious disease problems, i.e. had this nursing unit formally been a TB unit or HIV unit. Had there been any incidence of high infection rates or abnormally high rates of diarrhea in the newborn areas, or has there been an increased rate of respiratory infection in the long term care unit. Information of this nature is important from an architectural and mechanical design perspective. For example, if the areas have had problems in the past, it is important that these areas are surveyed and decontaminated prior to the start of any demolition. From a design point of view it is important that the design team is aware of any special requirements that the hospital may require to maintain antiseptic conditions and determine what level is acceptable. Will this facility house patients that require negative or positive air pressure in their rooms? Will the air need to be exhausted 100% or can it be filtered via HEPA filters and returned to the unit. Is ultraviolet lighting required in the return air duct or is an alternate method acceptable both to the Infection Control Committee and Engineering. These and many other questions as to the design and selection of finishes is why we involve the Infection Control Committee early on in the process.

3. TUBERCULOSIS CONTROL: The recent increase of tuberculosis in the U.S.A. jail and hospital population will soon become a concern to the rest of the population when the infected population mixes further with the healthy population. Isolation of contagious persons is no longer possible because it is not politically correct. All of the population has varying degrees of resistance to becoming infected with TB. Those persons with AIDS, those undergoing Chemotherapy Treatment, and other persons with inhibited immune systems are more susceptible to TB infection than healthy persons. Untreated TB is fatal. TB is generally fatal to those with deficient immune systems. Those with intact immune systems only just require more TB airborne nuclei inhalation contact in order to eventually become infected. Other (yet to be determined) methods of TB control or cure are not currently available. TB is transmitted VIA airborne nuclei that can be partially controlled by directional air flows, HEPA filtration, and increased air circulation. All public places of congregation are possible exposure locations. Gerald Spencer recently attended the ASHRAE seminar “TUBERCULOSIS CONTROL IN JAILS AND HOSPITALS”. TB transmission prevention is a design concern in most third world countries. With the increasing international travel to third world countries, U. S. Citizens can become TB carriers without having any TB symptoms. This will probably become a future health concern to the United States. SEI believes that HVAC design for public areas should consider airborne disease transmission control.

4. LABORATORY AND RESEARCH FACILITIES:SEI is the AE of record for many medical research laboratories where Bio-Safety was the primary concern. This includes protecting the laboratory technician form the biohazard and containing the biohazard within the confines of the laboratory. Air flow directions in the directions required to protect the technician from the biohazard, to contain the biohazard, to collect the biohazard (filters), and to dispose of the collected biohazard waste. Past projects where SEI was the AE of record for the specialized HVAC systems include the M D Anderson Surgical research Laboratory, NASA Lunar Receiving Laboratory, The Methodist Hematology Research Laboratory, The Methodist Hospital Immunology Research Laboratory, Fort Sam Houston Institute of Surgical Research, and The Methodist Hospital Brown Building remodeling of the 20 open heart surgery operating rooms on the 3rd floor is also the AE for Medical operating room HVAC systems where the air flow philosophy is generally opposite because we want to provide clean air to the area of surgical incisions and have all air flows from this clean area to progressively dirtier areas. SEI is the AE of record for more than 30 EXXON petrochemical research laboratories that have specialized HVAC systems for the protection of technicians and for containment or control of chemical and/or biological hazards. SEI is the AE of record for more than 20 petrochemical research and analytical laboratories for Schenectady Chemical - Freeport, Texas; Dow-Badische Chemical - Freeport, Texas; DuPont Chemical - Laporte, Texas; Celenese - Victoria, Texas; that have specialized HVAC systems for the protection of technicians and for containment or control of chemical and/or biological hazards. We have in-house mechanical engineers with recent extensive experience in the design of medical, biological, chemical and hazardous materials research laboratories that comply with the latest OSHA and the Current State Hospital Accreditation Guidelines. These projects have been at NASA and in the Medical Center at Houston.4.1. LABORATORY HVAC DESIGN: We have in-house mechanical engineers  floor with ancillary areas for cardiac surgery (Dr. DeBakey). SEI with recent extensive experience in the design of medical, biological, chemical and hazardous materials research laboratories that comply with the latest OSHA and the Current State Hospital Accreditation Guidelines. These projects have been at NASA and in the Medical Center at Houston.

