As a follow up to his "Small Hospitals, Big Technology" post on April 17, DPR's Gerry Dewulf discusses the concept of "Super MOBs" in his most recent submission to Healthcare Building Ideas' blog.
By adding imaging space, a small lab and a few procedure rooms to a hoteling MOB where doctors can see patients a day or two per week, we create the next generation facility--ideal for bedroom communities surrounding sprawling metropolitan areas.
For the concept to work, it takes a solid balance sheet, top-notch staff and the right volumes of service and patients.
Moving up 9 steps from last year, DPR was ranked the 24th contractor out of 400 of the top companies by Engineering News-Record (ENR).
Last year, DPR was ranked 33rd, so this leap to 24th is an exciting advancement. We ranked 2nd in the Telecommunications sector category.
Total revenue for the top 400 firms increased almost 9% from the year before. Domestic contracting revenue for the Top 400 rose 5.9% in 2011, to $220.49 billion, while international contracting revenue jumped 20.3%, to $61.65 billion.
The Fiatech Celebration of Engineering and Technology Innovation(CETI) Awards recently honored the individuals and companies that have conducted new and emerging technology implementations as well as to individuals who have made significant strides in advancing innovation in research and development in the design, engineering and construction industry. The UCSF Medical Center at Mission Bay team won the Scenario-Based Project Planning category for the 878,000-gross-square-foot project, which is serving as an example of applying integrated project delivery processes, tools, and technologies on a public sector project.
The new medical center, scheduled to open in 2015, will include a children's hospital, a cancer hospital, a women's specialty hospital, a rooftop helipad, an outpatient building, and a central plant. The team includes UCSF Medical Center, DPR Construction, Stantec, and key trades. The team began working together nearly 18 months prior to construction start and was able to reduce construction costs by more than $100 million without reducing scope through the integrated virtual design and construction process.
Some of the innovative practices used include:
Co-location (The Big Room)
More than 100 people from 19 companies were co-located to enhance collaboration and minimize delays in decision-making.
Cluster teams: Nine cluster teams, with representatives from designers, subcontractors, the owner, and the general contractor on each team, focus on driving costs down and streamlining information flow and decision making.
Pull and ICE sessions: Pull schedule meetings establish optimal sequences and durations. Integrated concurrent engineering (ICE) sessions solve multi-disciplinary issues quickly with all affected stakeholders approaching an issue and choosing the optimal solution.
Access to information: ProjectWise, a server-based document management system, is being used to allow for real-time access to the latest drawings and models.
Last planner: During construction, last planners for each of the different scopes discuss and agree to one- and three-week look ahead plans.
Target value design: An integrated effort set achievable cost targets per trade to reduce costs while maintaining cost, schedule, and quality.
Virtual design or Building Information Modeling (BIM) and construction: Highly detailed models to validate design, user requirements, and constructability resulted in a cost-savings of $15 million and higher schedule reliability and field productivity.
Coordination before permitting: This ensured constructability input from subcontractors was included in permit drawings.
This is the fifth consecutive year that one of DPR’s projects has won a FIATECH CETI award, beginning with Camino Medical Group Mountain View campus in 2008 followed by Sutter Health Eden Medical Center, University of California, Santa Cruz Porter B College for real-time supply chain management, and last year in this same category for Alta Bates Summit Medical Center, Oakland Patient Care Pavilion in Oakland, CA.
Big hospitals don't always mean better technology. In his latest blog post called "Small Hospitals, Big Technology" for Healthcare Building Ideas' blog, DPR's Gerry DeWulf explores how small hospitals in rural or suburban areas are now utilizing the same technology found in large or urban hospitals.
This technology can include "smart" ORs, electronic medical records and state-of-the-art medical equipment. Read up on small hospitals and how a flexible hospital can grow and adapt with its community.
DPR’s Gerry DeWulf’s latest blog post to Healthcare Building Ideas discusses the fast-emerging trend toward the development and demand of Hybrid ORs.
