This 14-phase hybrid OR renovation shared a sterile corridor with existing, functioning ORs. (Photo by Gregg Mastorakos)
Hybrid ORs are equipped with full OR equipment and imaging technology, and are monitored by control rooms, such as this one. (Photo by Gregg Mastorakos)

Delivering Predictability in an Unpredictable Setting

Overcoming myriad challenges on the University of Arizona’s University Medical Center’s hybrid OR renovation within a sensitive, operational facility

Team Players

CUSTOMER: The University of Arizona Health Network is Arizona’s first academic medical network. Nationally recognized for providing exceptional patient care, it teaches new healthcare professionals and conducts groundbreaking research through the physician-scientists of the University of Arizona College of Medicine.

ARCHITECT: Shepley Bulfinch

PROJECT HIGHLIGHTS:

  • This project was a $9.1 million, 22,000-sq.-ft. hybrid OR modernization and renovation.
  • The work area shared a sterile corridor next to 16 existing and fully functioning ORs. It was directly above sterile processing and adjacent to Diamond Children’s Medical Center and existing Post-Anesthesia Unit (PACU), and Pre-op Ready Room (PRR) space.
  • Project scope: PRR with 18 patient bays and four pediatric isolation rooms; a positive pressure room for special procedures; anesthesia work room and library; surgery waiting room; additional laboratory space; renovations to the existing PACU; and major utility upgrades.

Hybrid operating rooms (OR) have sprung up in rapid succession, with approximately 100 U.S. hospitals reportedly now having hybrid OR capabilities. These single rooms are equipped with both full OR equipment as well as imaging technology that enables minimally invasive surgery. Hybrid ORs allow surgeons to diagnose issues while patients are in surgery and make quick adjustments that can provide life-enhancing consequences.

DPR’s Special Services Group (SSG) team recently completed a modernization and renovation project for the University of Arizona’s University Medical Center - University Campus (UAMC) in Tucson. Challenges ranged from extensive hidden conditions and added scope to technology-driven late design changes to logistical issues. In the face of challenges and unpredictable circumstances, the team produced a predictably high quality result.

Complex From the Start

One challenge was the sterile and fully functioning spaces surrounding the modernization and renovation.

“It really couldn’t have been much more difficult if we tried,” commented Lynn Harris, senior project manager for the University of Arizona Health Network. “It was extremely difficult to plan the logistics of getting workers and equipment into the building through the construction zone, and keeping our operation running and maintaining the required sterility for air, dust and so forth.”

Hidden Conditions

Originally slated for four phases, hidden conditions and added scope caused the project to transform into a 14-phase job. With outdated drawings, the team needed to understand how the hybrid OR would tie into the existing building. The breakneck pace of the project left little time to find out. As a solution, they decided to laser scan above the ceiling systems. Among other things, they uncovered pipes in unexpected places, electrical discrepancies and ductwork shown on drawings that did not actually exist. This information was invaluable in the coordination process.

Building Around Unknown Equipment

As medical technology constantly evolves, equipment selection can be a challenge on hybrid OR projects. Adding to the project’s complexity was the fact that the equipment selection and final design for the hybrid OR and robotic rooms were not completed until six to eight months into construction. This is usually completed around mid-design.

“When trying to get pricing together, you’re making educated guesses without actual drawings from any of the vendors or suppliers,” said DPR Project Manager Nathan Lentz. “DPR has had enough experience nationally that we know what it takes to put together a room.”

Self-Perform to the Rescue

DPR’s self-perform work for metal stud, drywall and framing proved to be a major benefit in controlling schedule and costs for top quality results.
“It was an advantage to have self-perform workers quickly available to jump in and help,” said Lentz. 

In June 2013, DPR completed the project and received rave reviews from the owner and its user groups.

“This project required a lot of sensitivity to what the hospital’s needs were to stay in business, as well as construction knowledge,” said Harris. “We would welcome DPR back any time.”

Read more about the project in the extended case study.