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September 24, 2020
On Nov. 3, Donald Trump and Joe Biden will have some tough competition in King County.
While the presidential election will be front-and-center in voters' minds, local design and construction professionals will also closely watch the results of a King County bond measure that could bring a significant amount of work to Seattle.
If passed, the $1.74 billion measure for Harborview Medical Center is expected to attract a wide range of interest from firms with experience in medical design and the newest construction delivery methods.
“Harborview is at the top of everyone's minds right now,” said Kenda Salisbury, business development director at Degenkolb Engineers. “I feel like I talk about it several times a day.”
At a time when the design and engineering of health care facilities is rapidly advancing, local firms see the Harborview measure as a significant opportunity to showcase their recent accomplishments and advance Seattle's standing in the field of health care design.
“This is a once-in-a-career opportunity,” said Molly Wolf, a principal and architect with the firm Ankrom Moisan. “Beyond income certainty and an economic boost for our local business, our involvement with this project would allow us to partner with Harborview and King County to reframe how health care is delivered in our community.”
Architect Jose Sama, a partner at NBBJ in Seattle, said the proposed Harborview projects have an extra meaning to local firms.
“At NBBJ, we partner with health care clients around the world to design more adaptable hospitals and infrastructure, but this project has a special place in our hearts — it's home,” said Sama. “The planned renovations and expansion will bring present-day operational planning and technologies to modernize and improve health care delivery. From the planned seismic upgrades, to the need for expanding the emergency department, to enhancing behavioral health services, this project is essential to sustain care for our community and advance Harborview's position as a world-class academic medical center.”
The measure would approve construction of a new medical tower and renovation of existing space, increasing capacity for the hospital to serve more patients in an emergency, disaster or a pandemic, and to meet modern infection control and privacy standards, according to county officials.
The scope of the work would include expansion of the emergency department, construction of a new behavioral health services building to meet demand for behavioral health, and seismic improvements to the Harborview campus.
The project includes a $925 million medical tower building; $248 million in seismic upgrades for the Harborview Center Tower; $178 million to renovate existing buildings; $146 million for site and other improvements; $108 million for respite beds and seismic improvements to Harborview Hall; and $20 million for seismic upgrades to the Pioneer Square Clinic.
Although planning for the measure, known as Prop. 1, began in December 2018, the COVID-19 pandemic highlights the urgency of the improvements, according to Kelli S. Carroll, director of special projects in the office of King County Executive Dow Constantine.
“The pandemic has further emphasized Harborview's constraints and needs,” Carroll said.
She said that Harborview Medical Center often operates at 100% capacity, and critical surge capacity and emergency department capacity are limited. She added that a new inpatient facility would increase single bed capacity and enable HMC to meet modern infection control and privacy standards. It would provide surge capacity for the hospital to respond to a disaster, mass casualty event or pandemic.
She said the county anticipates holding pre-solicitation meetings in early to mid-2021 and will cover the project's vision, scope and schedule.
Several firms interviewed for this article speculated that the county will use the progressive design-build delivery system for some of the projects. But, Carroll said, “it is premature to say whether progressive design-build is advantageous or not for these projects.”
Mark Howell, senior vice president at Skanska USA Building in Seattle, said the measure is important to the region on many levels.
“Harborview is at the center of all medical crises in the county, whether a global pandemic, mass casualty event or natural disaster,” Howell said. “Increasing flexible bed capacity, modernizing infection control standards, expanding the emergency department and stabilizing existing buildings are required critical investments for Harborview to continue to serve the region well,” he said. “As members of this community, we have a vested interest in helping bring this vision to life.”
Howell said the complexity of the projects will require construction teams to demonstrate expertise in working on a site that has a steady flow of hospital patients and staff.
“Skanska has extensive experience delivering complex academic medical center projects and managing large, complex hospital expansions on fully operational hospital campuses with constrained, downtown sites,” Howell said. “We realize the importance of minimizing and eliminating any impact to patients, staff, visitors, Life Flight and the surrounding neighborhood around an active campus like Harborview.”
Howell said the progressive design-build delivery model “makes a lot of sense” for the Harborview projects. With similar health care projects under its belt at Virginia Mason and Oregon Health & Science University, he said Skanska has “vast resources” for projects such as Harborview. “We have a robust history of collaborating with contractors and architects to do what it takes to bring the best value to our customers,” he said.
At general contractor Aldrich + Associates, President George Ward has bet big on the health care sector.
“Aldrich's revenue has been 100% health care related for the last several years,” Ward said. “Our focus is in moderate-sized projects in both inpatient and outpatient clinical environments. For hospital acute care, our work is in renovations such as the recently completed bi-plane hybrid operating room at Harborview — a very challenging renovation delivered through progressive design-build.”
Aldrich + Associates, like Skanska and many other construction, design and engineering firms, has a history of working with Harborview Medical Center. “Our depth and breadth in a variety of project types — operation rooms, patient rooms, laboratories — makes us well suited to support HMC's enabling work,” Ward said.
Todd Parke, associate principal at PCS Structural Solutions, which also worked on Harborview's bi-plane operating room project, said such recent projects have helped “strengthen our relationship” with Harborview.
“We're keenly aware that the health care market is demanding future flexibility of spaces in a dynamic and fluid market,” Parke said. “To serve large, billion-dollar programs like Harborview's and the steady stream of enabling projects required to prepare for these major capital investments, we have to bring our robust health care experience, horsepower, focus and a fluent, collaborative culture. This complex program will combine the innovation of the small-scale approach with the capacity and depth of technical expertise that PCS prioritizes.”
If the Harborview measure passes in November, Parke said he expects the work to be divided into five to seven projects. PCS's experience in seismic analysis for health care facilities positions it for working on components of the upcoming Harborview projects, he said.
The Harborview projects would give local firms an opportunity to employ the latest design, engineering and construction techniques, Parke added.
“It's projects like Harborview that can really reshape the Seattle health care market and pivot it toward the next generation of health care, and we would be absolutely thrilled to support that vision,” he said. “To some consultants this might just be another big project. To us, these projects are a priority. These are legacy projects that deeply impact the community, and we want to be a part of that.”
Cale Ash, a principal with Degenkolb Engineers, which has worked on projects for the Department of Veterans Affairs in Seattle and Kaiser Permanente in Oakland, California, said the Harborview program will be an opportunity to use the most modern designs.
“Hospitals have been moving toward a desire for space flexibility for many years and the recent pandemic has further highlighted this need,” Ash said. “Flexible space can accommodate a surge in the emergency department and allow for future evolution in the use of technology during medical procedures. For example, hybrid operating rooms bring advanced imaging into the surgical suite and this requires larger rooms and additional supporting infrastructure. Ideally this flexibility is built into the initial design of the hospital.”
The projects will also give local designers an opportunity to showcase the Northwest's rich AEC talent pool, he said.
“The Harborview program represents an opportunity for the Pacific Northwest to drive the next wave of innovation in both health care delivery and behavioral health treatment,” Ash said. “This can raise the bar for the entire AEC industry, in terms of project design and delivery methods. A resilient Harborview will help the entire community respond to future disasters.”
Aldrich + Associates' Ward said the projects are important to delivering state-of-the-art health care to everyone in the region.
“Our region is in desperate need to fill the capacity gap in health care services and bring our existing facilities up to meet the current technology and processes for health care delivery,” he said.
Ankrom Moisan's Wolf said she hopes that many, or all, of the projects from the bond go to local AEC firms, based on each firm's “unique talents.”
She said Northwest firms have the expertise and imagination to handle the work. “These are the kind of projects that inspire us to explore beyond the expected.”