CR4HC Case Study: Spaulding Rehabilitation Hospital

Designing for Climate Resilience Pays Dividends

Image

In continuation of our ongoing research, we are pleased to present an updated case study building upon the findings of our previous Spaulding case study. This updated study delves deeper into the impacts of the successes of Spaulding since posthurricane construction.

Background 

Hurricane Sandy swept up the East Coast in the fall of 2012, causing massive flooding and power outages and underlining the importance of resilient, standalone healthcare facilities. While Boston was not severely impacted by the storm, models estimated that a direct hit would have put 6% of the city underwater, damaging every waterfront neighborhood. 

As sea levels rise and hurricanes increase in frequency and intensity, it becomes increasingly important to consider how power usage and reliability affect health center resilience. Amid growing concerns regarding the vulnerability of Boston’s healthcare infrastructure, in 2005, the Mass General Brigham Hospital system (MGB) took a preemptive step and acquired a contaminated brownfield site in the Charlestown Navy Yard. Their vision was to build a patient-centered state-of-the-art facility to replace the existing Spaulding Rehabilitation Hospital (Spaulding) that would be resilient in the face of climate change. In 2013, construction on the Spaulding Rehabilitation Hospital was completed. It stands today as an example of a healthcare facility designed to provide exemplary patient care and withstand the challenges posed by our changing climate.

Well-being Through Innovative Design

The plans for the new Spaulding facility were designed with the understanding that Boston’s climate in 50 years will be significantly different than current conditions. MGB initiated a prospective risk assessment, strategically modeling the impact of extreme weather events and climate scenarios that could potentially occur over several decades. The decision to base the assessment on predictive data, rather than relying solely on retrospective data commonly used in risk assessments, underscores MGB’s commitment to resilience and fortifies Spaulding and future MGB facilities against the impacts of climate change well into the 21st century. 

Multiple innovations were employed to increase the reliability of Spaulding’s power system. Their resilience activities include:

• Collaborating with the local utility provider to raise the electrical infrastructure above predicted flood levels,
• Incorporating operable windows to provide access to energy-efficient and refreshing harbor breezes and double as escape routes should an emergency occur,
• Utilize triple-pane insulated windows to increase insulation and reduce energy expenditure.

The cost of implementing these non-traditional hospital design features was minimal, and MGB was able to recover a portion of the additional costs through utility company rebates and incentives, and indirectly through the brownfield site clean-up. Additional enhancements, such as a green roof garden and aesthetic seawalls, reduce the medical center’s carbon footprint, increase its climate resilience, and provide significant benefits for the well-being of patients, families, staff, and visitors. A recent survey of MGB Spaulding residents indicate that an overwhelming 98% feel that the facility’s outdoor spaces have a positive impact on surrounding communities.  

Image

Community Engagement and Collaboration

Community engagement inspired one of the great successes of Spaulding—the development of a playground for children with disabilities, designed by Spaulding pediatricians on an adjacent site. The playground fosters community interaction and is an example of healthcare facility investment to improve community health and resilience. To this day, the hospital playground remains an extremely active community site.

The success of Spaulding Rehabilitation Hospital prompted MGB to consider delivery of care beyond its front doors. Hospitals can be thoughtfully designed to remain fully functional during natural disasters; however, patients’ ability to receive care is contingent on facility access. Many of MGB’s community health centers are the main healthcare providers for disadvantaged groups, which are particularly vulnerable during severe weather events. Engagement and cooperation among healthcare facilities allow for greater resilience to be established within the larger healthcare system. Collaboration with public agencies responsible for utilities, communications, and transportation is essential to ensure that healthcare services remain accessible and functional during crises. Notably, many of MGB’s hospitals have the potential to serve as no-cost havens for individuals seeking refuge from storms, heatwaves, or other extreme weather events, underscoring their pivotal role within the broader community resilience framework.

Since its unveiling in 2013, Spaulding has served as a proof of concept for many MGB projects. It successfully demonstrated that a hospital can operate without connection to the power grid for over 96 hours in the event of extreme weather. Indeed, the novel approach used at Spaulding informed a 32-site resilience plan that includes all 14 of MGB’s hospitals, administrative buildings, research facilities, and community health centers. Most recently, MGB has begun construction of a new hospital that draws inspiration from Spaulding’s overwhelming success. The new clinical care facility will be powered almost entirely by renewable energy sources and is designed to withstand disasters such as floods and high winds, allowing the building to serve as an emergency site.