Firm's role on the project: Planning, Programming, Architecture, Design, Interiors
To create a world-class facility using evidence-based design (EBD), LEED, and patient- and family–centered strategies. The re-design of the Ft. Bliss Army Medical Center not only took into account the Military Health System (MHS) World-Class Checklist, but also information gathered from 14 EBD working groups to further influence the design. Design topics included patient lifts, therapeutic gardens, hydrogen peroxide vapor cleaning/infection prevention, benefits of mock-up rooms, smart rooms, new technologies and best practices for flow of material/equipment/people, and the evaluation of antimicrobials with regard to patient and environmental safety.
The design team was challenged to use the MHS’s World-Class Facilities Checklist, which contains EBD, sustainable, and world-class objectives and strategies based on relevant research and best practices, as a starting point for the design. Wanting to go even further with EBD and “personalize” it for this project, EBD working groups were formed to investigate different topics and to make recommendations based on credible research results. One of the patient and family-centered goals of the MHS is infection prevention. Specific project goals included reducing infection spread by ventilated air: The team evaluated enhanced air filtration methods, performance, pressure drop, first cost, replacement cost, and placement beyond minimum code. There was also a need to reduce the time and cost of cleaning contaminated surfaces. The team evaluated the use of hydrogen peroxide vapor cleaning effectiveness on MRSA, VRE, and C. diff and other super bugs. Internally ducted systems versus a portable system were both evaluated for first costs, maintenance costs, efficacy, and safety.
The EBD working groups consist of subject matter experts from the A/E team as well as the client. Now in the design development phase, each group has conducted literature searches to find credible research and best practice results to inform their recommendations. Examples include:
- Additional patient lifts beyond those in the original program
- Mock-up rooms to further inform the design
- Expanded gardens and green spaces
- A MERV16 system (similar to HEPA but much more energy efficient and less costly)
- Limited use of antimicrobials
- Consideration of portable hydrogen peroxide vapor cleaning method.