Proj Overview

Project Overview

In 2014, Cook Children’s Medical Center in Fort Worth, Tex., broke ground on a nine-story addition for the largest pediatric healthcare provider in the Dallas-Fort Worth, Tex., metropolitan area. Building healthcare facilities always comes with a unique set of challenges, says Sean Patrick Nohelty, principal with David M. Schwarz Architects. These buildings must be designed to address the varied needs of patients and staff while meeting the highest standards for air quality, temperature and moisture control, and exterior aesthetics. The strict performance criteria and desire to create a lasting and beautifully designed solution for the community’s most vulnerable patients drew the designers to precast concrete.

Precast concrete was selected over a typical masonry design or cast-in-place concrete on a steel frame through “Choosing by Advantages” (CBA), a system in which each factor in the material selection was weighted according to the structural needs of the project and compared to find the best specification. The CBA analysis determined that a precast concrete facade would deliver ideal waterproofing, insulation, and sound transmission, as well as sufficient ceiling space. The precast concrete elements also brought speed and durability to the project and helped keep costs low. All of this was achieved“while still meeting the medical center’s exacting standards for high quality,” Nohelty says.

Brick and block—but better

In the preliminary stages of the project, Nohelty contracted Gate Precast Company to serve as a design-assist consultant for the exterior facade. That collaboration led to a more efficient design that addressed issues early in the process. For example, Gate’s team worked with the insulation manufacturer to conduct a series of thermal and moisture analyses to ensure long-term thermal resistance and eliminate concerns of condensation and mildew.


The early involvement of Gate’s team also allowed team members to assist in design development and detailing. They met weekly, using building information modeling (BIM) tools to revise the plans in real time. “This was our first foray into using BIM in a fully integrated way where all consultants were participating,” Nohelty says.

The resulting design features a hand-set brick and natural limestone facade that matches the architecture of the existing campus. To avoid an overly uniform design, false joints and color variation were incorporated into the precast concrete panels, providing a more authentic brick-and-limestone appearance. By using precast concrete for the design, the project team avoided the site congestion that is typical when limestone, cast stone, and brick are used in the field.

The insulated architectural exterior system saves more than 35% in annual BTUs when compared to a brick-and-block assembly, while providing an environment that is comfortable, quiet, and moisture resistant. The cohesive aesthetic of the precast concrete panels and the affordable construction contribute to the continued success of the hospital and opportunities for growth in the future.


2019 Design AwardsHealthcare/Medical Building Award
Project Team


Cook Children’s Medical Center, Fort Worth, Tex.

PCI-Certified Precast Concrete Producer

Gate Precast Company, Hillsboro, Ala.

Precast Specialty Engineer

Gate Precast Company, Jacksonville, Ark.


David M. Schwarz Architects, Washington, D.C.

CallisonRTKL, Dallas, Tex.

Engineer of Record

CJG Engineers, Houston, Tex.

General Contractor

Linbeck Group, Houston, Tex.

PCI-certified Erector

Precast Erectors, Hurst, Tex.

Photo Credit

Gate Precast Company and Steve Hall of Hall + Merrick

Key Project Attributes

  • Architectural precast concrete panels are resistant to moisture.
  • The continuous, low-permeability insulation creates a moisture barrier to prevent vapor diffusion and air infiltration.
  • Multiple mockups were produced to ensure that the veining technique would deliver the limestone appearance the architects desired.

Project/Precast Scope

  • Design and construction of a nine-story tower for a pediatric healthcare facility.
  • The project included 75,953 ft2 of architectural precast concrete composed of 667 individual panels.
  • Due to massive existing profiles, panel thickness ranged from 4 to 19 in.
  • Project cost: $289.2 million
  • Project size: 314,000 ft2