Balfour Beatty, in a joint venture partnership, expanded and renovated the National Naval Medical Center (NNMC) in Bethesda, MD as part of the Defense Base Realignment and Closure (BRAC) Commission. The upgraded facility is known as the Walter Reed National Military Medical Center (WRNMMC) and is a hospital and flagship medical institution for all military branches. It was the largest U.S. design-build hospital project at the time of construction, and it forms the U.S. military’s largest medical center.
This fast-track, design-build project consisted of constructing the American Building, a 560,000-square-foot ambulatory care clinic; the Arrowhead Building, a 165,000-square-foot in-patient addition to the existing hospital; and nearly 450,000 square feet of phased renovations to existing, operational medical facilities. In addition, Balfour Beatty received a separate contract for the design and construction of 20 main operating rooms in the existing hospital. Ancillary work included two new parking garages providing 2,100-spaces, campus entrance road/gate renovations and a 700-foot-long logistics tunnel.
Specialty service spaces built or renovated include an emergency department, imaging/nuclear medicine services, cardiovascular/invasive procedures (including cath lab), critical care units, patient rooms, diagnostics and surgery modalities, cardiology, women’s care, neurosurgery, general surgery and dentistry. Spaces for 409-beds were either built or renovated, including 50 intensive care unit beds with negative air pressure. In all, more than 40 departments and separate renovation/expansion projects were carried out as part of the overall project.
The ambulatory care clinic services wounded warriors and veterans. The building includes an amputee center complete with a gait lab to simulate movement and evaluate a patient’s walking motions to better design a custom prosthetic, and a Computer-Assisted Rehab Environment (CAREN) lab, which allows patients to train using their new prosthetics in different virtual worlds. The clinic also has a full prosthetics department, therapy pool, indoor running track and climbing wall. The Cancer Center of Excellence includes three rooms dedicated to linear accelerators with a Tomo therapy unit, which integrates CT imaging with conformal radiation therapy; and Novalis brain lab, which performs sterotactic body radiotherapy (SBRT), a form of non-invasive radiosurgery that uses precisely-shaped and targeted radiation beams to treat tumors. The vaults were built with four- to eight-foot-thick concrete walls and custom-made lead-shielded doors. The in-patient addition contains critical care units, angiography and nuclear medicine departments, and 100% private patient rooms.
This project incorporates such evidence-based design elements as all private patient rooms to reduce infections and increase patient comfort, decentralized nursing stations to increase patient contact and reduce nurse walking distances, standardization of room types and sizes to reduce errors, and extensive daylight for greater patient and staff comfort.
Walter Reed achieved LEED Gold certification for the new construction work, surpassing the LEED Silver goal. Cutting edge technologies—including unique enthalpy heat recovery wheels, state-of-the-art heat recovery chillers and high efficiency lighting systems—were used to save 28% of energy costs compared to the LEED v2.2 baseline. This energy savings was achieved despite utilizing a 100% outside air HVAC system to eliminate recirculation of inside air to help prevent airborne infections; fully outside air systems typically incur an energy cost penalty. Additionally, through an innovative construction waste management plan, 89% of waste was diverted from landfills.
All current medical center departments and services remained operational during construction. The project team constructed a temporary emergency department inside the existing hospital, as well as two temporary spaces to house other departments in transition. All renovation work, which occurred in the heart of the medical center campus, required a comprehensive infection control risk assessment (ICRA) to measure and reduce airborne toxins in sensitive areas.