The other night I had the opportunity to share with the architecture community some tools and recommendations on how to work remotely through a webinar hosted by the Boston Society of Architects (BSA). We were asked to participate as we’ve been incorporating remote working into our workflow for a number of years already so were fairly well prepared to transition our entire staff to remote working when the COVID-19 pandemic necessitated it.
We had initially set up a virtual private network (VPN) on our firewall to create a secure connection for people that needed flexibility to work from home when they had family obligations to attend to during the business day. When the winter of 2015 delivered back-to-back snowstorms every weekend, we increased access and encouraged more staff to connect and have productive days despite the snow-covered streets.
To ensure the security of our client’s project data, everything is stored on our network. When connecting in, the same security and virus protection software we use in the office is installed on the users’ home computer. Over the past couple weeks, we have had our staff test their home connections to ensure that if the time came to work remotely full-time, we would all be prepared. We scheduled a stress test on the system to track how much bandwidth was used to better understand any limits that could affect our productivity.
Along with the hardware testing, we started encouraging all staff to practice communicating internally with Skype for Business, even if the person was within talking distance. We selected Skype because we have about a dozen of our millennial staff who have been using it and they could help share their knowledge with others to facilitate the implementation and it had already been installed with our recent Office 365 upgrades.
Change is tough. Making major changes in how we work and the technology we use are especially tough when your staff encompasses several generations. We wanted to be cautious about making too many new moves when it is already a stressful time. Choosing platforms where staff could get help from others internally was intentional. While we have external IT support, now more than ever, it’s important to encourage supporting each other.
For the generation of staff (and clients) that prefer face-to-face connections, we increased our licenses so that video conferencing is available to anyone who wants to use it. Our internal message board has become an active place to share information on both what is working well and what has had some challenges. Where we have found gaps that needed a new format for remote working, we have started using new platforms. The underlying theme here is to be open to provide alternate solutions that support how people prefer to work and having open communication.
At the close of the webinar we were asked to share our key takeaways. We had covered lots of technical information, costs and comparisons of software and hardware, work methods, communication tools, but my takeaway was much simpler than all of that. Everyone at MP genuinely loves what they do, and we enjoy doing the work we do WITH each other. We need to reinforce these basic principles while we are working away from one another. We need to remind ourselves of the importance of this human connection. It is not just about being connected to share our work and collaborate with one another, but it is equally important to continue to share our lives with one another.
Architecture Firms and Remote Work’ was a virtual program hosted by the Boston Society of Architects on March 17. The free program welcomed over 375 members of the architectural community from across the country. The recording of this program is available for viewing at www.architects.org
The National Institute of Mental Health (NIMH) statistics show that nearly one in five U.S. adults live with a mental illness, and that one quarter of those adults suffer from Serious Mental Illness (SMI). These numbers from 2019 are expected to rise due to stress and uncertainty related to COVID-19, increased unemployment, and substance abuse. Southern Maine Health Care (SMHC) partnered with Maine Behavioral Healthcare to repurpose decommissioned inpatient med-surg and critical care beds at their Sanford Campus to expand inpatient behavioral health services to address the growing need for care in the communities south of Portland, Maine.
The building and the existing infrastructure presented some opportunities for substantial cost savings by re-using the mechanical, electrical, and plumbing systems. The 10’-0” floor-to-floor heights on the first floor and only 9’-2” clear to the underside of the structure in the corridors, challenged the design team to find a replacement for the existing window units, presenting several challenges to patient safety. The team determined the best solution was providing new chilled beams to provide heating and cooling to the new in-patient units that are ligature resistant and energy efficient and would allow the team to re-use the existing ductwork, already sized for 100% outside air for the required air changes.
Chilled Beam with Ligature Resistant Grill and Maintenance Access Panel located inside the lockable patient room for maintenance staff safety.
A typical four-pipe system uses double the amount of piping of a typical two-pipe system, so a four-pipe configuration has a higher construction cost due to the increased material needed. A typical two-pipe system is cheaper because it requires less piping and valves; however, it usually requires a manual or automatic change over between the central cooling and heating plants. Where there were existing hydronic heating and cooling piping systems in the areas being renovated, both configurations were considered. Upon further research, it was discovered the chilled beam manufacturer offered an option where they could provide a stand-alone valve control module for the chilled beams that could be connected to both the heating and cooling system (four connections on one side) and the inlet and outlet connections to the chilled beams. This allowed most of the existing piping systems to remain. The new piping that was required to be replaced and re-worked was limited to a single supply run and a single return run of pipe from the control module to the beam. Since these modules can be located away from the beam, the locations were coordinated to limit the amount of hydronic heating and cooling piping required.
