Sammy Ofer heart building– part 3 / 30/08/2011

Challenges in Constructing the Building
1. The Sammy Ofer Heart Building a very large scale tower constructed within the fabric of the medical center, while the medical  center continues to function as usual. The construction work was carried out around the clock due to very tight time constraints and the medical center's promise to the donors to adhere to the timetable. About 120 workers worked on the site during the day, including three active cranes on a limited area. About 30 workers worked at night.
 The Tel Aviv Municipality allowed the medical center to work at night, while absolutely requiring that the construction work not exceed maximum noise levels so as not to disturb the neighbors living adjacent to the site. The strict permits received from the Municipality had to be renewed every few weeks.
2. Compliance with the most stringent standards of the Environment Committee at all phases of the construction, including recycling materials at the excavation phase and removal of waste from the site in a manner that would not significantly upset traffic on the streets bordering the medical center. Excavation on three underground levels on an area of 5,000 sq.m. -each level.
3. Demolition of the old ER building (the main part of the new cardiology building is built on the same site) called for transferring operational functions from the demolished building to alternative sites, while meticulously planning the relocation of departments so as not to upset the function and construction of the new building. It was necessary to remove construction waste from the demolished building by intensive truck traffic through a traffic-heavy city street. This process had to be carefully and meticulously coordinated with the Tel Aviv Municipality, the Police Department and the Traffic Department.
4. Contractor Organizing Area – Entry to the construction site was very problematic. The organizing area was particularly small and only set back about 15 meters from the road, which is a main and important thoroughfare in Tel Aviv.  This called for stopping traffic several times a day and created bottlenecks throughout the area. The delivery of building materials and goods to the site had to be carefully coordinated with the Traffic Department.

5. In the course of construction, the client decided to add two floors to the building. This called for changing the urban building plan during the construction of the project plus changing the plans in-process.
6. Construction of a 55,000 sq.m. building within the delicate fabric of the medical center where patients are hospitalized called for pre-planning the many connections to the medical buildings adjacent to the new building, using electro-mechanical infrastructure located in nearby buildings, e.g.  hot water, diesel oil for generators, etc. It also required providing infrastructure systems to the new building, such as cooling towers and creating an optimal connection with the medical center's main water reservoir.
7. The new cardiology building was designed to serve as backup for the main energy center of the medical center and includes six cooling towers, a 2500 m3 water reservoir, generators, backup to the computer server's room of the medical center, etc.
8. The descending ramp to the three parking/emergency hospital levels under the new cardiology building was built about a year and a half before the construction of the basements themselves. This created problems and was a major challenge in the linking process.  During the construction of the basements, the client decided to add another basement floor. This was after the piles had already been driven into the ground, and this meant having to drive new interior piles into the ground.
9. The building was built according to green building standards with 2,000 sq.m. of photovoltaic cells installed on the roof of the new building, a special cistern for collection of a/c water, use of a fixed shutter inserted and sandwiched between the low energy glass of the curtain walls with special micro switches for optimally controlling the penetration of natural light into the spaces of the medical rooms.
 Throughout the construction process, materials dug out from the site during the excavation and shoring-up phase were recycled and reused.
10. The building was designed in a forward-thinking manner to create a versatile and elastic structure with the nucleus located at its center.
 All the hospital rooms were located along the building envelope in each of the twelve functional floors (3100 sq.m. per floor) to provide the patients with a view and optimal connection with the outdoors through the curtain walls.
11. An ecological fish pond was planned at the entrance plaza to the building.

1. Careful and protected excavation within the functioning and dense medical center site down to a depth of about 20 meters while building slurry walls were erected  next to existing buildings bordering the new building.
2. Construction of a sheltered 15,000 sq.m. emergency hospital resistant to chemical and biological warfare.
3. Conventional concrete construction of the building, taking into account the large number of electromechanical systems needed for the hospital. Careful planning went into making the building flexible and adaptable to future advancements in medicine and new medical functions to be applied in the course of time.
4. The concrete construction adapts itself on each floor in providing maximum leeway for the passage of vertical shafts in various places for the various departments located on each floor in the new cardiology center and providing specific solutions for unique functions, such as labs, catheterization rooms, ER setup, etc.
5. The design of red bridges, like arteries, which are suspended in the space of the main atrium and connect the new building with the hospital, built in the old international style. Solving the problem of vibration of the bridges and subsidence for maximum safety and convenience of the users.

