Category: Thought Leadership

By Milly Baker, AIA, ACHA, LEED AP, Senior Medical Planner at Margulies Perruzzi

Many hospital administrators feel pressure to increase the size of their healthcare spaces despite a shortage of capital available to support facility investment.  Even with efforts to tighten up space and increase efficiency to cut costs, hospitals need larger and larger buildings.  The outcome is more space per patient and provider and, therefore, increased costs.

Why is everything getting larger?  A combination of many program developments has added area to hospitals. These changes include technology, general improvements in diagnostic and treatment methods that require bigger clinical teams and larger equipment sizes, more robust mechanical, electrical, and plumbing (MEP) systems, the introduction of robotics, an increase in team collaboration space, and revised requirements for accessibility. Each of these changing requirements adds increments of additional square footage.

Technology

Technology, the equipment that continues to improve patient care, requires greater infrastructure capacity. Years ago, there were 20 square foot data closets, but now, data rooms as large as 180 square feet are needed to accommodate all the digital equipment racks.  Cutting-edge features throughout hospitals drive this growth, including the interconnectedness of different clinical and monitoring systems, intelligent boards in patient rooms, smart boards in conference rooms, digital communication at the patient room entrance, signage and tracking systems, and direct clinical access to patient records. Because of the continued increase in technology use, it is critical to build specific data room requirements into the program from the start.

Robotics

For many institutions, robotics are being introduced to augment surgery, save on staffing costs, and increase safety. While robotics in operating rooms, pharmacies, and labs is nothing new, re-engineering supply management through robotics is becoming more common. Robotic devices provide improved services, but they take up space both when in use and stored. Planners for new buildings should consider adding space to supply rooms and depots with dedicated corridors and elevators for this equipment. Isolating robotics equipment movement from staff and public circulation may also double circulation requirements.

MEP Infrastructure

Particularly since the start of the pandemic, hospitals require better air flow and humidification.  While new technology and equipment increase typical floor-to-floor dimensions, the MEP infrastructure should grow to serve the larger space requirements. Concerns for preventing contagions from spreading have also increased the demand for protective isolation wherever patients are treated. These robust systems need flexibility and capacity for future changes as well.

Equipment

Equipment size has increased, challenging staff to accommodate the need for more space within current program standards. An example that requires more space is the reliance on ECMO (Extracorporeal Membrane Oxygenation), a form of life support for patients with life-threatening illnesses, often used to combat COVID. An ECMO setup for an inpatient requires large elevators, wider doors, and greater patient room clearance than current standards.  Introducing ECMO into current, smaller patient rooms has proven difficult.

Hospital room size creep is frequent in treatment areas, including Operating Rooms, Nuclear Medicine Rooms, Radiation Treatment Rooms, and MRI Rooms.  These spaces are vital to each hospital’s mission but require more space than traditional planning methods. It is now not unusual for surgeons and patient staff to request 800 – 1,000 square feet for specialty and hybrid operating rooms.

Collaboration Space

As recruiting clinical staff has become increasingly challenging in recent years, many organizations have started paying more attention to the functionality of their workspaces.  Many hospitals have inadequate meeting areas and workspaces to accommodate all the staff meetings.  The historic administrative model, including a nurse station and one physician’s office, is no longer sufficient for an inpatient unit.  Staff now include clinical nurses, physicians, residents, case managers, social workers, educators, and nurse management. Workstations are needed for this range of support staff to do their jobs efficiently.

The ability for staff to collaborate in appropriately sized areas supports teamwork and protects patient confidentiality but is missing from minimal space standards in the Facility Guidelines Institute (FGI) guidelines.  Both patient-facing workstations and private areas are needed to support team workflow.  Many institutions have also started to request rest space for staff, particularly in high-stress areas, such as emergency departments and intensive care units.  Breakrooms and other areas should be carefully designed to support staff respite.

Accessibility

As Americans get larger, FGI guidelines are requiring a whole new category of room sizes for “patients of size” and a newly required expansion of the American Disabilities Act (ADA) Standards turning radius. These new requirements to build larger inpatient rooms, exam rooms, and bathrooms, have been put in place to improve patient care and staff safety. However, they come with added space and cost requirements.