The overall installation and operational cost of a chilled beam system can be less than a traditional fan coil or VAV system. Since the chilled beams can provide airflow from a dedicated 100% outdoor air unit, less total air is required to achieve the minimum outdoor air change rate called for by the Facilities Guidelines Institute (FGI) and ASHRAE 170 Standard. Since this airflow is approximately 60% less than a typical variable air volume system, the size of the supply ductwork mains can be smaller. This smaller ductwork translates to less material and lower labor costs for installation. The existing air handling systems serving the areas that were renovated for new inpatient space were previously fan coil systems with 100% outdoor air handling units. In this case most of the existing supply and exhaust ductwork mains were able to be left in place and be re-used, leading to reduced construction costs.
The smaller ductwork runouts to the beams aided in coordination with existing structural clearance and architectural ceiling layouts. A chilled beam can be installed within ceilings with 10 inches of space. With the low floor to structure heights here, the low profile of the chilled beams helped contribute to meet or exceed the minimum ceiling heights within the inpatient areas.
One of the biggest benefits of chilled beams is their energy efficiency advantage over traditional air heating and cooling systems. Only ventilation air is required to be ducted to the chilled beams to meet the required outdoor air change rate for the room as required by the FGI and ASHRAE 170 Standard. In a typical VAV system that uses airflow to heat and cool the space, this airflow could be more than 60% higher than the minimum required airflow. This results in needing a larger central station air handler with larger fans that consume more energy. The central station air handler would also require larger capacity heating and cooling coils to heat, cool, and dehumidify the larger air volume. The electrical costs for a fan coil unit system are higher than a chilled beam system because every fan coil terminal has a fan motor where chilled beams do not have any fans and do not require electricity.
Maintenance for the HVAC systems must be considered, especially in a behavioral suite. With a typical fan coil unit system, the fan coils need regular maintenance, including changing filters, cleaning coils, replacing fan belts, condensate pumps, and cleaning condensate traps and drip pans. Ideally, this service would happen on an annual basis. With chilled beams the frequency of maintenance and associated costs are lower than a fan coil or variable volume air system. Chilled beams do not contain fans, motors, or dampers that require changing or lubricating, and most chilled beams do not have air filters that require changing. When designed and controlled correctly, the cooling coil does not produce any condensation so regular cleaning and disinfection of the coil is not needed. The typical recommended preventative maintenance for a chilled beam is to vacuum the coil every five years. In a patient room setting it is recommended that this is done more frequently. However, the amount of time, effort, and cost is much less than conventional systems and this will decrease the amount of tools and objects maintenance personnel need to bring into high-risk areas.
The patient rooms are a high-risk area for patient self-harm due to reduced staff oversight to respect a patient’s privacy as they change and/or use the bathroom. They require a high level of ligature resistant design and coordination of all fixtures and furniture to minimize the risks to patients. The design created two zones within the patient room to maximize ceiling heights where the chilled beam, lights, and access panel were in a monolithic dry wall ceiling. The second zone at the entry of the patient room, including the patient toilet/shower room, had a lower ceiling to accommodate the ductwork serving the patient room.
Ceiling raised in patient areas to limit access to the lighting, chilled beam and sprinkler heads, lowered soffit for duct work.
The chilled beams are often hung from threaded rods from the structure above which in crowded ceiling plenums can present challenges to coordinating all the systems. The sizes of the chilled beams, some as long as 8’-0” are new elements to coordinate.
When all aspects of the design are fully analyzed and standards and guidelines are met, the existing mechanical systems can be adapted to meet chilled beam requirements. Most importantly, patient and staff safety can be addressed. Therefore, chilled beams are an excellent energy saving alternative to a typical VAV or fan coil unit system in a behavioral health unit.
