Meritus Regional Medical Center is on the fast track to create a regional infectious containment (RIC) unit on its Hagerstown, Maryland campus as part of its rapid response to the COVID-19 pandemic.

Targeted for completion in July, the 12,800-square-foot, single-story addition to the existing hospital will house an acute care, medical/surgical patient room program. It will include 20 patient rooms, entrance and exit ante rooms, respiratory therapy space and support spaces required for a medical/surgical facility.

Leach Wallace, which was acquired by WSP in 2019, is part of the design and construction team, providing the mechanical, electrical, plumbing, and fire protection (MEP/FP) design services, telecommunications and construction administration services, as well as testing, balancing and commissioning of the heating-ventilation-air conditioning (HVAC) systems.

“The primary purpose is to create an infectious isolation suite that is separated from the remainder of the hospital’s inpatient functions,” said Mike Lamdin, principal-in-charge for Leach Wallace. “This facility will provide a modern, safe treatment environment for both the patients and the healthcare workers.”

The RIC unit will provide surge capacity for the emergent needs, as well as serve as a future resource for treatment of infectious diseases in the Western Maryland region. The space will create a 20-bed, negative pressure and ventilator-capable area adjacent to the current wound center, which increases overall capacity while limiting exposure of the virus to the hospital’s general population.

Completing the $12.5 million facility within a span of four months demanded swift action on the part of the design and construction team, which includes Matthei & Colin as the architect of record, Gilbane as the construction manager and Frederick, Seibert & Associates Inc. for civil engineering, land surveying and landscape architecture. All of these companies were involved with the construction of the Meritus Medical Center building 10 years ago.

Authorization to proceed with the design was received on March 23 and by April 17, permit level drawings were produced. Construction is under way and the facility is on schedule for completion by July 30.

The new addition is being constructed on the backside of the facility connecting to a corridor that leads to the outpatient and administration wing.

When design work on the expansion started, employees in WSP’s Elkridge, Maryland office were still adjusting to the closure of their facility one week prior, and learning to operate in their new remote work environment.

“The biggest challenge with this project was that the design process was almost inverted compared to normal design practice,” Lamdin said. “At the same time, there were new procedures everyone had to learn in order to be productive and safe in a remote environment.”

Fortunately, the entire design and construction team adapted to this new approach rather quickly. Continuous communication remains an important component of the project’s successful progress.

A daily call is held at 4 p.m. with the construction manager, design team, project owner and the Washington County code officials to stay on top of the design process.

“Having the county code officials on the calls has allowed the design team to discuss the proposed design and gain input up front,” Lamdin said. “They understand the critical importance of this project and have been an active participant in some design decisions, which has helped ensure smoother permit submissions and on-site inspections.”

By addressing any concerns in real time, this process allowed for the underground piping design drawings, which had been prepared prior to the structural footing design being completed, to be reviewed and approved with no comments from the county.

WSP has also held daily team huddles via Skype to keep track of progress and tasks. Andrew O’Brien, WSP project manager and Jacek Grabowski, WSP Lead Electrical Engineer, used these huddles to keep his team on track and has been a valuable tool to encourage collaboration within the team.

Another consideration was the changes in supply chains and distribution, which threatened to further slow down progress. Fortunately, identifying this concern at the onset eliminated this as a potential problem.

“Major equipment and equipment with long lead times such as air handling units, exhaust fans, variable air volume boxes, plumbing fixtures, medical grade lighting fixtures, electrical transformers and panelboards were selected, submitted and approved in the first week prior to final load calculations or even a final floor plan was established,” O’Brien said.

Thanks to these initiatives, by April 22, site work was nearly complete, including the footings, foundation and underground piping. Slabs were scheduled to be poured afterward, and structural steel was expected on site the following week.

The HVAC system designed by WSP will include a dedicated outdoor air handling unit served from the campus chilled water system. The unit contains dual supply fans and HEPA filters in the final filter position.

Its dedicated, fully redundant exhaust system will consist of two high velocity, high plume discharge exhaust fans equipped with bag-in, bag-out HEPA filter assembly on the roof with bubble tight isolation dampers.

The new facility will also provide two distinct modes of operation – a “normal” mode where the suite acts as a typical med/surg patient floor and an “infectious” mode where all 20 patient rooms will operate under negative pressure and maintain a minimum of 12 air changes per hour. The entire suite will be negative in pressure in relation to the main hospital.

“Each patient room and the entrance/exit ante rooms will be equipped with room pressure monitors to maintain pressure requirements when needed,” Lamdin said.

The medical gas systems have been designed to allow for 20 ventilators to operate simultaneously and all critical functions are served from the emergency power generator plant serving the hospital.

Safety remains an important factor in all aspects of the project. Gilbane instituted a specialized personal protective equipment (PPE) policy specifically for everyone on the project site.

In addition to the normal hard hat, steel-toe shoes, safety vest, safety glasses and gloves, all workers on site need to wear a face covering at all times. In addition, workers are required to practice social distancing while on site and all workers have their temperatures taken each day prior to entering the site.

“The construction team is working two shifts each day to meet the demanding completion schedule, but have a time buffer in between shift one and two in the afternoon to minimize interaction of the two shifts,” Lamdin said.

The design approaches and strategies used for this project will lay the groundwork in future planning for other COVID-19 spaces.

“This will be one of the first permanent, totally new facilities in the U.S. specifically designed and constructed for COVID-19,” Lamdin said.

Health care is familiar territory for the Elkridge office, since most of its projects are medical facilities. But the critical nature and urgent timeline required of the Meritus project created a unique sense of purpose for the entire team.

“It has always been an area of pride to know that the projects we work on have a daily impact on the lives of others,” Lamdin said. “Many of the projects that we work on are at facilities that our staff and their families use for their personal care. It is very satisfying to know that we were able to respond to this worldwide crisis in an efficient manner and do our part to provide assistance to those that will need medical care fighting COVID-19.”

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