The vivarium inside the Biomedical and Health Sciences Building at Washington State University's Riverpoint campus is among the most state-of-the-art facilities in Spokane. Radiant heating technology creates a controlled environment where future students will conduct research in consistent conditions. The resinous floors are chemical resistant, slip-proof and highly cleanable. Before students can even enter the laboratory, a stainless-steel chamber sterilizes all incoming medical equipment. The student researchers, in turn, shower down the hall.
"We're creating a building that is top of the line to train future health care practitioners in the Pacific Northwest," says Scott McGlocklin, the site's project manager.
The 125,000 square-foot, $78.6 million Biomedical and Health Sciences Building was the county's largest construction project last year. The school, which opens its doors in January to pharmacy and medical students, exemplifies the kind of planning, expertise and innovation required to build a complex medical and research facility.
"There's so much more to do it in a health care facility, compared to your standard office building," says Traci Hanegan, a mechanical engineer in Spokane who specializes in healthcare design.
"Pretend it's your mother on the operating table. How would you want that facility to be designed?"
Modern healthcare construction and design play a critical part in protecting the safety of facility inhabitants. Hospitals, for example, must be able to withstand pandemics, explosions, a supply chain workers' strike, or a natural disaster like Hurricane Sandy, which closed a handful of medical centers in New York and New Jersey and forced hundreds of patients to relocate. They have morgues, autopsy rooms, and laboratories that run on specialized mechanical, electrical, and structural systems. The lights simply can't go off, nor the power shut down.
"They're complex types of buildings," says Doug Hammond, the director of business development at Graham Construction, the contractor for the Biomedical and Health Sciences Building. "It requires a certain commitment of staff resources to understand how to do it."
There was a time before the advent of modern medicine when hospitals were dark and dingy places where the poor and sick went to die.
In the mid-19th century, British nurse Florence Nightingale revolutionized hospital design. While caring for wounded soldiers in Turkey during the Crimean War, she advocated for high ceilings, natural light and fresh air. Many of her ideas laid the groundwork for modern hospital construction and nursing care, including her concern with sanitation at the army hospital, where more soldiers died from typhoid, dysentery and respiratory infections than bullet wounds.
Today, hospitals are designed to help prevent the spread of infectious diseases. Roughly one in 20 hospitalized patients contracts healthcare-associated infections, adding upwards of $30 billion in excess medical costs. Germs that are resistant to antibiotics can be deadly. A 2002 study by the Centers for Disease Control and Prevention found 1.7 million healthcare-associated infections that year, killing nearly 99,000 patients.
The most common method of transmission is unwashed hands. Some studies have shown that simply having an easily accessible hand-washing sink for staff use in patient rooms decreases healthcare associated infection rates.
As a result, healthcare contractors and designers spend a lot of time thinking about things like "air changes per hour" and flat surfaces: floors, ceilings, walls, countertops, the backs of patient chairs. What materials trap the least amount of dust, grime and fluids, and are easy to clean?
The American Institute of Architects, publisher of the most commonly used guidelines for hospital and healthcare facility design, forbids "Perforated, tegular, serrated cut, or highly textured tiles" on ceilings. Floors should be water-, wear-, slip- and acid-resistant. So at Graham, Hammond recommends seamless sheet vinyl flooring and hard, monolithic ceilings, where "there are no nooks and crannies for bugs to hide."
"It's very complex," says Bret Miche, a senior project manager at Graham. "You want to be aware of sharp edges and points where someone might bang their head... [and] colors and contrasts; the elderly could have a hard time differentiating the two and be subjected to falls."
Even noise can affect patient healing. "You don't want to have rattling fans. That could be very disruptive to patient care," Miche says. Between exam rooms, you don't want to have sound transfer for patient confidentiality."
As early as the design phase of a new facility or renovation, Miche says contractors will meet with clinical staff to get acquainted with their "flow and process." The goal of any project is to use the contractors' design and construction techniques to optimize patient safety and ensure that medical professionals have a facility they can use to provide the best care possible.
"At the end of the day, we're a small part in helping people get well," says Hammond. "Which makes it a unique application of our skill set."