To the spring of 2026 lecture series.

Today we have Ewing Cole joining us from Philadelphia.

So our guests are Mary Frazier, principal and healthcare architect, who's been with Ewing Cole since 2006.

And we have Phil Zimmerman, associate and project architect at Ewing Cole, with a focus on health and wellness.

And we have some guests joining on zoom as well.

And as you know, we have some technical issues.

So hopefully we'll hear our guests and the guests will hear us.

So we have this push.

So please help me welcome our guests to the podium.

Thank you, thank you.

Thank you.

So once again, thank you for inviting us here today.

As we mentioned, my name is Mary Frazier.

I'm a healthcare architect and planner.

I helped lead the health care practice with Ewing Cole along with our New York office.

And I'm Phil Zimmerman, project architect, licensed architect for the project that we're looking at today, though I was acting as the project architect.

So excited to be here and talk about the project with you all.

Hold on.

And our guests, if you could introduce yourselves for the audience as well, that would be perfect.

Sure.

I mean, my name is Christopher Barge.

I'm the director of design for Northwell Health.

I am a registered architect in New York and New Jersey, as well as a member of the New York chapter of AMC.

Hi, hi.

My name is Aquilla Sane, and I'm the president and owner of the fork Bill Branch of New Jersey.

Hi everyone.

My name is Kaela Bogart.

I'm a senior interior designer with Ewing Cole in the New York office, and I have a focus in healthcare design.

Everyone, my name is Yuze Deng.

I'm a design architect.

Work for Unico.

Okay, so which one do I head here?

So I guess we're good with.

I think moving forward, I think we're good.

Where's the.

There we go.

Okay, so Ewing Cole, for those of you that don't know us, we're architects, engineers, interior designers, planners, researchers and construction firm.

Actually, we've builders as well.

We've been in business for over 60 years.

We've got 11 offices around the country.

One of them is somewhat close by in Fort Worth.

And then we also have about 500 professionals, and we focus on a number of different markets.

Healthcare is just one of them.

We also have civic and what am I missing?

Civic.

Government, science and technology.

Sports and entertainment.

Yep.

And then from Northwell Health.

Oh, can you hear me now?

Is that better?

Hold on.

Hello?

I'm going on mute.

You guys hold on.

Oh, do I have to change that whenever they're talking?

Yes.

We.

Good good.

Yep yep okay.

Northwell health are one of the largest health care healthcare providers on the in the northeast.

We have 28 hospitals in our portfolio as well as 830 plus ambulatory services.

We spread throughout across New York City, Long Island, Westchester, Connecticut.

And we do have some other satellite locations located within new Jersey, Pennsylvania and Florida.

We have over 104,000 employees.

We are the largest private employer in New York State.

So what the fuck is Falck built?

So we are affectionately called the Falcons.

So Falco is really a simple off site approach to construction.

We manufacture components in factory that emulate stick build construction.

So it includes, you know, items and digital components like super studs, digital horizontals that house electrical components and utilities, finished cladding and millwork components that are flat packed and shipped to the job site and then erected for a fast and clean install.

So today we're going to talk about a project, and I'm going to move away from that.

Today we're going to talk about a project which is an industrial building which we've reused into a clinic space.

So we're going to talk a little bit about how we evaluated that site.

Some of the things that we looked at early on to ensure we weren't burdening this project with remediation efforts or things that really wouldn't make it a feasible project.

We're then going to talk a little bit about modular construction and the layout that we came up with for the clinic.

We're going to talk a bit about how we divided the roles of this process during design, construction and documentation.

And then we're going to talk a little bit about how this flexibility, these ideas of modularity, affected the cost point for the project because in the long term, especially for our health care clients, cost of construction is very much top of mind, especially in New York State, in New York City, where the cost of perhaps one square foot of construction can run anywhere between 1000 and $2000 a square foot.

So why do we like to use adaptive reuse projects?

So you'll see in especially in the northeast, we have a lot of buildings which are now abandoned.

This is an earlier project we did with Northwell.

It was a grocery store that had been abandoned, and we turned that through adaptive reuse into a cancer facility.

