What We Build

September/October 2007

Hurricane Proof, Earthquake Tough, Patient Friendly

The charm of Old Charleston meets stringent seismic and storm codes in the $200-million MUSC hospital expansion.

By Debra Wood

(Photo: Brennan Wesley/MUSC)

Construction aimed at modernizing and expanding the Medical University of South Carolina Hospital, which has served Charleston residents for more than five decades, is nearing completion.

“It’s an aging infrastructure that still serves us for today, but going into the future, we will outpace its capabilities in terms of technology and maintenance,” says Chris Malanuk, project director for the new hospital. “We’re in a

growing market. We identified, as part of a master plan, that we would have a defined need by 2010 for about 150 additional adult procedure-based beds.”

The $200-million, 641,000-sq-ft Ashley River Tower will provide those beds. During the next 15 to 20 years, MUSC will replace other campus facilities. A new central energy plant will serve the 156-bed, cardiac and digestive disorders hospital, now under construction, as well as future projects.

The Medical University Hospital Authority, a component of MUSC, funded design, construction and land acquisition for the Ashley River Tower through a $400-million Housing and Urban Development hospital mortgage guarantee. By insuring the loan, HUD expects the university and South Carolina taxpayers to save approximately $110 million.

The South Carolina Jobs and Economic Development Authority issued $61 million of bonds toward the construction of the 52,000-sq-ft central energy plant.

BGKS puts the finishing touches on the Ashley River Tower. (Photo: Brennan Wesley/MUSC)

Early Completion

The construction manager on the project is BGKS, a joint venture of Brasfield & Gorrie, Birmingham, Ala.; M.B. Kahn Construction, Columbia, S.C.; and Southern Management Group, Columbia. The team broke ground on the steel-frame facility in 2005 and expects to complete the job by November.

“We’re going to bring it in three months early, which is pretty remarkable,” says Jack Darnall, central region vice president for health care for Brasfield & Gorrie.

“The early completion will save about $4 million,” adds Steve Mann, senior project manager for BGKS. “It saves the project in many ways—overhead and capitalized interest on the loan.”

The project consumes two city blocks and required the closure and removal of a city road and relocation of utilities. Existing hospitals surround the site. Concrete pours took place at night so as not to interfere with traffic.

BGKS approached the project as two separate jobs: the seven-story bed tower with a two-level mechanical penthouse and the four-story diagnostic and treatment center. Each had separate supervision and subcontractors. Darnall calls the dual-project concept an outside-of-the-box approach and estimates it shaved seven months off the schedule.

To further accelerate construction, MUSC opted to avoid use of paper-containing building materials, Malanuk says. For example, the team installed fiberglass-faced drywall rather than paper-faced so that crews could begin drywall installation before the building was fully enclosed and the air-conditioning operational. 

BGKS estimates that its dual-project approach shaved about seven months off the schedule. (Photos: Brennan Wesley/MUSC)

NBBJ of Seattle designed the exterior and major public spaces, while LS3P Associates, Charleston, took the lead on the clinical and support spaces. “When you build a building in Charleston, S.C., that makes a project interesting,” says Greg Soyka, executive project manager for LS3P. “Charleston is an old, historical city.”

Darnall notes that the city has extremely restrictive codes, covenants and architectural reviews. “The town did not want to construct anything out of the town’s character, so the approval process for any building is tedious,” Darnall says.

Rodney Crumrine, senior associate and project manager with NBBJ, says that height restrictions kept the building closer to the ground and in keeping with Charleston’s residential character. “Stone [and] brick panels try to break up the scale of the building and give more complexity,” Crumrine says.

The mezzanine and some rooms at the Ashley River Tower overlook the Charleston harbor. (Photo: Brennan Wesley/MUSC)

Shake, Rattle and Roll

Charleston is located on a peninsula with a very high water table. Foundation work required constant dewatering. Mann says high tide backs into the stormwater system and roads. “The site would go underwater,” he says. “We would pump to the ocean and it would roll back in. That happened several times.” The project is located about a mile inland on a former swamp.

The hospital also was required to meet the International Building Code’s hurricane and seismic standards because of Charleston’s location along the Atlantic Coast and on a fault line. “The building code is extensive. There were a fascinating number of variables that came in place in erecting a facility to withstand lateral wind forces of a hurricane and the flexibility and expansion joint requirements of a seismic zone,” Malanuk says.

Soil conditions presented significant challenges. “It’s fluff mud,” Mann says. “It’s a watery, dirty soil and extremely fluid. The more it’s worked, the more fluid it becomes. Density changes with the tide.” Supporting the structure are more than 2,000 tip-bearing, steel and precast concrete piles, driven 105 ft through the fluff mud to a substrata called clay marl.

“When an earthquake comes, the building moves and sways,” Mann says. Expansion joints structurally separate the three sections of the building, which can move independently. Flex conduit, diagonal bracing and moment beams add to the durability.

“When the building shakes, rattles and rolls, these things have a limited area to move in, so it’s not tearing apart or breaking into other things,” Mann says. “At the highest level, the building can move 16 in. without failure.”

The main hospital sits 16 ft above mean sea level, with clinical areas and a garden-style dropoff area elevated 11 ft above grade. Parking and a loading dock are at grade level, which is about 5 ft above sea level. 

A four-story atrium creates extensive natural daylighting and connects the bed tower with the diagnostic and treatment rooms. (Rendering: NBBJ)

In the event of a flood, such as a hurricane storm surge, water would pass under the building without disrupting operations. A sealable door system prevents water from entering ground-level support areas of the structure.

Emergency power systems are 180 ft above the ground on the bed-tower roof. “In case of a major catastrophe, this place will be operating,” Mann says.

The team tested a mock-up of the custom laminated-glass and metal-panel curtain wall system to ensure it met small and large missile debris impacts and was watertight. “The key with hurricanes, which they learned with Hurricane Andrew 15 years ago, is you must maintain the integrity of the enclosure,” LS3P’s Soyka says. “As soon as there is an opening or compromise in the skin, it allows a differential pressure between indoors and outdoors, which can cause significant damage.”

Clinical areas are separated from patients' rooms so future upgrades won’t shut rooms.

Thinking Ahead

The curtain wall panels also have been designed to allow easy removal in order to connect any new buildings built in the future with Ashley River Tower. The panels can even be reused on a new structure.

Architects designed a flexible facility, recognizing that the hospital eventually will need alterations to accommodate new building and medical technology. Floor-to-floor heights on the diagnostic and treatment side measure 20 ft to accommodate utilities and ventilation systems and to allow easier installation of future equipment. Separating patient rooms from clinical space will allow future renovation without shutting down beds to move plumbing or other utilities.

Architects incorporated many green features into the project, including daylighting with control modules to adjust electrical lighting accordingly; use of recycled materials; and an air-cooling system that brings in cooler outside air when available, rather than relying on chilled water.

The team will not pursue LEED certification but still considers the long-term approach sustainable. “MUSC decided to invest in quality and durability,” Soyka says. “By doing so, that’s a good definition of sustainability.”