Packard Children’s – My “Fight Song”


Thursday was the ribbon cutting for the Lucile Packard Children’s Hospital at Stanford.

The event was small, and our friends at HGA gave us one of their tickets, so I was able to attend. And, I’m so glad I did. Thank you HGA!

The event was mostly for the donors who had helped to create the funding for the project. Speakers included all manner of dignitaries, each talking about this hospital being the most technologically advanced, patient-centered, and environmentally sustainable children’s hospital in the world.

I can be pretty emotional, and I was really moved when I listened to a mom tell the story of her daughter, diagnosed at age two with leukemia, and their fight, with the people at Packard Children’s, to save her life. I confess I was one of those who wept, then, when another young woman took the stage to sing. This woman had been diagnosed with Stage 3 ovarian cancer, and had, during her therapy at Packard Children’s, entered America’s Got Talent. Apparently, her singing went viral, and she gave us her song, “This is my fight song”, and she brought up the little girl who had been saved from leukemia. It was a powerful moment (to say the least).

We (Mazzetti with several design partners) started working on this project more than a decade ago. I remember all of the people who have come and gone from the project. I celebrate, especially, the genius of my friend Robin Guenther, of Perkins + Will, who lead the team to create this masterpiece of healing. As we were working on the project, Robin and I also collaborated to win the Kaiser Small Hospital Big Idea competition, and, though Kaiser never built the building we envisioned, pieces of it made their way into this building. I feel so fortunate to have been able to work with Robin through these years and to do this project with her.

Shortly after the ceremony, back at our San Francisco office, I talked with my Mazzetti colleagues about the project. As I looked into their eyes, I saw so many people who did so much work on the project. I told them that truly, they were the ones who should have been there, for they were the ones who made this building happen. I told them about the two kids who had appeared, and how it reminded me that our work makes a difference.

A long time ago, I reconciled myself to the fact that my talents were not ones that would allow me to practice medicine. But, through the years, I have consoled myself that, at least, I can help to create the stage on which those with these talents can do the work of taking care of people who need help.

Doing what we can to create the most patient-centered, technologically advanced, environmentally sustainable medical centers in the world, so that medical professionals can treat, and so that people can heal—this is my fight song.

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What is Energy “Peace of Mind”?


Energy Peace of Mind

Chapter 1: Starts with Energy Modeling


We take energy seriously. Towards this, we have participated in the AIA’s 2030 Commitment since 2012, using its framework to track the progress of our projects.  In order to inform our designs, we start with energy modeling–all projects over 10,000sf and, for which, the energy use will be significantly impacted (>15%). We see a large part of our role is to provide you, our clients, peace of mind. This implies both trust and appropriate outcomes. What better design validation than measuring actual performance?!

Did you know, that if your facility runs at a 5% profit margin, every dollar in energy cost you save is equal to grossing (approx.) $20 of additional revenue? Energy is a financial matter.

“Energy is no longer a facilities issue, it’s a financial issue.”

– Anonymous Treasurer, Large CA Health System

Mazzetti engineers uphold a responsibility to design smart, environmentally responsible building systems with a keen focus on energy efficiency. We “protect” this design aspect throughout the life of the project and those who have worked with us, can attest.

Swedish Issaquah (Issaquah, WA)

The significantly aggressive energy target, coupled with a tight timeline created both a challenge and even bigger opportunity. Mazzetti (at the time CDi Engineers) responded by making early decisions, conducting energy modeling, using VAV and Heat Recovery Chillers, integrating design and construction, and expediting equipment procurement. We delivered using Integrated Project Delivery Method (IPD). 

“Swedish Issaquah is the most energy-efficient hospital in the United States.”

– Robin Guenther, Principal (Perkins+Will)

“We are especially pleased that our aggressive energy-savings goals were accomplished.”

– Kevin Brown, CEO (Swedish Health Services)

Discover more about the project here.


Peace Health Peace Island Medical Center & Critical Access Hospital (Friday Harbor, WA)

Working closely with Mahlum Architects, Mazzetti provided Mechanical and Plumbing design for this award-winning project. Using the ambitious Living Building Challenge 2.0 roadmap, energy efficiency was a prime component. Peace Island Medical Center (PIMC) is achieving an average Energy Use Intensity (EUI) of 87.7 kBtu/ft2/yr (276.7 kWh/m2/ yr).