The reason why our clients like it is because it can not only shorten our time to construction, but if we do it appropriate, it'll shorten our cost or reduce our costs.

And although speed is important because many of our clients are trying to force or get as quickly to market as possible to keep losing, this does not want to stick to my shirt.

All sorts of technical issues today that even though we want speed for our projects, we don't want to sacrifice things such as safety, hygiene and flexibility in the future.

Hold on Chris.

Good to go.

Yep.

All right.

Just a general overview of the property.

This property is a 94 acre property.

It is a former industrial building.

The building actually covers is split between two separate municipalities.

It has two separate addresses from the roads that we're on.

It comprises of about one point 4,000,000ft².

1,000,000ft² of that is into footprint.

Footprint alone on site.

It's just around 3000 parking spaces and it has a very large setup before column spacings, which provides a lot of flexibility with inside the space.

The building itself was was the formerly Sperry Company, which operated in the plants there, building gyroscopes until about 1986.

It was then converted into a condominium complex for multiple tenants, including Northwell Health.

This location actually also served as the temporary headquarters for the United Nations in 1946.

Eventually, until they found their final location in Midtown Manhattan in 1952.

Currently, since 1986, when we went into the into the to, it houses multiple disciplines.

It has a cancer center and ASC and outpatient imaging facility, women's health services, and various other health care modalities.

Just to give you a frame of reference for the footprint alone, the footprint is about one eighth of a mile by about a quarter of a mile.

And to put that into perspective, it's like me maybe familiar with you could fit about one and a half of your Texas A&M stadiums within the footprint of this building.

So that should give you some kind of reference.

That's always challenged him is also opportunities.

But some of the challenges that we face for this particular site was that large footprint.

How do we get the patients and the staff and the visitors that have to be exterior?

How do we navigate through a site that is so large?

How do we provide that ability for wayfinding, which can be very challenging for patients?

And then how can we get that that team to have access to daylight as we begin to look at showing yourself with some of the things that was with a look at where these injuries entered the light, wanderers that went through the building and utilized those as ways to begin to introduce some of that daylight over time.

Another sounds of any team was the actual structure itself.

The structure was all like Covid with eight are like people.

And so we had to figure out how are we going to attack in a very detail, or in a way that would reduce the potential opportunities for anyone to get any hazardous exposure of time?

Yeah, that was count was also the floor structure.

Yeah, yeah.

Just to jump back to the primary steel structure of the building, we used all bolted connections.

So we avoided welding.

We wanted to avoid removing any of that lead coating so that it was all in the end encapsulated.

We'll see that in some of the images later.

But as Mary said, the existing structure is one of our biggest challenges for the project.

And the floor slab structure was really kind of the biggest.

The building was built with 12 inch slabs, structural floor slabs and anywhere where you were near the perimeter or column, you ran into like 18 to 24 inch deep footings.

So in a typical project, you would run all the piping for plumbing below slab.

That was a huge challenge for this project, because we really didn't want to penetrate the slab in any way because it was going to introduce cost and schedule impacts.

So in a clinic that has handwash stations in every clinical space and we have multiple toilets, this was a really big challenge for us.

So what we what the project team ended up using is this vacuum plumbing system, which offered a lot of benefits for the project.

Mainly we didn't have to run plumbing below the existing slab.

So it takes it takes waste soiled water from from the plumbing system into the walls up overhead, and then distributes it in the ceiling to a central distribution like building distribution area that takes it out of the building.

Again, cost and schedule benefits, but also can be modified in the future.

So offers a lot of benefits for for our project.

So the second rule that we have here is to bring in a daylight.

It was not just an esthetic decision but also a performance strategy for patients.

Natural light is linked to reduce stress, directly supporting converting recovery.

For staff.

Increasing daylight exposure is also associated with higher job satisfaction and reduce fatigue, which is critical in a demanding healthcare environment.

In addition, daylight helps with orientation across large floor plates, making navigations more intuitive for patients, visitors, and staff.

To serve the program need.

The clinic space took over half of the light monitor space, so we designed the slope ceiling to free space above and reflect natural light back to the interiors as much as possible.

