PALO ALTO, Calif.—A new hospital has opened at Stanford University, the storied institution of higher learning located in Northern California’s Silicon Valley. The Stanford Hospital, sited on the Stanford University Medical Center (SUMC), broke ground in 2013.

The 824,000-square-foot medical building opened its doors on Nov. 17, admitting 200 patients across a new skyway that connects it to the existing hospital, the university announced. Starting at 7:00 in the morning that day, the new facilities were gradually opened for business, including the brand-new Marc Andreessen and Laura Arrillaga-Andreessen Emergency Department. (The hospital’s older ER will now be solely for pediatric patients.)

Hundreds of patients were relocated to the new hospital on the day of unveiling, starting at 9:00, with one of the hospital’s administrators estimating a new patient was moved into the new hospital every four minutes. The work took several hours and required over 1,600 healthcare workers.

In a statement released by the university, Stanford Health Care President and CEO David Entwistle said he was excited the updated healthcare building is now accepting patients.

“I am also grateful to our incredible employees who went above and beyond to make this a seamless transition for our patients,” Entwistle said.

The new hospital has been under design and planning for a decade, with Rafael Viñoly Architects of New York working in concert with Lee, Burkhart, Liu Inc. of the Bay Area on the project. The latter firm designed the bridge and tunnel to connect the old and new facilities. Clark Construction Group-California LP and McCarthy Building Companies Inc. jointly broke ground on the project in May 2013.

The new Stanford Hospital is the only Level 1 trauma center in the San Francisco-San Jose corridor, the university announced. In its seven-story structure, the hospital will offer 368 private patient rooms and 28 operating rooms. Its emergency department is double the size of the older building, the university said.

“Welcoming the first patients to the new Stanford Hospital marks a major milestone in our precision health vision,” Lloyd Minor, the dean of Stanford School of Medicine, said in a statement at the unveiling. “In this world-class healthcare facility, we will not only treat disease, we will predict, prevent and cure it. … After a decade of planning and construction, I’m excited that the new hospital is open and ready to advance the health and wellness of our surrounding communities and people around the world.”

“This new hospital will be a place for firsts,” added Entwistle in another statement released by the university. “New discoveries will be made here. New procedures will be performed. And through this state-of-the-art facility, we will revolutionize the way patient care is delivered at Stanford.”

The Stanford Hospital is just one part of the overall SUMC Renewal Project. Other components include expanding the Lucile Packard Children’s Hospital and renovating the Hoover Pavilion.

The older existing hospital will continue to remain in operation and is being renovated to provide better private rooms for patients.

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Preventative Treatment: Enhancing a Safety Climate

Each healthcare facility has specific upgrade requirements to better treat its patients. These renovations bring unique challenges that can present potential safety hazards to the health of the workers and building occupants. Like we keep our bodies healthy through preventative and ongoing care, a project’s safety wellness requires proper implementation of good preventative treatment practices early and often throughout the project life cycle.

Through detailed planning and engineering solutions, project teams can create layered and comprehensive approaches to identifying safety risks and preventing accidents before they happen. These steps are a project’s first line of defense. For example, in order to ensure the safety of those working, as well as the employees and patients within the hospital – the first thing that is done is that the concrete is scanned with a gpr scanning device to help make sure that nothing is damaged during the entirety of the construction project. When done well and combined with personal protective equipment – the last line of defense – they result in a project that benefits the health and wellness of everyone at the facility.

Tread Softly (Or as Softly as Possible)

Progressive general contractors consider all possible outcomes, even before breaking ground. Keeping everyone as safe as possible and the project running efficiently requires planning and the procedural methods for project delivery. Plan for everything. Train workers in patient safety and comfort, use noise-reduction technology, implement separate worker entrances and manage material delivery flow to ensure that construction traffic doesn’t pose any risk to emergency room access, for example. Additionally, it is imperative to assign dedicated MEP personnel to ensure that plans and actions will not interrupt the facility’s power source.

Keeping It Clean

On any construction project, safety is paramount. In healthcare construction, however, this concern for safety becomes even more acute as the wellness of current and future patients must be considered. Protecting patients, who often have compromised or weakened immune systems, requires meticulous attention to detail. One way to do this is to isolate construction areas from active healthcare operations. This process involves taking every possible precaution to plan for and execute strict contaminant control procedures to protect building occupants, including, but not limited to, the use of portable dust containment units, noise reducing technology and separate worker entrances.

