2015 August-September

 

Cancer is a cruel opportunist, always taking away. Though lately, modern health care has won more battles against the disease than it’s lost. And in Missoula, Montana, one facility is a fine example of how patients with the disease receive comfort with treatment. It’s smart, deep-down comfort and energy savings from Mother Nature herself.

The new Community Cancer Care facility at the Community Medical Center benefits from a system that gives new meaning to comfortable, convenient healthcare.

“From the outset, the main design criterion of this project was patient comfort,” said Dennis Greeno, partner at OZ Architects, the firm that designed the facility. “From the floor plan that minimizes patient travel inside, to the heating and cooling system at work behind the scenes, the goal to provide comfort for patients was woven into every aspect of the building.” Input from staff and patients weighed heavily into the building’s design.

The 30,000 square-foot, state-of-the-art cancer treatment facility, also referred to as the Oncology Center, rests a mere 40 feet above the Missoula Aquifer. The massive underground aquifer is all that remains of prehistoric glacial Lake Missoula, which at one point held as much as 600 cubic miles of water – roughly half the volume of Lake Michigan.

According to the University of Montana, the aquifer flows at three to four feet per day; a rapid pace compared to most aquifers which move that distance over the span of a year. In Missoula, the water is consistently around 50°F. It’s the ideal resource for groundwater cooling applications.

To make good use of the aquifer, the Oncology Center uses a “pump-and-dump”, groundwater cooling system to tap the aquifer. Water is drawn from the ground, pumped through a large plate-and-frame heat exchanger, and injected back into the aquifer.

“The Montana DNRC (Department of Natural Resources and Conservation) handles well permitting here,” said Adam Perine, Sr. Hydrologist with NewFields, a national environmental consulting firm. “If water use is non-consumptive, and under 350 GPM, it’s a pretty simple process to acquire the correct permit.” Perine designed the three wells that serve the facility. Although the system only calls for 300 GPM, the wells have been tested at 500 GPM.

“It’s the most holistic approach to geothermal cooling,” said Jared Swartz, office manager for Associated Construction Engineering Inc. (A.C.E.), the company that designed the mechanical, electrical and fire suppression systems at the Oncology Center. “No compressor, no refrigerant; just a pump and a stainless steel heat exchanger to handle the building’s 1M BTUH cooling load.”

 

 

 

 

 

 

 

 

 

 

 

 

 

Tapping the aquifer

“The pump-and-dump cooling system isn’t that unusual here in Missoula,” said Cory Hanninen, project manager at 4G Plumbing and Heating Inc. “The system is designed to bring in groundwater at about 53 – 55°F, and return it to the ground at roughly 65°F. The aquifer is so huge that every building in Missoula could use it for cooling and it wouldn’t make a noticeable effect on the source temperature.”

The cooling system that A.C.E. designed stems from redundant, 10-inch bore extraction wells, each 130-feet deep. Each supply well has a 20-HP submersible pump. Groundwater moves through the 350-GPM plate-and-frame heat exchanger, and is then returned to the aquifer via an injection well. On the building side of the big heat exchanger, redundant 15 HP, VFD-powered Taco FI3011frame-mounted, end-suction pumps circulate a glycol-based solution to rooftop air handling units that supply ducted AC.

“We’ve completed roughly 25 buildings in Missoula that tap the aquifer for cooling,” said Swartz. “It’s more prevalent here than anywhere in the state, but they’re starting to follow suite elsewhere along the western side of Montana, where the water table aquifers are large and easily accessible. Last year, we designed a similar system for a large hospital in Kalispell.”

The new Kalispell Regional Medical Center Surgical Services Addition uses two, 1,200 GPM wells to feed a similar but more complicated ground-source cooling system. The water is used to provide direct cooling similar to Community Medical Center. In addition to the direct cooling, two more heat exchangers are piped in series to provide condenser water cooling for two 350 ton water cooled chillers. The return water – at approximately 65°F – is then used to cool a 240 ton IT load prior to be injected back into the aquifer

A.C.E. and 4G work together routinely. Both Montana-based firms are accustomed to the design factors seen in the intermountain west; long, cold winters with high snowfall and short, hot summers with very low humidity.

“We’ve concentrated on medical facility work and have been very fortunate to work on many facilities throughout the Northwest. On average, we complete $250 million in construction each year, with medical facilities accounting for more than half of that,” said Swartz. They’re a diverse firm with 30 employees in five different locations; Missoula, Belgrade and Billings, MT; Minot, ND; and Sheridan, WY.

Similarly, 4G’s focus is commercial and industrial work, also with specialization in hospital work. The mechanical firm’s 45 employees have worked on many medical facilities throughout the Northwest.

Warmth, healing

While the groundwater system at the Oncology Center is a unique way of cooling a building, the heating side of the system includes its own uncommon elements. There are some interesting and underutilized approaches to providing patient comfort.

