First free-standing infectious disease hospital built in US in over 50 years

Many Americans think tuberculosis (TB) has been eliminated in this country. But, while it is no longer as common or deadly as it was decades ago, it is estimated that more than a third of the world's population is infected with the disease. The new Texas Center for Infectious Disease (TCID) hospital was designed to provide patients with the care and treatment needed to help curb the resurgence of TB in the United States and reduce the drug-resistance of strains developing worldwide.

“Our focus throughout construction was not only on schedule and within budget, but also meets the needs of patients and provides a comfortable, healing environment.”

O'Connell Robertson provided architectural, engineering and interior design, and JE Dunn provided construction services for this one-of-a-kind facility, the first free-standing infectious disease hospital built in the United States in more than 50 years. The 60,000 square foot, 75-bed hospital replaces aging facilities on the Texas Department of State Health Services campus in San Antonio. The hospital also will house the Heartland National TB Center, a TB regional training and medical consultation center funded by the Centers for Disease Control (CDC).

"The TCID is one of only six hospitals like it in the United States, and with 75 private rooms, has the largest concentration of air isolation patient rooms in this country," said TCID Director James Elkins, FACHE.

A patient's stay with TCID typically ranges from six months to two years, during which the level of isolation required varies. All patient rooms have been designed as airborne infection isolation rooms, with the heating and air conditioning ventilation (HVAC) system designed to allow air pressure in each room to be changed from "negative" to "neutral" when a patient is no longer contagious. This allows patients to remain in the same room throughout their stay, while maximizing energy efficiency. Patient rooms also were designed to be more home-like than a typical hospital room to accommodate long stays.

To address TCID's special care and treatment needs, the O'Connell Robertson team developed specialized engineering and architectural design solutions to achieve the following goals:

• Support patient treatment and medical care
• Ensure the safety and security of patients and staff
• Maximize energy and operational cost efficiencies
• Incorporate sustainable finishes and mechanical systems that are easy to maintain

"This project presented a number of unique architectural and engineering challenges," said Richard Burnight, AIA, ACHA, managing principal of O'Connell Robertson. "Our firm has more than 60 years of innovative healthcare design experience, which our team was able to draw upon to design a highly specialized medical facility. Complex infection and isolation protocols for both staff and patients were cost-effectively established and controlled, while achieving an efficient, patient-centered environment that truly enhances the quality of their long-term care."

JE Dunn collaborated closely with the design team to create an in-place patient room mockup to test and ensure complete isolation of the rooms and to identify any barriers to achieving the intended design. JE Dunn and O'Connell Robertson utilized the latest technology, including building information modeling (BIM), to support the design and construction process.

"We are proud to have been involved in this amazing project and to have worked with great partners, including TCID, Texas Department of State Health Services, Texas Facilities Commission, O'Connell Robertson, which designed the facility, and a host of hard-working consultants and subcontractors," said Steve Welton, JE Dunn's Project Manager. "Our focus throughout construction was not only on schedule and within budget, but also meets the needs of patients and provides a comfortable, healing environment."

Construction began on TCID in February 2009 and was completed within budget and on schedule. TCID staff and patients began the move-in process in July, with a ceremonial ribbon cutting scheduled for September 22.