May/June 2023 | VOL XXIV, ISSUE 3 | |
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In the A/E/C sphere, we tend to generalize when talking about project types. For many of us, our work falls into big buckets titled things like K-12, Commercial, Industrial, Housing and, of course, Healthcare. The reality is however, that each of these project categories could easily be sub-divided into about a dozen more, each with its own specific brand of design requirements, challenges, and goals.
Healthcare is one of the largest buckets many of us work diligently to fill. In the United States, this category accounts for between $40-50 billion in construction annually. But within that bucket, the types of healthcare facility design are as varied and specialized as the medical industry itself. While general practice hospitals and clinics are major players, there is also an emerging market and need for specialty facilities designed to deliver highly-focused, expert care.
In this edition of Plains Talk, we discuss our design approach for several of these specialty environments, with a particular focus on procedure rooms, surgical suites, and imaging facilities. Perhaps just as importantly, we also talk about what makes them different.
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How MEP Impacts Procedures | |
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The design of medical procedure, surgical, and radiology spaces is critical to ensuring the success of various medical procedures, while prioritizing patient comfort and safety. These specialized spaces require meticulous planning and attention to meet the specific needs of healthcare professionals and ensure optimal patient outcomes. In this article, we will explore the mechanical and electrical design considerations that are vital for creating high-performing specialty medical rooms.
There are some general design factors that should be considered for any medical procedure room.
HVAC: Effective heating, ventilation, and air conditioning (HVAC) systems are essential for maintaining a comfortable and sterile environment. High-efficiency particulate air (HEPA) filters are incorporated into the HVAC system of many of these space types to remove airborne contaminants. Sufficient air exchange rates are also crucial to control the spread of airborne pathogens and maintain proper air quality within the room. Precise temperature and humidity control are necessary to enhance patient comfort and support the requirements of specific procedures, while preventing condensation that could damage important medical devices.
Noise Control: Reducing noise levels is important as excessive noise can be disruptive to both patients and healthcare professionals. Acoustic panels, insulation, and sound-absorbing ceiling tiles can minimize noise transmission between rooms and from external sources. The design team can also address the room layout to isolate the procedure area from adjacent spaces to minimize noise disruptions, specifically those created by mechanical systems.
Lighting: Proper lighting is crucial for visual clarity during medical procedures. Adequate and uniform lighting should be provided to ensure clear visibility within the operating field without causing glare or shadows. Incorporating adjustable lighting fixtures can then allow healthcare professionals to customize the illumination based on specific procedures. This includes selecting lighting solutions that provide accurate color rendering, as it is vital for distinguishing subtle variations in tissues and fluids.
Power Distribution: Medical procedure rooms typically require a substantial number of power outlets strategically placed to accommodate various equipment and medical devices. The team must assess the power requirements of equipment to ensure the electrical system can handle the load without overloading circuits. They can also incorporate backup power sources, such as uninterruptible power supply (UPS) systems and local power generators, to minimize dangerous disruptions in case of power outages.
Surgical Suites
It’s no surprise that surgical suites focus on promoting sterile conditions that accommodate advanced medical equipment and facilitate optimal surgical outcomes.
The creation of these sterile environments means implementing a positive pressure system to prevent the ingress of contaminants from adjacent areas, which can reduce the risk of surgical site infections. The mechanical design will also utilize HEPA filters in the HVAC system to ensure effective removal of airborne particles and microorganisms, enhancing the sterility of the surgical environment. Laminar airflow patterns throughout the space provide for consistent air movement across the operating field to improve both infection control and occupant comfort and safety.
Radiology Rooms
The design of X-ray rooms and CT suites must create an environment that supports optimal high-quality imaging while minimizing radiation exposure.
While there are a number of architectural elements that come into play for radiation shielding, the HVAC system can also play a role. In addition to installing upgraded post-filters, the system should also provide sufficient fresh air and total air exchange rates to maintain air quality.