5. HEALTH CARE REVALIDATION: We have applied for new JCAHO accreditation of nursing homes that were not required to have accreditation. (The economic expense prohibited this accreditation, which was not required anyway. We suspect that the owners wanted accreditation for advertising and marketing purposes.) We have designed corrections for deficiencies that were documented formally during JCAHO accreditation SOC inspections. We have not re-validated or applied for re-accreditation for healthcare facilities that have lost accreditation, closed down for other purposes, or for facilities that have failed to meet accreditation criteria. We believe that we could easily perform services as required to re-validate a facility that needs re-validation.6. ECONOMIC ANALYSIS FOR HEALTH PLANNING: We have prepared economic life cycle cost analysis of healthcare facility and infrastructure systems. We have not prepared economic analysis of healthcare delivery systems. Gerald Spencer, PE has been performing life cycle economic analysis for Federal Government projects since 1965. We normally perform life cycle cost analysis in accordance with Federal Government Guidelines as a part of the design making decision making process in order to design and specify systems that will benefit the government to the largest extent over the life of the project for all of our Federal Government Projects. We have the ELITE, and the DoD BLAST-LCCID energy consumption analysis programs in-house. We have in-house Computer Programmed for the preparation of economic analysis for the various commercial projects. We have familiarity with the various Corps of Engineers Life Cost Analysis directives, Energy Conservation Investment Program (ECIP), DoD Technical Manuals and most of the rules and regulations governing the economic life cycle cost analysis (LCCA). Most of these life cycle economic analysis have been to conserve energy consumption, but these principals of LCCA have been used to formally determine the greatest value for other building and operational systems.

7. MEDICAL PLANNING: Spencer Engineers, Inc. can provide Planning and Functional Programming for Medical Facilities as follows:Strategic/Long Range Planning Hospital Organization/Management Needs Analysis Clinical Program Definition Location Study Work Load ProjectionsCertificate of Need Planning/Design Assistance Operations Space Planning Facility EvaluationEquipment Planning Financial PlanningBudget Recommendations Research Facility Assessments

8. FUNCTIONAL REVIEW OF MEDICAL FACILITIES: Spencer Engineers, Inc. has 30 years experience in the design of medical facilities. The majority of these projects have been modifications and additions to existing facilities. We have performed analysis and studies for various parts & parcels of these facilities. These reviews have been to analyze traffic flow, food service flow, equipment flow, utilities and infrastructure. These projects have had medical gas distribution systems, central vacuum systems, emergency engine generator power systems, surgical suites, research laboratories, medical laboratories, isolation rooms, compressed air, sterilizers, nurse call systems, sterile storage rooms, photographic laboratories with photographic waste/recovery systems, intrusion alarm systems, and fire alarm systems. SEI is also familiar with MIL-HDBK-1191 for Military Medical Projects.8.1. SURVEYING MEDICAL FACILITIES FOR NFPA 101 AND JCAHO 8.2. SOC STATEMENT OF CONDITIONS SURVEY: SEI has prepared Statement of 8.3. SURVEYING FACILITIES FOR NFPA & JCAHO DEFICIENCIES: In DEFICIENCIES PREPARATION OF DEFICIENCY REPORTS AND EQUIVALENCY STUDIESConditions Survey (SOC) for the Joint Commission on Accreditation of Healthcare organizations (JCAHO) for the healthcare facilities in the Houston Area. SEI professional architects and engineers are familiar with the JACHO requirements.preparing a Statement of Conditions for the JCAHO, we generally begin by using the last survey submitted by the Hospital, reviewing all of ft plans for construction that have occurred since the last JCAHO triennial survey and interviewing the appropriate Engineering personnel that have a working knowledge of the overall building MEP systems. Once this information is compiled and reviewed, our A/E team will walk the areas that may have been cited in the past, to make sure that corrective action has taken place and to confirm that all of those areas are currently in compliance. In performing this field analysis, generally we find areas that require additional corrective action and this is Pointed out to the accompanying Engineer or is documented on a set of reduced floor plans, and sometimes, corrective action is implemented by the hospital, prior to completion of the Statement of Conditions. Statement of conditions as relates to facilities is an analysis as to the physical history of building. It is an assessment as to current condition and requirements as to bring the facility into compliance with all applicable building and life safety codes. An analysis is made of the facility’s mechanical system(s) as to the extent of its useful life cycle. Preventing maintenance measures are outlined and requirements defined. Electrical distribution systems are documented as to their conditions. If any upgrades are required, additional loads or service charges will be made to accommodate increased demand. We have a complete multi-discipline team of professionals who can conduct an in depth on-site investigation of any facility and who can provide a complete and comprehensive statement of conditions report in a timely manner.conditions being equivalent to new code requirements:8.4. EQUIVALENCY STUDIES: SEI has provided documentation justifying existing 

