There’s no doubt health care facilities face real challenges when dealing with construction and design. One way to combat these challenges is by staying up-to-date on industry-related trends.

One trend that will continue to expand is outpatient construction as it uses surgical technology to accelerate inpatient procedures into outpatient settings, as well as the continuing trend of patients being funneled by health care systems into outpatient settings. Additionally, as hospitals and health care systems focus on population health, determining what infrastructure will meet the needs of the communities they serve while still supporting current operational efficiency will become increasingly important.

Serious strategy questions will have to be asked. Do entirely new facilities need to be built? Would it be more cost-effective to renovate or repurpose facilities? Perhaps maximizing space through consolidating facilities would be the most advantageous avenue. Or maybe, depending on the circumstances, leasing facilities may offer the best value.

Each situation is unique and it’s critical that health care facilities accommodate necessary changes in finding alternative avenues to provide care in the communities they serve. That includes: ambulatory care facilities, long-term care facilities, imaging centers, medical office buildings and assisted living.

With so many options of potential health care service models available, health care facilities continually face the need to increase their capabilities within those models. Whether it’s keeping up with the latest in technology, adhering compliance to new code requirements, increasing efficiency or upgrading facilities to meet patient needs, the ongoing endgame is improving patient satisfaction.

Another ongoing trend is moving toward more green alternatives, such as LED lighting, low-flow plumbing fixtures and more efficient HVAC systems. Also, as rapid technology advancements involve more sophisticated techniques and equipment, facilities will need to address network data needs, security system enhancement and more up-to-date patient monitoring systems.

The health care industry needs to implement smart growth solutions to capitalize on their existing footprints. There is much to take into consideration. From planning, design and procurement, through construction and operations, each phase of the construction lifecycle offers its own unique set of challenges.

While navigating the complexities of health care construction can be a daunting challenge, opportunities for easing the load are real. Whether through capitalizing on current industry trends or taking on the different stages of the construction lifecycle using the above best practices, meeting deadlines and staying on budget do not necessarily have to be either/or propositions. This will ultimately allow for better overall experiences for health care staffs as well patients and their families.

Douglas Gayden is the director of health care for Greenville, S.C.-based Gordian. He can be reached at 678.920.3672.

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The total cost to build the new tower is $244 million, an increase from $239 million after a $5 million approval to add a hybrid procedure room. The project is Sharp HealthCare’s largest investment to date and is being funded through philanthropic donations to Sharp HealthCare Foundation, bonds, cash reserves and the Medi-Cal hospital fee program, according to a statement from Sharp HealthCare.

“We’re committed to expanding Sharp Chula Vista as this bi-national community continues to grow,” said Pablo Velez, Ph.D., RN, chief executive officer at Sharp Chula Vista, in a statement.

The design-build team for the project includes Greely, Colo.-based general contractor Hensel Phelps; Los Angeles-based architecture firm SmithGroupJJR; and San Diego-based architecture firm AVRP Studios. The grand opening of the new hospital at Sharp Chula Vista is anticipated for 2019.

One of the newest features in the hospital is the redesigned main entrance and lobby. Here, large windows will greet patients with natural light, which will also help to maintain internal temperatures during summer months.

“What really makes this project special is that so many of the craftsmen on the project call the South Bay home and utilize Sharp Chula Vista Medical Center for their health care needs,” said Damian Buessing, director of operations at Hensel Phelps, in a statement.

The hospital will also feature five high-tech surgical suites that offer state-of-the-art technology that used to meet the needs of patients who come to Sharp Chula Vista with health problems that could not be treated at other hospitals.

At 343 beds, the hospital will provide a comprehensive heart program and will also offer specialized orthopedic care for and women and infants. Sharp Chula Vista is the largest health care provider in South County and one of the largest private employers in the county as well, employing more than 2,000 staff and maintaining relationships with nearly 500 affiliated physicians.

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A feasibility study is designed to uncover the strengths and weaknesses of any project. Not only does this evaluate a project’s potential for success, it helps document every aspect of planning, engineering and construction while revealing the full scope of the project. To complete a feasibility study in full, precise documentation during each phase of the project is critical. In Part I of this article, the benefits of communication and accessibility were discussed, now specifics of the study are explored a bit more thoroughly.

By documenting each step in the process, projects are revamped and redesigned and will often go through several iterations of approvals or short delays. When a project is finally relaunched, it’s important for the team to have access to the feasibility study and the defined scope so they can address budget plans and timelines surrounding project construction. This approach can be particularly important for large-scale projects such as health care facilities.

Developed Components

Accurate information captured from the right sources contributes to key components of a study, including the following:

Floor-plan layouts: As with every other aspect of the assessment, floor plans must reflect the current state of the building. To verify the plan, visit the site and walk through it. Identify key systems and needed modifications or improvements. It is important to include a demo plan with the new work plan so that a facilities group can account for the cost of the demo. Also, make sure that the equipment plan is taken into consideration because it can lead to a lot of demand on the existing infrastructure, especially from an electrical standpoint.

Engineering narratives: To develop a realistic narrative, seek the technical, detailed input unique to the perspective of the maintenance staff. Recently, the project team serving the University of Alabama at Birmingham Hospital met with the maintenance group to walk through a space slated for renovation. The team learned vitally important details that they could not have derived from inspecting drawings, such as minor repairs and renovations that were completed by the maintenance staff but not documented.

Construction estimates: Construction estimates should reflect good historical data that is both regional and, when possible, client-specific. Experienced planners have the latest historical data and a working knowledge of its meaning and application. A project team conducting a feasibility study may have client-specific data, or the information might come from the facilities group. A real risk of an inaccurate estimate arises when material costs escalate between the time of the feasibility study and the time that the project is put out for bid. A feasibility study should explicitly clarify that its projections are based on prices known as of a specified date.

Dynamic Starting Points

So, why might a well-documented feasibility study not exist? At the initial starting point of the project there is no purchase order to associate with the cost of the study, meaning the funds to the study are not available. Usually funding is not available until a board of directors has approved a project. Although feasibility studies are not that expensive and can be done quickly, the funding must be allocated for them.

Experienced project teams see and understand this dynamic and have strategies to help facilities groups begin this important pre-planning step toward clarity and confidence that comes from knowing what a project entails and how it can be done within a reasonably precise time frame and within a well-researched and fully documented cost estimate.

By gathering key stakeholders and achieving consensus on the scope of a project, a facilities group begins to empower decision makers toward a very successful project.

Scott Heywood, AIA, LEED AP, is director at the Ghafari Birmingham, Ala., office, and can be reached at sheywood@ghafari.com or 205-203-4611.

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