As we get older, the milestones we reach become less celebrated. Becoming a teenager, an adult and turning 21 are all exciting birthdays. By the time we turn 50, nearly everyone will be asked by their doctor, “Have we scheduled your colonoscopy yet?” According to the Centers for Disease Control, colorectal cancer is the second leading cancer killer found in both men and women and this new rite of passage is an important preventative measure in reducing the number of cancers found and the number of people who die from the disease. As the number of procedures needed increases so does the need to increase capacities at endoscopy centers.
When a regional hospital in Massachusetts had the opportunity to relocate and expand its Endoscopy department, Margulies Perruzzi was excited to tackle the challenges presented by several emerging design trends in these clinics. In addition to accommodating the increase in volumes, the solutions led to better access for patients, greatly improved patient comfort and privacy, staff efficiency and reduced patient wait times.
The open office is not a new concept, and it is one that continues to gain global momentum as office designs become more progressive. But, if research indicates that organizations moving to more open work environments is here to stay, then why all the negative press? The issue stems from the definition of the “open office.” Visit this link to read the feature article on HighProfile.com
Joe Flynn will present “Home Base: Embracing High Performance Workspace in Behavioral Health” at the Healthcare Facilities Symposium & Expo in Boston, 9/18. Find out more about his session w/co-presenter Amy Fitzpatrick from Home Base at bit.ly/33g1QT9
–by Marc Margulies, Margulies Perruzzi, and John Civello, PTC
New technologies are disrupting traditional ways of working and standard concepts of workplace design and facility management. These so-called “disruptive technologies” for real estate and facility management functions offer opportunities to fundamentally change the workplace paradigm in three primary categories: real estate transactions, property ownership and tenant/workplace occupancy.
While each category provides distinct benefits that facilitate better interaction and more efficient management, tenant/workplace occupancy is the ultimate market driver because tenant users create demand for real estate product in the marketplace. A better understanding for the implications of these disruptive technologies can help building owners construct more cost-effective buildings and help facility managers improve efficiency and service levels for a wide range of facility management functions.
The shifting workplace — and workstyle According to a survey by Herman Miller, 40 percent of workstations are occupied less than half of the time, and private offices are on average occupied only 25 percent of the time. Corporate real estate executives and facility managers are coming to realize what an enormous waste of resources this represents — one that feels increasingly jarring as we move toward a more shared economy. Many companies are shifting their workplace from fully assigned seating to free address space allocation for activity-based work.
THE SHIFTING WORKPLACE — AND WORKSTYLE According to a survey by Herman Miller, 40 percent of workstations are occupied less than half of the time, and private offices are on average occupied only 25 percent of the time. Corporate real estate executives and facility managers are coming to realize what an enormous waste of resources this represents — one that feels increasingly jarring as we move toward a more shared economy. Many companies are shifting their workplace from fully assigned seating to free address space allocation for activity-based work.
For workers who are not devoted to one focused task all day long, the free address concept allows them to choose where they want to sit based on their daily or hourly task, who they need to collaborate with or what other adjacencies are important to their productivity. Remote working has also become ubiquitous as many companies develop remote working policies to help attract and retain talent. The trend toward open-plan offices, collaborative work and remote work is thus driving the use of disruptive technologies to maximize workplace utilization, increase productivity and communicate with staff to improve employee satisfaction.
Managing such a dynamic office environment — one that must be highly flexible and responsive — is only possible via a software support platform that is both simple to use and portable, and those technology systems now exist. The world of IoT (Internet of Things) has enabled an increasingly robust interaction between the interior environment and its occupants. Sensors installed in office spaces, light fixtures, workstations, HVAC equipment, hardware and audiovisual equipment facilitate the ability to gather data on activity, light levels, vacancy, temperature, security and media interface. With the data comes the ability to understand patterns and using that data to improve facility and productivity outcomes.
DISRUPTIVE TECHNOLOGIES DO IT ALL… EXCEPT THE WORK Myriad disruptive technologies can provide facility managers with aggregated data across the office to analyze trends, optimize building performance and reduce operational costs. Some systems known as “people analytics programs” gather data by tracking how and where workers engage each other, highlighting patterns of interaction and providing information to plan for the most effective strategic adjacencies. Some options include:
According to National Grid, 35 to 45 percent of an office building’s energy cost is due to lighting; the potential to save energy and money by turning off unnecessary lights is enormous. New lighting control technology is moving beyond just code-mandated occupancy sensors in offices in favor of control systems that dynamically modify the light fixtures in open-office areas too. These more refined applications allow users to adjust LED light levels in their work areas to individual preferences.