“There’s not one pleasant thing about receiving chemotherapy treatments,” said Swartz. “So a design criterion for the heating system was to make the physical atmosphere as comfortable as possible for patients that will already be uneasy and distressed. The chemotherapy infusion rooms have in-wall radiant panels that provide the first stage heat.”

Two 1.5M BTU, condensing Aerco Benchmark boilers are set up in lead-lag fashion. A 300 MBH, Taco brazed-plate heat exchanger pulls heat from the building’s 180°F, six-inch primary heating loop to supply 120°F water to the radiant panels. The 16 small rooms are split into four zones.

The low-temp branch stemming from the small heat exchanger also heats 2,400 square-feet of sidewalk outside the main doors. Before the building approach was poured, 4G installed three-quarter-inch Watts Radiant PEX+. The concrete is kept dry throughout Montana’s October through April snow season; adding further to patient comfort, safety and convenience.

For common areas, offices, and supplemental heat to infusion rooms, high-temp water is pumped to the rooftop air handler and multiple VAV Boxes throughout the building. The big primary loop uses a 7.5 HP, VFD-powered Taco base-mounted pump.

“We like to use Taco and Watts Radiant products because of the local support we get from Vemco Sales,” said Hanninen. “Beyond that, it’s good to know we have the performance we need and manufacturers willing to stand behind their products.”

The plumbing for the Oncology Center was completed by 4G as well. DHW is supplied by a 100-gallon gas-fired water heater so that the boilers don’t need to run through the summer.

Challenges

The groundwater cooling components came together smoothly, and the radiant portions of the project were no challenge for the 4G crews.

“But we were up against a fast-track, nine-month timeline,” said Hanninen. “Between drilling, plumbing, heating, cooling and working around other subcontractors, we had our hands full for most of 2013.” Construction for the first phase of the project started late in 2012, and wrapped up this past August. Phase two, which will offer radiation oncology services, is slated for spring completion.

Western Montana doesn’t see seismic activity like California, but Big Sky Country isn’t inactive.   At the Oncology Center, seismic restraints were used for potable water lines, and the pumps and boilers were anchored to the concrete slab. On the roof, the large air handler rests on a seismic-compliant Vibro-Curb unit with integral spring vibration isolation.

The big mechanical room provided ample space for the main system components, but in-ceiling space was at a premium. Ductwork left minimal room for hydronic piping, electric, fire suppression and domestic hot water lines.

Three’s company

Montana is the fourth largest state by land mass, but it’s 44^th in total population. A population density of 6.8 inhabitants per square mile simply means dealing with the same folks more often. Rep, installer, and engineer relationships are no exception.

“4G works frequently with A.C.E, and it definitely benefits both companies,” said Hanninen. “But our rep relationships are just as important. In Montana, we’re farther down the supply chain for a lot of things. Nothing is right around the corner, so Jared and I both lean on Dennis Nisbet, at Vemco Sales, a little harder than a contractor in New York might have to.”

“We do our best to be a resource to both firms,” said Nesbit, who is outside sales for the 35 year-old Northwestern manufacturer’s representative firm. “We get involved in as many projects across the state as we can. A.C.E. usually designs the systems and sizes boilers, pumps, etc. I help them select the appropriate equipment for the application. As you can see at the Oncology Center, we often get into some unique applications.”

Nisbet worked closely with Swartz as he did most of the front-end engineering work at the Oncology project. “I think our biggest challenge was staying under budget and ahead of the 12-month design/construction timeframe,” said Swartz. “Dennis definitely helped with both, as he does on all our projects.”

Affordable healthcare

The fast-flowing aquifer, which is constantly recharged by the Clark Fork River, is a boon to the Missoula community. When coupled with engineering and mechanical aptitude – it indirectly makes healthcare more affordable for those nearby.

“The hospital received a $43,000 rebate from the local utility for installing the groundwater cooling system,” said Swartz. “But we’ve calculated that the system also provides an energy savings of around 150,000 kWh per year when compared to a traditional chiller system – meaning an additional benefit of $11,000 or so per year.

“Before this building was complete, we enjoyed very high satisfaction with our cancer treatment services, but we wanted a facility that could offer even more,” said Devin Huntley, VP of operations at Missoula Community Medical Center.

“With the new facility, we set out to provide the best atmosphere and service possible,” said Huntley. “Patients and family members now tell us every day how much they love it. From an administrations perspective, I can honestly say that this is the first project I’ve worked on in a long time that far exceeded my expectations.”

The building is positioned to take advantage of the mountain views and the soon-to-come healing garden. Few people who enter the facility know about the natural resource that lies beneath their feet, helping to make the building a reality.

By Jim Hinshaw

I just heard an excellent sermon on story telling and how stories can help sell our cause, products, or even point of view. It dealt with passages in the Bible about Nehemiah and how he sold the King on letting him go help rebuild the wall around Jerusalem, which had been destroyed by battles. He not only got the King to let him go for several weeks, he asked for and received letters to get him through hostile territory safely, and a letter requesting lumber for the rebuild. So how does this apply today and our industry?

