The Aviv Clinics team at The Center for Advanced Healthcare at Brownwood (CAHB) is focused on the science of aging. In 2020, DPR Construction completed the CAHB’s 30,000-sq.-ft. state-of-the-art hyperbaric oxygen therapy (HBOT) facility providing the medical team with a new gateway to offering data-driven research aimed at improving the performance of the brain and body. Getting this great result for CAHB took close collaboration among project team members, a Lean approach that cut schedule, and a team with the technical know-how to cover every detail in a sensitive environment.

Located in The Villages, FL, the first of its kind in custom-designed hyperbaric suites are housed in one of the largest specialized cognitive therapy centers in the United States.

“This is a first of its kind facility in both scale of deployment and in the United States,” said Bill Hawthorne, a DPR Project Executive. DPR was able to anticipate project outcomes and precision execution by leveraging its self-perform labor force for many of the scopes on this project.

“We’ve set a new standard in hyperbaric facilities. The vision was to be able to offer this unique service and focus clearly on reverse aging in older adults who want to maintain their vitality. We also recognized early on that other people would want access to the facility,” said Dr. Elliot J. Sussman, MD, MBA, Chair at The Villages Health.

HBOT is a treatment where pressurized pure oxygen circulates through an enclosed environment allowing the body to take in increased oxygen levels stimulating regeneration, healing, stem cell and growth factors in the body.

“I was first introduced to the science of hyperbaric oxygen therapy during a trip to Israel by Dr. Shai Efrati (a medical advisor to Aviv Scientific LTD) at his medical center. I was intrigued by the research studies conducted on what the effect of hyperbaric oxygen therapy as administered by Dr. Efrati’s protocols was on a variety of conditions,” said Dr. Sussman. After returning to the U.S., Dr. Sussman stayed in contact with Dr. Efrati and began thinking about how hyperbaric oxygen therapy could be a potential service offered to the community. Coincidentally, Dr. Efrati and his colleagues were interested in expanding the availability of the therapy and began looking at locations around the world to build an HBOT facility including New York, Geneva, Zürich, and London. “I came forward with the idea that the first one should be in The Villages,” said Dr. Sussman. Following a series of meetings and two tours of Dr. Efrati’s existing operation in Tel Aviv, Israel by the project team, the idea to move forward with construction in The Villages became a reality.

“We are pursuing opportunities to conduct more studies here in the U.S. soon on various ways that HBOT can positively impact the brain,” said Dion Atchison, Head of Operations, Aviv Clinics.

Aesthetics Strategy and Uncompromised Lean Construction

Aviv Clinics and The Villages teams provided designer Earl Swensson Associates, Inc. (ESa) with clear goals of their functional, operational and marketing vision for the center including creating an experience of hospitality over the clinical environment.

“The interior architecture has a welcoming, clean and uncluttered brand, with a notable presence of technology throughout the Aviv center,” said Sam Burnette, Principal, ESa.

Working closely with Aviv’s team of global consultants, the project team focused their attention on the details of the design goals of clear wayfinding, upscale locker room and bathing spaces, access to physicians and technical staff areas, and incorporating natural lighting wherever possible throughout the center. Burnette says ESa initially designed the space as a two-story facility but after the teams reviewed a series of alternate designs which streamlined the overall program goals, a one-story design proved to be the best solution and validated the involved costs.

“As with most projects, modifications to interior amenities were needed. However, the interiors brand and quality of materials were not compromised. As an example, the design team and DPR’s team were able to find alternative finishes, lighting, and bathroom fixtures that had equal or better performance than costlier items originally proposed,” said Burnette.

“Utilizing our long-standing relationship with ESa and a Target Value Delivery process our team of Owner/ Operator/ Design/ and Construction we were able to drive outcomes and performance in a highly collaborative environment,” said DPR’s Bill Hawthorne.

Going into this project, the team at Anchor Health Propertiesknew that speed-to-market was a major differentiator.

