November 16, 2020

Upfront coordination was critical to success at the Banner University Medical Center Stereotaxis Cathlab in Phoenix, where DPR installed a first-of-its-kind robotic magnetic navigation system used to treat heart rhythm disorders. In this specialized facility, patients can receive expert care with the aid of a new generation of robotics.

The team delivered this project –including the first installation of the new Genesis navigation system in the U.S. –with zero rework under some of the most stringent quality healthcare requirements.

As this was one of the first Genesis Robotic Magnetic Navigation systems in the world, the project team had to pioneer its own installation process. Photo courtesy of Dustin Ridley

Piecing the puzzle together

As this was one of the first Genesis Robotic Magnetic Navigation systems in the world, the project team had to pioneer its own installation process. The system was also seeking FDA approval during part of the construction timeline, so the team had to plan to accommodate multiple systems due to the uncertainty of what would ultimately be installed. Collaboration with the designer, HMC Architects, engineering partners Pangolin Structural and LSW Engineers, and trade partners was critical.

Nine different pieces of equipment from various manufacturers needed conduit/raceways going through the floor and walls, and elements like air conditioning and lighting had to be incorporated without penetrating the room’s barrier. Additionally, the team could not shrink the room to make the walls wider or lower the ceiling, so there was extensive coordination for overhead infrastructure.

“Just like a traditional MRI envelope with copper shielding, this space had steel shielding and lead around the room,” said DPR’s Cody Murata. “In a normal room, you can just move an outlet. In this room, we would have had to rip off the drywall, steel shielding, and lead to make changes. We had to get it right and we had to get creative because everything had to stay inside the room.”

Starting with three different vendor drawings of the various systems and a floorplan of the room, Murata pieced together a single plan and sketched out all the conduits in the space. The team took this coordination effort further by leaning on DPR’s Virtual Design and Construction (VDC) capabilities to do clash detection and specific routing within the 3D model.

The team conducted a floor flatness analysis and scanned the floor before leveling material was poured to reduce variations and confirm it was within the tolerance. Photo courtesy of DPR Construction

Perfectly level

The facility will enable procedures where a doctor makes an incision in the leg and carefully maneuvers a catheter through the body. The system uses small rotating magnets and magnetic fields to navigate remotely, and thus requires very tight tolerances for floor flatness because of the way the magnets glide during operations.

Using a laser scan of the floor and underneath the floor, the team created a model to avoid structural steel. Next, they conducted a floor flatness analysis and scanned the floor before leveling material was poured to reduce variations and confirm it was within the tolerance. In the end, it was 0.008 inches within tolerance – exceeding the standard.

“The team went above and way beyond with major attention to the smallest of details and design coordination,” said Greg Borden, Banner University Medical Center’s project manager. “Stereotaxis [the Genesis system vendor] didn’t even need to shim the base plates to achieve laser alignment between the two robotic magnets. This goes along with DPR also having zero rework.”

In this specialized facility, patients can receive expert care with the aid of a new generation of robotics. Photo courtesy of Greg Mastorakos

Using all the tools in the virtual toolbox

Integrating DPR’s VDC capabilities into the workflow of its Special Services Group, which was enlisted for the renovation project, proved beneficial to this highly complex endeavor. Prior to construction, the team’s VDC specialist, Ted Barnes, worked with all stakeholders to evaluate, scan and model site conditions, as well as coordinate with design and trade partners.

“Integrating with the team early enabled us to review issues that would directly impact the project and communicate and resolve them before they could cause problems during construction, “said Barnes. “It helped foster an environment of decision-making and collaboration that made coordinating this project successful.”

Adding to overall efficiency and quality control, DPR self-performed concrete, drywall and other special scopes. Ultimately, the project was completed in just seven months and came in under budget, but the ultimate indicator of success was the fact that nothing had to be redone. “Zero rework is the goal,” said Murata. “How you achieve that is upfront coordination. If you have no rework then you will have zero defects.”