Duke Medicine Pavilion

Life Cycle Analysis for a Life-Saving Facility


Location: Durham, NC          
Client: Duke University Medical Center
Cost:  $243 million
Size:  611,000 SF, 8 Stories
Expertise: Structural Engineering
Architect: Perkins+Will
Certification: LEED Gold Certification

Duke University Medical Center’s 200-acre campus is home to one of the top-ranked hospitals and one of the top-10 medical schools in the nation (U.S. News and Report).  Duke Medicine Pavilion was planned as a critical part of the Center’s long-term growth. It was also the largest expansion of the hospital since it opened in 1980. It was set to open July, 2013.  And since the hospital was to remain fully functional during design and construction, there was no tolerance for operational disruptions.

The Medical Center had turned to Walter P Moore and Perkins+Will in an effort to put the project on a faster track. We were tasked to create a sense of urgency and speed the project toward completion.  By the fall of 2009, well before design was complete, we issued an early concrete construction package. This allowed construction to begin, accelerating the project schedule.      


Stand Out, Blend In
Duke Medicine Pavilion is the front door to Duke Medical Center’s campus and to a new complex of clinical facilities. Perkins+Will designed the addition to reflect the campus’ existing neo-Gothic style architecture. At the same time the new building was to clearly announce the hospital’s modern direction and advanced medical programs – along with an emphasis on patient comfort and care.

In addition to numerous patient and family amenities, the Pavilion adds 160 critical care beds, 18 operating suites, and 64 intermediate care beds.  Patient rooms are larger. Floor-to-ceiling glass windows and strategically spaced light wells bring in ample amounts of natural light to help patients in their recovery. Advanced technology is used not simply for medical purposes but also to increase patients’ comfort levels. In addition to multiple traditional MRI suites, the hospital added a dual iMRI suite. Here, two operating rooms flank a center unit housing CT and MRI scanning devices. This technology, which weighs as much as an average-size SUV (around two tons), comes to the patient. It rolls into and out of the flanking operating rooms suspended on steel rails. On top of this – literally – mechanical systems run just above the tracks of the scanning equipment. To minimize vibration and electrical interference, the mobile MRI and CT devices were detailed to be isolated from the main structure.

Collaborate, Communicate, Coordinate
Collaboration, communication, and coordination, along with our use of Building Information Modeling (BIM) were key to sticking to the Pavilion’s schedule and avoiding conflicts with existing utilities and building foundations.  

To help get the project back on schedule after the change in design teams, Walter P Moore issued the concrete construction package eight months before the architect’s final package. As design progressed, we incorporated late owner and architectural design changes into the structure, keeping the contractor in the loop to avoid slowdowns and rework.

Like many healthcare campuses, utilities serving existing buildings created interference with column foundation locations for the new facility. Early in design, Duke made it clear that no buildings were to be taken out of service, even temporarily. To overcome this challenge, we designed caissons to snake between the existing utilities and foundations, along with a series of complicated pile caps and grade beams to support the building columns.  During construction we responded in real time when the unexpected arose.

Other areas where precise coordination was essential included a 300-foot long pedestrian bridge and three other sky-bridge connectors, along with a tunnel between existing buildings. In every case when interfacing with existing structures, our use of BIM was integral to the collaboration that enabled the design team to connect these separate structures with minimal difficulty.

The Pavilion is the first inpatient facility in North Carolina to achieve LEED Gold status. The design team achieved this largely through a combination of green roof landscaping, energy-efficient mechanical systems, and sustainable building materials. The building was designed to save 3.5 million gallons of water a year and reduce energy costs by nearly 25%. We performed a Life Cycle Assessment of the building to determine the carbon dioxide-related impacts from various structural materials being considered. This earned the design team a LEED Innovation Credit. Since being pioneered on this project, Life Cycle Assessment has taken a more significant role in the LEED rating system. It’s now a core evaluation tool for high-performance Green Buildings.