User comfort is always a priority for building managers. One person’s hot is another person’s cold. New energy management technologies now allow for more efficient heating and cooling, and customized area controls are becoming more common. CrowdComfort, for example, addresses user comfort and organizational communication by allowing individuals to use their smartphones to communicate with building management directly, facilitating micro-adjustment of systems to user preference, as well as smooth dialogue with building engineers.
Security is of global concern, for reasons related to life and physical property and safety, as well as protection of intellectual property. Building reception desk greeters have become security guards, and front doors have become entry gates. At the tenant level, smartphones can now be readily programmed with owner identification. Mobile access control has the advantage of simplified and centralized credential management and offers the benefit of full data gathering and analysis. Knowing who and when users enter and leave a building facilitates a better understanding of how much space is really needed. An increasingly mobile workforce does not operate according to a traditional 9-5 schedule; thus, the amount and location of required space must be more deeply scrutinized.
AV systems have become the mainstay of collaboration. Few meetings in the knowledge economy are conducted without technology support, and screen sharing has become universal. Confirmation that the right AV is available for the meeting size and purpose is one of the functions of companies like TEEM (recently purchased by WeWork), a software that not only schedules rooms and equipment, but simplifies the sharing and display of information.
Finally, there are applications that interface with services and vendors inside and outside the office building itself. Corporate cafeterias now support the ability to order food via an app, either for individuals or catered groups, in advance of the rush-hour pickup. Many new dining facilities offer state-ofthe-art software capabilities for viewing and ordering customized selections from any of the variety of their culinary options. Other services ready to ride this technology wave may include dry cleaning, health and wellness services, day care scheduling and access to other amenities.
CASE STUDY: PTC’S NEW GLOBAL HEADQUARTERS PTC, a global provider of technology that transforms how companies design, manufacture, operate and service things in a smart connected world, recently relocated its global headquarters from suburban Needham, Massachusetts, USA, to a new 17-story, 400,000 square-foot office tower in Boston’s Seaport District. PTC’s vision for future growth drove a business transformation for its new 250,000 square-foot, technology-rich headquarters and a dramatic shift to a new way of working with an activity-based, open-office and free address concept for the workspace. PTC’s three project goals for its new headquarters were to: elevate the PTC brand and profile of the company; deliver space that attracts and inspires talent and taps the potential of its urban setting; and create a world-class technology experience for customers.
While PTC management was embracing the new changes to come, it recognized that moving to the Seaport District represented a major shift for the company’s workplace and workstyle, most notably:
Suburban location to urban hub;
Three-story horizontal campus to nine-story vertical workplace;
Private offices and workstations to an open office plan;
Assigned seating to 100 percent free address.
PTC’s previous office planning model was dated, cramped and did not allow for cross-pollination of departments. Of the 1,000 employees in headquarters, 40 percent worked in private offices and 60 percent in workstations that limited interaction. Conference rooms were mismatched to size and function. Based on facility data, the office had just 65 percent utilization on any given day and 40 percent attendance ratio on average, necessitating the rollout of a remote work policy. In sum, PTC’s former space was sub-optimal for how it needed to work.
To address these challenges and improve workflow, PTC collaborated with architecture firm Margulies Perruzzi (MP) and the Boston office of project management firm Cresa to devise a workplace strategy that embraced an open, activity-based workplace design with an abundance of technology. The free address model facilitates accidental collisions among employees and creates opportunities for interaction across departments. PTC’s transformational new headquarters reduced from 321,000 square feet to 200,000 square feet overall and 321 square feet to 196 square feet per person.
EVALUATING DISRUPTIVE TECHNOLOGIES WITH MIT CENTER FOR REAL ESTATE As with any new facility where a new workplace paradigm presents a major shift for its occupants, PTC’s goal was to implement facility management and employee productivity technologies that would facilitate input from their 1,000 employees in the 250,000 square-foot workspace, ensuring the new facility works properly as designed, gathering facility data in order to maximize space utilization and identifying employee concerns to respond in a timely fashion.
