Harris Health is a leading public health system serving the third most-populous county in the United States. The Lyndon B. Johnson Hospital is located on the north side of Houston, Texas, which is home to a diverse population that has traditionally been underserved in receiving medical care. Built over 30 years ago, it no longer reflects the needs of the community or Harris Health’s mission of delivering high-quality, person-centered care. As Harris Health hasn’t built a new hospital in nearly four decades, it was important that the project team with HKS and Arup guide them through its journey in building a replacement hospital that meets current and future needs.

The new Harris Health John M. O’Quinn Hospital is designed to provide high-quality care as well as offer a facility more fit for purpose that allows providers and staff to better serve Harris County. To meet this objective, Arup was dedicated to listening to Harris Health’s challenges and goals effectively, allowing us to take a tailored approach to deliver unique solutions that alleviate the health system’s pain points and challenges.

The design of the new hospital is founded on six key drivers: resiliency, flexibility, energy reductions, decarbonization, reduced maintenance, and overall return on investment. By working with Harris Health and HKS to identify these drivers and benchmarks to inform decision-making, we’re delivering mechanical, electrical, and plumbing engineering as well as architectural lighting consulting, which will assist with meeting program requirements and help deliver best-in-class treatment through resilient and optimized operations.

The John M. O’Quinn Hospital addresses the pressing need for modern, equitable healthcare facilities in Harris County, integrating resiliency, flexibility, energy reduction, decarbonization, and reduced maintenance to not only meet the demands of today but also incorporate the needs of the Harris Health campus for the next 50 years. By working closely with Harris Health and HKS, Arup is supporting the delivery of a facility that improves health outcomes and quality of life for communities across Harris County. 

Understanding expected challenges to inform a new, high-performing healthcare facility 

Arup supported the Harris Health client team in considering modernized approaches to their infrastructure by identifying and evaluating challenges their campus has faced in the past. This includes increasingly frequent extreme weather events and possible changes in policies and regulations for waste and carbon. We also worked to identify relevant healthcare trends they can expect to explore in the future, underscoring the value of designing for flexibility.  

To inform design decisions, Arup identified and leveraged historical data from similar profile healthcare systems. This data-driven analysis provided Harris Health with benchmarks that empowered their decision making for design choices that impact energy and cost. The insights also impacted MEP systems and guided the development of a new central utility plant to support the operational needs of the expansion.  

With a focus on resiliency and redundancy for operational continuity during expected extreme weather, the new central utility plant adheres to the N+1 reliability standard, ensuring critical systems remain functional even during equipment maintenance or unexpected outages. This facility exemplifies modern utility plant design, balancing efficiency, reliability, and scalability to support the hospital’s mission of delivering high-quality healthcare. The project aims to ensure that the new hospital and its associated facilities are robust and adaptable to various challenges, while also prioritizing sustainability and cost-effectiveness.

A group of people outside a building.

By working closely with Harris Health and HKS, Arup is supporting the delivery of a facility that improves health outcomes and quality of life for communities across Harris County. Image © HKS

Achieving operational resilience by optimizing system efficiency

The reliability of the utility power grid was a key consideration in the hospital’s electrical design. The infrastructure is engineered to ensure resilience at every stage, from power reception from the utility provider to equipment placement and emergency power system fuel sources. In the event of a disruption, 50% of the hospital facility will be on emergency power and robust electrical infrastructure has been put in place to handle surge events in patient care areas.  

The electrical distribution will be carefully organized with system zoning and vertically stacked electrical rooms, ensuring comprehensive building coverage while optimising initial costs and maintaining adaptability for future requirements. 

In hospitals throughout the Gulf Coast region, approximately 40% of energy used is attributed to heating. Recognizing this demand, a design that maximizes energy recovery and heat capture is essential to reducing heat loads. Energy conservation measures (ECMs) were developed with long-term operating costs at the forefront.  

While the new hospital is served by the utility grid, its heating system leverages free waste heat through a co-generation system that helps cut operational carbon by 34% when compared to the current coal-reliant grid infrastructure. Beyond cost-savings, the co-generation system provides critical operational resiliency measures as it can operate in a variety of modes, including emergency and ‘island mode.’  

The hospital’s plumbing, medical gas, and fire protection systems were selected to ensure continuity of essential utilities during major disruptions. Resilience strategies were incorporated not only through the utility potable water source, but also by implementing a robust on-site water storage system. Equipment specified for both the hospital and central plant was chosen to support future growth and enhance overall resiliency. 

Developing a flexible, future-forward design  

Arup is supporting Harris Health in navigating unknown regulatory requirements, including an evolving energy landscape, by designing with flexibility in mind. Arup worked closely with the project team and Harris Health to develop a long-term strategy for lasting infrastructure that balances first costs with lifecycle costs.  

The design includes considerations for future full electrification, determined by modeling the anticipated energy use of a hospital that would no longer use fossil fuels as its main source of heat. Arup designed the hospital with future, alternative energies in mind to certify energy resilience, including infrastructure that can support hydrogen such as boilers and power generation equipment.   

The project team’s focus on future considerations extends to patient care, recognizing the possibility for future pandemics and the need to consider innovative approaches to manage patients within the broader healthcare environment of Harris Health’s campus.  

Arup’s approach to airborne pandemics resulted in a modular and scalable design that can be implemented as demands grow, while maintaining a healing environment that is not encumbered by temporary equipment. In the bed tower of the new hospital, there are provisions for expanding a 100% passthrough air conditioning system that is minimally invasive to implement in the future.  

Arup brought more than engineering excellence to the Harris Health project; they brought innovative solutions. Their thoughtful approach to systems design supported the collective team’s key drivers while reflecting the project’s mission: to serve those who need care the most.

Whitney K. Fuessel

Partner and Regional Practice Director, Health at HKS

All images © HKS

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