The design-build team of McCarthy Building Companies, Inc. and Taylor Design recently completed construction of the John R. Anderson V Medical Pavilion.  Located at the Scripps Memorial Hospital La Jolla campus on Genesee Avenue in La Jolla, Calif., the new $130 million (development cost) medical office building developed by Scripps Health combines collaborative and efficient space for healthcare professionals with a holistic environment to enhance patient experience and medical care.

Providing comprehensive and advanced medical care to people in the region, the seven-level, 175,000-square-foot pavilion houses a variety of specialty services, including cardiology, gastroenterology, pulmonology, neurology, nephrology and endocrinology. It features four cardiac catheterization labs specially permitted by California legislation that allows physicians to perform certain cardiac procedures in an outpatient setting. The building also incorporates office and administration space, diagnostic facilities and roughly 15 medical procedure departments. The health system began serving patients in the new facility on June 1.

“The Medical Pavilion brings together exceptional physicians, staff and technology in a one-stop-shop for comprehensive outpatient medical services,” Scripps Health President and CEO Chris Van Gorder said. “We are extremely grateful to the Anderson family for their continuing generosity and support of our efforts to deliver the best care possible to our patients.”

Serving as design-builder, McCarthy completed the two-year long construction project in March 2016. The firm's scope-of-work included construction of the new structural steel-framed pavilion with six levels above ground and one below. Two pedestrian bridges were also built on the second and fourth levels, providing immediate access between the pavilion and the adjacent Prebys Cardiovascular Institute. Further construction entailed new surface parking, re-routing of existing underground utilities and a realignment of the main entry drive to the Scripps Memorial Hospital campus.

Taylor Design provided building program, site study and design services for the project. During the program phase, the design team worked closely with Scripps Health physicians, nurses and clinical staff to understand departmental and workflow relationships in order to create a design mindful of their operational needs, while at the same time respecting Scripps’ guiding principles for the project. These included designing a new facility that supports the adjacent Prebys Cardiovascular Institute, a high-level of care and efficiency for patients, graduate medical education and space for future growth.

In order to maximize the site's potential, Taylor Design reoriented the building from its initial location. This thoughtful approach resulted in numerous improvements to the structure and surrounding space, including the creation of a stronger gateway building, better land utilization, a more unified and larger landscape space, the addition of a wellness garden, improving fire department access and providing flexibility for future expansion of other facilities.

"Our primary goal for the building design was to create a forward-thinking building that complements Scripps Health in its new direction, while respecting the existing campus and celebrating Scripps’ proud heritage,” said Joe Lowe, Director of Taylor Design’s San Diego office.  To achieve this design intent, the pavilion's exterior skin serves as an extension of the adjoining Prebys Cardiovascular Institute, utilizing similar building materials, including a combination of precast brick panels, high energy efficiency glazing, metal panels and plaster.

"Creating four different exterior skin systems on the building facade required addressing hundreds of details as a part of each unique material interface during the exterior building process,” said Robert Betz, Executive Vice President of McCarthy’s San Diego office.  Using a hybrid of design-build and design-assist delivery, the team worked closely with the exterior trade subcontractors early in the design process to meet the aggressive 24-month timeline and address constructability challenges. 

"We used virtual design and construction (VDC) technology to further expedite progress of the complex building exterior and ensure quality installation with no rework,” noted Betz. “As a part of this process, our team imported virtual 3D models created by each of the four trade contractors into the Navisworks Manage clash detection module along with the steel structure and concrete models. This technology helped us anticipate and reduce potential problems among exterior systems before construction began. It also allowed all four trades to conduct prefabrication simultaneously and ultimately complete installation and building dry-in nearly two-weeks ahead of schedule."

Another time and cost-saving solution developed by the team entailed the use of a prefabricated brick veneer. "The precast brick panels were placed, aligned and welded in approximately seven to eight weeks, which would have taken twice as long if we had used a traditional hand-set brick exterior," explained Lowe.

"Although the pavilion's design references the adjacent Prebys Cardiovascular Institute, it also incorporates elements that establish its own identity," said Jamison Delfino, Associate Senior Interior Designer at Taylor Design. “The concept of connection was a main driver in guiding design decisions. At key junctures, warm wood adorns the walls to aid in wayfinding and provides a backdrop for departmental signage. Connection to nature is prevalent, as displayed in the main stairway directly off the building entry. Organic patterns imitating branches are found throughout the building, including glass, carpet and fabric. The finish palette was developed with the goal of patient comfort and creating a timeless and inviting environment for both patients and staff.”

Operational efficiency and staff collaboration was also a primary focus. Addressing this intent, staff dedicated space such as the physician's offices are concealed from the main flow of patients. Centralized care team hubs occupy the space in between exam rooms to provide optimal efficiency and collaboration among physicians and nurses while enhancing the patient experience by separating the "off-stage" support areas from the "on-stage" patient environment. This design also streamlines throughput by allowing patients to obtain a full-spectrum of care, such as exams, treatments, new appointments and prescriptions, all in one location.

While putting the patient first is a tenet of Scripps Health, staff space was also an important consideration. On each of the seven levels, dedicated staff break and conference rooms were placed mainly along windows with calming views to outdoor gardens. A 50-seat boardroom was created to provide a gathering area for meetings, lectures and discussions.

Other project team members included: KPFF Engineers, structural engineer; Latitude 33, civil engineer; MA Mechanical, mechanical and plumbing engineer; Stantec, electrical engineer; Urban Arena, landscape architect; and RTKL, equipment planner. Primary subcontractors were: Bergelectric, electrical; University Mechanical and Engineering Contractors, HVAC and plumbing; Cosco Fire Protection, fire protection; Standard Drywall and ISAT, exterior framing contractor and load designer; Tower Glass, exterior curtain wall; and Clark Pacific Precast, exterior precast.

The John R. Anderson V Medical Pavilion was named after the son of Scripps Health longtime supporters, Eileen and John "Jack" R. Anderson IV, who donated $25 million toward construction of the facility on behalf of their son who passed away from cancer in 2004.

For more information on Taylor Design, visit www.WeAreTaylor.com.

More information about McCarthy Building Companies, Inc. is available online at http://www.mccarthy.com/.