UTSW William P. Clements Jr. University Hospital

When the William P. Clements Jr. University Hospital (CUH) opened, it marked the start of a transformative era in clinical care at UT Southwestern Medical Center—which had previously been recognized for its award-winning medical school. The 12-floor, 460-room iconic W-shaped hospital established UT Southwestern as an inpatient provider and embodied its commitment to excellence and innovation. Experiencing greater-than-expected demand for care, UT Southwestern swiftly initiated a $480 million, 12-story tower expansion. 

A Patient-Centric Flagship Hospital 

Replacing the aging St. Paul University Hospital, UT Southwestern engaged our team to provide mechanical, electrical, plumbing, and fire protection engineering services along with construction administration services in the creation of a replacement flagship hospital. To accomplish this, the owner and project team consulted with physicians, nurses, clinicians, patients, and the Dallas community to understand their needs and hopes for a new hospital.  

The final design focused on three primary objectives: enhancing patient experiences, driving healthcare innovation, and unifying UT Southwestern’s research, educational, and medical missions by integrating cutting-edge research and the next generation of medical talent into patient care environments. Patient rooms were designed on a large scale to accommodate visitors and caregivers with large windows to maximize views and natural light. The hospital was also laid out to minimize the distance caregivers must travel to reach patients, facilitating efficient communication and fewer steps for caregivers.  

We designed CUH using early BIM technology including a full 3D model of the major architectural, structural, and MEP engineering building systems.  A dedicated project trailer was provided on-site for team co-location focused on this 3D coordination with the construction team.    

Additionally, our team designed the facility to be resilient including redundant utilities and infrastructure. This resiliency includes major equipment redundancies, emergency generators, and dual substation normal power feeders, serving the remote central plant, materials management building, support services building, parking garages, and hospital. The configuration supports the continued operations of each building in the event of an equipment failure or power outage. To date, the hospital has not experienced an outage. 

In its inaugural year, CUH was identified as a Top Performer by The Joint Commission.  

A Critical Expansion 

Just two years after first opening its doors, UT Southwestern initiated construction of a podium expansion and third patient tower that would connect to the existing hospital at each of its 12 floors. For this second phase, we provided mechanical, electrical, plumbing, fire protection, and technology design services. 

Having included plans for expansion in CUH’s masterplan, the original facility design allowed the expansion to proceed with minimal disruption to existing operations. The original hospital, including its ER, remained operational throughout the 30-month project. The expansion created new space to serve as the clinical home for the Peter O’Donnell Jr. Brain Institute, consolidated acute psychiatric inpatient care services formerly provided at Zale Lipshy Pavilion, and added operating rooms, angiography suites, interventional suites, intraoperative MRI, a high intensity focused ultrasound (HIFU), an epilepsy monitoring unit (EMU), an expanded emergency department, and two new parking facilities. It also brought the hospital’s total bed count to 750.  

The CUH infrastructure includes structured cabling for voice/data, video, and patient monitoring; wireless LAN and telephone systems; CATV/MATV; RFID/personnel and asset tracking; nurse call; security; OR integration; telemedicine capabilities; and more—all designed to optimize care.  

Expansion efforts also prioritized a dedicated behavioral health wing. Our team implemented force protection code standards that were not required by law at the time but functioned as best practices such as incorporating 11-inch-thick window systems. Our team also helped create a garden on the fifth-floor rooftop, consolidating and hiding mechanical equipment on the roof to mask its sight and sound, supporting a risk-free, distraction-free patient environment. 

SSR functioned as the executive engineer for the inclusion of multiple minority firm design partners for both the original project and the expansion.  This effort included directing the overall MEP and technology teams through the design, construction, commissioning, startup, and warranty phases of the project and being responsible for the performance of the overall MEP and technology design teams. 

With patient demand at the forefront, speed to market was essential. To expedite construction, we collaborated closely with the contractor in developing a phased approach, issuing the design documents in multiple bid packages. Our team also diligently integrated new infrastructure with existing systems to minimize impact on existing operations. 

Opening in 2020, the expansion enhanced UT Southwestern’s ability to respond to the COVID-19 health crisis. CUH’s infrastructure design demonstrated remarkable adaptability, allowing for swift conversions of ORs and patient rooms into negative-pressure isolation areas for those infected with the virus. 

Moreover, in the wake of Winter Storm Uri—one of the most devastating natural disasters in Texas history, inflicting over $ billion in damages—CUH maintained operational integrity without disruption. 

The Future of Medicine 

CUH was thoughtfully constructed to leverage emerging technologies. Our team facilitated planning for automated guided vehicles which are now utilized on campus in the form of robots that deliver telemetry boxes and perform other tasks. In the hospital’s epilepsy monitoring unit (EMU), specialized lifts assist caregivers in moving patients while continuously monitoring their brain activity. The hospital has also invested in advanced quality improvement technologies for ORs, recording procedures for continuous learning and enhancement of safety and efficiency.  

Innovative Engineering Practices 

Additionally, we played a crucial role in designing a massive interoperable OR integrating an MRI surgical suite with a neurosurgical operating room. Special care was taken to design the HVAC systems to respond to the dynamic changes in room pressure when the MRI was opened into one of the two adjacent ORs. These advanced imaging-guided surgical suites allowed for the smooth transition of the neurosurgical division from the Zale Lipshy Hospital to CUH.  

Other unique provisions included: 

• A TransVac system design utilized for efficient waste management. 

• A process chilled water system tailored to meet the specialized cooling needs of imaging equipment, enhancing operational and maintenance efficiency. This system also provides jacket cooling for sterilizers, significantly reducing domestic water consumption.  

• Water treatment design consulting, drawing on our civil engineering team’s expertise in civic water treatment methods to review a partner firm’s design of a secondary chlorine injection system. 

• Enhanced air filtration and pressurization control to reduce infection risk and improve patient outcomes. The air purification system devised during the CUH expansion project has since become the standard for all future UT Southwestern projects.  

Reaching New Heights 

The William P. Clements University Hospital has served as an effective launch pad for UT Southwestern Medical Center’s ascent as a premier inpatient care provider. In the 10 years following its inception, CUH has experienced incredible growth with an increase of 44% in inpatient admissions, 136% in procedures/surgeries, 43% in emergency department visits, and 137% in solid organ transplants. This demand is a testament the DFW community places in UT Southwestern for cutting-edge, reliable care, and we are privileged to have been trusted in turn by UT Southwestern to partner in creating an exceptional facility to provide this exceptional care.  

In the words of UT Southwestern President Daniel K. Podolsky, M.D., “CUH has, in a sense, catalyzed how we provide care, working as teams, bringing multiple disciplines together, for the benefit of our patients.” Susan Hernandez, D.N.P., M.B.A., RN, Vice President and Health System Chief Nurse Executive, affirmed that “CUH has helped us to reach new heights.” 

As demand continues to grow, along with UT Southwestern’s vision for enhancing patient experiences, we know the medical center is poised for even greater heights, and our team continues to partner in growth initiatives.