New York City Health and Hospitals Corp.

Building on history┬áNew York City Health & Hospitals Corp. is in the midst of a major overhaul of Harlem Hospital. Keith Regan learns how the project is breaking new ground while respecting history.  New York City Health & Hospitals Corp. is the countryÔÇÖs largest municipal hospital network, with 20 hospitals and more than 80 clinics located throughout the cityÔÇÖs five boroughs. In 2006 the system handled more than 4.8 million clinic visits, over 1 million emergency room visits and handled 22,700 births.   Like hospitals across the country, the public benefit corporation finds itself constantly seeking to modernize and upgrade the facilities in its network to meet changing care needs and to keep pace with changes in medical technology.┬á One of the largest modernization projects currently under way within the system involves changes to Harlem Hospital, an institution with a history dating back to 1887. The $320 million, five-year modernization plan will dramatically expand the hospitalÔÇÖs patient care capabilities while also adding significant parking to the urban location. The project will connect two existing buildingsÔÇöthe Martin Luther King Jr. Pavilion and the Ronald H. Brown PavilionÔÇöwith a seven-story, 158,000-square-foot structure known as the New Patient Pavilion. The project has been in the planning stages for a decade, says senior director Dean Pearce, with work starting in 2005 and currently slated to be completed in 2012. ÔÇ£WeÔÇÖre constantly looking to improve, expand and modernize our facilities,ÔÇØ he says.When the Harlem project is completedÔÇöthe new structure will house a new expanded emergency department, new intensive care units and additional patient rooms and diagnostic facilitiesÔÇöthe result will be a fully connected healthcare campus that joins existing buildings with an aesthetically pleasing new structure and links it all to a 300-car parking garage. The garage portion of the project has not come without some unique challenges. Erecting the garage structure required the demolition of four aging hospital buildings that contained several well-known murals dating from the time of the Works Progress Administration (WPA). The paintings, depicting scenes of both medicine and street life in the neighborhood in the early part of the 20th century, include an eight-panel, wall-sized mural, titled ÔÇ£Pursuit of Happiness.ÔÇØ Conserving that mural required the removal of 40 feet of wall along an interior corridor. The murals will be stored in a temperature-controlled facility until they are ready to be reused in the New Patient Pavilion. The murals will become part of the new facility, with some installed in a lobby gallery area and the image of one incorporated into the glass curtain wall of the front of the building. ÔÇ£It will be a statement to the community about the commitment the hospital makes to the neighborhood,ÔÇØ says Pearce. The hospital knew the murals would be part of the project from the outset, so the painstaking conservation workÔÇöwhich is the subject of an in-depth Web site created by Columbia UniversityÔÇöhas not slowed the overall project timeline. Other challenges on the project include the need to work around an active and busy hospital. As with other projects, the system works to segregate active work from the ongoing medical care, using exterior entrances whenever possible or dedicating elevators to construction workers to minimize conflicts. ÔÇ£WeÔÇÖll work in off-peak hours or design projects in phases so that weÔÇÖre able to keep working without interfering with operations,ÔÇØ Pearce says. Other considerations include the need to minimize dust and noise. As a public nonprofit corporation, New York City Health and Hospitals must publicly bid all phases of all its projects. On the Harlem project, the timing has been somewhat fortuitous, as the bids were received as prices in steel and other construction commodities began to settle down a bit after several years of intense volatility. ÔÇ£TheyÔÇÖre still going up, but not as fast and wildly as they were a year or so ago,ÔÇØ Pearce notes. ÔÇ£It has calmed down to the point where price estimates we had in place from five or six months ago are still pretty much on target.ÔÇØ Still, the bidding process can have its pitfalls. For instance, the winning bidder for the steel erection was a Canadian-based company, and another bidder has filed a challenge against the contract award. Pearce is optimistic that any delays while that protest works its way through the system will be minimal and not affect the overall timeline. The corporation is working with the Dormitory Authority of the State of New York, which acts as an ownerÔÇÖs representative, working directly with construction management firms, architects and others. ÔÇ£They help manage the day-to-day, while we keep an eye on the bigger picture of the program and the timeline,ÔÇØ Pearce says. Contracts have been awarded to TDX Corp. to manage the New Patient Pavilion construction project and to McKissack/Haks to oversee the building demolition, garage structure construction and mural conservation. HOK is the lead architect, with Kallen & Lemelson providing MEP engineering design services and Parsons Brinckerhoff providing environmental consulting services.The Harlem building project also required additional design attention because of the condition of the soils beneath the building site, which triggered requirements for planning for a major seismic event, given the height of the structure. The solution was to inject slurry mix into the ground beneath the site to create a solid base for the modified footings to be erected upon. Though it began its journey through the design process before the recent surge in interest in green building, the project will contain a number of sustainable design elements, Pearce says, including water-saving fixtures, low VOC-emitting materials, natural lighting use and highly efficient heating and cooling systems. ÔÇ£We decided not to pursue LEED certification, but all our projects are built with the environment in mind, both in terms of patient, family and employee comfort within the facility and with respect to the bigger picture as well as how our hospitals fit into their communities and the world.ÔÇØ ┬á