Intermountain Healthcare’s newest hospital—the Intermountain Layton Hospital—almost wasn’t a hospital. The project started out as the Ambulatory Care Center, but grew into a full-blown hospital when Intermountain re-assessed community needs.
“The shift took place as the [Ambulatory Care Center] headed into construction documents,” Corey Cracroft, RA, LEED AP, Architect, Sr. Project Manager, Intermountain Healthcare said. “We had to put the brakes on and almost start over.”
When the scope changed so drastically, so did the stress level. The design team had to return to the drawing board while keeping the original schedule. This unique challenge required the team to work more collaboratively than ever.
“We worked together to come up with creative solutions to implement the hospital design,” Roger Phillips, AIA, LEED AP BD+C, WELL AP, Architect, HKS said. “We had to include all parts and pieces while planning for future growth.”
When the scope changed, Jacobsen Construction had already been selected as the contractor. This allowed all parties to attend design meetings. Drew Watkins, Sr. Project Manager at Jacobsen Construction, said that once construction started the CDs came out in bid packages because design was still happening.
“Attending design meetings gave us the opportunity to be ahead of the game,” Watkins said.
In addition to the scope changing, this project presented other challenges like getting power to the site, which required coordinating with Rocky Mountain Power to bring a circuit across the railroad. Moreover, Corey Cracroft, Project Manager for Intermountain Healthcare, said the soil conditions weren’t ideal for building a building due to the water table being 15-16 feet down. Because of this, the project required some extensive soil work.
“To create a useable soil foundation, we used rammed aggregates,” Cracroft said. “This involved drilling down 80 feet below the lowest footings and ramming earth in aggregate to compact it.”
This method not only made the soil buildable, but guards against liquification. Additionally, Mark Harris, Principal Structural Engineer, with Reaveley Engineers said that utilizing this method also allowed for higher bearing pressure and ultimately larger column load in one spot. Without the rammed aggregate pier system, the buildings could have had some unwanted settling and future issues with the foundation. And, this system can reduce the amount of potential settlement in the event of an earthquake.
Once foundational issues were settled, the next goal was getting the clinic online one year prior to the completion of the hospital. With the scope shift putting pressure on the schedule, meeting this deadline was an extra challenge. Electrically, this includedSpectrum Engineers’ team temporarily setting up rooms so the distributed antenna system (DAS) would work and a portion of the data center, located within the hospital, could be accessed prior to the completion of the hospital. Furthermore, the central utility plant feeds all of the buildings, so the commissioning authorities at TBCx had the challenge of bringing things online at different times.
“The machine for cooling is pretty large and doesn’t like that it’s only loaded up 10 percent. It needs to go faster,” Ray Dodd, PE, LEED AP, CxA, President/Principal Commissioning Authority, TBCx said. “There were a lot of challenges when it came to bringing a portion online.”
With the clinic being open and the rest of the facility under construction, this presented some unforeseen challenges for the facilities management team, as well.
“We had to keep the Medical Office Building up and going while following up on the construction projects,” Ryan Grant, Facility Manager, Intermountain Layton Hospital said. “Patients were also unaware of which side of the building to go to.”
Although this project included a number of challenges, the major success was how effectively the team worked together. The main focus of each design element was healing.
For the Intermountain Layton Hospital, this started with looking at the building through the patients’ eyes while keeping the patient experience at the forefront. Everything from how they check-in to how they experience the room, with accompanying sights and sounds, was factored into the project. One example is how the lighting is designed with comfort and well-being as the focus. This includes lighting that reduces glare and can be controlled in each room. Furthermore, the decorative lighting contributes to the patient experience with wayfinding as the goal. This includes spaces being lit so people know where seating is or where they can go to speak with hospital personnel.
Additionally, the hospital was designed to maximize the amazing views of the Wasatch Mountains and features a giant class curtain wall at the east side. This allows patrons and staff to take advantage of the views on all floors while bringing in natural light that filters throughout the building.
“The decorative lighting was designed so it looked great through the glass,” Joseph “Jody” Good, III, LC, Lighting Design Fellow, Spectrum Engineers said. “We also took care to have the appropriate amount of light up, down and for way finding.”
