April 2023

M id A tlantic Real Estate Journal — Spring Preview — April 2023 — 9A


E ngineering & I ntegrated D esign By Jason Moss, PE, AKF Group A New Age of Adaptability in Healthcare Buildings


esigning buildings that are both flex - ible and sustainable

are grappling with incorporat - ing measures for transitioning to sustainable energy-consum - ing building systems. High- efficiency electrified equip - ment is increasingly popular to improve building energy per - formance. Heat-pump equip - ment, for example, is being considered as an alternative to fuel-burning boilers in future heating designs. However, incorporating flexibility into system design can introduce challenges such as costs, space constraints, and distribution issues that require careful coor -

dination. For instance, a facil - ity that heats with boiler steam planning a transition to heat- pump hot-water must contend with thorough analysis of the connected equipment and the prospect of extensive upgrades or limitations incurred by changing sources. Designing healthcare facilities that are flexible and sustainable can be accomplished with creative and comprehensive planning. Efficient heating and cool - ing systems are critical to improving building efficiency, and installing energy-efficient

equipment is often incentiv - ized by local, state, and feder - al governments. Some cities, such as New York City and Boston, have implemented policies with penalties for failing to meet energy per - formance benchmarks. How - ever, the future availability of natural gas is uncertain due to potential fossil fuel limitations, making it crucial for building owners and de - signers to carefully consider energy sources when making MEP design decisions. Deci - sions like using electricity

to create heat instead of fuel have a significant impact on system design considerations from electrical service to the building down to baseboard radiation size. Designing safe, reliable, adaptable, and sustainable healthcare buildings re - quires a unified vision, an understanding of trade-offs, and careful coordination. To meet the growing demand for adaptable patient care spaces and transition to sustainable energy-consuming systems, continued on page 16A

is a com - plex chal - lenge that requires a unified vi - sion and an understand - ing of the trade-offs involved. T o d a y ’ s

Jason Moss

building designs must sat - isfy functional requirements while also incorporating sus - tainability measures driven by policy, optics, and practi - cality within a dynamic en - ergy commodity landscape. In healthcare facilities, flex - ibility is a crucial aspect that is second only to safety and reliability. However, mechanical, electrical, and plumbing (MEP) building system designs in such fa - cilities face the additional challenge of adjusting to the growing desire for adaptable acuity patient care spaces and sustainability in build - ing energy. Building owners and designers must work together to create a unified vision for current and future planning while understand - ing the limitations and trade- offs involved in such designs. Designing safe and reliable healthcare building systems is not only a necessity, but also a complex task that re - quires the ability to adapt to changes in patient care envi - ronments and accommodate continuous improvements in diagnostics and treatment. The COVID-19 pandemic has highlighted the need for adaptable spaces that can support a higher level of patient care. For example, a space intended for standard treatment use would be suit - able for supporting critical care. To accomplish this, engineers must design for high ventilation rates and provide high-efficiency filtra - tion beyond typical require - ments. These improvements require significant heating, cooling, and power to achieve. A nominal spare capacity de - signed into building systems based on standard practice is swiftly exhausted by intro - ducing adaptable, pandemic- ready programs. Healthcare facilities, in ad - dition to program adaptability,

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