And here you can see some outcome photos taken from these corridors under different light conditions.

And the third rule here is plan for growth.

Planning for growth meant designing mechanical and electrical system to exceed day one needs by building in addition capacity for from the start, the facility can expand without repeating repeated shutdown that disrupt patient care.

This approach not only support long term flexibilities, but also ensure that future goals can happen safely and efficiently within an active healthcare environment.

So the diagram to the bottom right you can see an orange block right in the middle.

This is where we have this Central Italy room that holds additional space for future equipments.

And this piece of equipment right here.

This is that vacuum plumbing system.

Sorry.

Use jumping in there.

Yeah.

That's it.

So another priority for the project was plan for change.

And we really did this by trying to use a system that could be changed as, as the building evolved.

So by choosing to partner with fault built, we were using a relying on this modular system to allow us to begin to do that.

I'm going to let Aqua talk a little bit about how exactly that is possible for our project.

Yeah.

So one of the benefits and and differences in fault built and our digital component system is that we integrate and we coordinate and collaborate with the design team utilizing Revit and three BIM 360.

So we're all working in the 3D environment.

So in addition to that, Falck built has an echo software that actually identifies and has a barcode for every digital component that we fabricate.

What that means is that we've created a digital asset for the client so that in their inventory, they understand and can can manage the asset that they own in terms of what the digital components are.

So when any change addition adaptation needs to be made to the job site, we can scan the barcode of what's required as a replacement piece.

And then the factory has all that information already asked excess assessed in into the into the information for this particular project.

So Falck built is really a kit of parts.

We fabricate every component.

Every component is digitized.

We flat packet, deliver it to the job site and assemble it.

It's fast because all of the panels are pre finished.

So when it comes to the job site, we erect the framing structure and then apply the finished elements.

So we minimize all of the cutting and assembling and taping and sparkling sparkling that's required in a conventional build.

So really what we're talking about is a clean, fast, effective construction and sustainable for the client.

So as we mentioned, we wanted to be able to plan for change.

So as we began to look at the design for this particular clinic, we wanted to ensure we were able to expand this over time, because even though we were only in one portion of the quadrant, we were going to be expanding that module throughout the rest of the building.

And one of the first things we took a look at with our team was how to begin to organize that clinic.

And so the clinic, we took a look at two different things.

One clinic, one way to lay out a clinic was where we have patients and we have staff all walking in the same portals.

And then we have another clinic where we have an on stage, off stage.

So with this particular client, we decided to move forward with the more traditional layout.

The client was bringing multiple practices into one particular facility.

So that was a change.

And then the second change for them was they were very old school.

They actually had an exam room, and then they had a consult room that the doctors would run back and forth.

And so we had to bring them into really the 20th century century where we said, people don't do that anymore.

We need to do that all in one room.

So we wanted to or we felt we could only push them so far in what they were willing to accept.

And so I think the the off stage model for them was a bridge too far, we'll say.

But when we began to look at that original planning we had done, we realized we broke one of our first rules because we weren't aligning any of our circulation to the yellow bands, which is the light wells that we were looking at.

So we quickly had to iterate a couple of different ideas where we changed the orientation so that all of our east west circulation was aligned up to those light monitors, allowing that light to come into that space.

On.

One of the largest points to this is which was dictated by leadership, was an accelerated schedule.

This was another reason that we decided to have this big collaboration between having folk built with the design assist as well at Ewing Cole, as well as bringing a CM in early in the project.

So as you can see, this is a timeline kind of basing between a conventional as well as with and along with doing the project with the design assist.

So we were able and tasked to do the entire design package within about 10 to 12 weeks.

And that was maintained by leadership, which we were able to attest to, and we were able to cut about two months off of the overall project and get speed to market.

So in the same way that we were, we needed to find efficiencies in the project schedule.

We needed to be really, really efficient with our project team and how we organized it right from the beginning and how it was organized across the project phases.