To make this glass element and atrium a reality, the structural team incorporated extra steel into the structure. In addition to the glass wall, the team had to structurally engineer fairly elaborate canopies to give a sense of entry, weather protection and create the iconic Intermountain Healthcare look.
“It’s a gorgeous building with atrium space in the lobby,” Cracroft said. “It feels like a great place to receive healthcare.”
For the structural engineering of the facility, a special steel moment frame using side plate connections was used. This design allowed the team to reduce the amount of steel while designing a structural system that can withstand a lot of energy.
“A lot of importance is put on a hospital facility,” Justin Nadauld, SE, structural project manager, Reaveley Engineers said. “They need to function after natural disasters, the design standards are higher and it’s important that we select structural systems that are robust and can still function after a major event like an earthquake.”
Moment frames were also a great option when it came to the architecture because they gave a lot of flexibility to the layout and design of the space.
“We ended up with a primary structural frame that was economical, constructible and went up with very few problems,” Harris said.
Van Boerum and Frank Associates designed all mechanical systems including the medical gas system, pure water, domestic water and steam systems. The mechanical system includes a central variable air volume (VAV) system. On the hospital, there are five air handlers in the penthouse on top of the tower and for the clinic building there are two air handlers in a small mechnical penthouse. One of the major successes of this project, mechanically, is that the facility has a water reduction of 35 percent in comparison to the code minimum and other hospitals.
“We put a lot of effort into making this [hospital] energy efficient,” Scot Muir, PE, LEED AP BD+C, associate principal, Van Boerum and Frank Associates said. “Our energy modeler was calculating it to be a 30.9 percent energy reduction compared to the code minimum.”
Additional sustainable measures include green sustainable low water-use landscaping, motion sensor lights and daylight sensors, all of which were implemented so Intermountain could manage resources responsibly. Additionally, exterior lighting fixtures were designed with good optical control, so lighting levels could be managed for safety and security, but also meet the stringent requirements of cut-off and energy usage. Each of these design elements contributed to the LEED Silver certification.
In the central utility plant, Spectrum designed a state-of-the-art emergency distribution system that will keep the hospital running if there’s a power outage. The CUP features two 15 MW paralleled generators, a control system that communicates with the building management system and tells it which chillers and cooling towers can turn on before the emergency distribution system exceeds capacity.
“This design allows for the emergency system and BMS system to communicate and keep the hospital up and running during an outage,” said Johansen. “Furthermore, the hospital’s facilities team can remotely control the emergency distribution system loads on the transfer switch and generators and can shed them remotely.”
Mechanically, the central plant utilized a series of newer concepts where low-temperature condensing hot water boilers can run on natural gas and diesel for back-up.
“The low-temp hot water design utilizes condensing boilers and limits the amount of steam production,” Don Bradshaw, PE, CPD, CIO, Principal Mechanical Engineer, Van Boerum & Frank Associates said. “In the past, large steam boilers were used, but now we’re using water boilers that are 95 percent efficient versus 84 percent for the steam boilers.”
To commission HVAC, plumbing, electrical, life safety, fire projection/suppression and alarm, lighting, security and building management systems, TBCx utilized an online commissioning process that allowed for the entire team—Intermountain facilities personnel and commissioning authorities—to keep track of the 3000 pieces of equipment inside the facility and their installation process.
“Our mission is to have a successful project,” Dodd said. “We worked with the design team, contractor and facilities team from day one so we could produce a better project.”
One unique aspect of healthcare facilities is that there’s a high risk when things don’t operate correctly. Because of the critical nature, the commissioning process is a rigorous one and includes a team of people, especially for the pull-the-plug test. The testing protocol begins by killing the power to the building. Then, individuals in each section of the building have a script, or checklist, they must complete to make sure that every plug and machine that needs to be on emergency power is on emergency power.
“Buildings are completely computer-controlled including medical gas, nurse call stations, emergency power, HVAC and lighting,” Dodd said. “TBCx makes sure that everything works as designed.”
The project that started as an Ambulatory Care Center ended as a state-of-the art $164 million, 310,000 sq. ft, five-story hospital. The facility features an emergency department, inpatient services including a women’s center, NICU, diagnostic imaging, surgery departments. As well as, a clinic facility which houses Primary Children’s outpatient services.