Consulting Specifying Engineer Consulting-Specifying Engineer (November-CSE) : Page-13

center of the hub only providing the most acute care, the smaller outpatient centers are tasked with providing specialty ser-vices such as imaging, dialysis, imme-diate care, and outpatient surgery. Con-structing a primary care clinic in the past was not much different than constructing an office space. Constructing a clinic now and in the years to come requires diligent review of the building infrastructure and governing codes. Najafi: How and where health care is being delivered in this country is changing. While the Affordable Care Act and other recent legislation have played a part in this change, so has the high cost of owning and operat-ing hospitals, the needs of an aging population, and the general shortage of physicians. We’re seeing more and more services being moved away from the typical hospital or primary care setting, and into the community. Over the past few years we’ve seen a rise in the number of freestanding walk-in clinics, emergency rooms, surgery centers, imaging centers, etc. We’ve seen this with some of our health care clients, including most recently Adventist Healthcare, where many of these functions are being relocated to retail centers and commercial build-ings that were not originally designed to support these functions. Banse: In addition to more restrictive policies on infection control that will minimize patient re-admittance, HVAC systems will be under tighter scrutiny to deliver cleaner air in a more directional manner to help minimize the infection potential due to the building systems. When ASHRAE Standard 188P is pub-lished (most likely in 2015), Legionella control will be at the forefront of facility manager and design professional efforts. Acknowledging that it is of concern now, there will soon be minimum standards to meet and document in Legionella control. CSE: Many aspects of sustain-ability (power, HVAC, maintenance, etc.) require building personnel to follow certain practices in order to be effective. What, if anything, can you as an engineer do to help increase chances of success in this area? Kos: One method to support the effec-tiveness of sustainable systems is to incorporate an energy management sys-tem (EMS) into the building design, in addition to the typical building control system. The EMS uses facility metering data on each system and subsystem for measurement and verification that the sustainable design features are being operated per the design intent. Trending of energy usage through an EMS and NEW! The first elastomeric duct liner engineered for round ducts. AP Spiralflex 100% 25/50 Thermally efficient with acoustic properties that specifiers require Fiber free and non-particulating ASTM E 84 flame and smoke rated 7 REASONS TO SPECIFY DUCT LINER 1 Step Simplified one step installation 20% Lighter than dual wall ducts R-4.2 R Value for 1” thickness Microban ® Antimicrobial Technology GREENGUARD Gold Certified INSTALL IT. TRUST IT. © 2014 Armacell LLC. Made in USA. MICROBAN is a registered trademark of Microban Products Company. Certified to GREENGUARD Gold standards for low chemical emissions into indoor air during usage. | 800.866.5638 | Arm-715 CSE Spiralflex Ad_5_14.indd 1 input #8 at 5/28/14 10:12 AM


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