MRI Procedure Rooms
MRI (Magnetic Resonance Imaging) procedure rooms also require a space designed conducive to accurate imaging and reliable equipment performance. MRI machines generate powerful magnetic fields, necessitating strict safety measures to protect patients, staff, and equipment.
MRI procedure rooms require proper magnetic shielding to contain the magnetic field within the designated area and prevent interference by nearby sensitive equipment, including mechanical and electrical systems. The design team and owner must implement protocols to control the presence of ferromagnetic objects within the MRI room to avoid hazardous projectile effects or image distortion. This includes using non-ferrous materials for construction and ensuring all objects brought into the room are MRI-compatible.
The materials used within the HVAC system in an MRI room must be carefully designed to minimize electromagnetic interference (EMI) with the MRI machine and produce minimal noise levels to prevent vibrations and acoustic noise which could degrade image quality. All penetrations through the shielding must pass through a waveguide filter to minimize the impact of the magnetic field beyond the shielded area.
The MRI Suite, like all imaging suites, is very heavy on the power and controls requirements. A great deal of coordination goes into ensuring the appropriate high-quality power is designed for each piece of equipment. Protecting this equipment from power fluctuations and outages is critical to the operation of the suite and equipment longevity.
Specialty medical procedure rooms require an equally specialized approach to mechanical and electrical design. Proper HVAC systems, noise control measures, appropriate lighting, and well-planned electrical systems are vital for supporting medical procedures and ensuring optimal patient care. By incorporating these design considerations, healthcare facilities can create specialty spaces that meet the specific needs of medical professionals while prioritizing patient safety and comfort.
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Article collaboratively authored by WPE mechanical and electrical engineering staff. | |
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Black Hills & Sioux Falls VA Health Care Systems
MRI Site Preparations
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In 2020, the Black Hills and Sioux Falls VA Health Care Systems began gearing up for significant improvements in their imaging capabilities. To enhance patient access and safety, state-of-the-art MRI systems were set to be installed at three separate facilities: Ft. Meade, Hot Springs, and Sioux Falls. These upgrades focused not only on ensuring more accurate diagnoses but also addressing existing safety concerns regarding patient access. Our teams in Rapid City and Sioux Falls partnered with Stone Group Architects to incorporate the necessary MEP and architectural requirements to accommodate the new MRI systems.
Ft. Meade VA Medical Center
West Plains Engineering was part of the original team that designed the existing MRI suite and installation of the existing MRI machine, which had been serving patients well for over 10 years. However, the medical center had recently been awarded newer, more advanced equipment, which promised even more precise imaging and diagnostic capabilities. WPE evaluated the cut sheets for the new equipment and identified what would need to be demolished or upgraded, and how the new equipment could be installed. One of the bigger challenges was getting the old uninterruptable power supply (UPS) out and the new in. The new UPS was being delivered with batteries installed in the cabinet that was 34” wide x 42” deep x 74” tall and weighed 4,900 lbs. To fit it in the allocated space, we had to demolish the exterior wall of the mechanical room where the UPS was to be installed, remove the old UPS and place the new UPS through the opening. The wall then needed to be patched and sealed. Fortunately, our team had thoroughly reviewed all aspects of the information provided by the owner and caught a line in a purchase order stating that the batteries would be delivered preinstalled in the cabinet. There was no safe way to move this unit from the loading dock to its destination as the existing floors within the hospital would not have supported this load, but putting the unit through the wall was feasible, and resulted in no change orders.
Hot Springs VA Medical Center:
The Hot Springs VA Medical Center relies on a mobile MRI unit located at an exterior loading dock in the hospital's basement. Some of the safety issues needing to be addressed included the power cable that ran on the ground across the path where the patients had to travel to get to the Mobile MRI. There were similar safety issues related to existing concrete and paving heaving and drainage issues. As a result, a new pad was poured, and better drainage provided. Another safety issue related to the monitoring of the onboard fire alarm and code blue systems within the MRI trailer. Connections were provided for both the fire alarm and nurse call system to allow the systems to be monitored by the facility counterpart systems for alarm, and to ensure better safety and reaction times by staff. Prior to this project, patients and staff were provided no cover as they walked from the hospital doors to the trailer entrance. For better access and protection from the weather a covered canopy was installed with new LED lighting.
