By Dan Hounsell

Healthcare facilities these days have to do so much more than provide space to deliver healthcare services to patients. Long before COVID-19 rewrote all the rules of designing, constructing and operating hospitals, facility managers were under pressure to ensure hospitals  — especially new ones — helped their organizations achieve broader goals, specifically those related to sustainability and energy efficiency.

And when the building in question is one of the largest hospital projects underway in the United States and the largest in the Philadelphia region, the demands to maximize and perform are even higher.

Penn Medicine’s new 1.5 million-square-foot Pavilion rises 17 stories on its West Philadelphia campus. The $1.5 billion facility is set to open in the fall of 2021 and will house 504 private patient rooms and 47 operating rooms. It also will include a new emergency department, pharmacy, lab, cafeteria, and other support spaces.

The building is replacing a sprawling, aging facility that has presented managers with a host of challenges that only get more complex and expensive to address over the years. 

“The existing in-patient hospital, the Hospital of the University of Pennsylvania, is a complex of 14 buildings built over 140 years,” says Derek Tasch, Penn Medicine’s health system architect. “Many have spatial and infrastructure challenges that make renovations difficult. We also still have a number of shared patient rooms.

“This new project directly across the street and connected by a tunnel and bridge will allow us to convert to 100 percent private rooms, provide state-of-the-art space for all departments moving in, and create huge opportunities with the potential to reimagine the space.”

Eyes on efficiency

Maximizing sustainability and energy efficiency has become a top priority for most types of facilities in recent decades, and healthcare facilities are no exception.

“As a health system, we recognize that climate change and environmental degradation has a direct negative impact on public health,” Tasch says. “We also understand that healthcare projects come with unique challenges related to necessary energy use, so they require even more work to make a positive impact.”

In the case of Penn Medicine’s Pavilion, selecting the most effective and efficient HVAC technology and systems was essential in meeting the organization’s energy efficiency goal.

“Selection of the HVAC equipment within the facility was key,” says Kathleen Fink, Penn Medicine’s energy manager. “Not only did we make sure we were selecting the most efficient chillers, boilers, and air handlers within the facility. We added strategies such as fan walls made up of variable-frequency drives within the air handlers for added efficiency.”

Adds Tasch, “The building HVAC system incorporates 100 percent outside air and energy recovery wheels to capture and repurpose waste energy. We have also installed three below-grade rainwater cisterns totaling 210,500 gallons, which will help to supply the chilled-water system.”

Sustainability in the spotlight

While hospitals are among the nation’s largest energy consumers, sustainability has remained at the forefront of the project. The organization prioritized strategies for environmentally friendly construction, design, and operations, from using offsite prefabrication to rainwater collection and reuse.

“One project goal was to obtain LEED certification, and we are tracking toward LEED Gold,” Tasch says, referring to the U.S. Green Building Council’s rating system. “During the construction, there has been a continuous focus on waste reduction via prefabrication and offsite manufacturing, shared material ordering by our partner contractors, and a meticulous waste collection and sorting program.”

The Pavilion’s sustainable features go well beyond the HVAC system.

“Looking toward the impacts made after occupation, the project will add to the neighborhood parking for over 400 bicycles, a new pedestrian bridge and landscaped walkway connecting to the regional rail station, and over 32,000 square feet of landscaping with a focus on native and low maintenance species,” Tasch says. “The new building incorporates highly efficient equipment and the latest technologies for real-time performance tracking.”

The organization also will continue with efforts to ensure Penn-Medicine’s long-serving hospital operates as energy efficiently and sustainably as possible.

‘Our greatest challenges will remain within the existing campus,” Tasch says. “Incremental infrastructure upgrades in the historic buildings have resulted in a 9.8 percent decrease in our electrical carbon emissions over the last six years.”

In some cases, measures implemented in the existing hospital have given managers information vital to ensuring the efficiency of the new hospital.

“Some of the strategies that have had the most impact in the current facilities were also incorporated within the project,” Fink says. “Our success with two chiller plant optimization projects within the campus was a major component of our energy reduction over the past few years, and we wanted to mirror that success in the new building.

“Chiller plant optimization was added to the project as an enhancement to further increase the efficiency of the chiller plant that was originally planned, showing our commitment to ongoing increases in efficiency.”

The opening of the Pavilion also will give managers the space and opportunity to improve energy use within these buildings as wider renovations begin to take place.

“The Pavilion has also been built with the potential of additional energy efficiency projects in the future,” Fisk says. “One example of this is how construction was aligned to easily be able to add a cogeneration facility within the plant if we decide it is an effective energy efficient option for us in the future.”

Pandemic’s impact

As with every other healthcare system, the COVID-19 pandemic has created both challenges and opportunities for Penn Medicine as managers worked to finish construction and open the Pavilion.

“At the beginning of the pandemic, we worked to assess a variety of scenarios and possibilities for the health system,” Tasch says. “That included surge planning through the Pavilion to prepare 120 beds ahead of the facility’s opening. Safety protocols were quickly put into place to ensure staff were screened and traced to ensure the safety and health of the workers.

“In the end, that surge planning scenario was not needed, and construction was able to commence with continued COVID-19 safety precautions in place. We are now targeting a first-patient date in the fall later this year.”

The pandemic has prompted healthcare managers to rethink everything about facility operations as they take lessons from the last year and incorporate them into operations of both existing and new facilities. The Pavilion addresses two trends that have been highlighted during the pandemic:

Flexibility. The hospital features an adaptable room concept through which patient rooms are equipped to flex between an intensive care unit set-up, if needed, and a standard room as patients recover, or as the patient population and caregiving needs change in the coming years. 

Telehealth. The new hospital’s telemedicine functionality allows remote monitoring and consultations, as well as technology to link patients to their friends and families at all times, and in-room technology strengthens the communication between patients, families, and care teams.