Updated: Mar 26, 2020
It seems more and more frequently there are new medical office suites opening, breathing life into old, abandoned storefronts. These spaces run the gamut from walk-in urgent care providers to full service ambulatory surgery centers specializing in a variety of different procedures. While the availability of these storefronts and commercial office spaces is a boon for expanding the reach of healthcare organizations, repurposing them can come with some unique challenges. A more in-depth breakdown of these challenges in our upcoming guide, but for now, let’s focus on some common areas where engaging an engineer early in the design process can lead to beneficial outcomes.
Knowing the needs of the space is a crucial first step in determining the suitability of an existing building. As with inpatient facilities, outpatient medical uses are governed by the Facility Guidelines Institute (FGI). The most recent publication from 2018 has added a separate volume specifically for outpatient facilities. New to this edition, locations where the level of patient care provided is lower are permitted to meet the local building codes only, which may be less stringent than FGI. This has the most impact on private practice and walk-in clinics. Apart from above cases, most other use cases share many of the same requirements as inpatient facilities. Use types that require special consideration:
Operating Rooms: Operating rooms (OR) have strict air quality design parameters that must be met. The building mechanical systems must be able to maintain tight control over temperature, humidity, and space pressure differential, and do so at a high airflow volume. They also need to operate continuously during loss of building power, depending on the type of procedure being done. Adequate support space must also be provided for medical gas and humidification equipment needs.
Pharmacies: Pharmacies have strict air quality design parameters governed by US Pharmacological (USP). Similar to ORs above, strict temperature, humidity, and pressure control is required. Furthermore, a high degree of filtration is required to ensure a sterile work environment equivalent to an ISO 7 or 8 cleanroom depending on application. While redundancy is not required, loss of power may require the space be recertified, incurring significant losses due to the ensuing downtime.
For the above listed uses, among many others, it is likely that existing light commercial type equipment will be inadequate. Having an engineer on board during the planning phase can be beneficial in identifying these needs up front which can then inform and as discussed more below.
Once the intended use of the space is nailed down, candidate buildings can be evaluated to determine what upgrades, if any, are needed to the infrastructure. This is a prime area where engineers can provide value in the early phases of the project. The goal here is to understand whether the existing mechanical system is suitable for the type of use for the space and if not, what sort of upgrades may be needed. Answering this depends on the use of the space as discussed earlier. Some reasons why the existing mechanical system may not be adequate include limited existing capacity or an otherwise unsuitable system such as an existing plenum return system where a fully ducted system is needed like in the examples above. If upgrades are needed, then the anticipated scope, and therefore cost, can be determined, and then weighed against other candidate properties to help the owner gets the best possible value out of their investment. Knowing the extent of the upgrades needed can also be of use when negotiating the lease or purchase.
As the market for distributed healthcare continues to grow, there will be more situations where engineers can provide value in identifying candidate properties that meet the requirements of the space being built. Selecting the right building for the application can result in a smoother design and construction process and ultimately lead to savings for the owner when infrastructure upgrades can be minimized, positive outcomes for all! Be sure to check out our upcoming guide for a more in depth discussion on the topic.