Sioux Falls VA Medical Center:
The Sioux Falls VA Medical Center not only sought to replace the existing MRI system, but also to renovate interior finishes in the Radiology Department and install new patient lifts. Our team supported the reconfiguration and renovation of the ground floor of Building 5, including creation of an ADA compliant restroom, dressing rooms for MRI and CT patients, and rerouting the chiller vent to comply with VA regulations and safety requirements. The interior upgrades to the Radiology Department involved new LED lighting and a bathroom upgrade.
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Stuart Oster is a Mechanical Engineer and head of the Mechanical Department in Sioux Falls. He celebrates 10 years with WPE in 2023.
Email Stu
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Mike Sigman, P.E. is an Electrical Engineer and Office Manager of WPE's Rapid City location. He has been with the firm since 1998.
Email Mike
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Casper Medical Imaging Expansion | |
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Casper Medical Imaging & Outpatient Radiology (CMI) is dedicated to delivering advanced imaging and interventional services to patients across Wyoming (and soon…western Nebraska). At CMI, a team of highly skilled sub-specialists offers a comprehensive range of services, including lung cancer screening, MRI, breast imaging & biopsy, diagnostic imaging, interventional procedures, musculoskeletal (MSK) care, and varicose vein treatment.
Our collaboration with CMI involves two concurrent projects aimed at enhancing patient care. One project takes place in the McMurry Medical Arts building in Casper, originally designed by WPE. In this effort, we are developing an 1,800 square foot vascular suite that will feature offices, exam rooms, a procedure room, a post-procedure room, a nurse station, a restroom, a waiting room, clean storage, and bio-waste closets. Our team is responsible for the mechanical design, which involves extending the existing ductwork to new variable air volume (VAV) terminals equipped with hydronic reheat coils.
Simultaneously, we are engaged in a second project that will not only expand CMI's facilities but also broaden its footprint. This initiative involves the addition of an imaging suite to the Elite Health Center in Scottsbluff, NE, addressing a critical gap in patient care within the region. The new suite will offer an array of imaging capabilities, including MRI, CT, ultrasound, mammography, X-ray, and DEXA scanning. The current space is vacant, and our team is responsible for both the mechanical and electrical designs necessary to support the integration of these six essential pieces of equipment, all of which will require substantial power, as well as effective ventilation and humidity control.
Both projects are expected to be completed in 2023.
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Matt Stroh is a Mechanical Engineer and Manager of our Casper office. He is an ASHRAE Certified HVAC Designer (CHD) and is currently the Project Manager for both expansion projects with Casper Medical Imaging.
Email Matt
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Understanding the Nuances of Care | |
Sioux Falls Specialty Hospital | |
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Specialty hospitals provide care in highly specialized fields that require providers with unique skill sets – and facilities with unique features. Our team has worked with a variety of specialty facilities, including several projects with the Sioux Falls Specialty Hospital in South Dakota. We were part of a $13 million expansion to the existing facility, and have since supported remodels to the MRI suite, laboratories, patient and operating rooms.
Over the past decade, we have completed renovations within the existing building to realign space to improve care delivery as the needs and service offerings have changed or grown. We have been involved in upgrading the staff lounges and locker rooms to provide a more comfortable space during and after a long shift. A renovation to install an MRI room in one area of the facility was then relocated after just a few years of service due to shifting space adjacency and service delivery needs. A major renovation also provided updated patient rooms to provide optimal recovery spaces, which included new VAV boxes, radiant heat, LED lighting, and medical gas.
Included in these various projects was the design to remodel nearby spaces including laboratories, medical file storage, offices, and conference rooms. Our staff has also provided the design for upgrading several existing operating rooms, which added new LED lighting, T-bar grid LED lighting, and air supply distribution.
