Together, Skanska and Gates will construct a 366,000-square-foot addition to the existing medical center as well as renovate a roughly 48,000-square-foot section. The project will add three new levels as well as horizontal expansions, and will include a new 1,300-space parking structure. When complete, the facility will have 275 new beds, almost doubling its existing 349-bed capacity, bringing the center’s new capacity to 624 beds.

Dallas-based HKS Architects has been in design on the expansion and renovation for nearly a year. The team began the design process by working with a variety of hospital staff and stakeholders to ensure the facility fits the needs of all employees and users.

The health system has experienced a sharp increase in patient volume in recent years, prompting officials to seek expansion. While most years the hospital saw patient volume increase by less than 2 percent, recently hospital officials have reported a 9 percent increase in inpatient admissions as well as a 7 percent increase in ER visits. The uptick forced system officials to convert some offices and meeting rooms into temporary patient spaces during particularly high-volume months.

Speaking with the Naples News in August 2015 just as the project was entering the design phase, Josh DeTillo, chief administrative officer for the Gulf Coast Medical Center, noted that the large population of aging baby boomers as well as a rise in the area’s general population motivated system officials to pursue the expansion.

Construction is slated to begin by the end of the month and the team aims for a February 2021 completion. The project’s total cost is estimated at $315 million.
 

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Atlanta-based Heery International, program manager for the new project, broke ground in mid-July. Dennis LaGatta, Heery’s project executive overseeing the work, said there would be three components to the construction process. First, the facility’s central plant is set to be replaced, then a new addition will replace the emergency and operating departments, and at the same time, the hospital’s nine-story patient tower will be revamped to give the 1950s exterior a more modern look.

“We anticipate that the central plant will be operational in November 2015, and that has to be done first so that we can connect to the new OR-emergency department expansion in December of 2015 to allow the completion and opening of the OR/ED in the winter of 2015,” LaGatta said.

The new central plant will serve as the hospital’s connection point for vital building services, so it’s important for it to be operational first. It also houses the hospital’s back-up generator system.

“The next phase would be, once we have the operating room and ED up and running, that we’ll go back and reconnect the rest of the existing hospital to the new central plant for the purposes of upgrading their emergency power system. Running concurrently will be the re-cladding of the [patient tower],” LaGatta added.

The transformed patient tower will be the most visible element of the process with a glass curtain wall and metal panel system. The prominent tower can be seen from Broward County’s Interstate 95, and it overlooks the hospital’s 35-acre campus.

Inside the hospital, the newly expanded 53,000-square-foot operating suite and emergency department will allow the hospital to continue as the only Level II trauma center in the north end of the county. The ER has 53 treatment spaces, and each treatment space is identical in room orientation and available medical equipment. A decentralized nursing station model allows for flexible treatment space utilization during peak and non-peak event time frames. The operating department will feature six new class-C operating rooms.

When Broward Health hired Heery, the hospital system asked the program manager to use an integrated project delivery-lite (IPD-lite) approach. The traditional IPD delivery method creates a single team of project participants that are uniformly responsible for completion. IPD-lite uses some elements of traditional IPD, but there are still incentives to collaborate.

Heery then reached out to Dallas-based HKS Architects and Chicago-based Perkins + Will as well as Skanska USA Building in Parsippany, N.J., as the construction manager at-risk, to create a four-company team throughout the planning, design and construction phases.

“Our IPD-lite approach allowed our team to focus on meeting Broward Health’s needs in the most cost-effective and time-efficient way possible,” LaGatta said in a press statement. “The creative thought process yielded innovations in our approach to the program as a whole and substantially reduced the construction schedule timeline, which means these new facilities will be operational and supporting the hospital conservatively 12 months earlier than initially projected.”

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Located on the Tradition Center for Innovation Campus in Port St. Lucie, the new $110 million building includes emergency services, an intensive care unit, labor and delivery, neonatal intensive care unit, general and specialized surgery, inpatient oncology, diagnostic imaging, clinical research and gastrointestinal endoscopy. The facility was designed and built at a time when many health care systems were waiting out the recession and the uncertainty over the impact of national health care reform on medical reimbursement.

HKS Architects designed the approximately 200,000-sqaure-foot health care facility and Balfour Beatty Construction served as construction manager. Both firms hold regional offices in Orlando, Fla.

The center, which is expected to see 30,000 emergency department visits, 6,000 patient admissions and 1,500 births in its first year of operation, was designed with flexibility in mind. Traditional Medical Center has the ability to expand to 300 beds in order to meet future growth.

Strong Collaboration

The project team worked closely, using the Integrated Project Delivery (IPD) method to maximize efficiency. According to Roy Gunsolus, AIA, LEED AP BD+C, director of sustainable health care with HKS, the IPD method allowed for strong collaboration from the outset of the project.

Six “component teams” were established with a diverse set of players, Gunsolus said. The teams included site; exterior envelope/structural; interiors; MEP/sustainability; technology; and schedule/general conditions. Each team had members representing the owner, design team and construction team on the project, which brought about more informed decisions as well as unique perspectives.

“It intentionally varied in who was involved,” Gunsolus said. “Regardless of whether somebody was the stereotypical leader of that group or just loosely allied, everyone had an equal voice.”

The IPD method also allowed the team to design the project to budget rather than design and price later only to be over budget and require redesign, Gunsolus said.

BIM Technology

The project used BIM modeling and Constructware software to further foster collaboration across the project team. By using BIM technology, Gunsolus said, the contractor was able to view models and make comments or identify potential construction issues before decisions were made.

The team also took on a sort of lean methodology to the BIM process. Architects and engineers can end up drawing the same thing twice, Gunsolus explained.

