One of McCarthy's projects will be a build-out of a cleanroom in the outpatient center.

HOUSTON—In the last few years, more total joint and spine procedures, along with MRIs and CT scans have moved to outpatient settings, and moderate M&A activity within the outpatient surgery setting is impacting the industry, according to Becker's Hospital Review. Outpatient migration has been a multi-decade trend and is a topic covered in almost every healthcare real estate conference or industry whitepaper. This theme remains as relevant as ever, as the shift toward outpatient off-campus settings continues unabated this year.

Two projects are soon to begin at Houston Methodist Hospital that illustrate this phenomenon. Demolition, renovation and expansion of Houston Methodist Research Institute's imaging suite and a build-out of a new GMP cleanroom in the institution's outpatient center are expected to be complete in spring 2019.

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McCarthy Building Companies Inc. was recently awarded the two renovation and expansion projects. Within Houston Methodist Research Institute, McCarthy will undertake a complete demolition on the first-level 16,500-square-foot imaging suite, which will be reconfigured and expanded. The project will include significant mechanical, electrical and plumbing infrastructure upgrades, structural upgrades and finishes to accommodate new equipment.

When completed, the unit will house three pieces of imaging equipment including a Siemens 7 Tesla MRI, Siemens 3 Tesla MRI and a PET/CT. The 7T MRI scanner will be the first of its kind in Texas.

The size of the 7T MRI magnet–which weighs 45,000 pounds–and the opening space required to bring it into the facility poses several logistical and construction challenges for the McCarthy team. Positioning of the magnet will require removal of a portion of the existing building curtain wall facade, demolition of an interior stone/concrete masonry wall and 50 tons of magnetic shielding to be in placed in the suite's floor, ceiling and walls. Furthermore, it will require re-routing of existing mechanical, electrical and plumbing infrastructure, all of which will happen while the facility is 100% occupied.

“In order to bring the MRIs into the building, McCarthy will have to remove a portion of the exterior glass,” Damian Lee, senior project manager for McCarthy Building Companies Houston division, tells GlobeSt.com. “Given the 7T is so large, teams will have to demo the stone wall in the existing building to create an opening large enough to fit through.”

McCarthy will also work on a 5,000-square-foot demolition and build-out of a new cleanroom on the third floor in the outpatient center. This project will include approximately 1,500 square feet of a pre-fabricated GMP cleanroom space and 3,500 square feet of support spaces including quarantine areas, storage spaces, offices and three mechanical rooms; and upgrades to the mechanical, electrical and plumbing infrastructure. Additionally, renovations on level two and four will be required to add a new air handling unit and exhaust fans to support the new cleanroom environment.

Specific challenges will include erecting 40-foot scaffolding in the atrium for underfloor plumbing, building three new mechanical rooms and running overhead MEP infrastructure on three occupied floors for new HVAC. The project will require heavy coordination with the cleanroom manufacturer, owners and trade partners to ensure lab equipment is positioned correctly. New HVAC and plumbing equipment will also be required for the project including seven new exhaust gas scrubbers, a new fluoride removal system, RO/DI system, new bio safety cabinets and new lab wet benches.

“McCarthy values and is proud to continue our successful partnership with Houston Methodist Hospital on such transformational and high-profile projects,” said Preston Hodges, McCarthy Houston division vice president. “We look forward to the lasting impact that these projects will have on the institution and the community it serves.”