SEC Report Archives - HCO News

Construction of Northeast Georgia Medical Center on Schedule

MILWAUKEE — Construction on the Northeast Georgia Medical Center Braselton recently reached a significant milestone when the project completed its structural steel topping-off.

Slated for a spring 2015 completion, Minneapolis-headquartered HGA Architects and Engineers designed the 100-bed hospital and Turner Construction, headquartered in New York, is serving as construction manager on the project. As the first new hospital in the state of Georgia in more than 20 years, the new health care facility will bring a new level of patient care to the Greater Braselton community.

“The on-going evolution in health care delivery methods, technology, demographics and reimbursements is placing increasing incentive on hospitals to develop new ways to improve patient services,” said Kurt Spiering, AIA, vice president and principal of HGA’s Healthcare Practice Group, in a statement. “Community hospitals, in particular, are re-aligning their operational processes with a growing emphasis on accountable care. To prosper in the future, community hospitals are positioning themselves as leaders that can cost-effectively deliver quality care and services rivaling any larger hospital nationally. Northeast Georgia Medical Center Braselton is on the forefront of improving patient-centered services with a state-of-the-art community hospital that promotes safety, medical innovation and team-based care.”

Located on a 119-acre River Place campus, the new hospital will offer heart and vascular services orthopedics and neurosciences, cancer treatment, surgery and emergency services. Early in the planning stages, the design team identified seven guiding principles for NGMC Braselton:

• To create a total patient experience that is among the best in the world
• To use evidence-based principles to provide extraordinary safety and clinical outcomes
• To create a setting for physicians and staff that supports their effectiveness through coordinated team-based care
• To create a setting that is sustainable and advances the wellness and safety of patients, families, staff community and the environment
• To innovate through the creation of new ideas
• To create an overall health care destination “village” of which the hospital is but one piece

The design team also conducted a series of public forums, workshops and online surveys to identify the ideal patient experience and followed up with a series of Lean process transformation exercises with hospital staff to create operational practices that allow for smarter workflow.

“Rather than starting from a traditional programming method of designing from the outside in, we approached the project as clinical consultants, planning the clinical processes first and then the structure,” Spiering said. “We based every decision on a research-based approach in coordination with the NGHS Lean Six Sigma Team.”

The post Construction of Northeast Georgia Medical Center on Schedule appeared first on HCO News.

Barlow Respiratory Hospital Design Finds Balance

LOS ANGELES — The design of the new Barlow Respiratory Hospital (BRH) will strike a balance between the building’s modern features and the surrounding historic neighborhood, while also bringing in natural elements to nurture the healing process of the facility’s long-term patients.

The 80,000-square-foot, acute-care facility and 30,000-square-foot administration building was designed by HGA Architects and Engineers, with offices in Los Angeles, and will be constructed by DPR Construction, headquartered in Redwood City, Calif.
Construction will begin on the $80 million project in early 2014 with a tentative completion date of 2016. The project is aiming for LEED Silver certification.

Founded in 1902, the BRH lies just outside of downtown Los Angeles and adjacent to Elysian Park. Architects were charged with designing a building that did not appear as if it were built 100 years ago, but also to not disrupt the historic, park-like setting of the 25-acre campus.

“We could not retell the history but at the same time the building needed to say it was a brand new, state-of-the-art building and a new identity for Barlow,” said Satoshi Teshima, AIA, LEED AP, project designer with HGA.

The three-story building, which will replace the existing facility built in 1927, is also larger than the other structures on the campus. The architects decided on the size of the building because they wanted to blend in with smaller structures but also be significant enough to not be hidden in the background, Teshima said.

The structure of the building is a gentle S curve, which mimics the in and out motion of easy, flowing breathing. The design of the S curve developed from strategies in the planning process. As architects studied nursing pods, which occurred in eight-bed pods, a triangular or saw-tooted pattern began to develop, according to Joey Kragelund, AIA, principal with HGA.

“From there it started to refine itself as we started to learn more about the kind of care they provide and the softness of the S curve started to materialize,” Kragelund said.

