Healthcare Design - December 2015 - 29

TOM BONNER

Project: Palomar Health, Palomar
Medical Center (PMC), Escondido, Calif.
Opened: August 2012
Summary: Ten years in the making, the nearly
$1 billion Palomar Medical Center was designed
to be the "hospital of the future" at a time when
industry best practices such as building information
modeling (BIM), integrated project delivery (IPD), and
sustainable design were just starting to take off. In
fact, PMC served as a pilot project for the Green
Guide for Healthcare and had two main directives:
Create an environment that promotes health and
healing and reduce the impact on the natural environment in construction and operations. Thomas
Chessum, principal at CO Architects (Los Angeles),
says those goals were achieved largely through a
strategy of reduction and the avoidance of energy
consumption through such features as shading,
heat-load reduction, and daylighting. "All of those
things that were done at Palomar were the right
technology for the day," he says.
What stood out: One of the most striking-and
visible-green design features is a 1.5-acre green
roof over the diagnostics and therapeutics wing.
The undulating roof was designed to allow for
30-foot-high ceiling spaces in the unit to house the
HVAC, IT wiring, and plumbing, which otherwise
would be placed in vertical columns that could
make future renovations difficult and costly. With
few green roof examples in healthcare to follow
at the time, Chessum says the design team and
owner took a trip to the California Academy of Sciences in San Francisco to gather ideas on planted
rooftops. The final design features native plantings and drought-tolerant succulents that were
expected to reduce solar radiation by almost
30 percent and contribute about $1 million to
$1.5 million in energy savings. (For more on green
roofs in healthcare, see "View from the Top" on
page 32.)
To take advantage of the hospital's arid valley
setting and drive down energy costs, the building
is oriented to minimize east/west exposures. The
façade features a perforated metal screen on the
south side to provide shade to patient rooms, while
horizontal louvers on the building protect from the
sun's angle in the summer.
Chessum says PMC also made a large investment in a central plant that houses waste-heat
recovery equipment for chillers and boilers to save
energy at the point of creation. "Other than reducing heat loads through shading and things like that,
the biggest payback in terms of energy use was in

that central plant and using high-end premium equipment," he says.
Lessons learned: Aside from a small ant infestation
on the green roof, Chessum says the space has been
relatively maintenance-free and is providing the pleasant
view and heat reduction qualities that the project sought.
On the façade, the team did a lot of modeling to know
what shading would be effective in minimizing glare and
heat gain inside the patient rooms, so that patients and
staff could enjoy access to natural light and views. "One
of the goals is that the window blinds don't get closed
and I would say that's been pretty successful," he says.
Reflecting back on the project, Chessum says he thinks
PMC was five years ahead of its time. "Compared to
what we're doing today, I look at it and say, 'Wow, if we
had these things that we have the ability to do today,
what more could it have been?'" For example, LED lighting and automated lighting controls weren't advanced
enough or were still too cost prohibitive to fully implement. The important thing to note, he says, is that going
forward, as building systems continue to improve and
hit the market, the owner can introduce them into PMC
to further improve its performance. "Fundamentally, they
have what they need from the building itself, such as
proper orientation, the views, daylighting, and the shading," he says. "The building has given them all of that,
and now we can just continue to layer onto it."

HCDmagazine.com 12.15

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Healthcare Design - December 2015

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