Program needs are driving hospitals to increase space. The challenge to planners, architects, and builders is how to manage client expectations, specifically during the programming phase when space requirements are established. The old space requirement formulas for area per bed or area per operating room need to be carefully re-examined and revised.  It is critical to take account of these conditions when developing conceptual fit plans and pinpointing scope feasibility to ensure that clients understand this new paradigm. The old rules no longer apply.

This article was featured in Medical Construction & Design.

By Principal & Partner Janet Morra, AIA, LEED AP

During the early days of the pandemic, we collectively embraced the notion that once vaccines became available, things would return to a “new normal,” and a mass return to the office would follow.

In reality, the hybrid work environment – long a staple in certain high-tech industries and made possible through advancements in technology – was mainstreamed. At the time, Margulies Perruzzi’s workplace strategy report, “Embracing the Hybrid Workspace,” affirmed the logic of transitioning from a traditional to hybrid model.

Our survey of 8,600 people across multiple business sectors revealed that 44 percent of workers planned on being in the office three days a week, and 25 percent planned on two days. Only 9 percent responded that they would return to a pre-pandemic office presence.

A Buzzword Is Back

It seems appropriate to resurrect a late-1990s buzzword, “paradigm shift,” because the pandemic is almost solely responsible for a fundamental change in the basic concepts and practices related to the traditional, corporate 9-to-5 in-office model.

Corporate managers who make real estate and facility decisions are facing the new reality of altered employee expectations. We know of one company that had an epiphany when they realized that the 100,000-square-foot building they own sits mostly empty, because in their new hybrid work environment, they have never had more than 50 people show up to work in the office on any given day.

So where are we now, and what does the future look like?

According to JLL’s third-quarter U.S. office outlook report, return-to-office metrics have trended upward this year, with most Fortune 500 employers gravitating to around three or more days of in-office attendance and pivoting away from fully remote hiring.

CBRE reported in their September office occupier sentiment survey that in the U.S., 65 percent of companies have a formal attendance requirement in place versus 31 percent one year ago. The average weekly office utilization rate varies by region; in the Asia-Pacific region 45 percent of respondents report their spaces to be highly utilized, while in the U.S. that figure is only 24 percent.

Many Look to Alter Spaces

We recently launched a new initiative to find out how our clients are approaching hybrid work, and the results align with what other industry leaders are reporting.

Sixty-three percent of our clients said had no formal hybrid or flexible attendance plan prior to the COVID-19 pandemic. However, 70 percent have one in place now.

Only 40 percent of our clients required attendance in the office a specific number of days per week, while 60 percent had “suggested” in-office targets. Meanwhile, 40 percent of our clients said they were an “office first” organization, with 20 percent identifying as “remote first” and the remainder saying they had a “true hybrid” character.

And while only 40 percent of our clients said they had reduced their office footprint, half said they had altered their office space in some way.

Occupiers’ Options Abound

There are many options available for implementing a full or partial return to the office, but there is no “one size fits all” solution. For the company I mentioned with a 100,000-square-foot, underutilized building, alternatives included selling it, relocating to a smaller space and designing it for how their staff works now, subletting half the square footage and redesigning the space they occupy, or keeping the building and initiating a mandatory in-office schedule.

Companies opting to redesign current or new space to bring workers back to the office are using various tactics. Creating a more home-like atmosphere might translate into softer seating and less dependence on fixed workstations. Now that virtual meetings are routine, private offices can be transformed into huddle rooms where one or two people can conduct an online session with acoustic and visual privacy. There is also a move towards even more collaboration and team space, as well as organized events, activities and amenities designed to appeal to the basic human need to be together.

Sometimes the reconfiguration or downsizing of space boils down to pure math: If a company requires everyone to come in three days a week on the same days, then there is no option to reduce seating or decrease space. The only way this type of hybrid policy would work is if attendance is staggered throughout the week, and it is easy to imagine how quickly this could become complicated and counterproductive.

In the end, the most successful solution is one that is uniquely tailored to a company’s business model, strategic plan and corporate culture. Ultimately, flexibility of both thought and design are the keys to cultivating a successful hybrid work environment.

This article was featured in Banker & Tradesman.

By Director of Lab Programming Jane Kepros, LEED GA

There are many misconceptions about lab design. In this article, we will delve into some common myths and explain why these may not be applicable for a particular project.

