On the northern tip of the building, the double-skin facade is absent, offering dramatic views of the Hollywood Hills. © John Linden
An impressive new structure on the campus of the Cedars-Sinai Health System blends research, clinical, and procedural functions to create seamless functioning within the healthcare complex.
November 5, 2013—The bright, gently curved building facing San Vicente Boulevard in Los Angeles presents an impressive new face for the venerable Cedars-Sinai Health System. By bringing together research, clinical, and procedural functions in one facility, the structure aims to develop synergy where once there were barriers. The Advanced Health Sciences Pavilion (AHSP) marks the hospital’s entrance into the new field of translational medicine, which seeks to quickly translate research findings into practical tools and practices that can improve health.
The concept for the design of the facility evolved through a series of feasibility studies conducted by the Los Angeles office of HOK. As the firm and Cedars-Sinai staff examined the possibilities for siting new research space, clinical space, and procedural space around the campus, the idea of combining the functions into a single, state-of-the-art facility came to the forefront.
“That combination of needs equated to a really new model of care,” says Ernest Cirangle, AIA, LEED-AP BD+C, the director of design for HOK’s Los Angeles office. “Their needs were evolving, leading to this very advanced way of delivering health care.
“This building’s name—Advanced Health Sciences Pavilion—really says it all,” Cirangle adds. “The client wanted this building to be very flexible, to be able to handle all of those different uses under one roof. And they wanted it to express the kind of advanced work that was happening inside.”
The building attaches seamlessly to an existing parking structure
nearby, obviating the need for new ramps. © John Linden
The new building houses outpatient services for the Cedars-Sinai Heart Institute, as well as neurosciences facilities, research space, a pharmacy, a blood lab, and imaging facilities. The roughly 820,000 sq ft building rises 11 stories above San Vicente Boulevard, stretching nearly to the edges of a tight, triangular site. Its complex aluminum and glass facade employs a second skin, vertical fins, and horizontal sunscreens to minimize solar gain and reduce glare.
“We had different strategies for different orientations,” Cirangle says. “We looked at all the orientations in a very analytical way and crafted the exterior of the building accordingly. “On the northern prow, we peeled those other layers off. That was the one portion of the building that didn’t need protection and also happened to have the best views.” Prominent offices and meeting spaces are located in the prow, which offers views of the Hollywood Hills.
The facade was also optimized to reduce noise intrusion from the busy streets in the area and also from a functioning oil well adjacent to the structure. “We did—early on—have acoustical studies done on what [the] existing conditions were,” says Trip Grant, AIA, the vice president of science and technology for HOK. “And then we worked with our acoustical engineers and the curtain wall contractor to come up with the right type of system. We have offsetting thicknesses of glass in the dual-pane glass system in order to absorb different frequencies of sound to help mitigate some of the noise between the street and the inside of the building.” Because the building would house imaging facilities and research functions, vibration control was also essential.
HOK brought in the Los Angeles engineering firm John A. Martin & Associates as the structural engineers and the Los Angeles office of Hathaway Dinwiddie as the primary contractor, as well significant subcontractors, early in the process to streamline the design process.
The structure is founded on a concrete slab 7 ft thick. There are three belowground and two aboveground stories of parking. That, coupled with a high water table, meant that the project involved a great deal of dewatering and waterproofing. By connecting the new parking to an adjacent parking facility, the team was able to save space that would have been lost to new ramps.
“The building is a concrete structure from the mat slab all the way up through the plaza level,” Grant says. “From the plaza level up, it’s a steel moment-frame structure. We had research, clinics, operating rooms, parking, labs, cafes—multiple functions stacked vertically. And so finding a structural grid and structural system that would work all the way through these multiple functions was a key challenge.”
The new building connects to the hospital via a bridge that is
cantilevered from columns located roughly 100 ft from the edge.
© John Linden
The design utilizes bays as great as 45 ft long to provide Cedars-Sinai with the highest degree of flexibility. Those long spans, coupled with the need for vibration control, led to the use of extremely large steel beams in portions of the building.
“Because of the research [areas’] vibration requirements, special-sized steel members were utilized. If you have your steel manual, look in the back and go all the way to the bottom of the column,” Grant says. In particularly sensitive areas, the project used wide-flange I-beams 42 in. deep topped by a 12 in. structural deck. “They were big,” he says.
“In addition we had a moment-frame system, so there is no cross bracing,” Grant explains. “All the lateral movement was taken up through the moment frame because we didn’t want diagonal bracing, both from a view perspective and as well as a functional perspective.”
The structure required several areas to be specially designed to house certain functions and their vibration requirements, Grant says. “One of the challenges programmatically was how do you identify those areas. We didn’t make the entire building with the vibration controls for research, so we had to isolate certain floors for that. It came down to identifying how flexible do we want to make the building, knowing that the flexibility comes at a cost,” Grant says.
