With its “open book” philosophy, highly collaborative approach and emphasis on planning ahead and mitigating risk, healthcare owner HCA takes teamwork to a new level when it comes to managing the design and construction process for its facility projects. The shared affinity for building relationships, not just physical structures, has been a major driver behind a successful association that has spanned more than 25 individual projects over the last eight years.
Team Players
Client: HCA
Architects: PageSouther- landPage (South Austin); Polkinghorn Group (Bailey Square); Perkins + Will (Clear Lake & Round Rock); Gould Turner Group, P.C. (Rapides)
What started with some small facility-level projects at one hospital has grown into more than 25 different projects, including a succession of major hospital expansions and renovations, as well as a notable example of all that can be accomplished when cultures and goals are aligned and expectations are continuously met.
“HCA is just the type of customer that DPR enjoys working with,” comments Jason Choyce, project manager on the $29 million South Austin Hospital Expansion and Renovation, DPR’s first largescale project for the leading healthcare services provider. “The way they approach a project is through complete collaboration. We get involved very early on and help develop the budget—from the programming end all the way through—working with the architect and owner in a true team fashion. As far as doing it the right way, they’ve got it down as good as or better than anyone else we’ve had the opportunity to work with.”
DPR undertook its first project with HCA in early 1997, and after several small jobs, DPR was awarded its first larger contract in 1998, a $7.6 million OB/GYN Expansion project at South Austin Hospital. DPR subsequently has completed or is working on several major projects for HCA, most on a team with architect Perkins+Wills, including:
The $8 million Bailey Square Surgery Center project, entailing renovation of an occupied facility;
The $29 miliion expansion andrenovation of South Austin Hospital;
The $29 million Round Rock Medical Center Expansion and Renovation, currently underway and due to complete October 2006;
The $34 million Rapides Regional Medical Center Expansion in Alexandria, LA, scheduled to get underway this year with a scheduled completion in February 2008; and
The $47 million Clear Lake Regional Medical Center New Heart Hospital, currently underway with completion anticipated in March 2007.
A common thread through the projects is DPR Project Executive Wayne Fontenot, who oversees all HCA projects and attends quarterly meetings with the owner to learn more about the company’s long-term plans and expectations. Fontenot then shares the information with DPR project teams.
Consistency in the teams’ approach across project lines is also another key contributor to their success, according to Troy Ireland, project manager on the Clear Lake Regional Medical Center project.
“Among the HCA projects, the project managers, superintendents and project engineers constantly talk to each other about what’s working and what’s not. We consciously strive to have consistency through all the projects and conform to HCA’s specific guidelines”, Ireland said.
The challenges associated with building within an occupied hospital also can be substantial. Chief among them: control of airborne infection agents; scheduling for interruptions while maintaining the overall completion schedule; and creating as little disruption as possible for end-users of the facility.
Often, the solutions devised by the project teams have been used to create new standards both on HCA projects and on other DPR projects. On the Round Rock Medical Center Cardiac Catheterization Lab project, for example, one of the critical challenges was to preserve a sterile environment throughout construction. To ensure highly sensitive areas remained clear of dust or debris, DPR utilized negative air machines to create a vacuum in the rooms under construction. The project manager also developed a custom alarm system that sounded whenever there was a change in pressurization, giving the team the opportunity to make adjustments before there was any possibility of contaminated air entering occupied areas. The device is now used on other healthcare projects. Upon project completion, the owner’s facilities director rated DPR overall 47 percent better than his previous best general contractor, based on scores and comments on 10 areas of the construction process.
“DPR is very in tune with the needs of the hospital,” said Dennis Staszak, who worked for Round Rock Medical Center for 21 years before returning as a consultant. “Hospital settings are very difficult to work in, and DPR knows how to do it, and they do it without having to be told. Over my career here, I’ve worked with six or seven different general contractors, and DPR has been the best I’ve ever worked with.”
On the current Clear Lake Medical Center project, the team is also working in close collaboration with the owner to maintain the aggressive schedule despite a major change midstream that added two more stories to the four-story building. To minimize the impact to budget and schedule, DPR has broken the addition into smaller pieces and is moving forward with construction even as the architect works to finalize the design.
“We spend a lot of time with the hospital staff, getting their input on mockups and rough-ins, communicating to folks what’s going on,” comments Ireland. “We don’t take the ‘it’s not in the plans, so we didn’t do it’ road. As a member of HCA’s team, it’s our job to anticipate problems, get the right parties involved and solve them. It’s not just about building buildings; it’s the relationships we form with HCA and its hospitals.”