Myth #1: Lab Design Is Highly Regulated

While there are multiple regulations that need to be adhered to in an operational laboratory, clients are often surprised to learn that outside of general building, plumbing, and fire code requirements, there are often minimal (and sometimes zero additional) design regulations that are required solely because a space is designated as a lab. Most lab regulations have to do with the operations taking place within the lab, and the safe storage or transport of materials and waste in and out of the lab.

Of course, every project is unique. During the programming and planning phases it is best for clients to work with their design team and consultants to identify any special functions, hazards, or limitations of their site that may trigger special codes or regulations based on where they are located or the type of work they do.

Myth #2: You Cannot Use Certain Finishes or Products in Labs

Lab design involves the selection of many finishes and products, including flooring, wall paint, cabinetry, worksurfaces or lab benches, ceiling tiles or paint, piping, and plumbing fixtures. Many people think that certain finishes or products are never allowed in laboratories. This is generally not the case. Typically, certain materials are selected based on multiple factors including their durability, cleanability, resistance to chemicals or mold, sustainability, and availability. There are certain rules of thumb for using different materials that are considered best practice in particular environments, but they are rarely mandatory.

When selecting finishes and products, clients should work with their project, operations, facilities, and design teams to consider all the above factors, in addition to the upfront cost, including cost for both material and installation, and long-term cost, including maintenance or replacement.

Myth #3: The Rules of Lab Design are Absolute

There are many myths within lab design that are conveyed using “always” or “never” language, such as “sinks should always be located near the entrance,” or “wood casework should never be used in a biology lab.”  The reality is that it depends.

Often a client will make a request for their project design and use the “always” or “never” language themselves. This does not mean that all future clients think the same way. Their processes, safety program, material use, maintenance schedule, and even design aesthetic may dictate the exact opposite of the previous request. It is best to ask follow up questions to the client about why they have a specific preference and use that background information to inform your approach on future projects.

Just because you can do something does not mean that you should, and just because a material or product is available to use, does not mean that it is a good option. It is best to take multiple factors into account, weigh the options, and at the end of the day remember that except for code requirements, the client is the final decision maker. They are going to be the ones to work in and be responsible for cleaning and maintaining the space in the immediate future. The final layout and selection of products and materials must work with how they operate.

This article was featured in High Profile Monthly.

By Senior Interior Designer Jenna Meyers, IIDA, NCIDQ, LEED AP

There are many factors that prompt a company to begin thinking about whether they should stay in their current space or move. Chief among them is an impending lease expiration; significant changes in staff size; the need to cut costs; or a merger, acquisition, or consolidation.

A common misconception is that it is less costly to renegotiate and renew a lease that includes an allowance for renovations. This is not always the case when you consider the disruption to workflow that an ambitious construction project can cause, along with higher costs when there is no swing space to accommodate staff while their area is being worked on. This scenario would necessitate construction phasing, thus prolonging the project schedule and potentially requiring certain tasks to be performed at night or on a weekend, which means overtime pay. Even if there is swing space in your building or another building, there would be associated rental costs. However, if renovations are limited to simple cosmetic improvements like new carpet and paint, then disruption is relatively minor and short-lived, and staying may be the best option if a company’s current space will meet their needs for the length of a new lease.

Companies considering lease renewal versus a move should strongly consider working with an architect that will test fit their basic program to available space in feasible buildings, including their own. For new and/or small companies anticipating a stable head count, this traditional approach may suffice. But for larger and more established organizations or those with dynamic marketing goals and corresponding growth trajectories, detailed programming at the outset is to their ultimate advantage. Why? Because an accurate, comprehensive program is at the core of every successful facilities decision, particularly when it comes to one that has such critical first- and long-term ramifications associated with cost, productivity, and overall satisfaction.

In partnership with clients whose circumstances have led them to the “stay or go” point, that process involves conducting an in-depth programming exercise that incorporates a range of data, from operational information, spatial interrelationships and adjacencies, and current and projected head counts, to space usage and types, furniture, hybrid work scenarios, and goals surrounding brand, functionality, productivity, company culture, sustainability, and workplace environment, among others. Once the program and vision have been completed, the resulting information can be applied with high confidence to test fits.