9. MEDICAL EQUIPMENT PLANNING AND USE OF MIL-STD-1691, MEDICAL EQUIPMENT SCHEDULE FOR MILITARY MEDICAL FACILITIES: SEI has been designing DoD medical healthcare facilities since 1974 or before. We are familiar with the requirements of MIL-STD-1691 and have designed all of our recent DoD medical projects using this criteria. We have installed all types of Laboratory equipment, X-ray Machines, photographic processing equipment, silver recovery systems, medical waste systems, medical incineration systems, CA Scan systems, operating room equipment, recovery & intensive care equipment, laundry equipment, patient room equipment.

10. LONG TERM ON-SITE QUALITY ASSURANCE REPRESENTATION:SEI has been working at NASA-JSC since 1964. The generation of NASA personnel that we started working with have all retired, and we are working entirely with a second generation of younger employees. We can provide continuity and sometimes be a resource for answering questions (sometime) of why some thing was done 35 years ago.

11. CHARETTE DESIGN PROCESS: The SEI Charette design process usually means that the design professionals go to the existing using agency location, interview all personnel that will be involved with the new facility to determine mission, scope, and other requirements, and develop a preliminary design for the new facility. We will deploy a design team consisting of design professionals in each of the required design disciplines required to the site. The planning and programming for the conceptual Charette design normally requires that the design team be on-site to document the requirements of each function in detail and allow maximum user participation into the programming and design process. This will require interviewing the managers of each separate operation to determine current and future needs. The Charette designers will familiarize themselves with operations and the facility requirements of the facility users. This data will also include end user equipment utility connection requirements in tabular form. This data will be provided to our client in a written report form for review and approval as design criteria. This approved criteria will be used to formulate and design the building configuration during the Charette process. The design team will submit formal and informal floor plans for comments and/or approval by the used group. Hopefully the user personnel can approve the floor plan before the Charette design team leaves the site. If the Charette plans are not approved prior to leaving the site, at least the planning problems will be documented. The Charette Plans will then be used as reference (during telephone conversations) tool for later design decisions. The Charette designers will work closely with the facility users and create a facility design that enables the facility users to accomplish their mission. Engineering system space requirements (HVAC, Plumbing, Fire Protection, Electrical, Structural, etc.) will be determined at the Charette design and planning stage. This might entail familiarization with an existing floor plan design and site design to the point that we agree or have comments. Team members John Smith, AIA; and Gerald Spencer, PE recently (Jan 94) completed the Charette design process for the Fleet Mine Warfare Center at Ingleside NS, Texas. Mr. Paul Jones, AIA recently completed the (Dec 94) completed the Charette design process for the addition to the Amdahl Chapel at Kelly AFB, TX. Team Member W. Paul Jones, AIA recently (Jul 94) completed the Charette design process for the IAAFA Armory & Storage facility - Camp Bullis, TX.

11.1. SPACE PLANNING: Inter-relationships between spaces and functional requirements will be documented with “bubble diagrams”. This will document the space requirements and the functional relationship requirements between all of the various spaces. Spaces for the building systems will also be included.

11.2. BUILDING PLANS: With approval of space planning, we will develop conceptual floor plans that incorporate the space planning requirements. Spaces for the building systems will be included.

11.3. INFRASTRUCTURE: We include engineering into the Charette process more than might be necessary, but this eliminates drastic changes during the preliminary design process to accommodate building system space requirements that might have been ignored during the Charette Design Process.

11.4. MASTER PLANNING DOCUMENTS SHOULD INCLUDE UTILITY SYSTEM MECHANICAL, ELECTRICAL, ARCHITECTURAL, STRUCTURAL, LIFE SAFETY, AND CODE DEFICIENCIES: SEI has performed formal master utility planning for the R. E. Bob Smith Cancer Research Building at the M. D. Anderson Cancer Center in Houston, Texas. 

11.5. URBAN LAND PLANNING: We have extensive urban land use planning design experience. We have experience of planning, programming and documentation (Form DD1391 for line item federal funding) for many Military Projects for CESWF. We have the experience of 10 U. S. Army land planning projects, 3 U. S. Navy land planning projects, 8 comprehensive city plans, 18 Private sub-division land planning projects, and one zoning ordinance with zoning map for the City of Bellaire. These projects include new and remodeling projects. The following projects began with acreage: a/e work included site design, utilities and living unit buildings.

