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MEDICAL PROJECTS
1.
MASTER
PLANNING FOR HEALTH CARE FACILITIES:
We have extensive experience as the AE for military healthcare projects,
including planning, interior design, space evaluation, programming, and medical
equipment planning for healthcare projects. Strategic Planning and
Functional Programming for Medical Facilities is required to establish a
Comprehensive Business Plan (CBP) that defines realistic construction funding
availability forecasts that will coincide with the forecast of projected phased
construction cost requirements of the programmed facilities. 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 programming documentation. Documentation of your ideas is necessary
for the dissemination and review of your ideas.
1.1.
Strategic
medical facility planning for large scale projects involves a phased funding
process that is normally not 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.
1.2.
We believe
“user involvement” is essential to effective planning. Our most significant
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. We are your team and you are
aware of project direction at all times.
1.3.
From our
earliest assignments, we have been called on to serve both large and small,
urban and rural hospitals with complex development problems balancing clinical
program, facility and financial priorities against competitive and regulatory
realities.
1.4.
Medical
facilities are more complicated than an educational facility where student
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. SDJ&S believes that HVAC design for public areas should consider
airborne disease transmission control.
3.1. 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.
4. laboratory and
research facilities: SDJ&S 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 SDJ&S 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 10 operating rooms on the 3rd floor with
ancillary areas for cardiac surgery (Dr. DeBakey). SDJ&S 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. SDJ&S
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. SDJ&S 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.
5. LABORATORY HVAC DESIGN: We have
three 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.
6. 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.
7.
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.
8. MEDICAL
PLANNING:
Spencer Dunaway Jones & Smith, 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 Projections
Certificate of Need Planning/Design Assistance Operations Space Planning
Facility Evaluation Equipment
Planning Financial Planning
Budget Recommendations Research Facility Assessments
9. FUNCTIONAL REVIEW OF MEDICAL FACILITIES:
Spencer Dunaway Jones & Smith, 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. SDJ&S is also familiar with MIL-HDBK-1191 for Military
Medical Projects.
10.
SURVEYING MEDICAL FACILITIES FOR NFPA 101 AND JCAHO DEFICIENCIES PREPARATION OF
DEFICIENCY REPORTS AND EQUIVALENCY STUDIES
10.1.
soc statement of
conditions survey: SDJ&S has
prepared Statement of Conditions Survey (SOC) for the Joint Commission on
Accreditation of Healthcare organizations (JCAHO) for the healthcare facilities
in the Houston Area. SDJ&S professional architects and engineers are familiar
with the JACHO requirements.
10.2.
SURVEYING FACILITIES FOR NFPA & JCAHO DEFICIENCIES:
In 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.
10.3.
EQUIVALENCY STUDIES:
SDJ&S has
provided documentation justifying existing conditions being equivalent to new
code requirements:
11.
DESIGN
OF UPGRADES TO MEDICAL FACILITIES:
SDJ&S is the AE of record for the following medical projects:
11.1.
THE
METHODIST HOSPITAL - BROWN BUILDING - OPEN HEART SURGERY OPERATING ROOMS -
REMODEL - $1,600,000 - 1995 - HOUSTON, TEXAS
11.2.
UNIVERSITY
OF TEXAS - M D ANDERSON HOSPITAL - SMITH RESEARCH BUILDING PHASE I - HOUSTON,
TEXAS 1989 - $1,351,000 - We have also designed numerous other additions and
modifications to this same existing research building in the Texas Medical
Center. We are currently designing the Phase II addition $3,800,000 to this
Building.
11.3.
PERFORMED
JCAHO ACCREDITATION INSPECTION AND REPORT for Mariner healthcare facilities -
Houston, Texas.
11.4.
Darnall comunity hospital
- Repair Fire Alarm system - $150,000
11.5.
Darnall comunity hospital
- Photographic Waste Collection/Silver Recovery System - $150,000
11.6.
Darnall comunity hospital
- Replace Halon Fire Suppression Systems - $150,000
11.7.
ACOUSTICAL
CEILING BASE HOSPITAL USAF COMPOSITE MEDICAL FACILITY BERGSTROM AFB, TEXAS -
Replaced existing acoustical ceiling, except dental area, while spaces were
occupied.
11.8.
COMPUTER
ROOM BASE HOSPITAL USAF COMPOSITE MEDICAL FACILITY BERGSTRUM AFB, TEXAS -
Created computer room in an existing space, separate air conditioning, raised
floor.
11.9.