We often work closely with brokers and tenant representatives to evaluate the pros and cons of each location and assist with the final building selection. A case in point is Boston Trust Walden, an independent, employee-owned investment management firm. They decided to move after realizing that their office could not accommodate growth. Reevaluating their space usage helped crystalize their objectives, which were to achieve a contemporary, functional space that facilitates individual and collaborative work, accommodates future growth, and manifests their core values. Opting to stay at One Beacon Street, the firm moved to the 34th floor. As an outcome of conscientious programming and collaboration, their new office space, which was expanded by 50%, features a design based on equitable access to natural light, sustainability, and transparency, reflecting key company principles.

With many such examples in our project experience, we can attest that workplace decisions built on a foundation that combines factual data and aspirational criteria are always the most successful.

This article was featured in High Profile Monthly. 

By Jane Kepros, LEED GA

Whether you are a developer looking to build a new building, a landlord interested in converting an existing building, or a company looking for a new home, there are specific and important considerations for the layout and construction of a laboratory building. These key considerations are construction type, building infrastructure, lab utilities, and amenities.

Construction Type

First, consider the type of construction. How the building is designed and constructed is an important factor to support laboratory needs. Sufficient fire resistance construction ratings are required for hazardous material use and storage, control area or lab suite segregation, and improved fireproofing.

Anti-vibration methods to isolate sensitive equipment is another common requirement. Many items in a lab require low or no vibration, including imaging instruments, nuclear magnetic resonance spectrometers, lasers, and animal care facilities. The construction of the building must be robust to prevent or reduce vibration transferring throughout the building from various sources such as equipment with moving parts, elevators, mechanical equipment, nearby trains, and even people walking.

It is also important that the floor-to-floor height is sufficient to accommodate HVAC, plumbing, utilities/access and taller equipment, and that the floor loads can support heavy equipment.

Building Infrastructure

Elements in the building’s infrastructure are important for supporting the needs of a lab. Dedicated passenger and freight elevators allow for separation of materials, waste, and personnel are critical. Doors should be wide enough to move equipment, casework, skids, and waste; 3’-6” width by 8’-0” height is typical. A loading dock is essential for incoming/outgoing materials along with an adequate driveway for delivery of equipment, supplies, and compressed gases and liquids. Waste management areas are required for temporary staging/storage and collection areas for biohazard, chemical, recycling, and general waste.

In addition, labs require an increased need for air handling due to increased ventilation requirements which may include dedicated rooftop units or redundancy for specific functions or spaces. Any confidential science performed may require additional security for legal or safety reasons. Finally, adequate storage is needed for busy labs and environmentally stable areas may be required.

Lab Utilities

You also must consider: What type of utilities are being provided for the lab? Will these utilities be provided by the landlord and metered for tenants, or tenant-owned? Lab utilities are an essential consideration for building tenants. Landlords will need to consider what is pre-wired or pre-plumbed, where the “house” systems live, where the “tenant” systems live and how to access these for maintenance or replacement. A well drafted landlord-tenant matrix is essential for a tenant and landlord to understand their utility responsibilities.

A house purified water system may be preferred, or a tenant may provide a local unit that requires pre-filtering. There may be an increased demand for hot water supply to maintain a tempered water loop for eyewashes and emergency showers, which may trigger a boiler upgrade. An air compressor and vacuum pump are frequently needed and plumbed to the open bench areas. Various compressed gases may be required and these could be supplied as smaller cylinders, larger dewars, micro or mini bulk systems, or from a gas generator.

Thoughtful consideration of potential needs should go into planning the building or site to accommodate these gases, including truck access for refills or transport of full or empty containers.

Any potential sinks where hazardous materials may be disposed down the drain should be plumbed to a pH neutralization system. If this is centralized, it should be monitored on a tenant-by-tenant basis. Additional tenant utilities may include generator back up power for critical equipment, uninterrupted power supply for equipment that requires constant power, and networking needs for equipment that require specialty services like dedicated servers.

Amenities

Science and technology companies are often competing to attract and retain talent in hub markets, including the Greater Boston area. One way of doing this is by being thoughtful about amenities when moving to a new space. These offerings should be included in the building or available in the immediate surrounding neighborhood. Amenities may include: eateries and restaurants, vehicle and bike parking, a fitness center and showers, outdoor space, artwork, meeting and conference space, daycare, and public transit access.