11.6. DATA PROCESSING FACILITY PLANNING: - SEI has performed space planning for many different data processing facilities. This planning included minimizing cable, fiber, and other DTM requirements. These have also included Cray V Super Computer Systems, the Amdahl Super Computer Systems, and the other data processing & data storage equipment that feeds information into and supports the systems. Gerald Spencer has prepared different and radical concepts for data processing facility design that are available for review by any interested party.

11.7. POTABLE WATER PLANNING: SEI computer modeled the potable water system at NASA-JSC and evaluated the impact of future facilities that will be served with the existing system. SEI provided future programming preliminary engineering design & construction cost forecast requirements for annual phased budgets and construction of modifications to improve the capacity of the Potable Water System. SEI is the AE of record and NASA has constructed these improvements during 1993 and 1994.

11.8. WASTEWATER PLANNING: SEI computer modeled the wastewater system at NASA-JSC and evaluated the impact of future facilities that will be served with the wastewater existing system. SEI provided future programming preliminary engineering design & construction cost forecast requirements for annual phased budgets and construction of modifications to improve the capacity of the Potable Water System. SEI is the AE of record and NASA has constructed these improvements during 1992, 1993, 1994, and 1995.

11.9. EXTERIOR SITE LIGHTING PLANNING: SEI has performed an analysis of all of the exterior lighting at NASA-JSC. SEI evaluated the condition of each pole, documented code compliance deficiencies, and provided the services of a lighting design expert to provide aesthetic replacement lighting for the central Mall area of the site. SEI provided future programming preliminary engineering design & construction cost forecast requirements for annual phased budgets and construction of modifications to correct the design deficiencies and to reduce maintenance. SEI completed the study in 1997 and expects to be selected as the AE for the construction of this lighting project. SEI subcontracted the services of a lighting consultant for aesthetic appearance and effect evaluation documentation.

12. DESIGN OF ADDITONS AND UPGRADES TO MEDICAL FACILITIES: SEI is the AE of record and Gersald Spencer, P.E. is the EOR for the following medical projects:

12.1. Chilean Naval Hospital, Punta Arenas, Chile - MEP 

12.2. Medico Center Professional Building "B"- MEP 

12.3. U.S. Army Institute of Surgical Research - SEI - Ft. Sam Houston, Texas

12.4. Medico Building "C"- MEP 

12.5. Pasadena-Bayshore Psychiatric Unit - MEP 

12.6. Eastwood Professional Bldg – MEP - El Paso, Texas

12.7. Three Dental Clinics – SEI - Ft. Hood, Texas

12.8. TSU Pharmacy Building Remodel - MEP 

12.9. Riverside General Hospital Relighting - MEP 

12.10. Delta Medical Center up-grade – MEP - Greenville, Miss

12.11. Grimes County Hospital Remodel - MEP 

12.12. Ben Taub Hospital X-Ray Area - MEP 

12.13.Joseph A. Jachimczyk Forensic Center 3 floor Addition - MEP 

12.14. CAT System, Ben Taub - SDJS 

12.15. CAT Scan Unit - Third Floor - Methodist Hosp. - SDJS 

12.16. The Methodist Hospital Annex - CAT Scan & Simulator - SDJS 

12.17. The Methodist Hospital - 2nd Floor X-Ray - MEP 

12.18. The Methodist Hospital - Opthamology Lab 5th Floor - MEP 

12.19. The Methodist Hospital - 2nd Floor X-Ray - SEI 

12.20. The Methodist Hospital - Remodel ICU - SEI 

12.21. The Methodist Hospital - Brown Operating Rooms Remodeling - SEI - 25 open heart surgical suites.

12.22. The Methodist Hospital - RM. 248 Install X-Ray Unit - SEI 

12.23. The Methodist Hospital - UPS System - Data Processing Center 

12.24. The Methodist Hospital - Scurlock Tower Level 5 ST5 Mammography 

12.25. Mariner Health - JCAHO Reports - SEI 

12.26. Beeville Hospital - Remodel Surgical HVAC - SEI 12.27. M D Anderson Cancer Center - Surgical Research Laboratory - SEI 

12.28. M D Anderson Cancer Center - SRB Central Utilities Plant - SEI 

12.29. The Methodist Hospital - TV System - SEI 

12.30. The Methodist Hospital - Central Mail System - SEI