“We were able to leverage self-performing resources to dramatically advance the project, ultimately shortening the timeframe to engage our trade partners’ expertise and achieve real-time market impact. This early investment in collaborative knowledge-sharing helped to reduce risk, improve quality, and increase value for this project,” said Richard Paddock, Vice President, Development at Anchor Health Properties. Paddock says additional value was also realized through the team’s collective budgeting expertise which provided the opportunity to compress the procurement timeframe early on in the pre-construction phase. “By presenting a development budget with certainty and current market numbers, we helped the client expedite consensus and approval,” said Paddock.

Chamber Design and Installation Coordination

Fink Engineering, based in Queensland, Australia, combined an innovative design approach with state-of-the-art engineering and fabrication facilities to redefine the form and function of medical hyperbaric chambers.

“The rectangular shape is unique to Fink Engineering. We have placed rectangular chambers around the world, but the chambers for Aviv are unique because of their technology and comfort innovations,” said Eric Fink, Managing Director, Fink Engineering. Fink says the chambers at Aviv at CAHBweredesigned to set a new standard for temperature control, lighting design, and technology integration. “The inclusion of tablets for client use is one-of-a-kind. Aviv Clinics’chambers around the world will be modeled after The Villages clinic and have recently been installed in the newest Aviv Clinic in Dubai, UAE,” said Fink.

According to Burnette, the project team was cognizant that the HBOT chambers required direct access to the exterior shell structure for delivery, installation and future replacement.

“Developing solutions as a fully integrated team committed to working together on the front-end while embracing a collaborative approach, the teams shared a similar mindset of being proactive, creative, and flexible throughout the project,” said Katie Jacoby, Executive Vice President, Strategy & Development at Anchor Health Properties.

The project team engaged DPR’s VDC expertise early on to ensure seamless MEP coordination.

“The chambers themselves presented numerous challenges including how to phase the project while awaiting delivery, and then later how to get the chambers in place. The way the construction team figured out how to maneuver them into place was amazing, said Ryan Malloy, a mechanical engineer with Phoenix Design Group, Inc. (PDG)

From designing a complex network for oxygen flow, exhaust, controls, and electrical infrastructure to support the functionality of the chambers, to the coordination of equipment, piping, ventilation, and electrical; the coordination efforts serve as the blueprint for future HBOT facility designs.

“The surety of delivery was paramount for this project as the unique nature of the development required creative planning solutions. DPR’s collaborative approach to preconstruction, procurement and construction planning provided great value to us as a client,” said Brian Sellers, development and construction manager at The Villages.

Malloy says that the experience of DPR’s team helped bridge several gaps between the engineers from Australia who might not have been aware of all the U.S. requirements.

“They helped navigate the complexities of the infrastructure of the hyperbaric chamber systems that many (if not all) building code officials may not have been exposed to previously,” said Malloy.

Systems Meet the Pandemic Test

The Villages’ center can provide service to 56 clients in its two chambers. Each chamber has two separate compartments, and in each compartment, there is seating for 14 clients and a nurse during a two-hour session. With current COVID social distancing parameters, the team has limited the maximum capacity to seven clients per session. At full capacity, the center can treat 1,200 clients per year.

Treatment involves sitting in a cushioned seat while receiving pressurized pure oxygen through a mask(similar to a CPAP mask), a process that stimulates the body’s rejuvenation process and provides insight into how the brain looks and functions. “HBOT has the potential to reverse the pathology and symptoms of aging by supporting the improvement of cognitive and physical performance,” said Atchison. While in the chamber for the two-hour session, clients alternate breathing in compressed room air and stretch during four separate five-minute pure oxygen air breaks, where clients replace their oxygen mask with their COVID protocol mask. “Within the chamber, there hasn’t been a single documented case of COVID transmission. Thanks to DPR who did a really good job with the air filtration and other systems,” said Dr. Sussman.