by Courtland Blake
The recent demand for U.S.-based health care architects and engineers for international health care projects has not only created business opportunities, but has also expanded the experience and knowledge base of the U.S. design firms involved. This is knowledge and experience that can be applied to U.S.-based projects, as well. The lessons learned from working on international health care projects has benefited other international projects, of course, but has also greatly enhanced design, efficiency, and collaboration efforts on all projects. Some examples of where benefits can be seen are: teamwork and collaboration, and cultural sensitivity.
The complexities of international health care projects require the close collaboration of multiple firms, in multiple locations, across multiple time zones. There are often partnerships with local design firms that help with local codes, site issues and construction preferences. There are often differing construction delivery methodologies that involve the introduction of developers and contractors into the collaboration process. The multiple design consultants are often in different states, and different countries.
Since face-to-face meetings and discussions require extensive scheduling and costs of international travel are high, this arrangement has forced the design teams to become proficient at utilizing technology to assist collaboration; technology such as videoconferencing, web based computer screen sharing, live file sharing, and conference calls. Also, focused and limited communication time, due to differing time zones, sometimes with language barriers included, has forced us all to become very precise and succinct when requesting and presenting information. Simple bold graphic presentations can replace hours worth of written communication material. A picture really is worth a thousand words. While essential in international work, this technology makes us all more efficient in design and communication on all our projects.
Design efficiency is a universal goal that translates to any project, no matter where the actual site is located.
Differing cultural issues, and differing available resources on overseas projects have also expanded design experiences and technologies that can be applied to other projects. In the Middle East, for example, water is not always available seven days a week, and must be stored and treated and cooled prior to use. In some cases, water is more of a valuable resource than electricity, and therefore air cooled chillers are more cost effective than water cooled chillers with cooling towers. Or, custom air cooled cooling towers are more appropriate than conventional water cooled towers. The designs implemented to treat and conserve water can certainly be considered for application anywhere in the world. And the uncertainty of essential utilities like power and water (and even sewer!), make redundancy and reliability even more imperative, especially in health care design.
Availability of equipment is also an important consideration on international health care projects. In some locations, equipment is not manufactured locally, and must be shipped to the site by air or by sea. This limits the maximum size of air handling units, for example, to the size of standard shipping containers.
The knowledge, expertise and experience of the maintenance staff is another factor to consider in MEP systems design. Again, in the Middle East, smaller local systems are sometimes preferred or mandated over larger more centralized systems simply due to ease of operations and future maintenance, or the desire to not cross fire and smoke separation zones. Or, the maximum allowable size of electrical transformers is limited to what the local utility company can support and maintain. Or a fan coil unit system may be appropriate for patient rooms, not due to financial or space constraints, but because that system is familiar to the construction team and eventual maintenance staff.
Understanding the decision drivers of the region, and the owner, is again a universal concept that can be applied to the design and system selection for any project, no matter where it is located.
As technology and transportation make the world become a smaller place, and as international projects seek the use of US designers to help develop world class health care facilities, there comes with it a unique opportunity for knowledge and experience acquisition, as well as business growth. It is an exciting time to be a health care design professional!
Courtland Blake, LEED AP is an Associate Principal at R.G. Vanderweil Engineers, LLP in Boston.