Facts & Figures Owner: City of Los Angeles Type of Project: A replacement medical center Size: 1.5 million square feet Cost: Approximately $625 million (total construction costs) Construction Time: January 2003 - January 2008 The Need: A new medical center to replace an aging hospital damaged during the Northridge earthquake The Challenge: Dealing with design and equipment changes due to advances in healthcare and technology made during the long planning and construction process Architects: HOK, Culver City, CA; Lee, Burkhart, Liu, Marina del Rey, CA (associate architect) Construction Manager: Jacobs Engineering of Cypress California General Contractor: MCH (a joint venture among McCarthy Building Companies, Inc., Newport Beach, CA; Clark Construction Group California, LP, Costa Mesa, CA; and Hunt Construction, Phoenix, AZ)
Los Angeles, California
Electrical Contractor: SASCO, Fullerton, CA Exhaust Dispersion Consultant: CPP Wind Engineering & Air Quality Consultants, Fort Collins, CO
Los Angeles County and University of Southern California Medical Center Replacement Project The Los Angeles County and
First opened in 1878, the hospital
A new structure is rising along-
University of Southern California
was one of the first in the Los Angeles
side General Hospital, however,
(LAC+USC) Medical Center, also
County healthcare system and has
and stands poised to take over
known as General Hospital, has
become one of the county’s most
the hospital’s crucial role in the
served as Los Angeles County’s life-
prominent symbols. It has grown
future. “The new hospital is
line for more than 72 years. The
into the nation’s largest teaching
designed to replace the aging
facility is the largest inpatient and
hospital and accommodates more
General Hospital and its ancillary
outpatient service provider in the
than 785,000 emergency and
buildings, which suffered severe
county’s healthcare system.
outpatient visits each year.
damage in the January 17, 1994 Northridge
earthquake,”
said
Kamel S. Youssef, project director for the LAC+USC Medical Center Replacement Project. “The new hospital will respond well to the changing healthcare needs and the increased demand for outpa-
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tient
services
and
decreased
inpatient care.” Described as the largest capital construction project undertaken by the County of Los Angeles, the new 600-bed, 1.5-million-squarefoot medical center includes a seven-story outpatient building, an Photos courtesy of LA DPW
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southern california edition
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eight-story inpatient tower, a fivestory diagnostic and treatment building, and a below-grade central energy plant. The medical center,
staffed
by
physicians
from the Keck School of Medicine of USC, is expected to begin treating patients in the second quarter of 2008. According to Ken Lee, principal for Lee, Burkhart, Liu (LBL), the project’s associate architect, the project will be the highly visible focal point of the healthcare campus, and will reenergize the adjacent streets and neighborhood. The buildings feature metal panels, precast concrete and natural stone to achieve a civic, institutional appearance and balanced massing. Additionally, building materials were chosen that would reinforce the legacy of this institution while keeping in mind the physical abuse the materials would face, both on the interior and the exterior. Featuring eye-catching design elements and innovative technology, the new LAC+USC Medical Center will be both architecturally striking and functional. “With advances made in medical treatments, technology and a more comprehensive hospital design, the new LAC+USC Medical Center will be able to serve the county’s population in a more efficient and patient-centered manner,” said Alicia Wachtel, healthcare director for HOK, the project’s Photo courtesy of Lawrence Anderson Photography
architect of record. “The design team of HOK, with
environment in which to deliver
The largest of the buildings is
(D&T) facility houses medically
LBL acting as associate architect,
sophisticated and technologically
the 688,000-square-foot inpatient
sophisticated services, including
focused on creating a clear, intu-
advanced care.
tower, which includes intensive
diagnostic
itive and comforting environment
To accomplish this, the plan com-
care, acute care, a burn ward, a jail
emergency services and an inpa-
imaging,
radiology,
at LAC+USC to alleviate ‘hospital
prises three buildings surrounding a
ward, pediatric care and neonatal
tient pharmacy. “The D&T Building
anxiety,’ and help visitors navi-
beautifully landscaped courtyard,
care. The 335,000-square-foot out-
is designed with a seismic base-iso-
gate the intricate campus,” said
which includes outdoor eating, seat-
patient building includes a variety
lation system beneath its entire
Wachtel. The project team want-
ing and rest areas. “This creates a link
of outpatient clinics, including radi-
76,650-square-foot
ed to build a hospital complex
[among] the three main functions of
ation oncology, women’s care, psy-
Youssef. “This structure is located
with a higher level of organiza-
the hospital: inpatient services, diag-
chiatric care and pediatric services.
