HCA | Portsmouth Regional Hospital | ICU/Med Surg Vertical Expansion & Renovation | Portsmouth, NH

A successful project is often a result of early coordination and planning it right from the preconstruction phase. Early BIM collaboration with MEP and steel trade partners helped the team complete installation faster and eliminate rework during construction. Modeling scopes before install and conducting weekly BIM meetings with the VDC team to review clashes and clear constraints prior to install resulted in a smooth installation process, allowing the team to identify and mitigate issues virtually before they arose onsite. The area coming out of the mechanical penthouse is a prime example of this coordination. The space was congested with extensive piping and ductwork, prompting the team to dedicate time to ensure model accuracy. The team walked the area as soon as the foremen were onsite to verify the modeled install, which aligned the entire team and set them up for success.

The team also leveraged technology early on to avoid surprises and develop a course of action for challenging areas. Due to the age of the hospital, DPR expected the above-ceiling areas to be especially congested with existing MEPs. To mitigate this challenge, DPR utilized Insta360, a 3D camera, to explore the existing conditions within the ceiling before trade partners even mobilized. After reviewing the photographs, the team developed a complete and thorough logistics plan prior to starting work on the active first floor of the hospital. The team reviewed logistical concerns, identified if existing piping needed to be relocated, and if the installation was feasible as initially designed. The camera was also used to explore an area where the design intent was to install a structural kicker on an existing column. After reviewing the 3D images, the team determined the only way to install the kicker was to offset a section of ductwork first. The team coordinated the work accordingly and then brought in the steel trade partner to complete his respective scope. This proactive approach helped save time and budget and allowed the team to re-sequence construction activities for the most efficient install process.

Working closely with the hospital facilities department, especially throughout the COVID-19 pandemic, proved critical to the team’s success working within active areas of the hospital. The DPR team consulted hospital staff on logistics planning, such as setting up ICRA containments in mutually agreed upon areas including the radiology waiting room and emergency department nurse’s station to ensure minimal disruption to staff and patients. The team formed relationships with the heads of departments, using their input to coordinate work around busy times in the hospital. When tying in new AHU-19 ductwork, a three-day shutdown was needed in the active IR room. After discussing with the head of radiology, the team determined the least impactful timeline for the work and coordinated accordingly. Additionally, new pipe runs and core holes were required in similarly busy departments on the active first floor. The on-site team worked with the heads of each department to coordinate a timeline for the construction scope, while prioritizing hospital operations. This collaborative approach allowed the team to maintain a tight schedule while limiting the impact to patients.

During the project, the team made significant structural improvements to the columns and beams located in active areas that included the central nurse’s station in the emergency department and the radiology waiting room. Vertical construction was stubbed off of 50 existing columns, and 13 of the first-floor columns were reinforced. ICRA containment was set up and maintained while demolition, welding, and spray fireproofing were completed inside the contained areas. The team maintained open lines of communication with hospital and facilities staff, resulting in minimal impacts in the affected areas.

Working in an occupied healthcare facility throughout the pandemic caused even more urgency to turn construction over quickly. The DPR team connected with HCA early to discuss opportunities for prefabrication onsite to prompt schedule savings. HCA vocalized their desire to utilize prefabricated exterior panels which DPR was able to price, coordinate and incorporate into the schedule. DPR contracted with an HCA-recommended vendor and set up early coordination meetings with the exterior envelope subcontractors. The team color coded each of the critical details, outlining who owned specific parts of the scope. This approach mitigated disputes in the field and potential cost & schedule impacts.

Additional prefabrication elements onsite included prefab drywall soffits and prefab headwall systems. The headwalls were equipped with electrical, data, and medical gas receptacles and piping/conduit that was stubbed 6” above the top of headwall. Connections were then made in the field at the top of the headwall. They were delivered in 2’x8’ tall panels to fit in the predetermined wall opening, saving time that would have been used on the field to layout and rough in all the patient bed outlets, switches, in-wall blocking and medical gases. All 13 rooms had the exact same layout, making the prefabricated option more efficient.

The project team’s commitment to respecting hospital occupants and communication with staff was paramount to the success of the expansion and renovation. The project was completed under budget and on-schedule.