Okay.

Howdy, howdy.

Welcome to the Architecture for Health Lecture Series in 2026.

Today we have Megan Gallagher from HDR joining us.

Megan is a senior health planner in the Charlotte design studio for the HDR, and she pursued a career in architecture to blend her creative side with her upbringing and family of engineers.

And today, she will be presenting a project regarding adaptive reuse for healthcare spaces, which is compatible with the studio that some of the students here are taking.

So please help me welcome Megan to the podium.

Well, thank you very much for having me.

This is a wonderful opportunity.

I'm happy to share this story that we have.

So largely, what I will be talking about is our relationship that we have with Advocate Health.

This is a relationship we've had for about 13 years, and it's just a wonderful collection of stories and lessons learned.

So focusing specifically on adaptive reuse.

We have a variety of examples, you know, from a change station to a grocery store to a bookstore, etc.

so we'll go through those examples and what you can expect to learn and look for as you're doing adaptive reuse.

So really that is that is the point of this discussion is why are we considering adaptive reuse?

There are a lot of lessons learned, a lot of opportunities that they provide.

So we'll go through those in detail.

I want you to pay particular attention to why we would do this.

So expansion within the health care market.

Understanding what the constraints are and how to really think about a building as you're turning it into a health care space.

What it requires for coordination with engineers and trade partners and construction team members, and then what are opportunities within that?

So if you're working with a client that has specific, specific standards and things like that, how to think about those things within these unique spaces.

Before we get into that, I want to tell you a little bit about who I am.

So health planner architect, those are kind of the broad terms.

I have been with HDR since 2019, but I've been in the industry for about 20 years now.

So Fairmont of experience within that all doing architecture and most of the time doing health planning.

One thing I like to also do alongside of that is work with our default group, which is our pro bono initiative in HDR.

So I'm on the steering committee with that group, and what we do is provide design services for projects sort of outside of the the typical realm.

So what you see on the screen are two projects.

We did, one in India and one in Ecuador that's under construction right now.

So a really great opportunity to work with other partners like Engineers Without Borders, construction for change and other groups like that.

So HDR is a big company, but we've got a lot of facets that allow us to do things like this, which is wonderful.

Also want to talk quite a bit about advocate Health.

That's the premise for these projects.

As I mentioned, we've had a long relationship with them 13 or so years.

I've been working with them on and off for about six years.

So I've seen the ins and outs of the program.

Advocate health as an institution has grown quite a bit, so they have merged with Arora Health Care, Atrium Health Care in the southeast, and Wake Forest School of Medicine.

So this is just showing the locations of impact of where they are.

So they are big and they are getting bigger, but what they are trying to do is work with this collaborative care method.

So we it's HDR image as the engineers bolt construction.

And then we have trade partners.

So this is a partnership that we call IPD.

Does anyone here familiar with what IPD is.

Okay a little bit.

So it's basically we are all in the same boat together.

So if if somebody is really struggling we work as a team to make sure everybody is afloat.

So if if there's a problem that occurs, something with construction, we as, as the architects will come in and try to help.

So we're all, oh, we're all working together towards the same goal.

Which means when we succeed, we all succeed.

And that group, as I mentioned, has been has been working closely for the for the last better part of a decade.

So these are guiding principles for all construction projects, particularly these outpatient facilities.

Want to focus specifically on the design for change, system wide entry points and lifelong relationships.

So lifelong relationships is not just in construction, but it's also for patient access to.

So once you're a patient within the system, they want you to to be return patient within that.

Part of what we're going to talk about today is adaptive reuse.

So those system wide entry points making sure that we have opportunities within markets, within locations to provide that service and design for change.

So as we do these projects, thinking about how we are intentional with our design, we're not just creating unique things every every particular location.

We're talking about standards and taking concepts and applying them so that it's kind of a brand within every location.

Part of that, and what drives that particular aspect is a reduction of waste.

So because we can be standard about things, we can be really intentional about how we're constructing buildings, how we're designing buildings.

So this is really a goal for advocate.

Health is an elimination of waste.

Part of that is through the standards.

And I'll talk more about what that actually looks like coming up, but also thinking about, you know, being safe on construction sites and in various things like that.

All right.

So this is a long list of project locations focused all in the Midwest.