between the outpatient depart-
tion and transparency while cre-
nostic treatment and outpatient
ating a very efficient and flexible
care,” she said.
base,”
said
Encompassing 430,000 square
ment and the inpatient tower, and
feet, the diagnostic and treatment
as a result of the base-isolation continued on page 5
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The Owner’s Perspective with Kamel S. Youssef, Project Director, LAC+USC Medical Center Replacement Project Q: What were some of the project’s key design objectives? KY: The three distinct hospital buildings are physically interconnected at various levels. This accomplished the goal to physically cluster related services in the most appropriate building type so that cost efficiencies could be attained. In addition, horizontal and vertical relationships between departments have been carefully organized so that, when appropriate, there is a strong physical adjacency between services. The diagnostic and treatment (D&T) building is designed with a seismic base-isolation system beneath its entire 76,650-square-foot base. This structure is located between the outpatient department and the inpatient tower, and as a result of the base-isolation system, the D&T will be the “life boat” component of the medical center in the event of a major earthquake. The base isolators provide seismic resistance beyond code requirement. In addition, the D&T building has a larger emergency room than would be expected for a hospital with 600 beds. Also, with this central location between the outpatient department and the inpatient tower, key ancillary services can be easily provided from the D&T building without excessive patient or staff transport. Major and separate entries have been dedicated for different services to reduce congestion within and around the buildings. Location of parking areas are strategically planned to facilitate the public/visitors’ entry in a more safe and secure environment. As such, a pedestrian bridge spanning Marengo Street and connecting the Marengo Parking Structure with the medical center [was] built. A bus transit center is designed adjacent to the outpatient department courtyard. Q: What is the most unique or important feature of the facility (or of the design/construction process)? KY: Normal power to the site is provided via two separate Los Angeles Photo courtesy of LA DPW
Department of Water and Power (LADWP) 34.5 kV circuits, each from a different distribution system. This will allow the hospital to have a secondary power line in case of a major failure at a LADWP station. Emergency power will be provided via seven diesel-driven generators. Diesel fuel for 72 hours of operation will be stored in an underground storage tank. This is one of the measures included in the design, allowing the hospital to be completely self sufficient for 72 hours following a major disaster. Energy conservation/saving methods [are] incorporated into the design of equipment providing utilities to the hospital buildings. For example, steam turbine chillers were included, which will operate during high-peak electrical periods in order to reduce electrical demand and consumption.
LAC+USC Medical Center Replacement Project Outpatient Department Building 1100 N. State St., 2nd Fl. Los Angeles, CA 90033 323-226-4726 fax: 323-226-8273
continued from page 3
system, the D&T will be the
visual access to the exterior. The
owners selected a team to serve as
joint venture partners and the owner
‘life boat’ component of the med-
medical center also includes wel-
the general contractor — MCH,
are very good.”
ical center in the event of a major
coming features such as grand
which is a joint venture among
Excellent communication through-
earthquake. The base isolators
stairs, gardens, plazas and breeze-
McCarthy, Clark Construction
out the process helped the project
provide seismic resistance beyond
ways. “The project cleverly uses out-
Group - California, LP and Hunt
team meet the objectives for this
code requirement.”
door and covered circulation spines
Construction. “We act as a group,”
groundbreaking facility. Corey Harris,
As safety and movement control
for pedestrian traffic between build-
said Joelle Hertel, senior vice presi-
group executive with SASCO, the
are paramount in any hospital, the
ings, thereby reducing the need for
dent of Clark Construction, the
prime electrical contractor for the
point of entry to all three buildings is
enclosed and fully built-out, air-con-
managing partner of the joint ven-
medical center, agreed that excep-
secured by airport-type security.
ditioned interior corridors,” said Lee.