FY76 28
CHAIR DENTAL CLINIC FORT HOOD, TEXAS - New building with dental chairs, oral
surgery, X-Ray rooms, dental laboratory, plaque control center offices, zoned
air conditioning.
11.10.
FY77 28
CHAIR DENTAL CLINIC FORT HOOD, TEXAS - New building with dental chairs, oral
surgery, X-Ray rooms, dental laboratory, plaque control center offices, zoned
air conditioning.
11.11.
FY78 28
CHAIR DENTAL CLINIC FORT HOOD, TEXAS - New building with dental chairs, oral
surgery, X-Ray rooms, dental laboratory, plaque control center offices, high
pressure double duct air conditioning.
11.12.
HARRIS
COUNTY FORENSIC MEDICAL CENTER ADDITION HOUSTON, TEXAS - MEP Consultant - Added
three floors of medical laboratories to existing three story building.
11.13.
BAYTOWN
HEALTH CLINIC - MEP Consultant
11.14.
THE
METHODIST HOSPITAL HEMATOLOGY LABORATORY - Converted existing ninth floor
office space to research laboratory.
11.15.
THE
METHODIST HOSPITAL CA SCAN UNIT INSTALLATION - Installed new CA Scan X-Ray unit
into existing third floor space. This type of X-Ray has a computer for
enhancement and recall of the images created by X-Ray scan.
11.16.
THE
METHODIST HOSPITAL IMMUNOLOGY LABORATORY - Converted existing fifth floor
laboratory space to research laboratory.
11.17.
THE
METHODIST HOSPITAL ANIMAL TESTING RESEARCH - Converted existing seventh floor
laboratory animal kennel space to research laboratory.
11.18.
THE
METHODIST HOSPITAL ADMIN. ASSIST. OFFICES Converted existing basement floor
space to office use space.
11.19.
THE
METHODIST HOSPITAL CENTRAL MAIL FACILITY Converted existing basement electrical
repair shop floor space to mail handling office space.
11.20.
BEEVILLE
MEMORIAL HOSPITAL - SURGICAL WING REMODELING BEEVILLE, TEXAS - Remodeled HVAC
and filtration systems as required to bring hospital systems into conformance
with JCAHO accreditation.
11.21.
BEEVILLE
MEMORIAL HOSPITAL MECHANICAL SYSTEMS REMODELING BEEVILLE, TEXAS - Remodeled water
softener and diesel fuel supply systems as required to bring hospital systems
into conformance with current codes.
11.22.
DELTA
MEDICAL CENTER HOSPITAL ADDITION AND REMODELING - MEP Consultant - Consultant to
Caudill Rowlett & Scott - Greenville, Miss - Remodel existing hospital as
required to comply with current codes
11.23.
INSTITUTE
OF SURGICAL RESEARCH - FT. SAM HOUSTON, TEXAS
12.
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.
Chilean Naval
Hospital - MEP Houston, Texas
Medico Center
Professional Building "B"- MEP Houston, Texas
Medico Building
"C"- MEP Houston, Texas
Pasadena-Bayshore
Psychiatric Unit - MEP Pasadena, Texas
Eastwood
Professional Bldg - MEP El Paso, Texas
TSU Pharmacy
Building Remodel - MEP Houston, Texas
Riverside General
Hospital Relighting - MEP Houston, Texas
Grimes County
Hospital Remodel - MEP Houston, Texas
Ben Taub Hospital
X-Ray Area - MEP Houston, Texas
Joseph A.
Jachimczyk Forensic Center 3 floor Addition - MEP Houston, Texas
CAT System, Ben
Taub Houston, Texas
The Methodist
Hospital - CAT Scan Unit - Third Floor
Houston, Texas
The Methodist
Hospital - 2nd Floor X-Ray - MEP Houston, Texas
The Methodist
Hospital - Opthamology Lab 5th Floor - MEP Houston, Texas
The Methodist
Hospital - 2nd Floor X-Ray
Houston, Texas
The Methodist
Hospital - Remodel ICU
Houston, Texas
The Methodist
Hospital - rm. 248 Install
x-Ray Unit
Houston, Texas
The Methodist
Hospital - UPS System - Data
Processing Center Houston, Texas
The Methodist
Hospital - Scurlock Tower Level 5 ST5 Mammography Houston, Texas
M D Anderson
Cancer Center - Surgical Research Laboratory
Houston, Texas
M D Anderson
Cancer Center - SRB Central
Utilities Plant
Houston, Texas
The Methodist
Hospital - TV System
Houston, Texas
The Methodist
Hospital - Central Mail System
Houston, Texas
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