As part of the design of a new physical work environment, PTC recognized the opportunity to meld its role as an innovator in software for product design, IoT, and Augmented and Virtual Reality (AR/VR) to make its headquarters a global model for excellence in the use of disruptive workplace technology. The task? Evaluating the most appropriate workplace and facility/real estate management technology in an industry known for lightning-speed evolution.
To assist PTC and MP with evaluating the most appropriate technology options, the MIT Center for Real Estate (MIT/ CRE) was engaged as a research collaborator in the use of disruptive technologies. With a strong background in understanding disruptive technologies, MIT/CRE was well-positioned to help facilitate a conversation about the goals, opportunities, challenges and processes for a variety of potential technological directions.
The day-long workshop led by MIT/ CRE’s Innovation Lab helped the team define the technology landscape and curate the building technology stack. Discussions included how to work differently, engage the community, provide smart green spaces, use technology to improve commuter and visitor experiences, and integrate technology solutions into PTC’s platforms. After a collaborative team process, MIT/CRE provided recommendations and a roadmap for researching and evaluating disruptive technologies to incorporate into PTC’s state-of-the-art headquarters.
The selected technologies measure space utilization and heavy-use patterns in real-time and provide PTC’s facility managers with aggregated data across the office to analyze trends and adjust space allocations, optimize building performance and reduce operational costs. These technologies included:
CrowdComfort crowdsources occupant and building information to improve efficiency and service levels for a variety of functions, from climate control, lighting and acoustics issues to maintenance, audiovisual needs and space utilization. The CrowdComfort mobile application delivers an employee-driven data set, including geo-location and photo evidence, that facility managers can analyze to make informed maintenance decisions, saving time and money.
Steelcase’s Room Wizard and Workplace Advisor help to maximize productivity, collaboration and space utilization. With sensors installed in all workstations and conference rooms, facility managers will be able to identify areas of heavy utilization and communicate with users how to change meeting schedules to avoid congestion or modify facilities to meet the need. The software can be accessed by users remotely via their mobile devices to book collaboration space, and facility managers can measure heavy-use patterns in real-time, anticipating pressure on the space before it becomes critical.
REAL-TIME RESULTS Perhaps the most interesting lesson from the adoption of these dramatically impactful technologies is that new management practices and skills are necessary to interpret and respond to the plethora of data. For example, anecdotal reaction soon after move-in was that there were not enough desks available to meet demand. Sensor data, however, showed only 65 percent occupancy. Upon visual inspection, it became clear that users were leaving their personal possessions (laptops, coats, shoes, etc.) at workstations even if they were in meetings elsewhere. When the policy on using and vacating workstations was clarified, the problem went away.
The feedback through CrowdComfort has been voluminous. Just the newfound ability to easily comment has encouraged thousands of comments about the interior environment. This has allowed PTC to categorize issues and bundle them for efficient response and brought to their attention to seemingly small issues that can be easily addressed to increase staff satisfaction. It is clear that these new tools have radically changed how PTC operates its workplace. PTC’s facility management team itself has noted that it cannot imagine trying to manage a workplace this dynamic without these tools.
As companies seek to offer highly personalized employee interactivity within the work environment, it is essential that facility managers research and evaluate the most appropriate workplace management technologies for their facilities.
EARLY BENCHMARKS PTC is employing disruptive technologies to evaluate and manage the effectiveness of their new workplace strategy. Even in the first few weeks of occupancy, the benefits are being realized. For example, PTC’s new headquarters uses a 100 percent free address workspace model, a big change from the assigned seating in their previous Needham, Massachusetts, office. In addition, just 750 seats were provided for the 1,000 employees, with ancillary seating in collaboration areas to accommodate peak attendance.
Shortly after moving in, one group indicated that they were running out of space. The facility management team was able to leverage the data collected from Steelcase’s Workplace Advisor reports to determine that the group’s portion of the floor had consistent vacancies. The issue was with employees not following policy regarding claiming workspace overnight or during meetings.
Similarly, another group reported a lack of meeting spaces on their floor. In this case, facility management determined that employees were reserving rooms and never using them. While the rooms were automatically released after a few minutes of not being occupied, the facility management team was able to take the extra step of addressing these specific individuals, requesting they omit unnecessary meetings from their scheduling systems to make them available in advance to others.
