Integration to the Core

Consolidation of the hospital's sterile, operating, radiology and emergency clinics called for a well-integrated design

By Scott Siddens, Senior Editor December 1, 2001

Hartford Hospital is the cornerstone of Connecticut’s health-care system. Located in the state capital, the 65-acre medical campus houses 45 patient care and support buildings occupying 2.1 million sq. ft. At the heart of this sprawling complex sits the new Core Building, housing critical facilities for central sterilizing, operating, radiology and emergency services. As can be imagined, such a project required an integrated design-team effort, one in fact that has earned the engineering firm van Zelm Heywood & Shadford Inc. (vZH&S), West Hartford, Conn., a CSE 2001 Integrator Award in the institutional category.

Because this story is about engineered systems, an interesting historical note is worth mentioning. Founded in 1854, Hartford Hospital came into being when a catastrophic boiler explosion created the need to treat the injured. Building system design has come a long way in 150 years, but Hartford’s Core project is another excellent example of how needs drive solutions; in this case, a well-coordinated design effort successfully brought state-of-the-art technologies and design strategies to a complex project. The Core project was not engineer-led, but M/E/P design and construction accounted for nearly half of the $52.5 million total cost. ‘It makes all the difference to have architects who make the workings of the engineered systems a priority,’ says Robert Rutkowski, P.E., a mechanical engineer for vZH&S. ‘We have a very good relationship with the project architect [The SLAM Collaborative, Glastonbury, Conn.], having worked on several projects with them.’

All parties agree that teamwork was the key. Rutkowski explains that the architect and the engineering firms’ use of the same organizing principle: Both firms are structured into design teams or ‘houses,’ facilitating the meshing of separate teams from each company. Significant scope

Before the respective design houses could begin work, the team had to come to grips with the scope of the project. Hartford Hospital administrators initiated the Core project with the primary goal of modernizing several of its main clinics. The Core Building would ultimately provide seven new stories of space, including the basement and rooftop mechanical penthouse. Within that space had to go critical clinical functions: central sterile processing (ground floor), the emergency department (first floor), radiology (second floor) and surgery (fourth). Additionally, non-clinical space included pastoral service offices, a chapel and a hub for hospital communications and security on the first floor.

But the Core Building itself was only part of the story. The plan illustration above shows how the Core addition would augment wings in the High, South and Bliss Buildings. In these existing structures, areas throughout almost all levels would have to be renovated as a part of the project. This, of course, meant the engineering design team’s task was not only to create new systems for the Core Building, but also to upgrade an already complex infrastructure and integrate these systems with those of the new addition.

At another level, the broader challenge involved fitting the new addition into an urban medical center confined by lack of space and existing utilities.

Eric J. Oliner, director of facilities planning and design at the hospital, admits that the team had its work cut out for them. He gives three broad examples of challenges faced by the designers:

  • Coordinating and integrating systems for power distribution, controlled lighting, HVAC, medical gases and medical and communications equipment for 10 operating rooms.

  • Providing data and electrical distribution-including an extensive fiber-optic network-for high-speed transmission of patient information, digital imaging and archiving information from CT scanners and other types of radiographic equipment.

  • Specifying three emergency generators located in the basement of the new addition and connected to exhaust stacks that had to be threaded through five floors and supplemented by rooftop draft inducers that reduce the potential for entrainment into adjacent intakes.

Special needs

Like all medical facilities, the Core Building houses an intensive infrastructure. It is even more the case for the Core project, however, because of the high concentration of critical clinics in the addition. Even beyond the unique needs of the basic M/E/P systems, there are other specialized requirements for medical facilities. Rutkowski explains that there were some very specialized interfaces for medical gases and electronics in he Core Building because of the critical nature of its clinics.

Central sterilizing is a type of operation unto itself, according to Oliner, with functions more akin to industrial processes than to the operations of other departments and clinics within a medical facility.

Lighting also has its specific requirements, especially in emergency and surgical rooms. For example, in the Core Building examination and operating rooms, rapid-start T-12 lamps of 5,000 Collaboration is key

In the best of partnering situations, the public or the actual facility users get involved at the planning and designing phase, which can be crucial to guaranteeing these users’ satisfaction with the end product. Rutkowski points out that it’s not only input from users that’s invaluable, but from department administrators as well.

Oliner agrees: ‘The key was collaboration. We have various user groups that worked closely with van Zelm to ensure that their needs were met-especially our engineering, biomedical engineering and information services department.’

Rutkowski points out another potential consequence for a complex, long-term project like the Hartford Core addition, where the planning and design phases can last for years rather than months: The design team players can change during the life of the project. In fact, this is what happened on the Core project. The engineer responsible for much of the preliminary scope left before the end of the project.