Discover more about the project here.

Per the image below, we have predicted our projects will perform on average 36% better than the baseline, across our portfolio.

  • Our Inpatient Hospitals EUI has improved from 204 to 159 kBtu/sf/yr.
  • Our Medical Office Buildings EUI has improved from 64 to 55 kBtu/sf/yr.

In actual energy use, in the last 4 years we have seen our hospital projects improve by a predicted average of 45 kBtu/sf/yr, and our MOB projects by 9 kBtu/sf/yr.

EUIAnd, most importantly, we deliver. If modeling is step 1, measuring is step 2. We’re excited to let our projects speak for themselves. In upcoming “Energy Peace of Mind” chapters, we’ll be featuring various projects for which we have modeled and measured energy data. This is about outcomes, not activity.

Feel free to jump ahead and learn more about RCx benefits through the eyes of a client.



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Is your facility reaping the monetary benefits of RCx?


Over the last 12 months, one of our valued clients has saved a total of $983,470 from RetroCommissioning (RCx) services. Their cost after rebates was $584,380, with a payback of 0.6 years! Thanks to the assistance of Mazzetti’s experts, our client has reaped the benefits RCx services can provide. See more details here.

Are you reaping these benefits?

As industry experts, our responsibility is to see opportunities for our clients and advise accordingly, especially opportunities for savings and energy reduction. According to the 2017 Johnson Controls Energy Efficiency Indicator (EEI) Survey , HVAC equipment remains the most popular improvement. These mechanical systems often operate inefficiently for various reasons–lack of funding for repairs or replacement, insufficient knowledge of proper operation, inadequate staff, and poor documentation, to mention a few. Temporary repairs are common, and in the age of sophisticated systems, small issues can often manifest into large problems in healthcare facilities. Through the RCx process, building owners are made aware of specific areas requiring attention and restore their building’s performance with the help of a detective.

What exactly is RCx?

RCx is a systematic process for identifying and implementing operational and maintenance improvements in a building to ensure continued healthy performance over time. RCx goes beyond maintenance measures to identify deficiencies that aren’t always so obvious. That experienced detective, also known as a Commissioning Authority (CA), provides strategies that can lower utility bills and provide other benefits–reduced maintenance costs and improved occupant comfort and indoor air quality.

Low-hanging fruit

Consider your own facility. How confident are you in the effectiveness of your existing Building Automation Systems (BAS)? Do you think you’re “ringing out” (hence the banner image) the full value of your BAS to increase efficiencies, particularly re energy efficiencies?  The data suggests more value is available for most facilities with little to no capital costs.

You can discover more about Mazzetti’s Cx and RCx solutions (including our EXPERTS) here. 

Did you know, that if your facility runs at a 5% profit margin, every dollar in energy cost you save is equal to grossing $20 of additional revenue?

Our client recently distributed their annual savings report, which documents each project’s overall cost and savings. We thought this graphic  might help illustrate, literally, reaping the benefits of RCX, “ringing out'” every ounce of value.

Interested to discuss possibilities for your facility, contact me..

RCx savings

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Lucile Packard’s Children’s Hospital: Where Innovation is Reality


On Monday, I had a kind of bittersweet experience, as I was able to join Perkins + Will (P+W) Healthcare designers from around the country to tour the new Lucile Packard Children’s Hospital Stanford (Packard Children’s ). (We were design partners, along with HGA, for over a decade on this project.)

The sweet part was being able to spend time with so many wonderfully creative people, touring this most amazing, innovative project, and the pride I felt in what our people had collectively created.

The bittersweet part was that this is probably one of the last engineering design projects in which I can claim to have had an active role. As Mazzetti has grown and my focus forced to change, I am still able to help on projects here and there but not in the same leadership type of role I previously took. With Packard Children’s, I was privileged to work alongside a great team of architects, as well as the great people of Mazzetti. And my gosh, it shows!

Packard Children’s Hospital, in Palo Alto California, will be one of the most sustainable large hospitals in the country. It will be the first US hospital to use Displacement Ventilation in all patient areas, reducing first costs and energy consumption/costs. Accomplishing this feat required intricate coordination between the architectural team, the engineering team, and the energy modeling team.