We've done about over 60 projects with them so far.

A lot of them are ground up buildings, but a lot of them are the adaptive reuse.

So I just want to point out that we have quite a portfolio of projects and lessons learned through that.

Sorry, go this way.

So the adaptive reuse locations that we've looked at so far, a bookstore, grocery store, toy store, a lot of these things will find in strip malls.

So big box buildings or strip mall locations or just areas that tend to be abandoned and sort of forgotten about, really, the idea is being able to reuse a building is a is a form of a green building.

All right.

So with all of that being said, the agenda today I really want you to be able to walk away with a good understanding for location analysis.

So how do we pick these sites a building analysis.

So once we get into the location, how do we think about what makes a building a good opportunity to to put an outpatient facility in coordination.

So working with our trade partners and our team members and then application.

So what those standards are, how are we being intentional across the different facilities and then the next frontier.

So this is sort of the dream of what we've been able to explore just outside of the box.

So okay so location analysis how do we pick these spaces.

Advocate has a pretty robust real estate team that they look through different available locations throughout.

I want to talk specifically about Chicagoland.

So Chicago is a big urban dense city.

And then there's a lot of rural areas around it.

They have started out in the rural areas building ground up, and the last few years we've been focusing in on the city of Chicago itself.

So a more dense and urban environment.

So the real estate teams will look at what buildings are available, what plots of land are available, and see how that works with access to care within those locations.

So does that community need a new outpatient facility?

If so, what does that mean to build something in these locations?

So this first one I'll show you is this is in the heart of Lakeview in Chicago.

If anybody knows where that is very dense, very urban.

It was a sports authority that turned into one of those Halloween shops around October and then just kind of set dormant for a while.

And this was for years.

So this was a prime opportunity for advocate to think about having an outpatient clinic.

So they they took this a really dense and congested corner of the city and were able to to go into this footprint and provide a service for that.

And I'll show you a picture of what this building looks like after this project was complete.

But related to that is what what do these provide?

What do we want to think about with that?

It's really visibility and access.

This particular map that you see on the screen is another project not too far from the from that Sports Authority.

This is a Webster place that used to be a Barnes and Noble.

This particular project was located near the expressway.

It was located near an advocate hospital, so an inpatient facility.

So it had proximity to that site.

And it was it really served an underserved area within Chicago.

So thinking about all of those different things are really how the real estate team starts to focus in on different locations within within an area.

So these are these are those two projects I just talked about complete.

The one on the left side is that Webster Place, the one near the expressway, former Barnes and Noble.

The one on the right side here is that former sports authority.

So you can see how the team has taken and sort of refreshed and revived, revived these existing buildings.

I think it's particularly important to note that with coordination, especially with a major shell transformation, the relationships that are involved with this, because the landlord could have a relationship with an architect who designed the exterior.

That was the case for the Webster Place project.

This was a Gensler shell.

They redid the shell, we did the inside for the health planning, and then the one on the right side was all HDR.

So depending on the relationship with the landlord, it could it could dictate who's doing what within the building.

So that is one thing to think about.

The other part with these particular buildings is they're leased spaces.

They're not buildings that Advocate Health owns.

And that is one of the strategies.

So that they're not buying a plot of land in a very expensive part of Chicago.

They're leasing a space for ten years, and it brings new life to the location that they're in.

But it's also a cost advantage for the health system itself.

The other thing to note is putting a health care space in a place like this versus retail brings a different type of traffic to the area.

It can also bring more foot traf different types of people needs within the space.

So that's another thing to think about as you're as you're looking at different sites.

And with that also comes parking.

So there's a there's a ripple effect right.

There's code related to parking.

There's code related to how people are coming in and out of the space.

So all these things to think about, especially within a dense urban environment.

So I keep going back I'm sorry.

So here we go.

I talked about lease spaces.

That means our landlords are going to have requirements.

This particular project was a former toys R us in a strip mall.

And so it's sandwiched between an LA fitness and a TJ Max.

Not super exciting right.

But that particular building had a lot of limitations, including where we placed the entry door.

TJ Max didn't want us anywhere near their entry door, so we had to put it within a certain distance.

We had height requirements for where the signage could go, so we wanted to make sure that we were within those restrictions.

So this is just showing a study of all the opportunities or options that we could do.