-by Jason Costello, AIA, EDAC, LEED AP and John Fowler, AIA, EDAC, LEED AP
According to the National Institute of Mental Health, behavioral and mental health (BMH) conditions affect one in five adults in the United States each year, yet only 41% of adults in the U.S. with a mental health condition received mental health services in the past year. As the stigma of mental illness begins to lessen, the need for access to behavioral healthcare treatment will only continue to grow. Recognizing that often outpatient behavioral health facilities are not medical facilities, and shouldn’t be designed as such, healthcare designers are designing therapeutic environments that ensure patient safety and promote psychological wellness and healing.
Research and emerging evidence compiled by The Center for Health Design suggests that certain design features are important for BMH treatment facilities and can relieve stress, create calm, and facilitate healing. Behavioral healthcare settings today often feature a comfortable, home-like environment with access to daylight and views of nature, enhanced noise control and visual privacy, and supportive spaces that promote patient security, autonomy, and positive distraction. BMH facilities are also being designed with efficient floor plans, multi-functional spaces, and alternative workplace designs to improve space utilization and reduce waste.
The design of the built environment can impact a patient’s real and perceived quality of care. A study in the Journal of Environmental Psychology found that the design and conditions in doctors’ waiting rooms influenced perceptions of the quality of care delivered by the doctors associated with those spaces. In behavioral health facilities, natural materials and daylighting are used to offer a calming, hospitality-feel to the reception area. If a clinical program requires security, it is often provided by plain-clothes officers with a dual job function to promote a more welcoming environment from the moment patients enter the clinic.
The programming of a behavioral health facility centers around consult rooms, the primary clinical spaces of an outpatient care environment. Their design should create a neutral, residential look while utilizing commercial materials and products. Details are subtle yet critical, such as no-trip area rugs and comfortable chairs. The selection of carpet and luxury vinyl tile (LVT) surround supports the look of a living room but with a level walking surface suitable for a healthcare environment. Visual privacy may be controlled by motorized shades that limit visibility yet allow daylight to enter the space. Sound masking solutions should be implemented to protect patient confidentiality.
Some facilities are deviating from the private office model in favor of a free address, open work setting with unassigned and shared therapy spaces. This planning model is more efficient for clinics whose providers see patients at multiple locations, leaving their vacant offices unusable to others. The integration of room scheduling software, online for clinicians and at digital signs strategically located at consult room entries, can help to improve space utilization and room booking for clinicians in a free address workplace.
Group therapy is a key programmatic element in today’s behavioral health treatment plans, but can be underutilized in an outpatient program. Facilities should be designed for multi-use flexibility to improve space utilization. Moveable partitions between large group therapy rooms can enable configuration for a variety of additional uses, as long as acoustical privacy at the partition (particularly above ceiling) is addressed to ensure HIPPA compliance for speech privacy.
Behavioral healthcare is shifting toward treatment of the whole person as clinicians recognize that exercise and nutrition are key contributors to mental wellness. Facilities are expanding their program offerings by adding nontraditional treatment spaces for fitness, yoga, meditation, and art/music therapies and demonstration kitchens to teach dietary health and wellness. These activities may require dedicated spaces or share multipurpose rooms. Defining these space requirements early in the design process is important to reduce the sound and vibration impact on adjacent patient and staff areas.
With an increased focus on overall wellness in behavioral healthcare as well as emerging approaches to treatment, BMH facilities require a clear clinical vision for today and a flexible design for change in the future.
-By Tim Bailey
Wired certification is a new trend in the marketplace….
A few notes from wiredscore.com…
“Without reliable internet, businesses cannot function. Tenant-focused commercial real estate landlords pursue Wired Certification so current and future tenants can rest assured that they are paying for future-proofed, business-ready office space. Wired Certification provides crucial insight into connectivity as telecom requirements for tenants become more complex.”- Wiredscore.com
Want your building to be certified?
“Work with us to implement best practices to ensure the design and construction of your building meets the connectivity needs of the commercial tenants of the future. Buildings can achieve Wired Certification during the planning, engineering, construction, or early occupation stages of the development process. Owners and developers can promote their Wired Certification achievement across all marketing and PR channels as soon as the building rating has been awarded.”- wiredscore.com
Design of the built environment is changing radically for three fundamental reasons: improved technologies, improved products, and improved processes. These transformative drivers have revolutionized all facets of the construction industry and every aspect of how and what we build.