Temporary partitions are an important component to effectively isolate construction spaces from active patient areas. Conventionally, temporary drywall partitions are erected, and later demolished and rebuilt as the work progresses. In addition to this solution being costly and time consuming, it also increases the risk of infection due to the dust generated during assembly. New temporary wall systems, such as the Edge Guard panel system, integrate ICRA barrier requirements, including pressure monitoring, notices, security and filtration. These temporary walls are easy to reconfigure when necessary and allow for greater ongoing patient protection during construction.

Planning for the Prevention of Common Accidents

In the United States, construction is one of the most dangerous industries. We protect patients, but we also want to ensure that construction workers don’t become patients. The first step to worker safety – minimizing exposure to safety risks in the first place – is essential to accident prevention. Safety teams should examine the overarching plan of construction with strict attention to detail. Once a risk is identified, take steps to engineer the hazard from the project; find different solutions that remove possible safety dangers from the jobsite before they ever come into play.

Most common construction site injuries can be traced to just a handful of causes. Education, awareness of fall hazards, and a reinforced climate of safety are the hallmarks of a safe project. While proactive employers require mandatory safety preparatory meetings at the start of each shift, these meetings are only effective if the foremen and crew are engaged and focused on planning of their work. When done correctly, these meetings provide a great opportunity to capture the crew’s attention at the beginning of each shift, update workers on what will be happening that day, answer questions, and communicate if any new equipment or machinery will be used within specific work areas.

Fall Prevention & Protection

Even on the safest construction sites, there are still uneven surfaces, ladders, elevated work areas, and scaffolding – all that create the potential for dangerous falls. Unfortunately, as careful as workers are, gravity wins every time in the event of a slip, trip, or fall.

Exactly 879 fatal injuries occurred in the construction industry in 2015, with a rate that triples the overall U.S. workplace fatality rate. Falls and struck-by incidents were the most common injury mechanisms in the construction injury. A 2016 study in the American Journal of Industrial Medicine concluded that Traumatic Brain Injuries (TBIs) accounted for 25 percent of all construction fatalities, and that a large percentage of TBIs in the industry were due to falls.

In addition to permanent injuries and lost lives as the result of falls, businesses lose billions of dollars each year from significant increases in insurance premiums, workers’ compensation claims, product liability costs, and other related expenses. Additionally, the low morale of seeing a severe injury to a coworker can be traumatizing and decrease productivity from the remaining workers. These factors make the impact of even one fall from a relatively short height extremely high, and their prevention extremely valuable. Workers will try their best to adhere to the health and safety guideline put in place to ensure their safety while they work, however, there are some cases where these guidelines are not followed either because they are not properly trained or rules are ignored due to complacency. Personal injury can occur in these cases, resulting in bodily injury, which can vary from insignificant to fatal. The injured party or their family would, in turn, go to a personal injury lawyer in the hopes of getting compensation to cover medical bills, loss of income, and other items relying on financial benefits. Due to this, personal injury law firms have various services that aim towards helping workers should they require legal assistance. You can visit this page to get more information on the best kind of personal injury law services offered in such cases.

Ultimately, it is undeniable that workplace accidents can have devastating consequences for both employees and employers. With this in mind, if you have been injured at work, it is vital that you are aware of your legal rights. To learn more about the law surrounding workplace accidents, take a look at some of the personal injury resources on this Website.

Researching & Implementing the Latest in Certified Safety Equipment

While the focus of safety programs is clearly aimed at preventing all falls, forward-thinking companies are investing in more technically advanced safety equipment to provide better protection for workers who do slip, trip, or fall. Head protection may not be the first thing that comes to mind when considering fall protection, but given the data on TBI’s as result of falls, it makes sense. Researchers recommend that safety interventions must be emphasized in the construction industry. Prevalent industry standards for head protection uses equipment designed in the 1960s. To that end, new high-tech construction safety helmets with chin straps are being used to prevent TBIs by early-adopting companies.

The new rated helmets with chin straps – which look like helmets used in adventure sports such as cycling and rock climbing – still protect employees from dropped objects and flying debris while offering enhanced head protection if a fall occurs. The helmet weight is evenly distributed across the wearer’s head making the headgear more comfortable and offering more protection against impacts on the head. Most important, these new helmet designs include chinstraps that make it less likely to come off if a worker falls.