Within this particular building.

So once advocate health picks a site or a few sites, they they bring those sites to us and we do feasibility studies.

So we'll test the building to see if the program requirements that they need can actually fit in the building.

And then that will go through a cost process with our with our partners, and they'll determine if it's actually going to give advocate health a good return on investment.

So we go through quite a lot of process, quite a lot of studies within each location.

Okay.

So that is kind of a big summary for what we do for location analysis.

So this building analysis, what I was just talking about with these feasibility studies, the things that we like to think about are building proportions.

I mentioned standards which means that advocate for a typical clinic pod.

Does anybody know what a typical clinic pod when I say that means.

So if we have we have exam rooms, a number of exam rooms.

And then within that we have space that the staff will will serve the exam rooms.

So there's a typical complement of components.

And we take that sort of module and we repeat it.

Right.

So there's a dimension that works really well.

It has some flexibility but something that we look at.

So what you see on the screen is a ground up.

If we were to do it from scratch this is sort of the ideal scenario.

So we've got the front bar for entry, we've got our clinic.

And then the back side of the building is staff space.

So this particular proportion is is important to note because when we get into spaces that are in strip malls that are really deep and really skinny, it flips that proportion.

So this particular one is that toys R us that we were just talking about, it took that proportion that would be sort of front on and it rotated it towards the side.

So we've got to think about how that will work within that space.

What is the proximity of the different components that go into a clinic.

Like certain things want to be up front, certain things want to be in the back.

So typically we do things like immediate care, things that we don't want people to walk too far from, like orthopedic sort of requirements and things like that.

Those are all things we want located sort of closer to the front of the building.

So when we get into these long, skinny scenarios, it makes it difficult to start thinking about those adjacencies.

Okay.

This particular building was a former outdoor furniture store.

It started to fit a little bit better into that proportion that we like to work with.

But just another example of of adaptive reuse with that.

So I was talking about adjacencies and access.

This again is a brand new building showing our front entry point in the large orange arrow and then locating things that we want to be proximate to that front door.

So immediate care, physical therapy, imaging, all those things want to be kind of closer to the front.

And then you can see how that works in the former toys R us space.

So it becomes that long linear strip a little bit more difficult for for that relationship.

Some other functional zoning.

The public and staff space advocate has a pretty strict relationship with how this works.

So public runs along the front.

It gives patients good access to walk into their clinic pods and then staff come on the back side.

So we've got this sort of on stage, off stage approach that we push that we try to incorporate in every project.

However, when we get into buildings like that, Sports Authority, that really ugly sports authority, we get footprints that look like this.

So it becomes much more difficult to to start to keep those relationships.

So it forces us to think about them differently.

Where does the public space want to go?

In this particular example, it's in the middle.

And then you expand out to your clinic pods, and then staff support is still on the back.

So trying to maintain that on stage, off stage approach, but trying to think about it creatively within weird footprints like that.

All right.

The other component that we need to think about very important is structural constraints.

So that former Sports Authority had a weird structural grid, didn't quite work very well with our standard room sizes and dimensions that we like to do.

So we had to be creative about how we started to place those things related to the structure within that project.

The other thing I'll talk a little bit more about later is also vibration.

Making sure everything is is strong enough for what we're going to put in the building.

Life safety constraints A lot of these buildings come with specific entry points that don't necessarily work with our life safety, distances and egress.

So for some projects, we will have to put in new stairs or take out the old stairs and put in new stairs so that they actually are strong enough.

For what?

For transporting patients?

In a lot of times we'll have to put in elevators to so that we can make sure our patients can get to and from their their areas safely, and then code compliance constraints.

So if we're doing typical clinics or outpatient surgery centers, they have different requirements for how we are making those areas safe.

So different.

Ratings around the location.

So we're basically zoning in big boxes within within these buildings.

And it can get challenging.

You can see on the right side the existing structural constraints, trying to wrap these ratings around and thinking about it really in 3D and how that could work.

And then volume constraints.

So that particular that Sports Authority I was talking about before had really short floor to floor heights, 11ft.

So it really restricted the height of of where we were putting our ceilings.

It also meant that because part of that building was in the basement, we didn't have daylight.

That was another thing that we were struggling with.

So we can go from from really short or we can go from really tall.

