Turner Construction is providing integrated project delivery via a construction management contract that allows everyone to participate as a single entity, Maurice LaBonne, senior vice president of facilities services at the NS-LIJHS, says. “Integrated project delivery is not legally available for health-care projects in the state of New York, but we are adopting the processes,” he says. “We are among the first to adopt this type of delivery for a health-care project.”

New LEED Category

Since the U.S. Green Building Council this April added a special health-care category to its Leadership, Energy and Environmental Design (LEED) rating system, health-care developers have become more conscious of green design, Woodin says. “The rating system didn't work for years, with only one hospital becoming LEED-certified,” he says.

Hospitals have become more performance-driven with customers, clients, regulators and the general public demanding more operational statistics. “We have more high-performing hospitals with documented results,” Woodin says.

Sheffield says green initiatives are definitely more the norm for hospitals now than several years ago. “LEED is more rigorous for hospitals, with criteria for 24/7 operations, huge energy demand and the need for processed water and filtered air,” she says. “There is more of a drive to meet the challenges of the unique set of building requirements.”

The University of California required the Jacobs Medical Center to apply for LEED certification and incorporate many green features in the hospital design, such as a variable-air-volume air-distribution system, fritted glass to reduce heat gain and use of reclaimed water for water towers and irrigation. The project is on track for achieving LEED Silver, Cleaton says.

As hospital owners look to the future they are focusing more on ambulatory rather than inpatient care, sources say. While the aging population ensures there will be more demand for services, hospital owners recognize that stays will be shorter. “Hospitals need to be outpatient- friendly for those coming in and out,” Woodin says. “Basic way-finding is important so patients can get to the right place quickly.” LaBonne says, by the end of the decade, 50% of income will come from ambulatory care. “As an integrated health-care system with 14 hospitals, we see the need to have more of a population-based strategy shift in health-care initiatives from treating sick and diseased people to preventive care,” he says.

1 Stanford Univ. Medical Center Expansion, Palo Alto, Calif. New 3,500 Stanford University Medical Center, Palo Alto, Calif.
2 Medical LifeCare Campus, Riverside, Calif. New 3,300 March Healthcare Development, Riverside, Calif.
3 Union Village, Henderson, Nev. New 1,500 Haskell Company Corporate HQ, Jacksonville, Fla.
4 UNMH North Campus Hospital, Albuquerque, N.M. New 1,000 UNM Hospital, Albuquerque, N.M.
5 New Orleans VA Medical Center, New Orleans, La. New 800-845 Dept. of Veterans Affairs Medical Center, New Orleans, La.
6 Exempla St. Joseph Replacement Hospital, Denver, Colo. New 623 Exempla St. Joseph Hospital, Denver, Colo.
7 RFQ/AE: Tricare Medical Facilities, Huntsville, Ala. A/R, New, Additions 498 US Army Corps of Engineers, Huntsville, Ala.
8 CPMC Cathedral Hill Hospital, San Francisco, Calif. New 450 California Pacific Medical Center, San Francisco, Calif.
9 Highland Hospital Acute Tower, Oakland, Calif. New 431 County of Alameda General Services Agency, Oakland, Calif.
10 Children's Hosp. & Adult Critical Care Tower, Iowa City, Iowa New 270 University of Iowa Hospital Architects, Iowa City, Iowa
11 UConn Health Center, Farmington, Conn. A/R, New 258 University of Connecticut, Storrs Mansfield, Conn.
12 Jennie Sealy Hospital Replacement, Galveston, Texas A/R, New 250 University of Texas Medical Branch, Galveston, Texas
13 North Alabama Medical Center, Huntsville, Ala. New 250 RegionalCare Hospital Partners, Brentwood, Tenn.
14 Sacred Heart Medical Center, Springfield, Ore. A/R, New, Additions, Int. Comp. 250 PeaceHealth Medical Group, Eugene, Ore.
15 St. Michaels Medical Emergency, Newark, N.J. A/R, New, Additions 250 St Michael's Medical Center, Newark, N.J.
16 Ambulatory Services Expansion, Brooklyn, N.Y. A/R, New 234 SUNY Downstate Medical Center, Brooklyn, N.Y.
17 Centegra Hospital, Huntley, Ill. New 233 Centegra Health System, McHenry, Ill.
18 Suburban Hospital Expansion, Bethesda, Md. A/R, New 230 Suburban Hospital, Bethesda, Md.
19 Advocate Christ Hosp. - Ambulatory Pav., Oak Lawn, Ill. New 200 Advocate Christ Medical Center, Oak Lawn, Ill.
20 Emory Hospital Patient Tower/Garage, Atlanta, Ga. New 200 Emory University, Atlanta, Ga.
21 Meadows Medical Center, Las Vegas, Nev. New 200 JWM Ventures, LLC, Las Vegas, Nev.
22 Mercy Crystal Lake Hospital, Crystal Lake, Ill. New 200 Mercy Hospital & Medical Center, Chicago, Ill.
23 New Holy Cross Hospital, Germantown, Md. New 200 Holy Cross Hospital of Silver Spring, Silver Spring, Md.
24 Reading Hospital - Surgical Building, Reading, Pa. New 189 Reading Hospital & Medical Center, West Reading, Pa.
25 Washington Hospital Building Replacement, Fremont, Calif. New 150-180 Washington Township Healthcare System, Fremont, Calif.