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Design for disaster: Building with survival in mind


July 1, 2019

By John Palmer

As healthcare facilities consider their future needs and resiliency in the face of emergency preparations required by accreditation agencies, construction trends continue to focus on a modern look with the ability to stay operational in any situation.


Massachusetts General Hospital (MGH) in Boston looks to be the next big project on the horizon as the hospital has announced plans for a new $1 billion clinical facility to add to its downtown sprawling campus.

The planned 1-million-square-foot facility will reportedly include several architectural features focused on resilient design. It also will feature 12 levels of inpatient, outpatient, and support services space, as well as six levels of underground parking.

MGH officials declined an interview, but David Hanitchak, MGH’s vice president for real estate and facilities, told Healthcare Facility Management (HFM) magazine that the hospital (including the parking garage) will be able to be used as a refuge during events such as sea-level rise and storm surges, extreme temperatures, high winds, earthquakes, and manmade disasters.

“Like many coastal cities, Boston is susceptible to the impacts of changes in our climate,” Hanitchak told HFM. “In addition, much of Mass General’s campus sits on land that was once water and marsh, making it especially vulnerable.”

In addition, published reports cited an email from MGH president Peter Slavin to employees, announcing the hospital’s plans to build a 12-story structure for 450 single-bed rooms housed in a pair of connected towers. The new building is a “much-needed, vital structure that will enable the MGH to deliver 21st century care in a 21st century environment,” Slavin wrote.

Other features of the new design are reported in HFM to include:

  • Infrastructure and supplies to remain self-sufficient for 96 hours without outside resources (a key CMS requirement)
  • An emergency command center
  • Elevating critical equipment to withstand a 6-foot flood
  • Hurricane-proof windows and exterior skin
  • Cooling systems, building façade, and mechanical capacity to withstand more days above 90?
  • Elevating critical programs above street level
  • Submarine doors and watertight safety features to protect elements below street level
  • Green infrastructure to absorb storm and flood impacts

Hanitchak also told HFM the hospital is considering features such as operable windows for emergency situations, layout plans that will allow the facility to continue receiving ambulances during floods, and additional medical gas equipment to accommodate patient surges.

“The regulatory review process is estimated to take 18 months, and if the project is approved, the first phases of construction could start in 2020,” according to the January 25, 2019 issue of MGH Hotline newsletter. Construction is expected to be completed in 2026.

The city of Boston has done a lot of research on its future, contemplating building trends in the face of rising waters and increased severe weather patterns. Building plans in the city have ranged from giant harbor gates to stop flooding, to skyscrapers with raisable first levels, to the possibility of turning Back Bay streets into canals as waters rise ever higher.

Charleston, MA

MGH is taking notes from its neighbor that’s even closer to the water. In April 2013, Spaulding Rehabilitation Hospital opened a new facility on the historic waterfront in Charlestown, Massachusetts. Eager to keep Spaulding within Boston limits, the city gave the organization financial incentives to clean up and build on a former Navy shipbuilding yard. The result was an energy-efficient hospital built on an artificial, surge-resistant “reef” 42 inches above the current 100-year flood level and built to withstand a projected sea rise of up to five feet over the next 75 years.

In what has been called an example of “upside-down” construction, the main primary electrical services are located on the rooftop and powered by a fuel pump secured in a flood-proof vault, with a 150,000-gallon tank and reserve fuel stored on-site.


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