Improved Technologies
Gone are the days of delivering a set of drawings to a contractor who builds according to the plans and specifications. The distinction between design and delivery has progressively been dissolved. Contractors and subcontractors now participate in the design phase through a variety of delivery methods and contract types, including design-build, design-assist, and component-assist. Previously, architects and engineers illustrated their intent in 2D representation. Now, all design documents are in 3D, and most components are downloaded in 3D from product manufacturers, complete with parametric data on performance, maintenance programs, and infrastructure requirements. While this allows designers to take advantage of the detailed expertise of product manufacturers, it can also prejudice their selection based on the quality of the available downloads.
Through the collaboration of architects with contractors, subcontractors, and manufacturers, buildings and interiors can now be fully constructed virtually. Virtual reality (VR) and augmented reality (AR) technologies can create immersive environments as convincing as those used in the gaming industry, blurring the lines between visualization and documentation.
Manipulation of scripted mathematical algorithms to autogenerate complex forms allows the exploration of every possible solution, not just the few that designers and contractors can sketch. Multiple schemes can be tested for appearance, fit, performance, and cost. Documentation is now dynamic, with the static sheet of drawings replaced by computers, iPads, headsets, and other electronic supports that permit builders to view, query, and coordinate such that conflict and waste can be eliminated.
Implications for architects include the expectation that subcontractor shop drawings will arrive electronically, prepared by those most knowledgeable about and responsible for their trade. The vastly more complex products and systems require expertise that no single source can provide, and collaborative technologies (BIM 360 and others) allow each professional to refine this marvelous building model in advance of beginning actual construction. Improvements in innovation, communication, cost control, risk reduction, and outcomes assurance will be momentous.
Improved Products
Modularity is increasingly sweeping aside field assembly. Traditionally, buildings are constructed piece by piece, brick by brick — regardless of rain, snow, or temperature. Would you buy a car built that way? Of course not; the quality would suffer too much. More and more of the components of a building are being delivered to the construction site ready for placement. These components range in size and complexity from light fixtures and unitized exterior building façades to whole buildings.
Improved technologies also facilitate CAD/CAM production directly from the design drawings. Sprinkler piping, for example, instead of being measured and cut in the field, can be shop fabricated to the precise dimensions and delivered to the exact intended location for installation. CNC machines, essentially robotic manufacturers, produce cabinetry ready for final assembly and require limited human intervention for production.
Modular housing is built in a factory efficiently and safely, delivered complete with finishes, appliances, plumbing fixtures, HVAC, and sprinklers fully tested to unequalled quality standards. Factories can actually sequence and assemble differently than what’s possible in the field, altering traditional responsibility-by-trade paradigms.
The use of mass customization is on the cusp of becoming routine practice. Why must all bricks be rectangular? Instead of using rectangular molds, what if molds could be easily and inexpensively created via software/robot interface such that bricks could be any shape we want? Materials will be 3D printed more often as printers and printable products evolve and designers discover more opportunities. Building mass was previously part of how material performance was measured; now lightweight, highly engineered assemblies and materials are crafted according to highly specialized characteristics at a nanotechnology level. Building integrated photovoltaic glazing (BIPV), which transforms entire surfaces of buildings into solar energy collectors, is an example of the highly integrated multidisciplinary nature of materials that now combine the characteristics of transparency, insulation, waterproofing, building protection, and electrical integration in ways that simpler materials never did.
Improved Processes
By its very nature, the traditional model of design-bid-build tends to cultivate mistrust. Today, clients want to work with building teams focused on delivery of the best product for the best price. More innovative contract models, such as integrated project delivery (IPD), create a relationship where the owner, designer, and contractor are all legal clients of the project, sharing liability and reward. There are many other team formats — design-build or design-assist, for example — that establish relationships that are highly collaborative and mutually respectful. While the architect used to be the “master builder,” the ubiquity of the owner’s project manager (OPM) now means that traditional roles have been upended. Some companies will even assume responsibilities for everything from leasing of premises to delivery of furniture, IT, and AV in addition to design and construction. New FASB accounting rules dictate recognition of construction costs far earlier than previously done. The response by corporate tenants (who represent 50% of building users) has been to negotiate that building owners assume responsibility for design and construction through turnkey deals that further blur the lines of direct accountability. If the relationships between industry professionals are contractually different, altered processes must result.