Buildings must meet certain requirements to support laboratory space. The specifics will depend on the tenant, or desired tenant, and their science, processes and equipment. When starting a new project, make sure to evaluate the construction type, building infrastructure, lab utilities and potential or nearby amenities, as these are all important factors that should be taken into consideration in the design and layout of the building.

This article was featured in Banker & Tradesman.

By Tim Bailey, AIA, LEED AP

According to the Environmental and Energy Study Institute, residential and commercial buildings in the United States are responsible for almost 40% of carbon dioxide emissions and use an almost equal percentage of the country’s energy for lighting, heating, cooling, and appliance operation. In Boston, 70% of greenhouse gas emissions are from buildings, prompting the state to take large strides to reduce this alarming statistic. Cities and towns across Massachusetts are now more stringent with energy codes and introduce ordinances of their own to combat this climate crisis. In fact, as of July 1, 2024, Massachusetts energy codes will become more restrictive, and some municipalities may choose to adopt energy codes that go beyond the Commonwealth’s.

Boston is leading the way for the region in support of all-electric, carbon neutral buildings. As lawmakers here and in surrounding municipalities pass legislation that dictates the path to carbon neutral building functionality by 2050, owners are faced with the challenge of evaluating, improving, and future-proofing their property assets. Pursuant to Boston’s Building Emissions Reduction and Disclosure Ordinance (BERDO), buildings over 20,000 square feet must report their annual energy and water use to the city and reduce greenhouse gas emissions over time as stated in the BERDO regulations and policies and procedures adopted in January 2023. It is a game changer for developers, owners, and project design teams when it comes to designing a new building or renovating an existing one. Building owners will have three options; Update their buildings to comply, utilize alternative compliance payments, or ultimately face hefty fines for non-compliance.

With these new regulations there are a multitude of design considerations and decisions to be made. Architecturally, an energy efficient building envelope will take the strain off mechanical systems, so they don’t have to work as hard. Think triple-glazed curtain wall; increased insulation with attention paid to thermal bridging; use of recycled construction materials; and integrated lighting control systems. For mechanical systems, the goal is elimination of fossil fuels in favor of clean electric power. The issue now facing electricity providers is making sure they have enough capacity for these all-electric initiatives. Another tactic is switching from traditional building management systems to energy management and information technology that connects multiple building systems to optimize integrity and performance.

Other factors to consider are renewable energy opportunities such as solar panels, geothermal heat pumps, and off-site options. Up until now, geothermal may have been seen as a “nice to have,” but looking toward the future, that philosophy may change as we look at energy consumption. Geothermal technologies and solar opportunities go a long way to help reduce energy consumption of a building, thus reducing its electric load significantly. Smart building technologies can play a major role in achieving carbon neutrality and provide additional energy savings. For natural light control, options include automated shades, electric glass, and switchable films. For HVAC, energy efficient variable feed drives that can be installed in boiler pumps, condensers, water pumps, cooling tower fans, and chiller motor pumps could result in energy savings of up to 60%. Additional resources include lighting controls and tenant controlled plug-in electrical loads.

Meeting these new regulations comes with a cost—several costs, in fact, including, up-front inflated construction costs, technology upgrade costs, penalties for failing to meet regulatory requirements, and potential loss of revenue if your building does not meet prospective tenant expectations regarding local ordinance requirements or their cultural sustainability model. An April 9, 2023 Banker & Tradesman article by Steve Adams presciently addressed green leases, which align the financial and sustainability interests of building owners and tenants: “Typical green lease clauses include requirements for submetering of individual tenant spaces, cost sharing of capital improvements and agreements for tenants and landlords to share data on energy use.”

In preparation for a greener and cleaner future as set forth in BERDO and similar ordinances adopted by other municipalities, building owners, and developers need to begin to assess their buildings now. As architects who have been actively involved in retrofitting buildings for energy efficiency and designing new buildings to net zero and carbon neutral standards, we offer the following tips to help you get started:

1. Confirm energy loads associated with existing buildings in your portfolio
2. Determine the capacity of and cost for adapting buildings to accommodate converting gas service to electric
3. Develop a detailed master plan for the next 25+ years based on specific municipal requirements per building location to bring your buildings into carbon neutral compliance by the stipulated date

This article was featured in Banker & Tradesman.