ture. “Essentially, we abandoned
tional communication as well as
However, the center’s unique design
To handle the construction of this
our respective identities for the proj-
good relationships were key to this
maintains a sense of openness with
large and complex project, the
ect. Our relationships with both
project’s success. “SASCO worked continued on page 9
Photos courtesy of Lawrence Anderson Photography
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5
The Architects’ Perspective with Alicia Wachtel, Healthcare Director, HOK and Ken Lee, Principal, Lee, Burkhart, Liu Q: What were some of the project’s innovative design features? AW: …To facilitate building circulation, a concept of “building slabs” was developed to allow efficient, private pathways not shared by the different hospital populations. This concept of functional building slabs is expressed architecturally through coded exterior cladding: major circulation is glazed in curtain wall; metal paneling is used for the technological, interventional and service-oriented portions of the project; and areas of patient housing are enveloped in precast concrete. Q: What were the greatest challenges encountered on this project, either from your firm’s point of view or as a project team? AW: Challenges related to this project are centered on its size and complexity. …The project organization pivots on the diagnostic and treatment [D&T] building being seamlessly connected to both the outpatient building and the inpatient tower. Technical challenges related to connecting a base-isolated building (this building can move up to 30 inches in any direction during an earthquake in order to absorb quake energy and ensure continuous operation of the medical components during a disaster) to two fixed-base buildings were resolved by integrated Photo courtesy of Jason Hamlin/HOK
teams of experts from all the consulting engineering disciplines involved in the project. Anticipating changes in technology and allowing flexibility to accommodate new modalities of care were also major challenges. This was a project with a duration of 10 years from commencement of design to completion of construction. In order to allow this project to constantly adapt to changes in medical technologies, HOK approached the major building components in different manners. For example, the D&T is designed utilizing the concept of a “mechanical and structural exoskeleton.” All fixed building components, like major shafts and structural braces, are placed on the exterior of the building, allowing the floor plates to remain open to reconfiguration in the future if needed.
HOK 9530 Jefferson Blvd. • Culver City, CA 90232 • 310-838-9555 • fax: 310-838-9586 • jhamlin@hok.com • www.hok.com
Q: What were the greatest challenges encountered on this project, either from your firm’s point of view or as a project team? KL: Major challenges included the following: Creating a decision-making model at the medical center level that would enable the design team to plan, program and design the facility. A traditional “user interface” model was deemed to be undesirable, given the reality that a high percentage of line users would probably not be in a similar role when the new building became operational four or five years after programming and design. Instead, the design team and the owner agreed on a high level (“top down”) decision-making model, whereby an executive team (chief medical officer, chief nursing officer, hospital executive, hospital facilities executive) made almost all of the planning and design decisions. Their philosophy was to achieve the highest degree of flexibility, and to avoid designing the facility around individual wants or personalities. Q: What were some of the lessons learned from this project? KL: Lessons learned: Large-scale projects like this, which will extend for five to eight-plus years, must be budgeted with significant Photo courtesy of Lee, Burkhart, Liu, Inc.
project cost contingencies. Maintain a lean decision-making model with the owner. (The one that we’ve described earlier was very effective.) Design with maximum flexibility; avoid designing to specific individuals or custom operational models. Maintain an ongoing and collaborative relationship with the governing jurisdictions involved with plan review and post-approval review/building inspections. Acknowledge and plan for future technology; plan for growth and/or flexibility in building or site infrastructure.
Lee, Burkhart, Liu 13335 Maxella Ave. • Marina del Rey, CA 90292 • 310-829-2249 • klee@lblarch.com
Close-up of a wind pressure test model
Wind Engineering & Air Quality Solutions
Simulation of exhaust affecting a nearby building
CPP works on a wide range of projects, including healthcare facilities,
Armed with more than 26 years of experience, CPP Wind Engineering &
laboratories, academic research buildings, campus quads, arenas and
Air Quality Consultants is a leading wind-engineering consultancy that has
stadiums, and cultural centers among others. The company performs
completed projects on every continent. CPP’s founders and leaders include
exhaust dispersion assessments and air-quality assessments for hospitals
some of the most renowned wind-engineering experts in the world.
and laboratories. “We also do wind-loading assessments on structures,”
CPP’s overarching goal is to improve the environments where people
explains Petersen. “The information is used to design cladding and
live, work and play. The company’s skilled professionals tap into their
frames for buildings, making sure they are able to withstand these forces.”
vast knowledge of wind engineering and air quality to offer building
Petersen explains that CPP uses wind-tunnel modeling to study the
owners and architects valuable information during the design process.
air quality and wind effects on each distinctive structure. “We make a scale
With CPP’s expert guidance, owners can rest easy knowing that their
model of the building and the surroundings and then evaluate the effects of
structures are healthy, safe and comfortable.
wind on the structures. That can involve wind loading or air quality,” he says.
