“When you go into an area that’s designed to be state-of-the-art, there’s a certain excitement about that,” said current CEO Mark O’Bryant in a Tallahassee Democrat article. “There’s a certain flexibility in realizing you’re able to do some things you’ve never been able to do before.”

The five-story, 340,000-square-foot tower is estimated to cost $250 million. TMH already has 772 rooms. Construction will add a build-out of 28 new operating rooms, a new genetics lab, 12 shelled operating rooms, four suites for neurosurgical and vascular procedures, 72 adult care beds — 60 of which will be operational when the tower opens, 60 intensive care unit rooms (ICU) and 12 shelled ICU rooms.

Plans call for semi-private rooms to be converted into all-private rooms. The facility will also replace all existing operating rooms and related support spaces, including respiratory therapy, CT imaging, post anesthesia care unit, perioperative services, sterile processing services, blood banking and pharmacy services.

Designed by Gresham, Smith & Partners, another Birmingham-based company, the design included input from clinical staff, nurses, patients, physicians, family members and outside consultants. In a since-demolished mock-up room, nurses and surgeons inspected the long-awaited technology. Self-adjusting lights hung overhead. One person can man video and suction equipment. Surgeon Andrew Wong said, “The new equipment is cutting-edge. It could actually make performance of the surgery easier.”

The tower is also dedicated to and named after M.T. Mustian, the former CEO of TMH, who made significant contributions during his time as CEO from 1964 to 1989.

“He was the CEO during a very tumultuous period,” said current CEO Mark O’Bryant in a different Tallahassee Democrat article. “He was here as CEO for 25 years. When you think about the entire history of the organization, that’s a sizable portion of it. During that period of time, the hospital went from a small community facility to a large regional powerhouse.”

Despite construction on the existing campus, Brasfield & Gorrie ensures that the hospital will remain fully operational and easily accessible throughout the process. TMH currently serves Tallahassee residents within a 50-mile radius with hopes of expanding its care to 100-mile radius through the entire Panhandle. Already TMH received designation as a Comprehensive Stroke Center by the Agency for Health Care Administration.

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One of the busiest surgical hospitals in S.C., Lexington Medical Center performed more then 19,000 surgeries last year. Eight more operating rooms will be included, bringing the total to 31 operating rooms. An expanded surgical recovery area of 11,332 square feet will also be included to accommodate medical, critical care and surgical patients.

The Labor and Delivery and Mother/Baby departments — units that welcome more than 3,700 babies each year — will also be expanded. In the Special Care nursery, babies will have private rooms in order to provide more bonding opportunities for mothers and babies. Research has shown this leads to lower infection rates and more positive outcomes for the baby’s growth.

“The hospital is woven into the fabric of Lexington County and the Midlands. This clinical expansion will allow us to take care of our community for many years to come,” said Tod Augsburger, president & CEO of Lexington Medical Center, in a statement.

The pharmacy department, which services all inpatient needs and 60 physician practices and urgent care centers in the area, will be relocating from the oldest part of the hospital to the new patient tower in order to afford staff more space to work.

A central energy plant to support service needs of the tower is in the works, as is a new parking deck to add 950-plus parking spaces to the hospital’s campus. Terrace Café will also be expanded, providing more dining options to staff, patients and visitors alike.

Another project, Lexington Medical Park 3, planned at 175,466 square feet, is already under construction for future physician offices and practices.

The $400 million project is expected to be complete in 2019.
 

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The new unit will be added to the 3rd floor of the new North Tower. Features of the new OB program include:
• A total of 18 suites.
• Six labor and delivery suites
• Ten post-partum recovery suites
• Two ante-partum labor suites
• A 12-positon holding nursery for babies who need special monitoring or continuous observation
• A cesarean surgical suite located in labor and delivery in the event a surgical delivery is necessary
• Lactation specialist available
• Open visitation to support family-centered care.
• Next generation technology with modern state-of-the-art amenities, including the latest industry standards for patient monitoring (both mother and baby).
• Board-certified specialty nurses and other professional support staff.
• A secure unit at all times with a strict admission policy
• Wireless fetal monitoring for patients who meet the criteria.

The architectural firm that has been chosen to oversee the project is Gould Turner Group of Nashville, Tenn. The general contractor for the project is Brasfield & Gorrie, also based in Nashville.

“Our goal is to provide the highest level of quality care and customer service to ensure the birth of your baby is a treasured memory,” Chief Operating Officer Sonia Wellman, who is the project’s manager for Oak Hill Hospital, said in a statement.

“Oak Hill Hospital follows a patient and family-centered care philosophy,” Cindy Poirier, director of women’s servicers, added in a statement. “This means for all healthy births, our goal is to keep mom and baby together as much as possible in those first precious days, so the mother may learn to take care of her baby with the help of a compassionate care team.”

With a thriving pediatric program and rapidly growing GYN robotics services, the move to provide maternity services for the community is a natural next step for Oak Hill Hospital, which completed a $52 million expansion project in January 2013. The hospital recently completed a significant renovation project for its first class of Graduate Medical Education residents, and has purchased 40 acres of land for future expansions.

