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Managed Care Partners - Where form and function converge

Managed Care Spring 2012

Where form and function converge

Date: April 1, 2012


Sally MacConnell and Mike Iati have helped shepherd the entire project from idea to fact.
Sally MacConnell and Mike Iati have helped shepherd the entire project from idea to fact.

Michael Iati, Johns Hopkins Hospital’s director of architecture, likens the project to “building a 60-ton watch,” with constant, synchronized coordination required between architects, engineers, contractors, the construction manager and suppliers.

At the height of construction between 2009 and 2011, close to 1,000 workers were on site. “It took an army,” says Sally MacConnell, the hospital’s vice president of facilities. All of the buildings’ mechanical systems must work properly on day one. “That’s where it departs from being like a kitchen remodel,” MacConnell says. “If the stove doesn’t work on day one, you call the guy back; if the medical gas outlets don’t work, that’s a crisis.”

For six years prior to the groundbreaking, an in-house team including Iati, MacConnell, mechanical systems expert Anatoly Gimburg, architect Marge Smith, construction manager Howard Reel and support personnel from the hospital’s Facilities Design and Construction Department worked with faculty, staff and outside architects to prepare preliminary design drawings. They asked the future “users” of the towers—nurse managers, nurses, physicians and others—what they needed and wanted.

Driving the design was the need not just for more space but for space that could expand and contract depending on demands imposed by the patient population or evolving medical technology. 

What the planners called “adjacencies”—like placing the adult Emergency Department adjacent to the pediatric ED, with shared imaging suites and trauma rooms—was a design priority. So was placing almost all of the operating rooms next to their corresponding intensive care units. In addition, setting aside sufficient space for medical education was crucial, making certain that medical students and residents in clinical rotations had rooms in which to sleep, work, study and gather.

Along with these considerations, designers prioritized the comfort of patients and families, who often approach a vast academic medical institution like Johns Hopkins in crisis, MacConnell says. They need to feel oriented, safe and secure.

“We spent a lot of time thinking about how to make this building approachable, how to bring it to a human scale,” she says. “We want people to know where they’re going and to feel as comfortable as possible through the building environment and landscaping.”

Some building materials purchased were standard, others were customized just for the project. “We built a life-size portion of the building’s glass wall at a testing facility in Florida and subjected it to hurricane winds and earthquake forces to make it leak,” Iati says. Then it was rebuilt and tested until it was weather-tight. Materials came from all over—glass from a Minnesota factory and metal pieces to support it from a subcontractor in Georgia, concrete panels faced with brick from Canada, elevator equipment from Germany, steel from China.

Many nights after construction crews left, Hopkins electrical engineers and other facilities personnel crawled along miles of the buildings’ electrical conduit system testing every switch and transformer, making sure that all mechanical, electrical and fire alarm systems ran smoothly and that all work complied with stringent safety standards. They walked room by room noting any needed paint touch-ups or sprinkler system adjustments. And some 10,000 faculty and staff moving to the new buildings underwent training courses and tours to gear up.

“This is an enormously important building,” MacConnell says. “It’s the entry to The Johns Hopkins Hospital for the next 100 years.”

 Statistics at a glance
  • Architects and designers created some 10,000 drawings for the building.    
  • The main entrance is larger than a football field.  
  • The lower floors are nearly three acres each.      
  • The buildings’ copper wiring could stretch from Baltimore to Miami.
  • The buildings used 12,500 tons of structural steel, 44,500 cubic yards of concrete, more than 4,000 plumbing fixtures, 3.5 million pounds of sheet metal ductwork, and 244,000 square feet of glass window walls and exterior windows.
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