Three Form

Methodist Outpatient Uses Trinity Theme to Connect With Setting, Patients

By Debra Wood

Texas’ health-care market remains robust, with multiple, major projects under way across the state.

“I still see the health-care market being strong for the next eight to 10 years, with the baby boomer outcrop, people living healthier and longer lives, and the trend of folks moving to the sunshine states,” says Tim Hess, director of preconstruction services with the Southwest District of Hensel Phelps Construction Co. in Austin, which is building the 24-story Methodist Outpatient Center in Houston.

Robert Levine, senior vice president of the Turner Construction Co. health-care group in Nashville, Tenn., calls Texas the next Florida when it comes to health-care construction. He says an increasing number of retirees are moving into the state, and large providers, such as Methodist and the University of Texas, have major capital programs in the works.

Methodist currently has more than $1 billion in expansion and construction under way in the Houston areas, including one of the largest health-care projects in Texas, the $230 million Methodist Outpatient Center at its Texas Medical Center campus in Houston. Total cost for the facility is $331 million. The 1.6 million-sq-ft outpatient center will bring all outpatient diagnostic imaging and laboratory services, medical office appointments and ambulatory surgery procedures under the same roof.

The hospital system also is building a $218 million, 12-story research institute, which D.E. Harvey Builders of Houston broke ground on in January 2007 and will finish in 2010.

Austin Commercial of Dallas is working on a $247 million expansion of Methodist Sugar Land Hospital to keep pace with growth in Fort Bend County. And Vaughn Construction of Houston is building a $250 million expansion at Methodist Willowbrook Hospital in northwest Houston. The health system plans a $400 million to $1 billion north campus tower at the Texas Medical Center.

Sid Sanders, vice president of facilities at Methodist, attributes the number of projects and their scale to several factors. More procedures are performed on an outpatient basis. The health system began separating from Baylor College of Medicine about three years ago and now needs its own research facilities. The Houston area’s growth and Methodist’s aging main campus also factor in.

Easy in and out “Patients want a more convenient and less stressful environment to come and have services performed,” Sanders says, adding that Methodist’s centers of excellence attract outpatients because people know they will receive a high level of clinical quality at the facility.

The new outpatient center features open spaces, natural wood trims and resource centers for patients to wait for care, rather than traditional waiting rooms. The areas will allow access to the Internet and places to relax quietly and meditate, says Roberta Schwartz, senior vice president of operations at Methodist.

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“The goal was to have more of a guided experience, where we can connect with patients,” Schwartz says.

The center will employ the latest technology. Officials are investigating systems that will identify the owner of a car when it pulls up and then announce the person’s arrival. Easy in and out are priorities.

A symbolic design WHR Architects of Houston designed the outpatient center. It includes 1,300 parking spaces. Patient clinic floors start above the parking.

At the 18th floor, the building transitions from an L-shaped, precast and curtainwall structure that wraps around an existing building to a sleeker, triangular-shaped, glass tower. That allows greater space on the lower floors for parking, operating rooms, diagnostic equipment and back-of-house functions, as well as light, airy patient exam rooms and offices on floors above. The triangular tower has a 35,000-sq-ft floor plate, and the lower floors have a 70,000-sq-ft floor plate.

“The client wanted a building character that expressed the personality of the organization with a vision toward the future,” says Manolo DePerio, senior project designer for WHR. “They wanted an iconic form.”

DePerio combined two themes in designing the building-the Trinity, reflecting Methodist’s religious origins, and the three major tenets of Methodist’s mission: to create excellence in discovery, care and knowledge.

“I interpreted that as a triangle,” DePerio says. “When you are faced with a challenge like that, you come up with something unique.”

The triangular portion of the building also gives the appearance of a ship on the ocean, a safe place. The play in the geometry will change the lines of the building as someone looks at it from different locations, DePerio says.

A steel-tubing architectural element, dubbed “the tiara” and rising above the

roof, hides the cooling towers and is symbolic of something achieving a high stature.

“At the tallest peak, it’s about 60 ft above the roofline, and it tapers 10 to 15 ft above the roofline at the shortest point,” says Michael Dwight, project manager for Hensel Phelps. “On top of the building, there’s a stout structural-steel structure that holds up the curtain wall and that tiara. The height of that above the roof is a challenge.”

Four-lane John Freeman Boulevard will run though the center of the building, creating a space for people to valet park or enter the garage. Methodist’s Sanders says that extending the road through the structure should improve traffic flow around the medical center.

Construction Construction manager-at-risk Hensel Phelps began construction in September 2006. The structure covers from property line to property line, on all sides. Major arterials run along two sides of the outpatient center.

“We are building within 12 in. of their existing hospital, which is currently in operation and will stay in operation while we are building,” Dwight says.

Deliveries take place on one side of the building, between 6 p.m. and 6 a.m. Construction cannot disrupt traffic or rail service.

“One challenge is the logistics. The medical center is in a congested area,” Sanders says.

Houston’s poor soil conditions and high water table also presented challenges during excavation and mat and column foundation work. Underground portions of the structure site are 2.5 levels below grade. Crews worked for 10 months--excavating, dewatering, placing retaining structures and pouring the mat foundations--before the building reached street level during summer 2007.

Due to its large size, the building was split into two pieces held together with expansion joints. The building has two 8- to 9-ft-thick mat foundations, the largest 100 ft by 200 ft. Drilled piers serve as retention and support structures.

Heavily reinforced, 4- by 4-ft columns outline the perimeter. Where the pieces join, the columns become 4 by 8 ft, with a column on each side of the joint. Concrete placement occurs during the early morning hours.

The team expects to top out in November.

“We are running three tower cranes of this job and will jump each one three times,” says Randy Barr, operations manager for Hensel Phelps.

Sanders says Methodist opted for a concrete frame, “because it gives us a cost-effective, stiffer frame. We can use more delicate medical instruments with a greater degree of confidence.”

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Concrete also offers greater options for renovations to accommodate future changes, Sanders says. And he adds that it will carry the loads generated by heavy equipment, including a central utility plant and mechanical level on the 17th floor that includes generators and boilers.

“That is definitely a challenge, not just for construction but also for the hospital down the road for maintenance,” Hensel Phelps’ Dwight says. “Because of the proximity of our building to the existing, there was no way to exhaust generator exhaust and all the other exhaust. The only solution was to take it all the way up to the 17th floor, so it can exhaust through the roof of level 18.”

Operating suites sit directly below the central energy plant, which raised noise and vibration concerns, but that problem was solved by placing the mechanical equipment on an isolated, floating concrete slab. The building includes 16 surgical suites, with a shell floor set aside for another 16 operating rooms. The top three levels of the tower will remain shell space for future expansion.

The building also is designed to accommodate linear accelerators, which produce radiation to treat cancer. Each of these spaces is surrounded by 54-in.-thick concrete walls and floors.

The Methodist Outpatient Center is scheduled for completion in April 2010.

“[The outpatient center] is going to be one of the biggest buildings in the medical center on gross square footage,” Sanders says. “It’s going to help us deliver more user-friendly, high-quality ambulatory services.”

Key Players

Owner: Methodist Hospital System, Houston
General Contractor: Hensel Phelps Construction Co., Austin
Architect: WHR Architects, Houston
Program Manager: Broaddus & Associates, Austin
Structural Engineering Consultant: Hanes Whaley Associates, Houston
MEP Consultant: SSR, Houston
Electrical Contractor: Henderson Wayne Electric, Houston
Mechanical Contractor: TDIndustries, Houston
Plumbing Contractor: Humphrey Co, Houston
Precast Contractor: Coreslab, Austin