借助其新的Medical Tower II项目，位于弗吉尼亚州诺福克市的国王女儿儿童医院旨在为弗吉尼亚州东南部提供新的心理和行为健康服务。这座耗资2.24亿美元的14层医院在2019年9月破土动工，计划于2022年2月进行实质性完成。它将容纳遵循非传统方法的行为和心理健康治疗方法的服务，要求团队进行广泛的协作以进行协作以开会其独特的设计考虑。

Tamika Harris, vice president of facilities and support services at CHKD, says the hospital system has seen increased demand for inpatient mental and behavioral health services in recent years, but it didn’t have the facilities to properly care for patients at its existing 60-year-old hospital.

她说：“通常，我们在等待社区住院床开放，以便那些要转移心理健康诊断的人。”“我们一直将它们留在急诊室，直到社区中有一张床，这并不理想。”

The health system brought in the design team of Norfolk-based PF&A Design and Array Architects of Conshohocken, Pa., which has a behavioral health design practice. In evaluating the best approach for its new program, CHKD and its design team adopted a philosophy that reduces or eliminates the need for restraint therapy and de-emphasizes medicating patients. Rather than moving patients to isolation rooms, patients will be allowed to “act out in place.”

Array行为健康的首席兼行为总监Jon Sell说，如果工作人员看到患者感到烦躁，“设计模型要求将其他患者带出该地区并进入相邻的隔间。因此，这使患者没有将[激动的患者]拖到隐居室中一个小时，而是使患者能够降低并自我舒缓。”

Built to last

从施工的角度来看，卖出的说法，该方法要求与传统设施相比，所有设施都必须更高的耐用性和安全性。墙壁具有抗冲击力的干墙，天花板不可访问，所有固定装置均为反衬里，拐角是圆角，家具附着在地板上。

David Artman, associate principal at Array, says the team also did extensive impact studies on windows. While the curtain wall could be built to resist hurricane force from the outside, it wasn’t sufficient for interior impact. Ultimately, the team designed a system of polycarbonate framed panels that will be placed in front of windows for added protection.

The program’s approach also guided the design and layout of the inpatient floors. Sell says floors are “compartmented” so that access to small areas can be closed off, as needed. All compartments have at least two exit points for removing patients and staff. No more than four beds are located within one compartment. Sections of corridors can also be isolated.

In delivering a new nontraditional facility, CHKD chose a highly collaborative approach to design and construction, bringing on key partners early in design. W.M Jordan serves as construction manager at-risk, although CHKD had initially considered using a contractual integrated project delivery method. Harris says the medical tower would have been the first use of IPD for CHKD, but as early work progressed, it decided to stick with the more familiar CM at-risk model. “IPD might have been too new for us,” she says. “It might be something to consider in the future.”

Still, Harris says the team adopted many of the approaches used on IPD projects. W.M. Jordan brought in key specialty contractors early in design, including for mechanical, electrical, plumbing, curtain wall and structural steel. LEAN processes were used throughout, including pull-planning sessions, process mapping, empathy mapping and A3 documents for continuous problem-solving and improvement.

Early engagement also aided in a significant redesign of the building early in the process. To maximize space on the health care campus, the building was initially envisioned with a tower atop a parking structure.

在通过建筑成本进行工作时，团队选择建造一个更大的364,000平新利18备用官网登录方英尺的塔楼，该塔楼将容纳更多的床和临床空间，并带有一个独立且相邻的98,000平方英尺，八层楼高的预制停车场。最后的足迹使用了大约2.4英亩的校园。

Tight spot

Although the building will house the new behavioral health unit, the tower will feature a variety of services. The lower floors are dedicated to more traditional medical office facilities, including orthopedics, sports medicine, radiology and other general ambulatory services. The behavioral health unit occupies the upper floors of the tower from the 11th floor to the 14th floor with a total of 60 beds. Shell space is being built below the 11th floor for possible future expansion.

With space at a premium, designers chose to add an outdoor play area on the roof, directly adjacent to the behavioral health facilities. At 248 ft in the air, special design considerations were required. The play area is surrounded by curtain wall that extends up to two stories above the roofline.

防止患者眩晕,the curtain wall is opaque near the bottom edge so they can’t see the ground, while the skyline remains visible. The roof is topped with a raised paver system, featuring 2-ft-sq pavers that are 3 in. thick with security clamps to hold them in place. The space features a half basketball court as well as artificial turf play fields that can be used for soccer and other sports. The upper edge of the framing is topped with a stainless-steel netting to prevent anything from exiting the play space.

考虑到建筑物的复杂性及其紧密的占地面积，W.M.乔丹及其贸易伙伴早期合作，找到了成本有效的方法来对建筑物进行排序，包括广泛使用预制。

Decked out

Due to the fact that the tower is built near sea level, the structure is set at grade with no opportunities to go subsurface. Chuck Arthur, senior superintendent at W.M. Jordan, said the team chose a DeWaal pile system, which uses auger-cast displacement piles.

The system allowed the team to compress the schedule by several weeks. Crews could average 25 piles per day and completed 548 piles for the tower and garage within two months. The strategy also allowed the team to avoid driving traditional piles, which could have generated vibrations that might interfere with existing hospital operations on the campus.

Due to the tight footprint, the team relied primarily on one freestanding Liebherr 420 crane with a 17.5-ton capacity and a maximum height under the hook of 278 ft. The team also used Preston decks extensively. Arthur says crews could lift most materials by tower crane, then telescope out the Preston decks to transfer those materials onto each floor. The project used a total of three Preston decks that could be leap-frogged up the building, as needed.

Arthur says its material transportation strategy was particularly successful given the extensive amount of prefabrication used on the project. Whenever possible, materials were placed on palettes and wheels so they could be easily moved around. Since laydown area was limited, shell-space floors were used as holding pens for materials until they could be moved where needed.

Mechanical elements were extensively prefabricated off site, including mechanical racks that were roughly 20 ft long by 2 ft high and 6 ft wide. The main electrical rooms on each floor were also prefabricated at a site near Richmond by contractor MC Dean.

亚瑟（Arthur）说，有这么多预制的元素，该团队能够利用许多即时交付。

“The [electrical rooms] arrived sheet-rocked and covered with panels and transformers hung, all tested and shrink-wrapped,” Arthur says. “We’d fly them up to the floor, slide them into place and set them.”

One of the main prefabricated elements was the rooftop chiller system, which was split into four large sections for ease of transportation and installation. Because each piece weighed upward of 45,000 lb, an additional 600-ton hydraulic crane was brought in to lift each section to the 14th floor.

Arthur says the prefabrication strategy also provided an unforeseen benefit when COVID-19 protocols had to be put in place. The strategy meant that fewer materials had to be transported through elevators, reducing traffic and the potential for close proximity between workers.

Because the team collaborated early on and created detailed drawings, it was able to procure materials in advance with better certainty as a way to head off any potential shortages.

Final Phase

The team started setting steel on March 11, 2020, the same day the World Health Organization declared the coronavirus a global pandemic. The team successfully topped out the building on time in August.

随着室内工作的开始，其几个更独特的空间将开始形成。在13楼，住院患者将可以使用艺术和音乐疗法的空间（包括音乐录音室）以及室内运动区。还将创建降级空间，该空间使用带有镇定颜色和音乐的感官板。

2月份建设完成后，将为415名员工（包括16名儿童精神科医生）进行搬家的准备工作，他们将在塔楼工作。门诊空间定于2022年4月向公众开放，然后在2022年8月住院空间。

哈里斯说：“重要的是为这些心理健康儿科患者提供综合护理。”“这对我们来说是一项新服务，我们很高兴提供。”