LOMA LINDA, Calif. — Using lessons from the past, hospitals across the country are preparing for the unknown. From climate change to deadly pandemics, billions are being spent on safeguarding facilities.
"You're not sure what the conditions are going to be, five years, ten years. No one would've expected COVID was going to hit us," said Eric Schilt, vice president of planning design and construction at Loma Linda University Health (LLUH).
After more than a decade of planning, the medical center opened its new $1.2 billion campus in August.
"When you design a hospital, you've got to be able to design it for 50 or 60 years," said Schilt. "What's hard about health care, in my opinion, is you don't have to be experts at just health care. You have to be experts at a lot more."
In their case: earthquakes. Located less than a mile from the seismically active San Jacinto fault, the 16-story tower features new technologies to meet updated state seismic codes for acute care facilities.
"A lot of large hospitals have employed this sort of technology; this is the latest version," said Schilt.
Building standards of the 21st century are rooted in lessons learned over decades.
The new hospital sits on 126 base isolators, seismic devices designed to absorb the shock of an earthquake and reduce the shaking of the building.
Using 27,000 tons of steel, officials with LLUH say it's the heaviest building per square foot in North America.
"Have the ability to absorb movement through the isolators, but we also have a tremendous amount of steel in the building for strength," said Schilt. "So, we kind of have the best of both worlds."
He says the seismic devices serve a role beyond structure resilience.
"For the thousands of people that would be in a building during a seismic event, they are going to not have that same level of psychological trauma by experiencing such intense shaking," said Schilt.
The new campus is designed to be fully functional after a large-scale earthquake.
"Earthquakes that would be expected over a period of 50 or 100 years in this region," said Schilt. "Sustainable for up to 72 hours without any outside electricity, any outside water, any outside utilities."
Tampa General hospital is also planning decades ahead, bracing for floods and expanding facilities to support the growing population.
Some states are grappling with challenges never-before-seen. Hospitals faced power, water and food supply disruptions in Texas during an unprecedented stretch of below-freezing temperatures.
"It's impossible to predict, but you try to design flexibility. And that's the shape of the building; it's thinking about infrastructure for the future."
The new LLUH campus houses both the 16-story Medical Center and 9-story Children's Hospital tower, though they operate independently.
In a mass casualty incident, Schilt says one emergency department could provide extra space for the other next door.
Post-COVID, he says hospital designers will likely account for patient surges.
"But you also don't want to just build a bunch of empty beds. That is a significant problem in and of its own," said Schilt.
He says flexibility is critical when building for the future.
"Something that you know is going to be there for the next 50, 60, maybe even 70 years."