The critical element to designing these projects has always been a keen understanding of the care being provided and any potential patient environmental vulnerabilities. Each of these renovations has required a design that facilitates moving forward while allowing the facility to continue to operate and provide services and care throughout the renovation timeline. The attention to system layout and the equipment involved in that care, coupled with how the care is delivered, is also a major factor in assuring systems are optimally supporting providers and patient outcomes.
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Article collaboratively authored by Sioux Falls mechanical and electrical engineering staff. | |
West Plains Engineering News | |
Check out some of our recently completed and ongoing projects featured in the news! | |
Stroh Earns ASHRAE CHD Designation | |
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Mechanical Engineer Matt Stroh, P.E. recently passed his examination to become a Certified HVAC Designer (CHD) from the Association of Heating, Refrigeration and Air Conditioning Engineers (ASHRAE). This designation is managed under ISO/IEC 17024 requirements for ANSI-Accredited Personnel Certification Programs and validates competency to design HVAC systems to meet building requirements. This includes equipment, equipment sizing, load calculations, mechanical equipment room design, duct and piping design and layout, and the development of HVAC plans for permit and construction.
Matt joined West Plains Engineering in the summer of 2022 as the office manager in Casper. He has more than 10 years of experience as a mechanical engineer, previously working as a Senior Engineer for both Multistack and the Trane Company.
Congratulations Matt!
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Christensen Completes ACEC Pathways to Executive Leadership | |
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Join us in congratulating Marty Christensen on completing his American Council of Engineering Companies (ACEC) Pathways to Executive Leadership training program!
The session connected Marty with peers from around the country to learn critical leadership skills specific to our industry. (And we're willing to bet they learned a thing or two from him as well...)
Congratulations Marty and thank you for your ongoing leadership at WPE!
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Welcome to WPE One and All! | |
We've had the good fortune to welcome a number of new faces the last few months, including a couple of bright new graduates and some outstanding summer interns. Welcome to the WPE team everyone! | |
A native of Lincoln, Neb., Jessica Rau recently graduated from South Dakota State University with her degree in mechanical engineering. In fact, we met Jessica at the SDSU Jerome J. Lohr College of Engineering Career Fair this past Fall and she joined us in Rapid City as a Mechanical Designer in June. | |
Chris Mentele went official with us after spending a year in the Rapid City as an electrical intern. We were extremely fortunate to find this guy at SD Mines and are thrilled he decided to become a permanent part of the WPE team as an Electrical Designer. | |
We're excited to welcome South Dakota State University student Cole Hulstein for the summer! Cole just completed his junior year at SDSU and joins our Sioux Falls team as an electrical intern. | |
Carson Soles joined us in Cedar Rapids as a mechanical intern. Carson is from Rockford, Illinois and is heading into his senior year in the Fall. | |
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If you haven't seen this man's stamp on a set of electrical plans West River, where have you been hiding?
Mike Sigman celebrated 25 years with WPE in May...and just as importantly, we got to celebrate 25 years of his engineering expertise, client-focused service, leadership, and laugh. If he isn't in the Rapid City office (typically before the sun), you'll find him surrounded by his "other" passion...his horses.
Thank you for your commitment to both Mike and congratulations!
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We had three additional team members celebrate 5 years with us in May and June. Congrats guys...we hope to see you at the 25 year mark one day! | |
Cedar Rapids office manager and mechanical engineer Mike Drahos joined us in 2018, and brought with him with more than 25 years in the AEC industry. We knew we were getting expertise and leadership, but were pleasantly surprised to also welcome a fun- and food-loving teammate who has helped create an amazing culture in Iowa. | |
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Rapid City CAD Tech Matt McTee has been with WPE since 2018 and is also a musician, artist, and dog-lover extraordinaire!
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Five years ago we found CAD Tech Richrad Panton in Rapid City...and asked him to move to Eastern Iowa. Lucky for us, he said yes. Richard joined us in Cedar Rapids in 2018 and is one of the awesome cast of characters that makes that office a pretty darn great place to be. | |
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Rapid City, SD | Sioux Falls, SD | Casper, WY | Cedar Rapids, IA | | | | |
