Fairview Health Services Proves the Value of “the Matrix”

By Staff July 1, 2006

As an integrated health-care system, Fairview’s six community hospitals, academic medical center, children’s hospital, 31 primary care clinics, 25 specialty clinics, four urgent-care clinics and specialty service centers across the state of Minnesota provide a complete range of health-care services.

In partnership with University of Minnesota Physicians, Fairview plans to open the Maple Grove Outpatient Specialty Care Center in 2007, a 135,000-sq.-ft. specialty care center that comprises six operating rooms, a diagnostic center, a cancer center and outpatient clinic.

Fairview, Walker and Assocs.—the owner’s representative—and the M/E/P firm, Hammel, Green and Abrahamson, Inc., Minneapolis, decided that the mechanical systems and equipment would be dedicated to serving the Phase I ambulatory care center, with space allotted for a central plant to house the heating plant, water-cooled chillers, cooling towers and other equipment to meet the future building’s needs. The present system will then be tied into the central plant.

Fairview used an objective approach and decision-making matrix to select among four options for the mechanical system:

Option 1: Rooftop units (RTUs), with cooling provided by a refrigerant cooling coil, compressor and air-cooled condensing unit; gas-fired heating; and ventilation in one package; with screening.

Option 2: Improved RTUs with an integral hallway for each RTU to provide better access to the roof and enable maintenance to be performed indoors.

Option 3: Rooftop-level air-handling units (AHUs) providing ventilation, with cooling provided by a cooling coil and basement-level chiller, and heating provided by a heating coil and basement-level boiler.

Option 4: Similar equipment to Option 3, but with the AHU located in the basement, with shafts for outside air and relief air.

The building user group and members of HGA’s project team identified and weighted 12 financial and performance criteria, which included several high priorities: patient and staff safety; patient and staff comfort; initial cost; energy efficiency/payback; flexibility for vertical expansion; and sustainable design. HGA developed early schematic designs of each of the four options, and Walker and Assocs. and Knutson Construction Services, Minneapolis, developed construction estimates.

Option 1 offered the lowest initial cost, fast installation and a single equipment package, but came with higher life-cycle costs, lower energy efficiency and increased labor cost for maintenance when compared with the other options. Option 2 offered a moderate initial cost, with lower maintenance costs and higher-quality equipment, yet energy efficiency and life-cycle costs remained drawbacks. Option 3 offered better life-cycle costs than Options 1 or 2, yet it was the most expensive and reduced future flexibility for vertical expansion.

The decision-making process was complicated by the prospect of the Phase II addition. The group recognized that Options 1 and 2 were priced to qualify as “throwaway” systems when Phase II is implemented, but not Option 3. Moreover, if Phase II were to be built above Option 3, potentially costly structural modifications would be required.

The user group, project team, architect and Fairview executive-level leaders ultimately chose Option 4 because it combined reasonable initial cost, good life-cycle cost and flexibility.

Criteria Weight Option 1: Rooftop units Option 2: Rooftop units w/access Option 3: Penthouse AHUsw/central plant Option 4: Mech. room w/central plant
Patient comfort and safety 25% 2 2.7 2.7 2.7
Flexibility and future growth 25% 1 2.5 2.5 4
Low first cost 25% 4 2 2 2
Energy efficiency 10% 1 3 3 3
Maintainability 5% 1 2 3 4
Aesthetics 5% 1 1 3 5
Integration w/floor plan 5% 3 3 3 1
Total unweighted 13 16.2 19.2 19.6
Total weighted 2.1 2.4 2.5 3