The birth of wind engineering
design of a building were often overlooked. Years ago, architects didn’t
Until recently, the effects of exhaust dispersion and the air intake In the 1960s, Dr. Jack Cermak laid the foundation for wind engineering
use air-quality assessments at all during their design process. However, in
at Colorado State University. Widely considered to be the father of the
an effort to create cleaner, healthier structures, an increasing number of
discipline, Cermak performed work at the university that expanded the
building owners and architects are incorporating air-quality consultation
world’s understanding about the way air flows in and around natural and
and wind engineering into their design process.
man-made objects, including buildings, structures and terrain. As a result of his discoveries, Cermak became an industry leader in the
Invaluable guidance
commercial applications of wind engineering. In 1981, he partnered with
Because CPP provides its clients with critical air-quality information,
Dr. Jon Peterka. Three years later, when Dr. Ron Petersen joined the team,
building owners turn to the company time and again. For example, the
CPP was born.
CPP team offered up some priceless advice during a recent project for the San Diego Children’s Hospital.
Specialized solutions
“They had a few generators — emergency generators — and there were con-
Today, CPP offers its clients an array of superior solutions for wind
cerns that the fumes may come in through the air intakes when the generators
engineering and air-quality consulting. “Among the three founders of
were operating,” says Petersen. “There were some adjustments to make sure
CPP, we have more than 100 years of experience,” says John Carter,
the stack heights were okay so there was no adverse air-quality impact.”
senior associate with CPP. “We do several projects per month, and we
In addition, there were several exhaust stacks on the roof, including those for
see a lot of ideas in a lot of people’s designs. We like to learn from that
the hospital’s isolation room. CPP worked with the architect to develop a plan
experience and bring it to the next project.”
to ensure adequate exhaust dispersion and an influx of safe and fresh air. “The client looked at it and said that every hospital should be doing this kind of evaluation,” says Petersen. “Our challenge is to educate everyone about these very important issues.” The driving force behind CPP’s success is the company’s unwavering commitment to innovation. “We’re bringing current research knowledge to the design field; we’re putting it into practice,” says Petersen. And in the long run, this research saves money for CPP’s clients. “We can minimize
Test model and surroundings in the wind tunnel
some of the costs on the project — fan sizes, stack heights — and at the same time we can maintain a healthy environment on the project,” he says. “We do this in an innovative manner. We like to think outside of the box.” — Corporate Profile
CPP Wind Engineering & Air Quality Consultants www.cppwind.com • 970-221-3371 • info@cppwind.com Demonstration of airflow around a roof corner
CPP engineer inspecting a test model
The General Contractor’s Perspective with Richard Heim, Managing Partner, MCH (joint venture among McCarthy Building Companies, Inc., Clark Construction Group - California, LP and Hunt Construction), and President, Clark Construction Group Western Region Q: What were the greatest challenges encountered on this project and how, specifically, did you overcome them? RH: One of the biggest challenges we had [were] the changes that occurred, both the jurisdictional code changes or code interpretations as well as changes by the owner. The amount of changes [was] significant, and that ends up to be quite a challenge in how you work the change into the flow of the field, how you manage the change in terms of subcontractors and getting the price resolved. The number of men and subcontractors was also a challenge — we had upwards of 85 subcontractors, and we probably peaked out at 1,100 or so workmen on the job. So it was a challenge keeping track of all of that. As opposed to an office building where each floor is just alike, hospitals are very different. So we almost had to have supervision on every floor to maintain the momentum of the work. So, I would say the biggest challenge was just the scale of the project. Q: How did you work with the architect and owner to save time and/or money on the project? How was value engineering applied to your responsibility? RH: The owner and architect were on site as well, and that helped significantly. Not only was the architect on site with an appropriate staff, but also he had several of his design consultants there, too. So, the adjacency and intimacy of having them there was a tremendous help. We could grab them and walk out in the field and discuss stuff. HOK was very supportive of the construction effort. We probably have had a 20-year collaboration with HOK, so we know the firm well. Our people interface well, and it was a good effort.
Photo courtesy of Clark Construction Group - California, LP
Clark Construction Group - California, LP 575 Anton Blvd., Ste. 100 Costa Mesa, CA 92626 714-429-9779 fax: 714-429-9778
hard to establish and maintain relationships with the general contractor, the construction management team and the county,” he said. “This, along with our on-site relationships with the other subcontractors, allowed us to keep pace with the numerous design changes and constantly changing schedule.” “One of the main challenges was bidding a project of this magnitude while ensuring a competitive
bid
environment,”
said
Wachtel. “In order to assist the
and
County of Los Angeles in the bid
Throughout that time, changes
process for the project, the design
and advances in health care and
team designed a bid strategy that
technology occurred. “Planning,
allowed for the county to bid the
programming and design over
project in a flexible manner as well
such a long-term period is inher-
as
ently challenging, and reinforces
to
through
process
the
OSHPD
approvals [Office
construction
process.
of
the need for maximum flexibility in
Statewide Health Planning and
building design, building systems
Development] in the most expedi-
and medical equipment support,”
tious amount of time,” she added.
said Lee. “For many medical equip-
Another challenge stemmed
ment systems, we have seen two
from the project’s long planning
or three generations of equipment Photos courtesy of Lawrence Anderson Photography
Photo courtesy of Lawrence Anderson Photography
evolve.
