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Mass General Brigham Integrated Care Center, Salem, New Hampshire

Reimagining the future of healthcare through sustainable patient-centric design

As Mass General Brigham’s first “new generation” ambulatory surgery center in New Hampshire, the Integrated Care Center is designed to provide affordable world-class treatment to patients in close proximity to the communities in which they live. Located in Salem, the Integrated Care center provides both primary care and specialty treatment for patients in Merrimack Valley and southern New Hampshire, eliminating the need for lengthy travel to the Boston metropolitan area. The new patient center brings a holistic approach to treatment utilizing sustainable design solutions that support first-class healthcare operations while minimizing wait times and encouraging real-time patient and staff interactions.

As the Engineer of Record, Arup collaborated with Gensler to develop replicable, program-wide building designs and standards for the network’s future healthcare clinics that can be replicated across multiple sites in Massachusetts and New England. Arup provided MEP, fire protection engineering, energy, IT and AV, lighting, and security consulting services to realize this efficient medical facility.

Project Summary

62,000ft² Healthcare facility


30+Exam rooms

In line with Mass General Brigham’s commitment to sustainability in all aspects of its operations, the design for the Integrated Care Center includes a high-performance building envelope, efficient heating and cooling systems, use of the highest efficiency light fixtures, and the elimination of harmful chemicals in furniture and interior finishes. The facility focuses on the patient experience through the integration of architecture, lighting design, and digital systems.

© Robert Benson Photography / Gensler

Applying multidisciplinary expertise

In collaboration with the project team, Arup contributed to creating a visually inspiring destination for best-in-class care while also meeting multiple layers of technical requirements and sustainability goals. Doing this within a very tightly managed budget was critical to keeping the project on track and was aided by the use of parametric energy modelling. The result was an evolving design that never lost focus of the vision for the center, and allowed for cost management, constructability, and sustainability to remain at the forefront of critical decision making by the client and the project team.

We, at Mass General Brigham, are very excited about this new generation of Ambulatory Surgery Centers that provide affordable, world class care to our patients where they live. Our aspirations for this prototype have been to integrate a patient-first focus to service with high quality design and sustainable operation. The design team has been integral to us achieving those goals at Salem, NH and for future locations. ” John Messervy Senior Director of Design & Construction, Real Estate, Mass General Brigham

© Robert Benson Photography / Gensler

Ensuring healthy outcomes through optimized lighting design

The Integrated Care Center’s lighting design was developed to support the architectural vision of an inspiring patient center with a focus on sustainability and user experience. As healthcare facilities typically require a very high level of energy and other resources, our approach provided a comprehensive system design to ensure efficient sustainable daily operations. Additionally, the architectural lighting for the building was built on an extensive network of controls using both wired and wireless technology for maximum flexibility as well as cost management. The result was a lighting system capable of providing the highest level of user interaction within the various spaces, while balancing performance and visual comfort.

As this is an outpatient center, the project included lighting solutions ranging from highly technical spaces including operating suites and exam rooms to community facing spaces that are utilized for public education on health and wellbeing.

The implementation of highly efficient and effective design strategies, full-range and daylight dimming, high-end trim, and extensive user controls contributed to the building’s robust energy efficiency measures, allowing the project to achieve LEED accreditation.

© Robert Benson Photography / Gensler

Designing for energy efficiency

The Integrated Care Center is a complex facility that includes four operating rooms, a sterile processing department, a pharmacy, and an imaging suite, all of which drive the baseline energy load higher than a typical medical building. To address this demand, we incorporated numerous efficiency features into the design, including optimized façade performance through the use of parametric energy modeling to create a solution that balanced energy, carbon, daylight, and costs. The sites were all reviewed for the feasibility of geothermal wells and photovoltaic panels. Two of the future sites have these fully incorporated into the design while the Salem site has been designed for the future installation of a photovoltaic array over the parking lot.

The high-performing façade also eliminated the need for perimeter heating, and high heat recovery energy wheels within the Air Handling Units to further minimize the heating load. In addition, the building utilizes adiabatic humidifiers rather than steam to reduce fossil fuel use and a split air-cooled chiller removes glycol from the chilled water system to maximize heat transferability. With these systems in place, the building’s energy performance exceeds ASHRAE 90.2016 by more than 30% and achieves a design EUI of 125.

To ensure the highest performing solutions were implemented, we investigated multiple MEP options for the central plant at different sites through a problem solving process that scored each option based on a range of criteria, allowing the client to make informed decisions at each stage of design. While the Integrated Care Center has a high efficiency boiler and chiller solution, subsequent integrated care centers will incorporate geothermal heat pumps and solar photovoltaics.