The S curve also works with the topography of the site, which is situated against a hillside, and provides views of the surrounding natural scenery to all patient rooms. Additionally, the formation eliminates all sharp corners and does not disrupt the historic context of the campus.

“It was actually generated by planning with an overlay of the specific context in which this building is located in and that resulted in this soft S curve, which makes this building much more intriguing and also tells a great story about the act of breathing itself,” Teshima said.

The challenge to finding a balance on the exterior design of the building also occurred in the interior design, Teshima said. Because patients at BRH have an average stay of 30 days, the architects are creating an environment that is both clinical in function but organic and home-like in atmosphere.

“It has to feel warm and welcoming,” Teshima said.

The 48 all-private patient rooms are patterned after themes of “tide” and “metamorphosis” to symbolize the act of easy breathing while creating a serene, organic environment for patients and their families. The organic and warm tones of the interior materials were specifically used to evoke emotions of nature, Teshima said.

“If you can evoke that consciously or unconsciously it makes people more comfortable. At the end of the day, you might get bored looking at a certain image or a certain color, which happens to be a trend, but you’ll never get tired of looking at the ocean or the sunset,” Teshima said.

The post Barlow Respiratory Hospital Design Finds Balance appeared first on HCO News.

Owensboro Replacement Project Under Way

OWENSBORO, Ky. — Construction has begun on a $420 million, 780,000-square-foot replacement hospital for Owensboro Medical Health Center.

When the project is completed, OMHC will house 447 beds and service patients from 11 Kentucky counties. The project is being built in three phases and is schedule for completion in 2013.

Designed by HGA Architects and Engineers of Milwaukee and built by Turner Construction Co., the team is utilizing an integrated project delivery to coordinate scheduling and the budget.

Situated on a 145-acre campus, the medical center will include a nine-story inpatient bed tower, a three-story diagnostic and treatment building, a 30-bed transitional care unit, an emergency department organized around pods of care, and a women’s center with dedicated drop-off and entry points. OMHC will also feature a heart center, a neuro-diagnostics area, and outpatient diagnostics facility.

Linking the diagnostic and treatment building and the curving bed tower is a nine-story spine that houses inpatient support and administrative spaces. These structures are organized around a central courtyard that provides views and natural lighting.

“HGA introduced lean design principles into the planning and development process to enable Owensboro to achieve a lean business model,” says Kurt Spiering, vice president and principal with HGA in Milwaukee. “The new hospital will be one of the leading medical centers in Kentucky offering state-of-the-art technology and advanced delivery processes to maximize the patient experience.”

The bed tower will have twin 24-bed units on each medical floor, designed with an emphasis on staff efficiency and patient and staff safety. Design features include same-handed rooms, dedicated family spaces in each patient room, and two-leaf room entry and patient toilet doors.

OMHC will have a number of technological innovations, including registration kiosks, wireless staff communication tools, electronic medical records, barcode medication administration, and a patient education network.

Slated to achieve LEED Silver rating, the medical center will utilize locally harvested materials to create warm, healing interior and exterior environments. A series of courtyards will provide interior daylight and green roofs are planned for the women’s courtyard, the bed tower, and a connector hallway. Outdoors, bioswales, native grasses and plants, and a restored adjacent flood plain will mitigate storm water runoff and reduce irrigation needs.

The post Owensboro Replacement Project Under Way appeared first on HCO News.

Review Process Impacts

California healthcare construction costs are among the highest in the nation, with $2.5 million as the average cost per bed for new hospitals. That’s why healthcare leaders in California are now utilizing a program called Phased Plan Review for more than 70 projects at 50 hospitals throughout the state.

What is Phased Plan Review? In California, most healthcare projects must go through a rigorous review process with the Office of Statewide Health Planning and Development. The traditional process is a continuous cycle of state reviewer comments and architect responses on the completed construction documents, which can take up to two years.

Sometimes these reviews result in a complete reworking of a hospital design. To save time and decrease the potential for project escalation costs, a committee of hospital, design and OSHPD representatives came up with a collaborative streamlining of the OSHPD review process that also incorporates a lean project delivery approach to decrease waste and increase value.