Architects wonder about the future of the profession. The adoption of innovative technologies, incorporation of specialized products, and embrace of more-collaborative processes can either help the discipline flourish or relegate designers to the junior position of façade decorator. Creating unique, one-of-a-kind buildings can be inefficient, risky, and expensive, yet construction is one of the greatest and most noble creations of humankind. How will we choose to build in the future?
About the Author
Marc Margulies, FAIA, LEED AP, is a principal and senior partner at Margulies Perruzzi.
Photo by Genevieve de Manio Photography
By Jason Costello and John Fowler. Originally published on Healthcare Construction+Operations.
September 17, 2018 – Just as healthcare delivery is evolving through new patient-provider approaches and transformative technology, so is the design of healthcare facilities rapidly advancing by the use of Lean process improvement methods. Lean in healthcare has focused on continuous, incremental improvement of existing processes that were primarily concerned with the operational aspects of the delivery of care. Recently, this focus on Lean has expanded to the design of clinical space so the architecture supports simplified operational models with the goal of maximizing patient satisfaction while minimizing waste and using fewer resources. Today, healthcare designers are employing the more advanced Lean 3P (Production Preparation Process) approach to designing patient-centered spaces.
Hospitals are complex facilities with intricate workflows and dedicated patient care that greatly benefit from operational efficiencies provided by Lean process improvement. For example, the Lean 3P approach was used in designing a cancer center to reduce waiting times and improve patient flow. The process significantly decreased the times a patient had to move from one space to another. For patients receiving both radiation and medical oncology on their first day of treatment, patient room moves were reduced from 21 to 6.
A recent project for a metro-Boston community hospital utilized Lean 3P planning for the renovation and expansion of the hospital’s central sterile processing (CSP) suite. The project required a multi-phased approach to keep the suite operational during construction. The Lean 3P process was introduced to minimize construction phases and provide a deeper understanding of the project’s priorities and functionality to identify critical adjacencies and flow for the CSP suite, accommodate new clinical programs for robotic surgery, and expand the hospital’s surgical capacity.
The planning process begins by going to ‘Gemba’ (where the work is performed) to observe and question the current state of how materials, patients and clinicians flow through a clinical department. The CSP suite was suffering from a lack of flow of surgical supplies from the decontamination process through the utensil washers, creating a backlog of case carts and requiring additional staff time to process sterile supplies for the next day. The project team observed the specific tasks and operations of the entire CSP cycle from the operating rooms through decontamination, prep and pack, sterile supply, and then back up to the surgery department. The observations were then reviewed step-by-step with the end users to find opportunities to maximize flow and eliminate steps. This process forms the ideal or future state goal from the user group.
The Lean 3P process allowed the team to identify the root cause of workflow obstruction through the CSP department, which was originally believed to be through-put capacity of the washers but was identified as duplicative tasks performed during decontamination and prep and pack. By eliminating the cataloguing step from the decontamination process, the processing time for soiled items could be reduced, thereby increasing valuable through-put.
The information derived from the existing state and the proposed ideal forms the basis mock-up portion of the 3P Planning Event. The complexities of renovating a CSP department in place required the team to understand the most efficient layout of the decontamination sink area to simplify phasing. The team created three mock-ups of the sinks and ran simulations through each option to study cross traffic, areas for carts, and required sorting space. The mock-ups provided a broader group of people to be involved in the design process, actively moving around boxes to replicate equipment in order to customize the space to meet their needs. Ultimately, this led to decisions in concept planning that held true throughout the remainder of the planning and design process.
The use of Lean 3P principles can help to improve end users’ understanding of the planning process and enable them to make informed decisions for their future space. The process can illustrate a complex workflow with many variables, identify obstructions, challenge original assumptions, and minimize duplication efforts. Using Lean 3P for healthcare can accelerate process design improvements and improve decision-making created in the early design phases of a project.
About the Authors
Jason Costello, AIA, EDAC, LEED AP, is an associate principal and partner, and John Fowler, AIA, EDAC, LEED AP, is an associate principal in the Health+Science studio at Margulies Perruzzi Architects (MPA). As one of New England’s top architectural and interior design firms, MPA designs Workplace, Health+Science, and Real Estate projects that inspire and nurture human endeavor. More information may be found at www.mp-architects.com.