The team used building information modeling (BIM) software to develop the complex structural system. They examined not only the size and placement of the massive beams, but also how the fields from magnetic resonance imaging (MRI) machines would affect pedestrians on the parking garage below. They also modeled the affects from the movement of vehicles in the garage on the MRI equipment.
“One of the real success stories of this is not just having all the consultants and engineers on board from the very beginning, but very early on the contractor became part of the team,” Cirangle adds. “We were dealing directly with some significant subs for cost and making major decisions that were going to affect the design of the building,” Cirangle says.
The building is connected to the hospital at the fifth floor via a 180 ft long bridge across Sherbourne Drive. The bridge serves as a seamless horizontal connection between the new building and existing facilities, but that connection presented several engineering challenges for the team.
“Because the fifth floor bridge runs 85 ft above grade between two buildings that utilize structural steel moment-resisting frames to resist lateral loads, the seismic gap between the existing hospital building and the bridge was required to be quite large, allowing the buildings to move a combined 50 in. laterally without damaging either structure,” said Barry Schindler, P.E., a vice president of John A. Martin & Associates, in written comments to Civil Engineering online. “At the existing hospital, the bridge was detailed in such a way that it was allowed to move freely in the east-west direction (toward the new building), and the existing hospital building was reinforced to resist north-south lateral forces from the bridge,” Schindler explained. “This required adding substantial structural-steel drag members along most of the east wall of the existing hospital to take these lateral forces.” This design was reviewed and approved by the California Office of Statewide Health Planning and Development (OSHPD), he added.
However, the existing hospital structures could not support the added vertical loading from the bridge, Schindler said. The solution was to support the bridge from two columns located at a point roughly two-thirds from its end and cantilever the remaining one-third of the structure to the existing hospital.
With this solution, though, came a challenge—where, precisely, to locate the columns. “There is not a good spot,” Grant says. “We were very confined in terms of where we could drop columns down to support the bridge.”
The medical complex’s urban campus is heavily developed. Beneath Sherbourne Drive is a central plant with chillers and pipes that serve the entire campus. Farther along, the span crosses a conference center. Beneath that conference center is a major food service area the serves the entire complex. “Dropping something through the conference center, as well as the food prep area, became very problematic,” Grant says. “We looked at a number of solutions. We found a utility chase between the central plant and the hospital, which is about two-thirds of the way across the span. It was just wide enough to drop a couple of columns down.”
The two columns were designed and specially detailed to be hinged at the top and bottom to ensure that they would not take any out-of-plane bending, according to Schindler. The columns employ specially designed pot bearing hinges that the OSHPD required to be tested in a laboratory because they are not a commonly used system for this type of application.
“The foundations for these columns consist of several drilled piles located in a small utility space 25 feet below grade between the subterranean central plant and the basement of the low rise of the existing hospital,” Grant says. “Due to problems installing and testing these piles, a total of eight piles in a single line with a very large pile cap were used rather than the originally designed six piles.”
“It was a tight fit,” Grant recalls. “It was snug. We had to reconfigure the supports that were [bearing] the utilities, because they were in the way. Thankfully, the pipes could stay there and stay operational because they come out of the chiller plant to feed the whole campus.”
Working on a tight site adjacent to an existing parking structure, a subterranean central plant, and busy city streets created construction challenges for the team on a project that required some exceptionally large steel members, Schindler said. The erection of the bridge trusses was a special challenge.
“Each truss was quite long, requiring special permitting to be shipped from the shop to the field,” Schindler said. “As the streets are not very wide, it was quite difficult maneuvering the trusses into the site. Once in the site, the erection of these trusses required a large crane to rest on the existing subterranean central plant building and reach over the existing lowrise hospital building with each heavy truss pick.”
Because the existing central plant building roof was not designed to support the outrigger loads of a heavy crane, engineers designed and detailed supplementary structural steel grillage framing to span over the central plant roof to its walls, which were adequate to transfer the heavy crane reactions safely into the supporting soils below, Schindler explained.
“This framing was installed when convenient for hospital operations and covered over until needed to allow truck traffic to run over it unimpeded, and it was removed after the bridge was erected,” Schindler said.
The project has earned a gold rating from the U.S. Green Building Council’s Leadership in Energy and Environmental Design (LEED) program, thanks to a host of sustainability features including the high-performance facade.
The building opened this summer to glowing reviews from the medical staff. “It’s one of those projects that had a lot of complexity and a lot of challenges and interesting decisions along the way,” Cirangle says. “We had a great client who always went for the best answer. They think the end results are great, both for the character and functionality of the building.”