Planned opening for the obstetrics project is for the end of the first quarter of 2016.

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A joint project between Mississippi Sports Medicine and Orthopaedic Center and Baptist Health Systems, the facility is designed to help people who need rehabilitation as well as offers sports and fitness activities for a broad range of athletes. The two-story, 100,000-square-foot sportsplex and medical office building features a training floor with strength and cardio equipment, an indoor walking track, indoor pool, therapy pools, an indoor field house and athletic field. It also includes 20,000 square feet of medical office clinics for the Mississippi Sports Medicine and Orthopaedic Center, the Eye Group of Mississippi, Image Optical and Mon Ami Spa & Laser Center.

The outside turf field is 45 yards by 55 yards with an outdoor sprint track that is 70 yards long, reported the Missisippi Busines Journal. That is not all though. The performance weight training area contains more advanced weight training equipment specific for training athletes such as weight sleds so that athletes can complete a sled workout. Additionally, the fitness center features cardio equipment such as treadmills, bikes, stair steppers, rowers, elliptical trainees, and adaptive motion trainers. There is also a traditional fitness center with weight training equipment and a functional training area for body weight training and working with kettle bells and medicine balls. Plus, there is an indoor track around the general fitness area that will be about a twelfth-of-a-mile long.

The complex features a wellness clinic that will be staffed by a nurse practitioner offering help with preventive medicine, nutritional advice such as help with weight loss and developing an exercise program. Group exercise classes are also available, including Zumba dance, yoga, body sculpt and boot camp type classes. There are also group water exercise classes in the aquatic facility, which includes a warm water pool with programs for arthritis patients.

“This is an exciting time in the history of Madison,” Mayor Mary Hawkins Butler told the Mississippi Busines Journal. “This is only the beginning. Madison will one day be the area of specialized medicine for the state of Mississippi.”

While Brasfield & Gorrie served as the general contractor on the project, Atlanta-based Oswell + Nitishin served as the architect. Construction started in November 2012.

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The firm, which is serving as contractor, has worked closely with project subcontractors and architect of record HKS to collaborate on the $297 million project. Both Brasfield & Gorrie and HKS hold local offices in Orlando, Fla.

“Collaboration is an element of IPD in which the contractor and the subcontractors work together with the designers through the design phase so the end result is a product that is achievable, is buildable and all the while we’re providing real-time estimates and budget updates to ensure the owner that we’re staying consistent with our financial responsibilities,” said Jerry Whitfield, senior project manager with Brasfield & Gorrie, in a statement.

The project consists of the 10-story, 300,000-sqaure-foot North Tower, the five-story, 100,000-square-foot south expansion and 100,000 square feet of renovation. The project team recently celebrated the topping out of the North Tower.

According to Brasfield & Gorrie, the IPD delivery method improves construction efficiency, risk management, and the predictability of cost and schedule. The construction project has implemented detailed phasing due to the sites urban setting and close proximity to the existing hospital, which continues to operate daily.

“This approach invited everyone to the table early on to map out the construction strategy, thereby increasing transparency and enabling us to provide Orlando Health with realistic cost projections at the start of the project,” said Ren Tilden, operations manager at Brasfield & Gorrie, in a statement.

Currently, all project subcontractors on the project are working in a warehouse near the jobsite in order to work alongside the project team to increase collaboration and maintain strong communication.

“The best outcome of this process is that it is enabling us to deliver a building that satisfies the expectations of our client while deepening trust and support between contractors and subcontractors,” Tilden said.

This is the third IPD health care project for Brasfield & Gorrie. The firm has also implemented IPD in past projects including the Texoma Medical Center in Denison, Texas, and the Spring Valley Hospital in Las Vegas.

Construction on the Orlando Regional Medical Center is expected to complete in late 2014.

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The MIBG treatment targets cancer cells directly and avoids collateral damage to other parts of the body that can occur during traditional therapy. Because of the high volume of radiation transmitted during the procedure, the patient is isolated from his or her family and friends during treatment, which can add anxiety and stress to the situation.

Brassfield & Gorrie based their design for the therapy room around this situation and gathered feedback from Erin and Stephen Chance, who had a son that was a patient at Children’s Healthcare of Atlanta. Previously, he had to travel to Children’s Healthcare of Philadelphia for these treatments because that was the nearest MIBG facility. The Chances worked with the construction team to develop a new design to make the experience more bearable. Televisions are included in each room, as well as three-way video and microphones, so the patient can see their family, talk to them and even play video games with them through the monitors.

Healthcare Construction + Operations News spoke with Tom D’Aleo, project manager at Brasfield & Gorrie, about the patient feedback and the experience designing for this new kind of patient experience.

Q: What kind of questions do you have to ask to get patient feedback that can then be incorporated into a design?

D’Aleo: Throughout the project the number one question was in regards to what can be done to make these two rooms — the parent and patient room — as comfortable as possible because both the patient and parent will be in the rooms for several days.

Q: What other aspects of design did you have to consider in terms of considering the patient experience for this project?