So that toys R us had really high ceilings, which makes it difficult for either hanging something from the ceiling or, you know, just having a big volume between our ceiling and then then the roof point.

Envelope constraints a lot of these buildings are designed cheaply, so they don't necessarily think about a static or windows or, you know, thinking about where the entry point is and not thinking about anything else.

So we are often faced with situations like this where we have big blank walls.

So do we want to how are we going to do that or are you going to put signage there?

Are we going to make it an interesting element for the facility.

And then also loading dock locations.

So we've got that really deep floor plate.

Where to where is all the services coming in for those sites.

And then in the opposite end of that, this is that Webster Place project, the former Barnes and Noble.

It had all windows and not good windows.

So there was no draft, there was air, and there was a lot of things that we had to make better because it just didn't work for the function that was going in that building.

So those are some of the building constraints that we think about.

Moving on to coordination.

So this is working with our trade partners, our engineers, our construction partners, and thinking about after we've gone through design, how are we building this, you know, in an area that usually has neighbors.

So this particular site is that toys R us, there were a lot of constraints around access for the construction teams, locating things that they needed to keep on site.

Well, you know, TJ Max is operating every day.

So a lot of coordination with landlords and timing of things, fire department needs and things like that make it very difficult.

And this was a site that was a little bit more rural when we go urban.

So that Webster Place project that's in the heart of downtown, we're surrounded by busy streets and easements that we have to consider.

And how are we pulling materials in.

So we had to utilize on that project a an alleyway that I don't I can't point to it, but towards the right here we have a drive through for Chase.

So we were coordinating with how are people coming out of the Chase Bank and how are we delivering materials to our second floor ambulatory surgery space.

And we've got DV bikes.

So those bikes you can rent located here.

So there were just a lot of constraints around the building for actually getting construction to work.

And on the first floor of this building they did the clinic.

So they had the prefab exam room pods.

And they had to deliver those big, those big pieces in as well with all of these constraints.

So the other thing that we will do with our engineer partners is scans of the building.

So taking pictures point cloud references so that we know what's going on.

We always try to do this as early as we can.

Once we know we have a building and sorry, which site we're going to use so that we can really understand what the existing conditions are, because there's always surprises.

Speaking of surprises, the Webster Place project, the former Barnes and Noble had an escalator going up the middle of the building.

So giant hole essentially, which made the second floor very wavy.

And guess what was going on in the second floor operating rooms?

So we and we weren't able to figure we weren't able to get into that building early enough to understand really what was going on with the structure.

So we they had gone through signing all the contracts and everything to, to secure this building.

Once we got in, we started to the, it just started to unravel and we started to learn all of these things.

We went through with this particular project, I think well over 30, 40 options to figure out how to lay this, the orgs out.

That would make them okay to be able to function on this second floor.

We even looked at options where if we completely replant it and put them on the first floor, does that solve our problems?

It was just a series of other things to think about entry points and and stuff like that, that, that forced it to be on the second floor.

But all that to say, get in as, as soon as you can to understand what what's going on in the building to help avoid these things they ultimately wound up building.

I think they call them kingpost.

So really strong structural elements from the second floor up to help solve with this problem.

They were looking at here we go.

They were looking originally as one option vibration dampeners underneath the oars.

And those are very expensive.

They use those a lot in like high rise buildings, like maybe $1 million a pop.

And so it was just an expensive option that they considered.

Ultimately, they wound up building additional structure on the second floor and were able to manage that that issue according to that.

So that building was the gift that just kept on giving.

But it it just opened a couple months ago when they were very pleased with it.

So I'd like to think that it was all worth it in the end.

Prefabrication.

So this is another thing that we think about on every project.

And what you see on the screen is the the warehouse.

That advocate has I think it's bolt construction actually owns it, but all of their prefabrication comes out of this facility.

So any clinic that has, you know, any clinic, essentially items come from this facility towards that.

And there's an economy of scale that comes with us.

So because clinics are small, the prefabrication works well financially when you can do it a lot, when you can build a lot of things.

So it works well for very large hospitals, for an outpatient facility.

This is how they achieve that is they just crank through exam rooms, MEP racks in various things like that through here.

So they're able to achieve that.

A common economy of scale because of the quantity of buildings, not the size of buildings.

