Pandemic readiness is designed into new replacement facility

Intermountain St. Vincent Regional Hospital’s replacement project is not just a response to aging infrastructure. It’s a forward-thinking investment in pandemic readiness and scalable care for the Billings, Mont., region. The 737,000-square-foot, 14-story facility will feature 243 adaptable patient rooms and design strategies informed by lessons from the COVID-19 pandemic.

“All patient rooms are sized for intensive care unit (ICU)-level care so clearances can be met if the room is converted to an ICU room in the future,” says Amanda Owens, architect and vice president at HDR, the design firm leading the project. “Rooms have modular headwalls designed for easy conversion.”

This universal room concept allows the hospital to scale up critical care capacity quickly. Twenty-five rooms will be equipped with negative-pressure capabilities, and another 50 can be converted.

“Isolation rooms equipped with negatively pressurized mechanical systems for infectious disease containment are designed throughout the hospital,” Owens says. That includes eight emergency department exam rooms, two labor and delivery rooms and additional critical care spaces. Additionally, the emergency department features a dedicated decontamination entrance linked to isolation-ready exam rooms.

The facility also is designed for compartmentalization. “Each patient floor can be subdivided to allow for a unit to be isolated to address an outbreak,” Owens says. “If required, an elevator can be used only for infectious patients.”

Jordan Zepeda, senior manager of infection prevention at Intermountain Health, emphasizes the importance of this flexibility, noting, “This design allows us to dedicate an elevator to infectious patients if needed and also control traffic flow to the dedicated containment unit.”

Mechanical systems add another layer of readiness. All air-handling units can support HEPA filtration, and dedicated pandemic exhaust systems are built into specific rooms. Department-based zoning minimizes cross-contamination, while high-risk areas, such as operating rooms and interventional radiology, feature increased air exchange rates.

Technology adds another safeguard: patient rooms will be equipped with telehealth, and remote monitoring is under evaluation to reduce staff exposure.

Zepeda says the pandemic served as a blueprint for how to design this new facility. “Facilities quickly ran out of negative-pressure rooms, and many ran out of ICU-capable spaces,” Zepeda says. “In this new design, all patient rooms will be equipped to handle ICU-level patients.”

Construction is expected to be complete in 2029.