Oregon's Health Care Market tops $2.9 Billion for 2006 and 2007

By Melody Finnemore

When Providence Health System took a big-picture look at its Oregon facilities several years ago, its planning team foresaw a wave of future users who were going to require more than many of the system's existing facilities could provide.

Providence's system wide master plan accounted for the growing demand caused by an aging generation of baby boomers as well as population growth in various areas of the state, most notably Newberg and Medford. In addition, the master plan identified older hospitals that were not able to accommodate the increased demand, technological advances and other market dynamics.

The result is a capital expansion program that includes several projects across the state. At Providence Portland Medical Center, a $22.3 million renovation of the Child Center is underway as well as the construction of a $200 million cancer care center. In Newberg, a $68.5 million medical center will replace an existing hospital. And in Medford, Providence has launched a $60 million expansion that includes larger emergency and maternity departments, a new patient bed tower, a medical office building and a parking garage.

Karen Weylandt, regional director of design and construction for Providence Health & Services Oregon, said the capital expansion program presents opportunities to integrate sustainable design into all new facilities.

The Newberg medical center, Providence's first new facility in nearly 30 years, was on the drawing board for six years as the health system sought to replace an existing hospital, Weylandt said.

"The existing facility was very old and very small, and frankly it didn't have the capacity to meet the community's needs," she said. "When we did the feasibility studies we decided to build it according to LEED guidelines."

Providence conducted an eco-charrette with regional leaders in sustainable design. The process helped craft a state-of-the-art community hospital that is three times larger than the existing facility and is designed for LEED Silver certification by the U.S. Green Building Council. It is the first of its kind on the West Coast and just the second LEED-certified hospital in the country.

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The Newberg medical center is a model Providence hopes to replicate in future projects. That's no easy task given that many regulations for hospitals, such as those regarding air quality, are not compatible with the measures required to obtain LEED points.

"Our other projects aren't LEED certified, but we do incorporate sustainable guidelines such as energy models and storm water runoff strategies that are environmentally beneficial," Weylandt said.

While Providence has several success stories to celebrate in its capital expansion program, the process of accommodating future needs has not been without challenges. The rising cost of construction materials consistently threatens to undermine project budgets, and a boom in health care construction has created a shortage of skilled workers.

"Right now there is so much construction going on in Oregon that there's not a ton of labor available out there," Weylandt said. "There's just so much going on that timing is really critical to make these projects happen."

OHSU - Peter Kohler Pavilion

Oregon Health & Science University in June celebrated the opening of the Peter O. Kohler Pavilion, a 16-story tower that will provide 335,000 sq. ft. of clinic space, 120 new patient beds and a Radiation Medicine suite. The patient care facility also will offer expanded surgical services, including eight new operation rooms and space for four future operation rooms, and a sterile processing area that is more than triple the current available space, according to OHSU.

The project cost $216 million, which included the pavilion and ancillary projects to support the expanded bed capacity. Construction, which started in Spring 2003, included three levels of underground parking, terraced gardens, landscaped courtyards and easy access to walking trails and bike paths on Southwest Portland's Marquam Hill.

OHSU's Board of Directors named the building for Dr. Peter O. Kohler, who has served as the university's president since 1988 and will retire at the end of this year. Kohler is one of the nation's longest-serving academic health center presidents.

Greg Martin, project manager for Portland's Andersen Construction Co., which built the Kohler Pavilion in a joint venture with Hoffman Construction Co. of Portland, said logistics posed several challenges. The pavilion is built into a hillside with a wooded environmental zone on one side and busy Southwest Sam Jackson Parkway on the other. Traffic, including ambulances, needed to be able to negotiate the construction zone the entire time.

"It was a very confined site and you had to deliver materials as needed," he said.

By this fall, OHSU will have completed a trio of major expansion projects. In addition to the Kohler Pavilion on its Marquam Hill campus, the Center for Health & Healing at the South Waterfront will be finished as well as the Portland Aerial Tram.

The 3,300-ft. tram, which will connect the Marquam Hill and South Waterfront campuses, also will link Pill Hill to a mixed-use neighborhood of houses, offices and medical facilities being planned in the North Macadam Urban Renewal Area along the Willamette River. The tram is scheduled to be finished late this fall at a cost of $55 million.

The Kohler Pavilion's construction is part of a strategy called the Oregon Opportunity, a statewide public-private partnership to make the state a leader in biomedical research. Through a $500 million initiative, OHSU will invest in facilities, endowments, research infrastructure, scholarships and programs, and the recruitment of scientists and researchers.

