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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: 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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