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MEP Design Trends in Healthcare Facilities

© Skidmore, Owings & Merrill
By Hani Mardini, Associate, LEED AP BD+C
June 1, 2016

Hospitals and Academic Medical Centers (AMC) are some of the largest consumers of energy and water in the built environment. Climate change and environmental awareness are increasing demands for “green” solutions to these building’s resource requirements. Sustainable design has been at the forefront of our industry for many years. With green rating systems such as LEED®, challenges such as the AIA 2030 Commitment and by extension, the Target 100 program, as well as advances in energy codes, new buildings are being built with a focus on better use of resources. There is also a growing trend towards making medical facilities more “well”. Human wellness, a measure much beyond building “green,” is being factored into the architectural design and construction of buildings. This includes creating spaces that are healthier for occupants, with better airflow and ventilation, and weaving landscape into the building aesthetics. Most importantly, the space created (within a building as well as outside the building) foster the patient’s natural inclination to recover from their treatments and illness through the positive surroundings.

Trends indicate increased stringent requirements for building energy codes that will affect how MEP systems will need to perform when it comes to environmental impact. Although our industry does not yet regulate “wellness” in medical building design, there are new guidelines such as WELL Building Standard, which is geared towards human health and wellness, which includes a focus on understanding of lighting, air and water quality systems. While Facilities Guideline Institute (FGI) may require a certain number of air changes in a space, WELL would also focus on the quality of that air and thus contribute to mitigation of Hospital Acquired Infection (HAI) and increased patient comfort. Good lighting design minimizes glare and eye strain, and using daylighting accompanied by a good window view has a positive impact on the patient’s wellbeing.

Our team believes that right selection of MEP systems during design helps to protect the environment and save energy, and it also fosters a happy and healthy patient experience and improves staff satisfaction, and that happy, healthy patients and staff lead to improved recovery results.

On average, MEP typically constitutes 25-30% of the total project cost, creeping closer towards 40% with a complex/specialist medical facility. There is an increased commitment from Architects, Owners, and Construction Firms to invest in selecting the right MEP systems, recognizing the significant benefits to be gained in the long-term. 

For the past several years, there has been a noticeable improvement in the perception of the MEP design for Hospitals and AMC’s. Whereas it was usually “the boring, technical stuff” that was engaged after the concept stages, it is now increasingly viewed as vital to the intended performance of the building. The clients understand the significant long-term operational cost savings that can be made by conceptualizing and identifying benefits and challenges for system options early in the process.

If we are going to meet expectations when it comes to building performance, energy efficiency and wellness, MEP needs to be fully integrated into the design process from the early pre-conceptual and concept development stages. Rethinking a building’s aspect or optimum window sizes and shapes at the start of a project, for example, can significantly reduce the need for air conditioning, thereby using natural shading to reduce solar gain without compromising on daylight. This has a positive impact on the energy efficiency and carbon footprint of a building, and on the environment for occupants.

We have been privileged to work with clients that embrace the early engagement model, with excellent results. On some of our major international hospital campus projects (several spanning over 8M sf) we drove the pre-concept stage in order to assist with identifying challenges with programming, block and stack, form, and building massing intent as related to its projected functionality and energy model.  It is better start early with clients on identifying ways to “reduce” loads before we apply solutions to maintaining environmental conditions. Today’s standard of care in the healthcare industry require that we approach the building and its engineering infrastructure as a “system” and set energy use criteria that enhance the indoor environment, and consider the health and wellness of the people in the spaces, rather than focusing on incremental improvements beyond a conventional baseline.

The benefits of early engagement are tangible and within our reach. An integrated design approach should be the norm across our industry. Only then will we be able to realize the full potential of our buildings and make the environments we work and live in more efficient and enjoyable to inhabit.