“We tried to have people take ownership and do everything once,” he said. “We discussed as a group who would be the logical person to implement whatever feature it was into the model.”

For example, lighting fixtures would be a responsibility dedicated to the electrical engineer with guidelines given by the project team.

Sustainable Goals

The project team, which is seeking LEED Gold certification for Tradition Medical Center, made sustainability goals clear from the outset. The team began with a sustainability workshop.

“We talked about the advantages of being sustainable and why it made sense to do this not only from a cost savings standpoint, but also from more of an intangibles perspective, such as patients healing quicker when they have connections to nature,” Gunsolus said.

The acute care hospital, which overlooks a large retention pond, used connections to nature and natural light as an overarching design driver. In addition to typical public spaces such as the main lobby, dining and waiting areas, daylighting was also used via high windows in uncommon areas such as the receiving area, pharmacy, lab and the kitchen.

Approximately 83 percent of construction waste was diverted from the landfill. Additional green features included a heat recovery chiller, LED lighting and a reflective roof. The siting of the building, which also provides connectivity to a medical office building developed in collaboration with Mann Research, also created energy-efficiency opportunities.

“The natural inclination might have been to site the building in the middle of the site to maximize proximate parking,” Gunsolus said. “The project team considered a variety of factors and ultimately located the building more proximate to the retention pond to maximize patient views while minimizing eastern and western exposures to maximize energy efficiency. This location reinforced the overall master plan, which was developed to allow for future ambulatory services and structured parking while separating public and service traffic.”

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The St. Louis-based contractor McCarthy Building Companies Inc. announced the construction milestone on Dec. 20. HKS Architects, headquartered in Dallas, and St. Louis-based Archimages are serving as the project’s architects.

Following the devastation of an EF-5 tornado that hit the city in May 2011, the former St. John’s Regional Medical Center was left in ruin after it was directly hit. The tornado was recorded as the state of Missouri’s deadliest since 1947. The community quickly responded by planning the new replacement hospital, which began the planning stages in July 2011 and broke ground in January 2012.

“This is hallowed land that no longer belongs to Mercy but to the story of Joplin, of residents enduring a massive disaster by coming together to rebuild and move forward,” said Gary Pulsipher, president of Mercy Hospital Joplin, in a May 2012 statement. “We hope new uses of the campus can weave together as sort of a healing quilt for the city.”

The 260-plus private room replacement hospital will be larger than its predecessor and will include medical surgical, critical care, women’s and children’s, behavioral health and rehabilitation units. The 50-acre campus will also include a seven-story patient tower and a four-story clinic tower.

The milestone is on track with the construction team’s aggressive schedule, according to Ryan Felton, project director with McCarthy.

“In order to keep everyone on track, we have been managing quality through daily inspections, pre-installation meetings and by involving third-party building exterior consultants,” Felton said in a statement. “To date, all built-in-place mockup rooms have been completed, first installations have been verified, windows have been water tested and a thermography scan has been conducted.”

Offside roadwork, two permanent service elevators and a separate 30,000-square-foot central utility plant connected to the hospital via a 450-foot underground tunnel were also reached substantial completion. The central utility plant is expected to open in the early months of 2014.

The contractor’s 39-month schedule includes more than 750 tradesmen. In order to keep up with the aggressive schedule and ensure jobsite safety, McCarthy conducts weekly jobsite toolbox talks, weekly manager walks with all subcontractor managers and daily task hazard analysis.

“McCarthy has a strong quality assurance program that provides strong leadership and oversight of the building enclosure elements such as precast, window and roofing systems,” said John Farnen, executive director of planning, design and construction for Mercy, in a statement. “This includes inspections and testing of these systems during installation. On the Mercy Hospital Joplin, this process uncovered issues during the installation that were addressed and resolved preventing schedule delays. I am confident the McCarthy quality program will achieve the level of quality Mercy expects. McCarthy understands the importance of quality on the project and delivers it.”

The project is scheduled for completion in March 2015.

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The center’s ambulatory surgery and complex diagnostic services will expand to provide 39 inpatient beds for up to 72-hour stays, 17 urgent care treatment rooms, four operating rooms, endoscopy rooms and 25,000 square feet of shell space for future development. In addition, the finished site will provide increased imaging capabilities including an X-ray fluoroscopy facility, ultrasound and CT unit.

St. Louis-based McCarthy Building Companies Inc. was chosen as general contractor on the project because of its design-build delivery approach that involves open communication between the trades, creating efficient processes as a result.

The on-site construction team will be using standard BIM practices, such as above ceiling coordination, virtual mock-ups and concrete lift drawings. UTMB will be working closely with Dallas-headquartered HKS Architects, the designer on the project, to use a BIM technique that will deliver a spatially coordinated design model. This helps with communication, lessening assumptions that the design team has to make during the design phase and reducing the need to redesign early on.

“UTMB is committed to providing the best patient care possible in its mission to improve health for the people of Texas and around the world,” said Donna Sollenberger, executive vice president and CEO of UTMB’s Health System. “We are excited that this expansion allows us the opportunity to provide more services and convenience to our patients who live in the rapidly growing Bay Area in a completely integrated system of care.”

The $82 million specialty care center is slated for completion in the spring of 2015. The $8 million, 5,000-square-foot central plant facility will also be built to provide utilities to the 62-acre Victory Lakes campus and is scheduled for completion in August 2014.

McCarthy has worked on several health care faciities, including the Children’s Hospital of Orange County and Torrance Memorial Medical Center Replacement Tower in California, and the new Mercy Hospital Joplin in Missouri.

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