The resulting PPR process starts with OSHPD reviews at the outset of the project. The architect submits milestones on a set schedule agreed upon by the design team and OSHPD, which is referred to as the PPR matrix. Review is under way soon after each segment or increment of the project design is completed instead of looking at documents as a whole.

The design team can quickly respond to OSHPD’s comments when that portion of the project is fresh, while also preparing the next agreed-upon package of drawings and materials. As a result of PPR, the time from design to construction to occupancy is expected to be about 12 months less than that of a comparable project going through the traditional OSHPD review process.

Lessons Learned

HGA Architects and Engineers recently used PPR to help expedite its work at Clovis Community Medical Center in Clovis, Calif., a large and complex project that involves the addition of a new bed tower and expansion of the diagnostic and treatment platform, as well as infrastructure upgrades.

Through this project experience, HGA’s designers can offer the following tips and observations that can contribute to the success of any complicated project that requires reviews and approvals:

Agreeing to PPR

An owner and its design team must understand and consent to some key caveats before utilizing PPR. Since changes to OSHPD-approved project components are a deal breaker for PPR, the owner must agree to not make any changes to portions of the design that have already been reviewed and approved via PPR by OSHPD. Issues are worked out prior to implementation documents, saving time and rework.

Another agreement is that the design team must be willing and capable of dedicating staff resources to up-front design work on tight schedules. They, and OSHPD, must be prepared to work hard and fast to keep up with the milestone review schedule. The timeframe for reviews needs to be negotiated early with OSHPD so that expectations are clear.

It is recommended to build in buffers to absorb schedule delays. Ultimately, both the owner and design team must be in agreement about the value PPR will bring to the project, and understand its implications in regards to keeping schedule commitments, making decisions and sticking with them, and following through on promises, as well as continuous communication and collaboration.

First Steps

As part of the first PPR milestone at Clovis Community Medical Center, HGA submitted a package that addressed structural and Fire Life Safety (FLS) design approaches to OSHPD. These two segments usually create the most need for rework and resubmission on a project. By first receiving OSHPD’s approval of the design approach for structural and FLS, many of the other design components moved ahead on a faster schedule.

For easy reference and continuity, the FLS plans should be kept with the architecture drawings. Additionally, alternate methods of compliance must be determined and approved early in the process.

Working the Phases

Planning and working toward a reasonable number of submittal milestones helps maintain a more aggressive schedule. Conversely, compiling too much information into one phase can result in the need for more review time.

Smaller, more frequent submittals enable OSHPD to complete reviews in a timely manner. Submittals must be complete and offer sufficient information and reference drawings necessary for decisionmaking. This proactive preparation results in more productive and complete feedback, resulting in less rework and waste.

To be successful with PPR, the team must be cohesive and adept with multi-tasking. While one milestone is being prepared for submittal, responses to comments on previously submitted milestones are also expected.

Utilizing online logging to track progress helps keep the team informed and coordinated. Continuity of team members throughout the project helps increase the team’s affinity and builds trust, as well as increasing efficiency and keeping project knowledge alive and accessible. All team members are responsible for being up-to-date on the intent of submittals and keeping abreast of project comments and responses to questions.

An Evolving Process

As with anything that is new, there is fine-tuning and continuous learning taking place for the process improvement of PPR. Consideration of conceptual approvals on areas such as duct wrap, fire dampers and structural systems are being discussed.

Overall, the learning and adoption of PPR will be built on a framework of openness and willingness to listen to new ideas, as well as patience and respect for team members as everyone becomes more familiar and adept with the process.

The PPR process is forging a new path founded on determination, positive attitudes and skilled collaboration that is resulting in significant changes in the way healthcare projects are reviewed and approved. Certainly, it illustrates a philosophical shift and a welcomed change in the healthcare design industry.

Bonnie Walker, AIA, is vice president and healthcare practice group leader for the Sacramento office of HGA Architects and Engineers. Walker can be reached at bwalker@hga.com.

The post Review Process Impacts appeared first on HCO News.