So we wanted to make sure that we engaged the right people at the right time and early enough, making sure that we had feedback from the client early in concept and schematic design, making sure that we brought our design assist partners fault built into early these early design discussions, so that design was able to be translated directly from the client through us and build as that partnership evolved and then ultimately fork Built was awarded the job and became the primary sub installing these pre manufactured materials.

And so they transitioned from a design role to a construction role.

And and that relationship brought its its own efficiencies as well.

So Northwell Health and Ewing Cole has a 25 year history of working together.

We've worked on a lot of projects together.

And so going into this project, we knew we really wanted to carry forward that institutional knowledge from all the past projects.

So we were it was really important for the project team to have by in an agreement on using these previously developed standards to help shortcut some of the things that would typically take a lot of time during design and design development.

So things like clinical space templates, material and finished standards, and even some of the clinical space mock up reviews were basically accepted at the beginning of the project and allowed everything to move smoothly into design documentation.

So Aqua kind of started to touch on this a little bit, but I want to elaborate a little bit more.

Our project had both conventional methods of interior construction and the prefabricated pre engineered systems.

So just to help describe or illustrate the efficiencies with the prefabricated system, I want to describe the conventional method first.

So pretty typical standard stud framing metal studs with drywall on either side.

Those materials are brought to the site in a rough form.

They're cut on site, they're screwed to the wall or to the sub framing.

There's a decent amount of waste.

There's a lot of finishing involved.

There's taping, sparkling, priming, painting multiple trades involved takes a lot longer than what we'll see.

The folk built system taking the fall quilt system really is, as Aqua had described, a kit of parts.

So it has a similar structure with their Super Sud system, which is like it is similar to a standard steel stud and it has cladding panels.

The main difference is that these items are are prefabricated, pre engineered, brought to site like ready to go set up.

As a kid of parts in the field there's very little waste.

There's very little coordination between trades because it's all Falck built team that's putting this system together on site.

So there were huge efficiencies in using the prefabricated system.

And I'm going to talk a little bit more about the extent of that in a second.

But just to show you for our project what some of these systems look like, the fault built super Stud again looks very similar to a standard steel wall framing member that you would you would see on a typical wall.

Again, it's all precut and prefabricated and brought to site, erected as as a kid of parts.

So actually much different than a conventional system then how how the two different systems are finished conventional system.

As you can see on some of these images on the right sitting there, tape spackle probably need another spackle layer.

More sanding, priming, painting, the fall build system.

Those panels come in precut pre finished fall quilt.

People hang them on the super studs and they walk away and it's a finished space.

So.

So.

Again we relied on our partnership with fault built greatly for this project to bring to help bring efficiency to design, documentation and construction.

And really at the end of the day, like 80% of the interior scope of the project was this pre engineered prefabricated system for fault built.

So everything you see here in green is the fall quilt system and that's interior walls, casework, countertops, all the clinical spaces, ceilings and flooring that's standard construction.

The perimeter walls are also conventional construction.

It was really important for our team to make sure that we delineated the scope of both the engineering and the standard construction for our own documentation purposes to make that efficient, but also during construction to make sure that the contractor was, you know, knew what they were responsible for and fall built, knew what they are responsible for.

And then really, really important because Falck kind of owns 80% of the project during their documentation phase and moving into construction, it was really, really critical that Ewing Cole and the design team work closely hand in hand with Forkbeard to make sure that our design intent and the client's design intent was properly conveyed, properly documented, and then ultimately, that 80% of the project was executed to meet our design intent for the project.

And this is just one of the examples of where we really had tight, close collaboration between Ewing Cole and Falck built.

This is that kind of central design feature for the project, the light monitors, which not only had both conventional methods of construction and the fault built system in this detailing, but they were really butting up to one another.

And so.

So we wanted to make sure that the scope and design intent for both the conventional system and the folk build system were aligned, but also making sure that the detailing between those two systems, where the systems came together and met, was executed properly.

And then in its final form, we feel like we had a very successful kind of execution of the design intent.

This is what it looks like.

I think these photos were taken like a week ago or something.

So and this is all the fault built construction.

As you look at the wall surfaces that you see, this is standard construction.

Everything that's above this black line is standard construction.