"It was a very rewarding project. OHSU was able to respond quickly and keep the project moving," Martin said. "It was also nice that they thought to employ local contractors and provided 2,000 jobs throughout the course of the project."

Rachel MacKnight, university spokesperson, said these projects are essential as OHSU prepares for the health and medical needs of Oregon's growing and aging population. Within the next 12 to 18 months, OHSU will initiate the master planning process for the educational expansion of the Schnitzer Campus on the South Waterfront, she said.

When it opens this month, Providence Newberg Medical Center will be the first health care facility on the West Coast to obtain LEED certification from the U.S. Green Building Council. The Silver certification will earn the facility bragging rights as just the second hospital in the nation to meet LEED standards.

The 187,000-sq.-ft. structure includes a 41-bed hospital, administrative space and a healing and wellness garden. The $68.5 million project will replace an existing hospital and is Providence's first new facility in nearly 30 years.

The project also includes a three-story, 45,000-sq.-ft. medical office building, which Providence already has leased out. The hospital plans to add an additional office building in 2008 that will double its capacity for physician and other outpatient services.

Because hospital standards make many LEED points unattainable, such as those related to air quality and ventilation, plans focused on points available for site design, said Victoria Nichols, project manager with Portland's Mahlum Architects. Providence purchased 52 acres for the project, but developed only 19 and left the remainder in its natural state.

"It actually required us to be a bit more rigorous, which was refreshing," she said, noting the building stretches south and north, with limited exposure to the east and west to reduce heat gain.

Mike Smith, president and chief executive officer of Mahlum and the firm's principal in charge of the Providence Newberg project, said day lighting played a key role in the design as well.

"We wanted to create a bright, airy environment where people feel comfortable," he said. "People are under a lot of stress when they go to a hospital anyway, so we really wanted to do anything we could to alleviate that stress."

Tony Church, project manager for Skanska USA Building of Portland, said the lack of examples for how to build a LEED-certified hospital forced the project team had to create its own model. In addition, rising steel prices put pressure on Providence's budget.

Despite the obstacles, however, Providence Health System remained committed to building a sustainable facility that benefits everyone who uses it.

"It's been a healthy investment in the local economy not to mention the health of our patients, visitors and employees," said Mike Antrim, hospital spokesman. "We're proud to be pursuing LEED certification to ensure that we've built a healthy facility. We'll reap the rewards of our initial investments in building green for years and years."

Providence Cancer Center

A delicate choreography is underway at Providence Portland Medical Center, where a 494,000-square-foot cancer center is being constructed in the heart of the historic campus.

Providence Health System recently completed a $22.3 million expansion of the Child Center on the Northeast Portland campus. The Child Center expansion was part of a larger program that includes a new 1,000-car parking garage and an 11-story North Pavilion that will house the Providence Cancer Center.

When completed in February 2008, the $200 million North Pavilion will feature 94 patient rooms with the capacity to build 144 more in the top three floors. The center, which will integrate cancer research with patient care, will house 21 operating rooms and 33,000 square feet of outpatient and radiation therapy space and physician oncology offices.

In addition, the cancer center will include a resource library, a healing garden and an integrated medicine clinic where patients can receive naturopathic treatments such as massage and acupuncture as well as wigs, prosthesis and other support services, said Linda O'Hara, special projects manager for the health system's Design and Construction division.

"One of the major goals of this project was to make it a comprehensive cancer center so patients wouldn't have to go to several different places to receive care," O'Hara said. "All of these things are housed in one building and that has great advantages for both the patients and their families."

Architect Zimmer Gunsul Frasca Partnership of Portland integrated the three structures by including a bridge that connects the parking garage to the Child Center and North Pavilion. Principal John Thompson said one of the most difficult aspects of the project was synchronizing its chronology. The existing Child Center, which was seismically inadequate, electrically outdated and filled with asbestos, had to be demolished to make room for the North Pavilion and a central utility structure. Demolition work started in late 2004.

"This is a very compact urban site," Thompson said. "To get a new building on that campus that was nearly a half million square feet was very challenging."

Molly Nichols, project manager for Turner Construction Co. of Portland, the project's general contractor, said the steel-plate shear wall system used for the structure requires heavier columns, which added to the complexity of installing the mechanical, electrical and plumbing systems. A trio of large trusses also was necessary, and two of them had to be erected over the boiler room that generates power for the entire campus, she said.

"This is definitely the biggest project I've ever been on and it's been a great learning experience," Nichols said. "To know that you're building something that is going to help so many people is a great thing."