This is just sort of the history of advocates work with prefabrication.

They started with prefabricated walls, exterior walls and then as well as interior walls.

And then they went to MEP racks.

And then around in 2019, actually, the first advocate project I worked on was the first fully prefab building.

So the clinic portion was all built in these pods that you see kind of on the the right side here.

And then the front of it was stick built.

So it was it was a pretty cool achievement for them.

And then just to give you kind of a side by side.

So that's the the model, the computer model.

And this is it actually built at the toys R us area.

So you see the the exam room and then above it are the MEP racks that they do prefab.

All right.

So application.

So what is the standards actually look like.

This is something that has been an ongoing sort of lesson learned a lesson always learned over the course of every project they like to think about how can we improve.

So the term standard is a is a personal pet peeve of mine because people will like to use that word for kind of anything.

But really it's I believe it's when a health system defines well, we want this particular room to always be like this maybe 90% of the time, and then maybe we have some rooms that are more typical.

They have a lot more opportunity for variability.

So understanding how to understanding how someone defines the terminology is very important.

So for a typical exam room and this is a standard component for advocate out there constants are all of the built in pieces.

So it's the the door size the general room size and then casework.

So all those things that can be prefab those are standard where we get variability is within the medical equipment that goes in there.

And then sometimes the room sizes can adjust depending on the project.

But the variability really comes down to the specialties of clinics that they serve.

So.

So these constants as I was mentioning the door size room zones.

So every exam room is set up the same where we've got a patient side and the staff side and then typical casework.

And then those variables as I mentioned really come down to the specialties.

So, so equipment as being the prime driver.

Sometimes we can get depending on the building.

Sometimes we can get exterior windows into exam rooms as well.

Okay.

So that typical clinic pot I was talking about this is this is a basic diagram of what I mean by that.

The green boxes are the exam rooms.

And basically the patient flow comes kind of out on the outside of it.

The staff zone, which is mostly furniture spaces, you know, charting and different documentation area for staff as well as things like medication, clean supply.

All those services are within the blue area, so staff can kind of flow behind the scenes on one side of the exam room, and patients and families go to the other side.

Over the course of this development.

One thing advocate has has really laid out there is that they want their staff spaces to have daylight.

They've just gotten so many, so much feedback about that, that that is something we try to incorporate in all projects.

And the adaptive reuse projects make it a lot more difficult than other projects.

Also, within a typical pod, we use wayfinding, so color trying to define which area a patient can navigate to.

So color signage and things like that.

The new model they're trying to do is self rooming.

So if you are you check in at a clinic you get a badge and then you find your way to your exam room essentially.

So wayfinding is a huge component to do that.

Typical pod size.

As I mentioned this can change.

And it does have a lot of variability within adaptive reuse environments.

And then this I love this slide because it just shows you sort of how we've taken those standard components and laid it out in all of these really unfortunate shape and size of buildings.

So, so and those are the clinic spaces I mentioned daylight earlier.

The let's see, these two pictures are are both adaptive reuse.

And the one on this side was a former gymnastics center.

We didn't have access to window walls, so we put skylights in for them.

And then this was a was the former grocery store.

And it was again like one of those really long and deep floor plates.

And we use barrel light for to, to really try to pull daylight in for the staff.

So it's, it's a bit layered, but you can still you can still get some daylight there also that same project, it was located right next to a pond.

So we were able to locate staff space along that and try to take advantage of that location.

And then back to that Webster Place project.

Early on when we were doing the feasibility study, it a lot of components within this facility drove that the clinic would be on the first floor, and that the ambulatory surgery center would be on the second floor.

And then once we got in and started developing, understanding what the existing building was like, we started to play with that a little bit because we had to.

But opportunities within some of these spaces are that it can drive a solution forward a little quicker than, than maybe a brand new site.

And then this is that Webster Place project as well.

So I really like this picture because it shows you what it came from and then what it's doing and sort of the process in between.

All right.

So maybe this might be what you've been waiting for.

The next frontier.

So what how have we taken all of this knowledge and started to think outside the box?

This is the oil change station that we started studying.

Who remembers Covid?

So this.

Yes, this was that around that time there was a doctor with an advocate, health that really wanted to try and understand what it would be like to have a drive through testing center.