It required carefully designed exterior shading systems integrated with sensors in the building, working with the building automation system (see below).

shading Indeed, the energy design of this building was so critical, that in early stages of the project, we worked with the EIR team to craft a Carbon Emissions forecast and a set of sustainability strategies from water to effluent to energy that are remarkable in their aspiration. Many of these ideas originated from the Kaiser SHBI competition, we won with P+W.

But, as proud as I am of the exceptional engineering that went into this building, I was blown away by the care, and the thought, and the genius, really, of the whole team, led by my friend Robin Guenther (at P+W). I started working with Robin on the Green Guide for Healthcare (GGHC), when I was a young engineer, eagerly trying to help Kaiser with its national energy needs. Robin and I spent years working with so many great people on the GGHC. So, to now be able to bring that spirit of voluntarily innovating to eliminate waste in the form of wasted energy, water, materials, and health on this beautiful building was the opportunity of a lifetime.

The teamwork to craft this place of healing was truly inspiring and a monument to all the many people we have worked with along the way to make it a reality.

(Scheduled Open Date: December 2017)

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Employee Spotlight: Jesse Avery, Electrical Engineer


Discover how this former robotics guru went from Temp to Team Leader & Associate Principal at Mazzetti…

Jesse Avery, P.E., started his Mazzetti career with Lucille Packard Children’s Hospital Stanford project. Now, eight years later, he is completing this work and turning the page to a new chapter as Associate Principal and Team Leader.

A few words that describe Jesse: humble, pragmatic, surprisingly humorous, curious

How did you get into this industry?

I actually graduated from San Francisco State with a degree in Electrical Engineering and an emphasis in mechatronics (i.e. ‘robotics’). I envisioned myself at a ‘techy’ firm, given I lived in the Bay Area, but a downturn in the high-tech market didn’t facilitate this path. Rather, I ended up in New York, building houses (I do enjoy the hands-on labor). After about six months or so, a family member convinced me that I should actually USE my engineering degree, which led me back to the Bay doing lighting design and eventually more electrical design for mixed-used & residential buildings.

How/when did you start at Mazzetti?

After the housing market crash in 2008, I was searching for a new industry—my wife found the opportunity at Mazzetti. I interviewed for a temporary position, pending full-time employment with the Packard Children’s Hospital project. Three months later in the fall of 2009, I was rolling into the office full-time and quickly became immersed in all things Stanford Health.

Progression at Mazzetti to be a Team Leader

I was fortunate to be promoted rapidly from temp to designer to Project Manager to Team Leader. I more or less became “the face” of Mazzetti for our second largest project in the San Francisco office, Packard Children’s Hospital. I think I’m somewhat similar to John Karmiris, a Mazzetti Principal at the time, which helped progress me to this new leadership role. I’m not willing to do something just because it’s asked—I need to understand ‘why’ first. And, I strongly believe in managing time efficiently—not just for the project’s sake, but for my own—so I can go home and spend time with my family every night. It is also important to me to respect others’ time with reasonable deadlines.

What keeps you coming back for more?

I highly value stability and a family-friendly employer, both of which we have at Mazzetti. When I started here (yes, as a temp), my wife was four months pregnant with our first child. Shortly after the baby was born (David, now 7 years old), I entered an intense design period. Karmiris and others ‘forced’ me to go home and be with family as much as possible. This is a not a sweat shop operation, which I appreciate. We do a variety of interesting projects that keep me engaged. Seeing drawings come to life in constructed buildings—makes you feel particularly proud (especially in our Healthcare work—knowing you’ve contributed to creating a place of healing).

Most Challenging Work

Building things is a challenge—reality is dirty! But managing people, both internally and externally, is the even more challenging. We’ve experienced turnover of (external) people on the project, for various reasons, causing additional stress on schedules and budget. However, with our portion of the project coming to a close in mid to late spring we’ve been able to mitigate these stresses. (The first patient is scheduled to be admitted later this year!)

Favorite/Most Proud Project

Surprisingly or not, the project I’m most proud of is a little apartment complex in Emeryville, CA, that was unoccupied for the first six months. This was my first real project as a junior electrical engineer. So, when the building was first “turned on” and didn’t explode, I was thrilled!

