netcare christiaan barnard memorial hospital rudham.pdf · hamilton naki – rename square . 9 ......

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CARE • DIGNITY • TRUTH • PARTICIPATION • PASSION

A Case Study In

INTEGRATED SUSTAINABILITY & PLANNING FOR

GROWTH

presented by:

Theuns Langenhoven & Chris Rudham

NETCARE CHRISTIAAN BARNARD MEMORIAL HOSPITAL

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CARE • DIGNITY • TRUTH • PARTICIPATION • PASSION

• Introduction: Project Ethos

• Key success factors

• Integrated

sustainability • Intelligent Façade

• Partitioning solution

• Mechanical installations

• Wet Services installations

• Electrical installations

• Water purification plant

• Planning for Growth • Organic growth

• Helistop

SYNOPSIS

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Netcare Values Design process:

Care – Ensuring best design principles to guarantee best and safest care and focus on infection control

Dignity – In design for patients, visitors, staff and doctors

Participation – Design committees, patient, doctors, staff and management involvement

Truth – transparency, expectations, affordability

Passion – Full dedication to providing a special, iconic legacy for the future of healthcare

INTRODUCTION:

The Project Ethos

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A world class flagship hospital that is not a citadel but a:

Timeless, “living building”

with a sense of its place in history & community which

Treats humanity and the environment with humility and respect

Recognises culture with exhibition, interpretative spaces & artwork

Acknowledges pioneers in

both community & health

INTRODUCTION:

The Project Ethos

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PROFESSOR CHRISTIAAN BARNARD

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NELSON MANDELA – MEANING OF FREEDOM

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ROBERT SOBUKWE (ON HUMANITY)

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HAMILTON NAKI – RENAME SQUARE

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ENTRANCE ARTWORKS : BY MARCO CIANFANELLI

“THRESHOLD” & BARNARD PORTRAIT

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Integrated Sustainability

Abridged technical brief

2009

• 254 Beds with (30%) ICU & High Care beds expandable to 356 beds without

single disruption to existing hospital or consulting suites.

• Functional flow ensuring operational efficiency – centres of excellence,

ward design.

• Level 1 design trauma facility with helicopter access

• Centres of excellence in:

• Cardiology

• Maternity

• Oncology

• Access to day hospital & ancillary medical care

• Modern, sustainable, efficient and maintainable plant throughout with

singe control and measurement and verification enabled

• Risk mitigation and renewables resources

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Key Success Factors

• Project programme with time for

Idea generation Desk top analysis & testing Life cycle costing Value management & engineering Client/sponsor approval Integration across all disciplines

• Leadership & teamwork with a solution focused orientation

2018

2009

• Early commitment

Integration & Growth opportunities reduce exponentially with time

• Client/Sponsor Commitment

Capex implications necessitate buy-in from all company divisions motivated by: o Corporate responsibility o Environment & sustainability o Life cycle costing o Space & cost benchmarking

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Capex & ROI decisions informed by: • Area & cost benchmarking by

bed & functional area • Life Cycle Costing (LCC) • Sustainability budget (in addition

to project budget)

Value Engineering & Management • Dynamic brief • VM Workshop attended by

• Client/Developer • Professional team • Medical equipment team • Technical services team • Commissioning team • Senior hospital management

team


Key Success Factors: Value Engineering

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Integrated Sustainability & Future Proofing

Mechanical installations - Summary

• Integrated Sustainability o Ventilated Double Façade

o Heat Recovery for Domestic Hot

Water Generation

o Exhaust Air Heat Recovery or

HVAC)

• Future Proofing o Spare capacity

o Plantroom organic growth space

Description Actual Capital cost Actual Annual Savings

Roof System R 1,287,386 R 194,016

8th Floor System R 147,933 R 27,619

1st Floor R 153,733 R 19,614

Total R 1,589,052 R 241,249

Description Cooling

Energy

(kWh)

Heating

Energy

(kWh)

Electrical

saving:

Cooling/

Heating

(kWh)

Running

Time

(hours)

Electric

power: extra

pumps & fan

(kWh)

Electrical

Energy Saving

(kWh)

Roof System

16,068.1 235,412.6 240,162.3

3,342 94,946.2 145,216.1

8th Floor

System 70,443.2 5,646.9 26,470.0

2,840 2,130.0 24,340.0

1st Floor

System 77,744.4 382.3 23,363.6

2,878 2,158.5 21,205.1

Total 164,255.9 241,441.9 289,995.9

9,060 99234.7 190,761.2

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Impact of a double skin façade.

Integrated Sustainability - Façade 2:

Why a Double Glazed Façade ?

Ceiling spandrel opaque

Vision section

Wall opaque

Solar heat trapped once it passes through outer skin

Single skin Double skin

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Reduce solar heat gain Ventilate the void when cooling

Heating Mode


Cooling = ventilate void

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Improve thermal resistance Do not ventilate the void when

heating

Heating Mode


Heating = do not ventilate void

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Façade Void (during contruction)

Helical duct (to terrace)

Façade Void (external skin unglazed)

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Impact on Capital and Energy Cost.

0

5

10

15

20

25

30

35

HV

AC

En

ergy

R/m

²/an

Heating

Cooling

Intelligent Facade • Estimated Energy Savings R120,000

per annum • Estimated capital cost R800,000

Integrated Sustainability - Façade 9: Impact on capital cost and energy consumption

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Partitioning 1 – Why ?