Telling a story is the best way to present your case or influence your customers to consider key variables in making a good sound decision about their circumstance. But not every story is effective and beneficial to the listener. Consider the movies and the innumerous books available that people read. They all tell a story and the audience anticipates every movie frame and every page of the book. But not all movies are good and all books do not become the number one best seller. Some movies and books simply do a better job of telling the story than others. They are more convincing, compelling, and capture the audience’s attention. Therefore, it takes thought, practice, and several key elements to consider. Being unskilled in this, it’s not recommended to simply wing a story, but detail it out to master the art of telling impactful stories based on various customer circumstances.

Consider the effectiveness when you’re with a customer discussing an issue they are having with their water heater. Or perhaps their hydronics system or some other product used in a hi-rise building. With experience, most of you have had other customers with similar issues and circumstances in the past. You can help lead that customer along to an effective decision they can have confidence in based on a compelling story you can tell them about a similar circumstance and the outcome of that circumstance, whether good or bad. You can boldly lead them to conclusions about a particular product and service based on the effectiveness and truthfulness of that story. But it’s only effective if told correctly and with relevance to their situation.

Therefore, consider these important concepts.

Have a goal: What are your audience’s needs, wants, and what do you wish to accomplish with your story? What concept do you want to highlight or share?

Grab their attention: Every successful story has a “wow” moment, where the audience is in your shoes. They not only understand what you are sharing but they have experienced a similar circumstance in many cases.

Prove your point: Show the end result of what happened to you or a previous customer. Allow them to easily conclude what was learned and how it applies to them and their circumstance. It’s simply not enough to have a great story that does not apply to your customer, it must be transferrable to them so they see themselves in that same situation.

Engage: You can engage your audience and customers in many ways. Using humor, sadness, children, animals, money, and things we have all gone through can be beneficial at times. The effectiveness in human emotion is a very powerful tool when used with honest intent to help another such as your customer.

Empower: Show how the concept you are sharing can help your customer in making a decision on a particular product or service. Many decisions by customers may be made by the immediate financial cost without considering the long-term consequences of their decision. In some case, the long-term result could cost them much more financially. Telling a story can help them come to a proper conclusion and decision they can be satisfied with and thank you for. In addition, this usually results in more business and revenue.

I’ll give you an example of how this works in my life? First, I understand that my goal is to help improve sales and profits for my customers. Many of you may recall a story I’ve told about my dogs Pixie and Popcorn. Pixie was our beloved Staffordshire Terrier who was part of our lives for 14 years. We had a friend who is a vet come to visit us. As she was petting Pixie, she suddenly stopped and said “uh oh!” Nobody ever wants to hear “uh oh” from a dentist, doctor, or a vet as it means things may cause you some pain and money. I asked her why she said “uh oh.” She said, “I feel a tumor.” And I replied, “Maybe it’s not a tumor, but maybe a strained muscle.” She quickly responded, “I am a vet, it is a tumor.” My wife asked, “What do we do next?”   “Bring her down for a full workup” , said the vet. I had no idea what a full workup is, but it only took a couple of days to find out. It meant an MRI, blood work, x-rays, and all sorts of things that cost a lot of money.

It turns out she was full of cancer. I said, “We’ll just have to put her down.” My wife May said, “The vet said she could give her some pain meds and the dog may get another year.” So we started giving her pain shots as directed. It began with one every two weeks, then one per week, then two a week. In December, Pixie could not even get up and down the stairs. We knew what was happening and knew the outcome that was about to come upon Pixie and us. So the vet was kind and made a house call. It was as good as something like that can be. She came, we said goodbye to Pixie, and she went to sleep. May and I sat on the sofa bawling our eyes out, saying “Never again, never again”. However, within only 45 days we thought, Noah (our Doberman) needs a new play partner. So we went to a Lab breeder and immediately brought home a beautiful yellow lab.

We took her to the same vet to get her shots, a health check up, and all the things you do with a new dog to keep them healthy and become part of the family.

So here is my point to this story: Did you realize that we took the new puppy to the same person who we paid a lot of money trying to keep our old dog Pixie alive? We paid her to put our old dog down to sleep and were now paying for the new dog. Why? Because she is a trusted advisor regarding everything related to our dogs. We listen and do what she says even when it costs us money, even if she gives us bad news.

You, as a contractor, plumber, or sales rep, need to become the trusted advisor for all of your customers when it comes to anything related to plumbing. By using truthful, powerful, and effective stories, you can become an advisor your customers can trust in and have confidence in to help them make sound and confident decisions regarding their plumbing needs. Some stories your customers want to hear, and others, they need to hear.

Enough for this issue, I have to go take my dogs for a walk!

 

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