The
challenge
is
to
acknowledge that such changes are inevitable, and that the program and budgets must be adjusted to reflect this reality. In California, it is not unreasonable to expect, for a project of this size, a design/plan
check/construction
schedule to extend seven to eight years or more,” he continued. “Clearly, the opportunity for evolving technology and practice delivery is undeniable.” Although the project team members saw their share of challenges along the way, they pulled together to overcome the obstacles. “You learn to take day-to-day challenges in stride,” said Hertel. “You just have to work through them and not lose sight of the overall goal.” — Amy Bell Photo courtesy of LA DPW
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gold medal award winner
Built to Last: More Than 40 Years of Electrical Expertise Founded more than 40 years ago, SASCO has become the largest electrical contractor in the Western United States. Today, SASCO offers superior electrical contracting and consulting services ranging from design and concepts to implementation and integration of electrical and data system infrastructure. “Our mission is to be the best electrical contractor in the world through innovation, creativity, technology and action,” says Jerry Jordan, executive director of SASCO.
From humble beginnings to industry leader Founded by Larry Smead in 1967, SASCO began as a modest, single-office operation. Over the years, the business has grown and flourished and is now considered to be a leader in the electrical contracting industry. As one of the largest privately held electrical contractors in the country, SASCO has the ability to serve its customers worldwide. Although SASCO has grown exponentially, the company has managed to preserve the personal feel of a smaller business. “The real secret to serving customers and main-
know how we are spending your money and why,” says Jordan. “At SASCO, you won’t have to ask where you stand — you’ll know.”
taining relationships over the years is SASCO’s unique structure and operating philoso-
SASCO prides itself on being the lowest cost provider of electrical services. The
phy,” says Jordan. “We have combined the strength and resources of a large company
company achieves this by its unique means-and-methods approach, utilizing a
with the responsiveness and personal services of a small, entrepreneurial organization.”
200,000-square-foot warehouse where job planning, staging, prefabrication,
SASCO continues to attract new customers because of its high-quality products as
assembly, packaging and shipping are vital components to this process.
well as its exceptional project management skills. “We manage resources (labor and material) to complete work on time, on budget and with the utmost quality,” says
Setting a new standard
Jordan. Additionally, due to the company’s financial strength, SASCO’s clients can
The SASCO team is known throughout the industry for its unmatched project man-
count on virtually unlimited bonding capacity on any job, no matter how big or small.
agement skills. “At SASCO, we are setting standards for our industry with a manage-
Because SASCO is determined to stay on the leading edge of the industry, it oper-
ment organization designed to perform efficiently and economically,” says Jordan.
ates under the highest standards. As part of this mission, SASCO offers its clients
By maintaining clear communication with the customer throughout each project,
affordable prices and top-notch services. Furthermore, the SASCO team is commit-
the SASCO team is able to identify unique requirements for each project, carefully plan
ted to keeping the lines of communication wide open, ensuring customers aren’t left
the work, effectively execute the plan and monitor performance throughout the project.
in the dark at any point during a project. “Throughout your project, we want you to
“We make it our business to know what is going to happen before it happens,” he says. Although all companies employ systems, SASCO has developed one that has proven to be successful time and again. “At SASCO, we have one system, designed by us and for us, to provide the most current information available in order to be responsive to the specific needs of your project,” says Jordan. SASCO’s system is oriented toward “performance,” which helps to reduce the customers’ costs and minimize their risk. “The system works,” he adds. To further ensure each customer receives nothing less than superior service, SASCO invests in continuing education and training for its staff. Because of this, SASCO is proud to employ some of the most skilled experts in the industry. However, the company believes that it is the collaboration among these experts that has driven the company to its prominent position. “Our group mentality is based on the premise that ‘not one of us is as good as all of us,’” says Jordan. “Our people are some of the best in the industry, but we know skilled people by themselves are not enough. To be effective, people have to work together as a team.” — Corporate Profile
2750 Moore Ave. • Fullerton, CA 92833 • 714-870-0217
24445 Northwestern Hwy. Ste. 218 • Southfield, MI 48075 • 248-945-4700 • fax: 248-945-4701 • www.constructionreviews.com