And then everything from the black line and below is fault built.

And I think one of the things that you'll see is the panel, because obviously there's a limit to the size of the panels that come through.

Yeah.

All right.

And then starting to think about the design of this space, we really wanted to have three guiding principles.

The first one being a consistent brand.

So we wanted to deliver a space that reflected the standard of care that Northwell delivers to their patients.

We also wanted to think about the site context.

So the space is in Long Island, New York, which has a unique set of users, and the unique set of patients rely on deliver a space that felt familiar and comfortable to them.

And then we also thought about the existing conditions and the fact that this was an industrial building.

So we really thought about how we could celebrate the history of this building through the design of the space.

And this just gives you an idea of some of the things that we show the clients during early design phases.

So these are two options that we presented to Northwell, some more photorealistic renderings.

And you can see here how we kind of brought in those design principles.

So some of the materiality reflects the the nature of the site and the industrial feel.

In this option.

Northwell went forward with option one.

And then we started to talk to some of the users.

Depending on the project and the client, the users can have varying levels of involvement in the design process.

Here they felt like this image was a bit too dark, and they had asked us to bring some more brightness and some more color into the space.

So we achieve that by editing key materials and upholstery.

So you can see how that really brightened up the space and takes advantage of all that natural light in the waiting area.

And then behind clinical lines, which is all the quilt scope we presented to options here to Northwell liked the architecture of option one, but prefer the palette of option two.

With some of those warmer floors and those cleaner white walls.

And you can see how we really used the bulk built system and the reveals that were really inherent to the nature of that product as almost a design feature in this space.

And here we worked with built to create a custom solution for this clinical corridor that really organized three different modalities, which was sub waiting storage, and then also Ma touchdown stations.

And these are some other examples of the types of diagrams that we like to show during the design phase.

And here you can see some site photos in progress.

So you can see how the space is really starting to take shape.

Construction moved really quickly on this project, which was exciting to see.

We're punch listing this week and next week, and then we'll start to install furniture and eventually move in the user and start to see patients in this space.

You can see here a typical of them, and you can see a little bit about how we detailed all of that fall quilt system.

So everything you see here that's those penalized walls is the fourth built including all the mill work, the doors, everything.

What's the biggest, biggest portion about every project?

What is it going to cost.

So this was a big debate with us within within the system is the difference between going either the folk build system or going conventional.

There is a premium to using the full build system up front, but overall, through the whole duration of the project, we found that there's just over just under a percent or so of really cost deviation between this and conventional construction.

So for us, the biggest part of this and the most important piece was the speed to market.

And being able to get this built and built quickly and have the flexibility to make adjustments in the space in the future.

So for us, it was a very big benefit to go with the system.

Yeah.

So like we try to do with every project when we're done, we we kind of take a pause and we take a step back and we try to figure out what went well, what what maybe could have gone a little better and collect our thoughts for some lessons learned.

So it was really important in this project, especially to do that because we really never worked with folk built before.

It was a unique relationship, the design assist relationship, having someone in that position then go into construction, it it was very unique.

So making sure these are just a couple of the lessons learned, making sure that we engage the right team early.

So again, Falck built was right in there during early design phases with us.

And we were talking directly with their engineering team, which was critical in making sure that that speed to market and all the efficiencies that we were talking about were able to be achieved when working in a partnership like this.

Again, making sure that scope and responsibilities are clearly defined, just so that everybody knows what they're doing and what they're responsible for.

One of the most important.

Making sure you understand the the system constraints.

So like anything in architecture, the fault built system is a system.

And it's got a system of parameters that we all need to kind of work within.

So we needed to understand those so we knew what we could do and what we couldn't do, and where we could start to push the boundaries a little bit.

And then the last one here is really for any architecture project.

You want to make sure you're talking with all the, you know, all of the stakeholders.

So and talking to them up front, not just your client leadership or the client design team, but maintenance and facility folks, the IT team and making sure that you coordinate with all of those people before you get to construction.

And I think with that can take some questions.

Yeah.

Okay.

Thank you again.

Thank you.

Wonderful.

Thanks for having us.