Based on our experience at Banner Health at Good Samaritan Hospital, Gerry shares a couple of things for owners to think about as they consider hybrid ORs for their facilities. Read Gerry's "Hybrid ORs--The Magic Kingdom" post on Healthcare Building Idea's blog.
Any renovation in the OR department is complex – but the Hybrid OR just raises the game to a higher level. So, in addition to his blog post, Gerry has the following advice for project teams when it comes to Hybrid ORs:
Typically Hybrid OR’s are being added on, or built next to, existing ORs. There will be more demolition noise, more cores to drill in the slabs, and more structure to be drilled and bolted. Get to know the department staff around you, respect their concerns, start planning early, and share your schedule for the work well in advance. Tell them how you will mitigate the impact to them – and keep your promise. Prepare for lots of off-hours work and ICRA that gets put in place every evening and removed prior to start of business in the morning. Remember that some departments, like ER, never close and you may get very limited access during very brief time periods.
For structural requirements, demanding tolerances of today’s new imaging and angiography equipment require stiffer structural supports than in the past. This can be a major disruption the departments located beneath your new Hybrid OR room, and dollars and time in your construction budget and schedule. Try to reinforce/stiffen what you have.
For Cooling/HVAC requirements, there are two areas of concern:
1) The OR room itself will probably require a larger volume of air than that of the previous function in that location. Make certain that existing air-handlers have the fan capacity, humidity control, and cooling coils to handle the additional load.
2) Cooling load in the equipment room that houses all the computers and UPS systems that support the communications, controls and operation of the new equipment. The most common solution is a CRAC (Computer Room Air Conditioner) unit that requires house-generated chilled water supply and return.
Power, control, data, and display wiring is everywhere. Ceiling space is already full of HVAC ductwork, medical gas piping and electrical conduit, which now may need to be relocated. This can be a budget and/or schedule concern if not identified early in the design process. Find the accurate as-built drawing or get your head above the ceiling and get BIM coordination started during the design.
Look for opportunities to re-route existing utilities out of the footprint of the new Hybrid OR. You will need every inch of space possible for new ductwork, med-gas piping, boom and light supports, and conduit. The best time to have the most budget impact is early in the design process.
Once the project is complete, staff will fight tooth and nail to keep you out of their new OR, now and in the future. Create your “as-built” drawings or updated BIM model as you go and make certain everything is documented before you close up the ceiling. Good record drawings also means that future projects will not require design teams to access the space – a great benefit to the client!
Hamilton Espinosa contributed another blog for Healthcare Building Ideas. In it, he describes G3Box, an innovative startup created by Arizona State University students that recycles materials and turns it into medical clinics around the world.
This impressive student venture has been featured in Entrepreneur and Inc. magazine, as well as other national media outlets.
The non-profit turned to DPR and SmithGroup to create their first maternity clinic, which is now on-track for completion at the end of July. Read more about this amazing project here: "ASU Students Putting Ideas into Action."
The first data center to be owned, designed and operated by the omnipresent social network, it's easy to see why the industry "liked" the project so much. The first of three ground-up data center buildings at the greenfield site, PRN1 (acronym for Prineville Building 1) is Facebook's first LEED-Gold certified building. The data center cooling system utilizes 100% outside air for free, natural cooling. BIM, innovative green features and design-assist subcontractors were used to construct the 320,000-sq.-ft. mission critical facility. PRN1 was completed ahead of schedule and under budget.
Over the next six months, I will be contributing to Healthcare Building Ideas' blog. In my first post, I discuss how the term "value" can have a different meaning to owners and project team members.
I discuss how issues like BIM and IPD can come into play when determing value. Is value merely saving money? Is it providing upgraded systems or streamlined delivery methods? What does value mean to you from your point of view? Check out the "What is Value?" post and see what you decide. Keep checking the Healthcare Building Ideas' blog to see more thought-provoking entries on a variety of healthcare topics.