Living the Foursight Brand

I try to operate in my wheelhouse, which is project delivery, and use the other lenses to help clients make decisions and get things built. If all we do is design things based on what an architect sends us, then we are providing little value relative to any other engineering firm (just turning out documents). SO, what differentiates us is what we bring clients when they hire us… We provide our research and policy expertise and a firm-wide knowledge of what works and doesn’t work in healthcare design. This sets us apart as more of a consulting partner.

What are you most excited about?

Well, even though switch boards have been more or less the same since the 1940s, I’m excited to see new technology and new tools coming online to help design and build better buildings. I’m excited about our new dedicated lighting design services and healthcare technology/IT consulting via the GBA merger. We have a TON of talent and a wealth of knowledge here. We can do a lot of great things!

Advice for Younger Generation

Know your priorities and defend them with a firm hand (otherwise, someone else will set them for you). No matter how much you know, keep learning. There’s always a different way to do things, and always people who know more than you!

Life Outside of Mazzetti

I live in Fremont (East Bay of San Francisco) with my wife Melissa and three children (David-7, Sophia-5, Diego-almost 2). Whenever possible, we try to get outside to hike, bike, rock climb, you name it—great ways for us to expend energy freely!

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Haiti’s Urgent Need for HOPE Combating Cholera


What an opportunity in the “Season of Giving”

We said we’d be back. And now we have that opportunity to follow through. Following the reconnaissance work via the Sextant Foundation and Mazzetti employees Walt Vernon, Tamara McDonald, and Johnny Chung, Project HOPE was able to secure funding to construct the new Cholera Treatment facility requested by the Minister of Health from the state of Nippes, in Haiti. Read more from our reconnaissance trip in early November.


Haiti is currently bracing for an expected onslaught of Cholera, following the recent devastation of Hurricane Matthew. Approximately 2.1 million people were impacted by the storm, leaving 1.4 million (12% of Haiti’s population) in need of assistance in some capacity. As of October 14, the death toll was at 546 with 128 people missing and 439 injured. The Haitian government estimates nearly $1.89 billion in damages, including primary healthcare infrastructure in the state of Nippes; the country has no resources to rebuild. Project HOPE and Mazzetti/Sextant, at the request of the State Minister of Health, have planned, designed, and are beginning construction on a new cholera treatment facility at Hospital St. Therese, in Miragoane, the capital city of Nippes.


On January 12, 2010, an earthquake of 7.0 magnitude hit Haiti. It killed 1⁄4 million people, injured over 300,000 and left 1.6 million people homeless. Far from the epicenter, CRUDEM Foundation’s Hôpital Sacré Coeur survived the earthquake and thousands were flown in by helicopter. When most NGOs, including Project Hope, sent only medical workers, Project HOPE also sent engineers. The goal was to assess the remaining health facilities to best deploy medical professionals with infrastructure that supported these medical missions. Thus was born the Mazzetti/Sextant Foundation and our long-running commitment to improving health facilities in places in the most need. View the video here.

Months after this earthquake, the country faced a new challenge. Cholera. Though not endemic to Haiti, prior to the earthquake, Cholera broke out, killing thousands. More on the suspected cause of the outbreak here.


Since returning from our most recent recon trip, We have sent Jeff Rodriguez, friend of Mazzetti’s, Sextant Foundation activist, and former Hospital Facility engineer, back to Nippes (in Haiti) where we will meet with Project HOPE members and local Haitians to start work. Haitians urgently need more cholera treatment accessibility. Through Project HOPE’s coordination with the Haitian government and specifically the Ministry of Health, we have planned, designed, and will construct a cholera treatment center. The center will be located at the St. Therese Hospital in Miragoane, the capital of the state of Nippes. The new facility will include 20 beds and a bioreactor, for hospital waste water treatment, appropriate to the local maintenance abilities. It will be powered by solar panels to eliminate the need for expensive diesel fuel. It will be designed to treat cholera victims, but the Ministry intends to use it beyond any potential cholera outbreak to treat various diarrheal diseases into the future.

Mazzetti/Sextant is sending two more of our people early in the new year to help complete this project. Our volunteers will mostly oversee the work of Haitians who we will pay to perform the bulk of the work, thus providing some level of economic benefit to the people there, as well.

Mazzetti/Sextant are funding 100% of the costs of our volunteers, and we can use your help. If you can, please donate here: http://sextantfoundation.org/donate/.

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