So we have about five minutes for a few questions.

What's the first, Zach.

Zach.

So I was kind of intrigued by the vacuum plumbing system.

I've never heard of that.

Is that the go to system for adaptive reuse projects?

That's a really good question.

I think for this project, it definitely was.

Again, if you don't if you're using traditional plumbing, right, in an adaptive reuse project and you're a slab on grade, you're going to be trenching, you're going to have to cut through all that, that existing concrete and rebar and whatever's in there and this, this buildings like 80 years old.

So we don't know the condition of the slab.

We don't want to compromise the structure.

So it comes down to cost.

I think for this project it definitely was the right solution.

But again, like the vacuum system offers modularity.

You can modify it and you don't have to mess with the slab.

So we weren't into reverting to projects specifically in New York, where, I mean, there's a project we're working on right now in our clinic.

Portion of it is above a lobby in a historic building, and we can't penetrate the slab.

So for that will also be using the vacuum plumbing.

I would say it's a case by case basis.

It's it's also something that not all of our clients bought into.

And I think it's something that's a conversation ever time.

But it is very useful depending on what the project is and what the sacred springs are.

Thank you so much.

Questions.

So Beth, Kathy and Danny.

So Kathy.

Similar questions as in the filming.

I was because I did the adaptive reuse project for a hospital for two years and I, I also I, I it kind of reminds me all the memories like all the things and for the plumbing for especially this is a hospital on the client didn't like afraid of plumbing go like pump it up.

It was.

Yeah.

Well, this is an outpatient clinic, so it's not impossible.

But no, there isn't a concern about the vacuum plumbing.

Surprisingly, vacuum plumbing is something they use a lot in person systems.

Because to get into the details a little bit, it's very hard to block up a vacuum.

Fleming system has a vacuum that sucks things through the system, so it can be a very, Right.

What would be a very handy.

Yeah, it's actually there's two reasons that they use it in, in prisons.

One is so you can't like block up the toilet and flood your cell, but also so you can't talk to your neighbor through the plumbing because you can actually do that to in a standard plumbing system.

But again, it really comes down to a case by case basis.

And also your clients like have to be accepting that there if there are risks that they're willing to accept those risks.

So one thing so.

My our problem when I was doing the project was the ceiling height.

And because it's a adaptive reuse, we were having a problem with the ceiling height because of the these days modern has care facility.

There's a new like mechanical things.

And we had to deal with the large space of the.

Upper levels.

Yeah, yeah, yeah.

There's you were limited on space and there was no problem with this.

Yeah.

So we were fortunate enough to have a pretty high above ceiling condition like for the majority.

I mean, the light monitors were really high, but anywhere where we were in the standard height, we still had like 12ft of clearance, which which, unbelievably, and you'll come to find when you get into the profession will be filled with, you know, mechanical systems and all kinds of building support systems in a, in a snap of a finger.

But we were able to coordinate the plumbing system.

And again, for this project, it really was not feasible to do anything else, you know.

Yes.

Thank you.

Great questions.

We have time for one more.

Danny.

Okay.

So thank you all for your presentation.

It was really nice to follow along with, one of my questions is, what is like or did you all consider abilities to kind of mitigate acoustics in your large corridor spaces with, like the really large ceiling heights for the monitors with this fork built system?

Like, did they have any like panel materials that kind of dealt with acoustics at all?

Yeah.

So acoustics was definitely something that we were really concerned with.

And so this project followed guidelines, which has specific acoustic performance requirements for spaces.

And it was it was challenging because the fork build system does not go all the way to the to the roof deck to be full height.

That's that will give you the best acoustic performance for a space.

So the walls all came to just above ceiling.

And so we did have to use special ceiling tiles.

And we used special like approaches to making the spaces more acoustic.

That said, the fault built walls do provide adequate STC rating, which will make the performance room to room work.

But we did.

We had to we had to use a variety of methods to achieve the acoustics for the space that were required.

Yeah.

Thank you.

Yeah.

Well thank you so much.

Great questions.

And thank you again for joining us today.

It was a wonderful presentation.

Thank you.