While technology will continue to develop and change the shape of how healthcare construction projects are completed, a responsible company aims to create a higher standard of safety for both patients and workers. A multi-pronged approach that focuses on a job site’s safety climate, elimination of risk, and adoption of research-based, innovative PPEs, will lead to fewer injuries and a safer work environment. The need for innovative ways to prevent workplace injuries is crucial. Dr. David Michaels, assistant secretary of labor for Occupational Safety and Health, recently stated, “OSHA believes advances in technology and greater flexibility will reduce worker deaths and injuries from falls.”

The healthcare industry provides care for communities and saves lives. We understand that purpose with the greatest sense of respect. As contractors, we honor this duty in a number of ways: by keeping impact low, by proactively preventing patient risk and by ensuring workers don’t become patients themselves. We strive to bring and reinforce a climate of safety every day at job sites for workers, clients and patients.

Kris Manning is vice president of safety with Clark Construction Group LLC and has been with the company since 1998. He is an Envision Sustainability Professional (ENV SP) and has a Lean Enterprise Certification.

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Part I of this article focuses on research and how it affects the impact on hospital design, especially facilities geared towards veterans. One such facility focusing on patient-centered design is the Southeast Louisiana Veterans Health Care System Replacement Medical Center, a VA medical center destroyed when Hurricane Katrina devastated New Orleans. Designed by national architectural firm NBBJ with two local New Orleans firms, Eskew+Dumez+Ripple and Rozas Ward Architects, the new four-story, 1.6 million-square-foot campus, dubbed Project Legacy, now serves more than 70,000 veterans in a 23-parish catchment area and across the Gulf Coast with an anticipated 550,000 annual visits.

Read on to see the other elements of the project that made it a success in achieving patiet-centered design for veterans.

Timing

Planning for the project’s successful delivery began during the pursuit process when Clark/McCarthy Healthcare Partners (CMHP), the joint venture that constructed the project, proposed a phased construction schedule. Turning over the project in segments allowed VA personnel more time to commission, activate and move into their new buildings. In 2014, the project’s first building, the renovated and restored historic Pan-American Life Insurance building, was turned over to the VA for its administrative offices. The remaining eight buildings were turned over upon completion, the most recent being the diagnostic and treatment building in October 2016.

To maintain the client’s target date for medical care, CMHP further phased construction to turn over critical portions of the facility before buildings were fully complete. The team turned over the main computer room in the diagnostic and treatment building 10 months before the remainder of the building to allow VA medical center personnel to expedite the installation and activation of much of the campus’ technology infrastructure.

Construction Collaboration

The City of New Orleans and CMHP worked collaboratively on logistics, infrastructure planning, small business outreach and communications, which included working with the Louisiana Department of Transportation. Maximizing opportunities for small, local, disadvantaged, minority-owned and veteran-owned businesses was a CMHP priority throughout construction.

The team’s phased approach allowed subcontracting packages to be divided into smaller scopes that were more manageable for small firms. A typical project of this size would have between 70 to 90 subcontractors; this effort had nearly three times as many. More than $230 million of contracts were awarded to small businesses. The contracting team further increased opportunity for local businesses by hosting two, six-part training sessions to help educate small businesses on federal contracting and construction best practices. Approximately 50 companies completed this CMU Building Blocks program. CMHP also followed up with hands-on construction training and setting up a mentorship program. The result is that local businesses not only understand procurement, but individual tradesmen have developed a trade in coordination with this job.

The Result

Project Legacy, as this medical center is nicknamed, broke ground in June 2010, began accepting outpatients in December 2016 and is opening in phases throughout 2017. This facility sets new standards for VA’s patient-centered care, in a facility that honors veterans’ service and reflects the culture of New Orleans. The campus includes 200 inpatient beds, 370 outpatient exam rooms, 21 procedural suites, ambulatory clinics, emergency and imaging departments, mental health services, patient education facilities, transitional living and outpatient rehabilitation, a central energy plant and two parking garages. The hospital also features a gymnasium, swimming pool, healing gardens, courtyards, and walking paths. The facility is designed to meet the full array of VA missions — education, research and national emergency preparedness and assistance.

Conclusion

By linking health care construction and design strategies with key desired outcomes, such as reduced health care–associated infections, fewer falls, increased energy savings, better patient satisfaction and increased market share, the discussion at the design table is no longer about the first costs of health care facility design or about meeting immediate facility space needs but about the role of the physical environment in supporting the mission of the organization in providing high-quality care. This is a positive trend that will affect the quality of health care facilities being built in the years to come.

Barbara Wagner is senior vice president with Clark Construction Group – California, based in Irvine, Calif.

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