We had several different opportunities that came about new construction, a car repair station, an oil change station, and another oil, a lot of oil change station.

So we were trying to come up with a sort of a standard for what what this would be.

So the module for this one became your exam room is basically your car.

And then, you know, where do we locate our staff related to that.

Then all of the things that go along with having a car trying to treat a patient in their car, right?

So we basically came up with a new module for this, and we tested that within these different locations.

And ultimately the the one that we landed on was a was an oil change station.

So you can see we've kind of wrapped the side of the car bay with our, our staff service area.

Another key component that we hadn't really had to think about before was really the site coordination for how patients would arrive.

What is that process step by step?

And a lot of this took into account technology to we talked about like the sort of the screens that McDonald's used like do you, you know, are you typing in things before you get to the, the actual car bay?

And then what is what is that process really look like?

So it was a fun project.

It never actually came to fruition, but it was a fun project to go through and sort of think, you know, hypothetically about how all of this would work.

So again, just a little bit more detail as to what that that typical module turned out to be for this project.

So key takeaways for this thinking about the site location being strategic, about where we're picking what locations, we're picking, what customers were going to serve and how that works financially for the system.

What available buildings are there?

Is it a building?

Is it just a plot of land in our we are rebuilding new and then in particular maybe a little bit more coordination with the team members and then finding out where we can be flexible within our system standards, and then just thinking outside the box and trying to to widen our perspective with that.

So with that, I will open it up for questions.

Thank you so much.

Wonderful presentation and right align with the studio project that we're working on.

So students for this class and also studio because I know some of you are in this presentation also.

So who wants to ask the first question.

Anybody.

Okay.

Grace.

What in your experience has been like the community response when these spaces are put into clinics?

Like are they excited or kind of skeptical?

Like what's the response?

Like most responses that I've heard, they've been very receptive and very happy about having access to care more immediately within their within their communities.

Cassie.

I'd like to hear about the staff corridor between the rooms because I, I did a little bit of practice in healthcare and I heard a feedback of the nurses.

It's if it's too narrow, it's kind of stuff.

They feel stuffed.

Okay.

Yeah.

Let me.

I'm gonna pull up a picture.

Yes, that's very right.

That's very true.

The dimension of that is important.

And here's two examples.

So this one is a very skinny staff corridor where they have their backs to the exam rooms.

We've always tried to widen it so that you have something a little bit more like this.

This is actually an on stage off stage.

So your patients are walking kind of through here.

But that width that dimension is something that we would we would do in either scenario.

And also if it's too skinny noise can be a concern as well.

So there is kind of a magic dimension considering all of those things.

But sometimes you get stuck and have to and have to do that.

But yeah, that's a good question.

So I will ask one question that most of the students who are not here from the studio were asking.

So we're working on a on a project which is somehow like adaptive reuse, more renovation.

It's focused on renovating an older facility and changing some aspects so that it better responds to patient needs.

For example, this facility has all double patient rooms, and it's a mental and behavioral health facility.

And we're working on maybe transforming some of these rooms to a single patient rooms.

So what are some of the challenges when we are transforming a patient room?

Let's say, for example, there were questions from student sites side regarding moving the bathroom.

So with the costs and challenges, how feasible would it be if we want to, let's say transform and inboard, you know, bathroom in a patient room to an outboard or vice versa.

Yeah.

I mean, that could could be very challenging.

I think it depends on what's going on on the within the building where the structure is, where we're plumbing lines are various things like that.

What are you what are you seeing within the building that you have that is constraints for that I see.

And what about the cost aspects like how mindful should the students be of the costs when they are working on these renovations as a student?

Is that a is that it's a real world project, so they have to account for it, although they might not have a good idea about the cost estimates, but we encourage them to consider it.

Yeah.

Yeah.

I mean it's important.

It's always something that's going to drive the the design of the project.

And that sometimes does dictate the design decisions that you can do because you just can't afford.

So being strategic about where you're spending money is probably like, why are we doing something here if we're if we're moving a plumbing line because we think that the bathroom should be inboard versus outboard, like, what is the the trade off of that?

Awesome.

And George, how do you know I'm not going to do Carioca?

Megan, thanks for an excellent presentation.

And to the students you may want to look at the video of this when it's up on PBS.

I, I couldn't detect one stumble or mispronunciation or or you could be on TV.