D’Aleo: HKS was the architect on this project and they were great to have on the team because this project was one that evolved throughout the construction process. One item that was taken into account during the planning stages of this project was how to create two adjoining rooms similar to a hotel room due to the fact that there was not enough space to have an anti-room. We used the existing patient room adjacent to the MIBG room as an “ante-room” and the parents’ room because during this treatment process the parent will be the person interacting most with the patient. During the treatment the patient emits radiation and others can only have limited exposure. We installed a lead-lined door between the parent room and MIBG room similar to what you see in adjoining hotel rooms.

Q: What was the biggest challenge on the project and how did you overcome those challenges?

D’Aleo: Space limitations were probably the biggest challenge because we had to work within the footprint of two existing patient rooms and convert one to an MIBG room and the other into an “ante-room” or parent room.

Q: Do you have any other pieces of advice for a professional designing a facility based on the patient experience?

D’Aleo: During the treatment, there are lead shields that need to be rolled into the room and placed in front of the doors, because the walls were lined with ¼-inch lead and the doors were only 1/16-inch lead. While this room is not being used for treatment, the heavy lead shields need to be stored somewhere, so having a storage closet nearby to store these shields and radioactive waste is something that needs to be considered. This is sometimes very hard to do while renovating due to space limitations.

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The firm was recently awarded the vertical expansion and renovation of Medical City Hospital. The project is expected to begin in October and will include a 160,307-square-foot, four-story expansion above the existing emergency department and ambulance drop-off. It will also feature a 68,576-square-foot, phased interior renovation of several campus departments, including surgery, medical oncology, surgical oncology, stem ell and the emergency department/cardio diagnostic unit. This will be the fifth — and largest — renovation project that Brasfield & Gorrie has completed for the facility. Perkins + Will, with offices in Dallas, is serving as the project’s architect of record.

On May 31, the firm also celebrated the official topping out of the South Tower addition at Kingwood Medical Center. The 152,000-square-foot project, which began in October 2012 and is slated for completion in October 2014, includes a three-story addition and renovations of the existing hospital.

The first floor of the addition will feature 12 labor, delivery and recovery rooms, eight high-risk antepartum beds, 24 neonatal intensive care beds, two C-section operating rooms and a four-bed obstetric triage suite. The second floor will include 36 postpartum beds and 32 well-baby nursery beds. On the third floor, there will be shell space for future pediatric and medical or surgical beds. Also part of the project is the new central energy plant. Nashville, Tenn.-based Gould Turner Group is the architect on the expansion.

During construction of the addition, Brasfield & Gorrie is also working on several renovations of the existing hospital, including ones to administrative, admissions and kitchen and dining areas. Parking will also be added to the southeast and northwest corners of the campus.
 

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The replacement hospital will be seven stories and 295,000 square feet; it will open with 56 beds but is built for 112 beds. The top two floors are shell space and will be built in the couple years following the opening. Marietta, Ga.-based CDH Partners Inc. is the architect on the project.

“The job is a fast-track project, and started before design was complete,” said Reed Weigle, senior project manager with Brasfield & Gorrie. “It’s really been a team effort between the owner, design team, and all contractors to keep up with construction, but it’s gone well and the project is on schedule.”

Perhaps the biggest design element — and therefore the biggest challenge — was building the hospital to be reliant on geothermal energy. The site required 209 geothermal, 400-feet deep wells. The total system of geothermal system piping is about 38 miles long. The construction team completed geothermal drilling on the facility in November 2012.

“The geothermal system is a first for everybody on the team,” Weigle said. “A typical hospital will have more equipment to heat and cool the building, including cooling towers located outside that aren’t attractive. The geothermal system is a closed system so you don’t lose any water. It uses cool temperatures from the ground to adjust the temperature of the water to cool and heat the building instead of large chillers, boilers and cooling towers.”

The design includes glass and a lot of natural light, with a center atrium that has more than 22,000 square feet of glass, as well as 30,000 square feet of radiant floor piping, which Weigle described as pipes that contain water within the slab that heats or cools the floor to condition the air. This allows the hospital to avoid wasting money on energy to heat and cool unoccupied spaces. “The radiant floor piping just radiates off the floor and conditions the space where people are,” he said.

The project was completely designed in 3-D, allowing mechanical, electrical and plumbing work to be prefabricated, which reduces the amount of manpower and waste on site. “Our curtain wall designer designed in 3-D, and it was a first for them,” Weigle said. “It was a significant help to the project to coordinate the location of steel.”

While there’s still work to be done, Weigle said that he’s learned a lot about the process of incorporating a geothermal system, especially the testing required and making sure all the checks and balances are in place. Planning and scheduling for geothermal and how the site is used are critical in the early stages. For instance, approximately 100 geothermal wells are underneath the parking deck, which created scheduling and sequencing challenges with construction.

The hospital is part of the Pebble Project, a collaborative in which forward-thinking health care organizations, architects, designers and industry partners work together to identify designs and solution that measure patient improvement. Therefore, it will serve as a research facility for members of the organization to come in and review the design.
 

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