When a hurricane hits land, hospitals are some of the most vulnerable structures. A power outage can send entire medical facilities into critical condition, as patients who depend on machines are placed at risk and incoming patients are turned away at the door. The result can be deadly.
No other U.S. city understands the consequences better than New Orleans. In a Louisiana government report, researchers found that at least 70 hospital patients died during Hurricane Katrina in 2005. Another 57 bodies were recovered from hospitals in the days following the hurricane, indicating that their storm-related deaths occurred inside hospitals. Seven of the city’s 16 hospitals were out of commission for more than two years, and some were deemed beyond repair.
One of those wrecked hospitals, a Veteran Affairs facility, is now being rebuilt on another campus in downtown New Orleans—and this time it has been designed for resiliency in the face of another hurricane. The plan quite literally overturns the conventional organization of hospitals, moving the emergency room and essential utilities above the 20-foot flood line and filling lower levels with less mission-critical features.
The 1.6 million-square-foot VA hospital, dubbed Project Legacy, is designed to set a new benchmark for storm preparedness. In the event of flooding, patient rooms, the power plant, and even the kitchen would remain dry and operational, while the reception area and administrative offices might be at risk.
“We basically built an upside-down hospital,” says Doug Parris, the project’s lead designer and a partner at NBBJ, the architecture firm heading up the project. “We flipped what you would typically see, so that not only are all the services coming to the building—heating, cooling, water—on the fourth floor, but also supplies and removal of waste move back and fourth on the upper concourse.”
In a response to lessons learned during Katrina, Project Legacy will also have a boat dock for receiving patients and supplies. “When we were basically on our own for quite a few days, we had to share supplies with the hospital across the street, and by boat is actually the way we tried to do that,” Failla says.
Each of the 200 private rooms has enough power outlets and medical-gas provisions to go double-occupancy if needed. “There’s a newfound appreciation for how bad a natural disaster can be for these big critical facilities,” says Mike Bolen, the chief executive of McCarthy Building Companies, which is overseeing construction with Clark Construction Group. “Hospitals are upgrading their approach to survivability to include being able to operate in the immediate aftermath of a disaster.”
Some upgrades address not just the worst-case scenario but also the very real possibility of a power outage happening once every couple of years. The hospital will have enough backup power, as well as potable water, to operate off the city’s grid for five days while serving 1,000 people. The budget for the new VA medical campus is $995 million.
According to Parris, the hospital’s architect, many of these contingency measures could be retrofitted into an existing structure, even though VA officials decided to rebuild from scratch in New Orleans. “You’re going to have the challenge of reallocating your systems—of getting them up out of the basements,” Parris said of a retrofit. “But any hospital should be able to take steps to making a more resilient facility.”
Building anew meant that the designers could also meet the VA’s antiterrorism security requirements. The shatterproof-glass façade does double-duty by protecting occupants from the impact of an explosion or the 129 mph winds of a Category 3 hurricane. “We were basically blazing a new trail in terms of how to create a resilient facility,” Parris says, “but also how to integrate that with the VA standards for physical security.”