The Hartford Core is an excellent example of how an integrated and coordinated team effort can function over the long term, even through such transitions, to bring a project to successful completion.

Tale of the Tape

Project: Hartford Hospital C.O.R.E.

Location: Hartford, Conn.

Program: New addition with renovation of existing M/E/P, communication and lighting systems

Size: 1 million sq. ft. (100,000 sq. ft. new)

Total Cost: $52.5 million

M/E/P Cost: $25 million

Architect: The SLAM Collaborative, Glastonbury, Conn.

M/E/P/Fire/Life-Safety Engineer: van Zelm Heywood & Shadford Inc., West Hartford, Conn.

Plumbing Design: Accommodating Future Growth and Special Needs

Major medical centers are forever growing and changing. In developing a plumbing design for Hartford Hospital’s new Core Building, administrators and facility planners were already thinking about future change.

For example, plumbing risers for domestic water are situated at a central point and use valved and capped ends to accommodate a future six-story addition. Sanitary vent stacks were also designed for future growth.

Regarding the hospital’s current needs, specialized systems jumped to the fore of plumbing solutions. A separate acid waste and drainage system was required to serve facilities such as darkrooms. Additionally, special plumbing, fire protection and medical gas systems in renovated areas of the complex had to be altered to accommodate the changes to the existing systems that were not subject to renovation.

Siting of the new addition, which interconnected with several existing buildings, also affected the plumbing design. For instance, piping above ceilings in existing structures had to be relocated because it breached the confines of structural columns for the new addition.

Automatic sprinkler heads and piping were also moved to allow for installation of new HVAC ducts on the second and third floors of the Center and South buildings. Areas of the fourth floor of several existing buildings were altered to support the new fourth floor surgery area in the Core Building, meaning new plumbing, medical gas and sprinkler systems.

Finally, the first floor of the Core Building is an extension of existing emergency areas in the hospital, entailing a full complement of plumbing fixtures and medical gas outlets for compressed air, oxygen and vacuum.

Electrical, Life-Safety Highlights

Electrical and life-safety-systems for the Core Building project at Hartford Hospital are far too complicated to cover in detail here but highlights include the following:

Increasing the capacity of the existing primary feeder pair to accommodate the new load.

Adding a new 1,600-amp, 480-volt emergency feeder. Additionally, a new substation room was created in the basement of the Core Building.

Generating essential power with three 600-kW 750-kVA diesel generator sets and associated paralleling and distribution switchgear.

Integrating a fire-alarm system node for the Core Building into the existing fire-alarm network. Fire-alarm devices are provided throughout the building, and the new detection and initiating device is an addressable type, supplemented with addressable interface modules as required for flow and tamper switches, high temperature heat detectors and other conventional type devices. A new fire-alarm system node was installed in the heating and cooling plant as well.

Controlling building access with alarm contacts on public entrances to monitor status after normal hours. Each exterior entrance to the building has a combination intercom/CCTV unit wired back to the central security area to allow security personnel to activate doors.

Expanding communication systems. For example, the nurse call system was extended and expanded for the renovation and for the new building. Security panic buttons and CCTV cameras report both to the central security area and to local nurse stations.

HVAC Highlights

Design and installation of HVAC systems for the Core Building, including integration of systems into the HVAC of the existing buildings, was a Herculean labor, including:

Re-siting HVAC site utility piping.

Removing HVAC systems in existing buildings, installing temporary systems and then tying into the new systems.

Relocating steam piping and ductwork to accommodate the new addition.

Installing temporary steam piping, supply- and exhaust-air ductwork and hot- and chilled-water piping to be used until new systems were up and running.

Adding a 1,750-ton centrifugal chiller, in the the Hartford Hospital campus’central plant, to replace the original 900-ton absorption chiller. The new unit includes a digital control package. The centrifugal chiller is also served by a new primary chilled water pump that provides 4,200 gallons per minute (gpm) of flow at an estimated 50 feet of head.

Squeezing new condenser water pumps next to the chiller to accommodate a new induced-draft cooling tower system. The cooling tower itself is configured in a four-cell arrangement, each cell sized to provide 675 tons of condenser cooling at 3 gpm per ton.

Implementing a completely new piping network. Limited spare capacity in the existing utility tunnels meant the need for this new network.

Creating a separate steam system. Steam supplied to the Core Building is separated into two systems, one for HVAC and the other for process steam. The latter is essential to the needs of the central sterile department.

Using central-station chilled water air-handling units. These four new units are housed in the penthouse of the Core Building and serve zones in the there, as well as in the three adjacent buildings.