• Flexibility: o Add or change with

minimal noise &

disruption

• Sustainabilty o Overcomes functional &

technical obsolescence

o Reusable components

(H-frames)

• Time & cost savings: o No drying time for

brickwork & plaster

o Saving off-sets extra

capex

o LCC = significant cost

benefit

• Practicality o NCBMH is 16 storey

building where access

for wet trade works is

problematic

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Partitioning 2 – How? & Lessons learned

• Firewalls in brick: o Drywall detailing

problematic

o Drywall fire sealing difficult

• Design & prebafricate

supports: o Door H-Frames: for heavy

doors, fire doors and sliding

doors

o Sanitary fittings

• Sequence of work changes: 1. Wet trades: screeds &

brickwork & plaster

2. Ceiling services

3. Drywall framing

4. Prefabricated H-frames for

doors and sanware

• Programme changes as a result

both:

o Documentation

o Construction

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Wet Services 1

• Flexibility: o Reusable components (H-

frames; composite water

pipe, fittings, brassware,

etc)

• Sustainability o Heat recovery for hot

water

o Sterilized hot water

recovery from autoclaves

and renal care

o Desalination plant

• Time & cost savings: o Capex & opex savings

Slide background: Plumbing Africa magazine - February 2017 Vol

2

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Electrical 1 - Summary

• Sustainability

• Hospital transformers

• Luminaire selection and

lighting systems

• Load monitoring confirms

efficiencies exceed design

estimates by +/- 30%

• Green initiative:

o Standby Generator

installation – noise

suppression

• Future proofing:

o Electrical system designed

for the future expansion

o Plantrooms sized for the

expansion

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Electrical 2 – Extra Low Loss Transformers

o Additional capital cost for the Dry Type (not oil filled)

Extra Low Loss transformers: R243 174

o The savings due to reduced losses estimated at

R48 999/annum (excluding escalation in electricity

costs)

o Simple payback period: 5 years

Transformer Type Transformer

Size

Fixed

Losses

Variable

Losses

kVA P0 (kW) Pk (kW)

1600 2.80 14.50

2000 3.60 18.00

1600 1.60 13.00

2000 1.90 15.50

Standard Dry Type

Transformer

Extra Low Loss

Transformer

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Electrical 3 – Luminares & lighting systems

Luminaire selection: • LED used to the maximum:

o prices were coming down

o efficiency is going up

• LED lights except T5 recessed 600 x 600

and 1200 x 600mm which was more energy

efficient at that stage

LED Bump Rail Lighting (Night & Emergency)

LED Lighting to the Theatre Corridor

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Desalination Plant - Background

Background

• Non-viable at project start

• Became viable to mitigate “Day

Zero” scenario risks

• NCBMH Daily demand: 100 000

litres

• Also address the needs of all

Netcare Western Cape facilities

• Total capital cost: +/- R 7 million.

Raw water source – basement

sump:

• “Fresh” water from Table Mountain

side – but dry during drought.

• Underground tidal water –but high

TDS silt-laden salty water.

Capacity:

• 400kL per day

• Tanker filling point

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Desalination Plant - Challenges

• Variable Total Dissolved Solids

(TDS): 4500 - 15000ppm (in drought

conditions). Solution : plant operating

pressures increase from 12 Bar to >

40 Bar.

• Basement Location: posing height

restrictions as well as complexity in

rigging the plant into restricted location

via difficult access route. Solution:

bespoke design.

• Programme:

• 90 Day time frame available to

March 2019 completion date.

• Statutory compliance with: o City of Cape Town, Department

of Water & Sanitation

o Department Environmental

Affairs

o Marine and Coastal

Management

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Integrated Sustainability & Future Prooofing

Desalination Plant – Components

Reverse Osmosis System

The Reverse Osmosis System in place and connected with the balance of the plant

Carbon and sand filters

Level -1: 400kL/day Desalination plant

Level -2: 50kL Buffer tanks

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Future Proofing

Helistop Background • Requirement for fully licensed Helistop as

required for a full Level 1 Trauma Facility

• Assists City of Cape Town in bidding for world

class events

Some key definitions • Heliport, Helistop vs Emergency landing zone

Approval process: • Land Management & Town Planning

• National Ports Authority – leading lights & flight

path

• Cape Town Disaster Management – no fly zone

• Civil Aviation Authority

Programme • Complete “roof feature” in Phase 1 Hospital

Opening by December 2016

• Complete Helistop construction during Phase 2

– by December 2017

• Procure and fit out 2018

• Commissioning and flight training 2019 with full

operations now imminent

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Future Proofing

Organic Growth

Background • Grow from 254 beds at opening to 356

beds once fully developed

• Seemless growth with minimal impact on

operations during construction

• Mitigate technical obsolescence

• Obviate functional obsolescence

Solutions • 8th Floor parking designed to

accommodate future ward

• Organic growth space on floors

immediately adjacent to areas likely to

expand (theatres, plant rooms, ICU’s &

Wards)

• Flexible and re-usable buiiding

components (partitioning, wet services,

Phase 2 – Add Hybrid Lab

Phase 2 – Radiotherapy bunker

Phase 2 – Add 2 Theatres

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Future Proofing

Organic Growth (10th Floor)

Future Expansion

Future Expansion

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….and thank you to our

project team…

THANK YOU

netcare christiaan barnard memorial hospital rudham.pdf · hamilton naki – rename square . 9 ......

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