Thank you.

This is years ago, CRS.

I don't even know if you know who that firm is.

Cut out.

They started here, they became worldwide, and then they all died.

And the firm dried up and blew away.

They were looking at educational facilities and junior colleges, and nobody knew what a junior college would imply.

So they compiled a group of junior colleges that they'd done, and they turned it into a book.

I think you have a book here, certainly an article.

But this is this cuts to the heart of so many communities across our country.

Could you for a moment go to the was it the Webster one and pause on the aerial photograph of the of the building and the parking.

This one?

Yes.

That one.

There was an aerial drawing of looking down.

Oh the drawing.

Yes.

Oh, I did something.

Hold on.

Time is going to come back.

This one, I think, is what you're talking about.

Then you had one showing all the parking from a satellite looking down.

Well, I don't want to take your time with this.

I think it was this one.

Right.

Well, we can use this one.

Okay.

In this book that you may or may not.

Right.

Things like square footage cost per square foot.

Would you have a helipad for.

This is in a shopping center.

Where's the hospital?

The context of if you go here, how is this linked into the health system.

And yeah.

And I think that's very important.

You can't show everything.

Yeah.

The health system is very I think it's it's kind of off in this direction, but it's very close.

So that was that was strategic about this one.

You've taken an area.

How did this happen at HDR?

Because I think HDR was Pranav and Fernando have images of doing 1000 bed hospitals in Saudi Arabia and everything.

Did did they ask you to do this or did you ask them that you wanted to do this?

How did I get involved with the advocate?

I when I was hired, I was put on it was an opportunity and I was I was put on it.

So you seize the moment.

I seize the moment.

Yeah.

Well, did you ever take a public speaking course?

I have not.

No.

I'm going to give this back because I don't want to.

Dominating.

Thank you, thank you, thank you so much.

And Danny.

Thank you.

Thank you for your presentation.

So originally I was going to ask about the challenge of getting daylighting into, like, patients bases and staff spaces.

But I do think you touched on that.

So my other question is with like a ten year lease for a lot of these locations and prefab modules, do y'all plan for like redesign or renovation throughout that lifespan?

That's a good question.

I, I don't know that it's come up yet because it's still fairly new, I would think certainly for certainly for the new builds, the new construction, they would they would do that.

A lot of these spaces where we have fixed footprints, the adaptive reuse we build in shell space.

So we'll say they they'll project maybe I need another clinic pod in five years.

So we'll we'll size that and then they get a shell space for that.

So we do some of that thought early on within the project okay okay.

Thank you.

Awesome.

Thanks.

And I have another question.

If you have no other student asking the project that you presented with the operating room, it was absolutely fascinating.

And just considering how complicated or our projects are, it would be very difficult to accommodate ORS in existing buildings that are non healthcare.

So with that project that we presented with a damning system and issue of vibration, and the solution turned out to be quite costly.

Yeah.

How did that client actually respond to that.

That's a good question.

I think it was a lot of we have committed to this, so we're going to make it work.

So we did present several options to help think about what the solution could be structurally for it.

And we wound up not going with the dampeners.

We we went with the, you know, sort of stick built additional structure.

Let me find it.

This one.

So they actually there was no structure from the ceiling.

So all the blue pieces are brand new structure that they built on the second floor to serve this.

So it was quite closely.

It was in a lot of it was just because we couldn't get into the building soon enough to understand what that was.

So and was a was there a trade off with not using solution A just because of the costs and transitioning to the structures?

Yeah, I think it did come down to cost pretty much like what what is the what makes the most sense.

So this served not only stiffening the the slab that was on the for the operating rooms, but we also attached all of the structure for the ores, for the lights and booms to this.

So it was there were several things that we were trying to achieve with one solution.

So that's how we wound up, wound up with this.

And I will say this is the first ambulatory surgery center for advocate health.

So in addition to all of these building challenges, it was the first time that they were they were building an or in an outpatient environment.

So a lot of a lot of challenges, a very challenging project.

Well, if there are no other questions, I think Megan will be here for a few minutes.

Unfortunately, she will not be able to join us for the studio review at this time, but we will have her in the future.

Studio reviews.

So again, thank you so much for joining us.

Thanks for having me.

It was a wonderful presentation.