1. Basements: The new cardiology building has four basement floors, consisting of three levels, 5000 sq.m. each, and another basement level of about 800 sq.m.
 The 700-bed emergency hospital was planned on basement levels -2, -3, and -4. Technical spaces were also planned in the basements, including air-conditioning rooms, areas designated for air filters for the emergency hospital and an emergency water reservoir.
 About 150 parking spaces were planned in the basements. During wartime the basement will be converted into hermetically separated areas with the use of special airtight steel doors. The emergency hospital will be equipped with hospital beds, and the medical center will be evacuated via ramp and elevators. On -2 level, a passageway was planned leading to the medical center's general operating rooms wing also situated in the shrapnel-protected space.
2. Level (-1): This level borders Weizman Street, one of Tel Aviv's main thoroughfares. An ecological fish pond separates between the "urban galleries" and the wide public plaza for the benefit of the public. The urban gallery has a coffee shop and theater/lecture hall, including seating areas in the plaza.
 Clinics are also located on this level, such as the obesity clinic, a transplants department, a diet department and a preventive medicine department.
3. Level (±)0 – Medical Center's Ground Level: This is the entrance level to the cardiology building from the main plaza of the medical center.
 The non-invasive cardiology department is located on this floor, including examining rooms, Holter monitor rooms, echocardiogram rooms, ergometric and electrophysiology exam rooms (pacemakers). Also located on this floor is the heart rehabilitation department, which includes a gym with close supervision of heart patients, and a breast clinic. The main pathway connecting the medical center plaza leads the public to the ground level of the main atrium, providing an upward view of the red bridges suspended in the space of the atrium, with a connection to the old Ichilov building and the visitors' elevators.
4. Level (+)1 – First floor: Two departments are located on this floor: the intermediate care department for people hospitalized for supervision and monitoring and a cardiac intensive care department, with an adjoining bathroom and shower adjacent to each room for the use of patients and visitors alike. All the service functions, e.g.  doctors' rooms, dressing rooms, staff rooms, etc. are situated around the central nucleus in the building.
5. Level (+)2 – Second floor: Four catheterization rooms, an MRI room and a CT room as well as a heart-chest surgery department are located on this floor.
6. Level (+)3 – Third floor: Two internal departments, designed at a four-star hotel standard, were located on this floor, with day areas and nurses' stations, 16 rooms in each department with a therapy room with six stations. Each room accommodates two patients. Several rooms in each department were planned for one patient.
7. Level +4 – Fourth Floor: This floor has two neurological departments. There are 14 rooms in each department with two beds per room and three rooms with a single bed.
 An intermediate treatment department for stroke patients was also planned on this floor, including five rooms with two beds in each room, a day hospitalization room with four beds, a neurological intensive care ward with ten rooms and one intensive care bed in each room. There is also a five-bed unit for epileptic monitoring.

8. Fifth floor:  This floor has two neurosurgery departments. The neurological intensive care department with 18 rooms and a single intensive care bed in each room is supervised by a nurse.  A neurosurgery department is also planned on this floor.
9. Sixth floor:  A plastic surgery skin care department and skin diseases department are located on this floor.
10. Seventh to tenth floors: These floors were left empty to accommodate future needs of the developing medical center.
11. Eleventh floor:  A technical floor with machine rooms.

- All the hospital rooms were designed for two beds or a single bed and have adjoining bathroom and shower as well as a sink in each room.
- All the rooms were designed at a four-star hotel standards and international standards with emphasis on an interior design that is user-friendly.
- A landscape picture hangs on the wall of each hospital room opposite the hospital beds. The picture is meant to have a calming effect and to help the recovery process.
- The "red windows" - The "heart chambers", serving as an urban icon in the fa?ades of the building, turn into single-bed hospital rooms or balconies in the interior design.  These rooms or loggias are for the benefit of the patients, guests and medical and nursing staff.
- The nucleus of the building holds 8 visitors' elevators stopping on each floor, with a spacious lobby overlooking the atrium. All the levels in the new building were connected by red bridges ("arteries") to the old Ichilov building that lies opposite it. The old Ichilov building, , is a building for conservation and part of Tel Aviv's Bauhaus heritage. It will be renovated and restored to its original glory.
- All the hospital rooms in the new building are located in the envelope of the building with a view of Tel-Aviv's impressive cityscape which can be seen through the curtain walls. A wooden bench for sitting away from the curtain walls is installed next to each curtain wall.