Add a Lesson Learned

Month: September 2020

One Hundred Percent Outside Air AHU

Facility name: P-SL Medical Center

Project name: PRSTLK-022017P1-Surgery Renovation
Location: DENVER, CO
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 2720000020
Lesson Learned number: 114
Impact: Cost, Schedule, Quality, Scope

Cost impact: $108,706


Lesson Learned/Best Practice

 In November of 2019, AHU-01 sustained some damage to the filter rack from sucking in snow and clogging the filters. Because the unit is 100% outside air the snow did not melt before reaching the filters. The filter rack was repaired by JCI under warranty. In order to prevent this from happening again during another large snow storm, WSP has directed Layton to install two new larger hoods, 72″ deep in order to reduce the suction at the hoods and install a SnoStop product that is a heat traced pre-filter that will melt the snow before entering the unit.


Suggested Actions for Future Projects

Anytime a 100% outside air AHU is to be used in this region, a SnowStop device should be incorporated into the original design.


Actions Taken / Current Status

HCA comment:  This is a best practice in climates where it snows.  Please note the devices can be any type that performs the function.  SnoStop is a brand and HCA is not endorsing the brand in this comment.

Early install of Interior Prefab Components

Facility name: East Florida Division Office

Project name: DAVHOS-102018M-New Hospital (NOVAMC)
Location: Davie, FL
Project classification: Hospital – New
Project type: Acute Care
Project number: 3597900001
Lesson Learned number: 113
Impact: Schedule, Quality


Lesson Learned/Best Practice

At HCA Davie, the hospital project was a 4 level concrete frame, and the team could not start the exterior walls, interior framing, or overhead MEP until the reshores were removed and the top concrete deck was poured. B&G decided to bring in BLOX components as soon as reshores were removed and layout was complete, creating a unique advantage in sequencing and an early release of subsequent trades inside the hospital. Typically, BLOX components are not installed until the building is mostly dry and the envelope is closed in, so the main risk in bringing in the units this early was keeping the units protected from the elements with no skin on the building. Utilizing additional boat wrap and leaving the bottom 1’ off of the headwalls helped keep the units dry while allowing the early delivery to streamline the prefabricated interior components’ delivery and installation.


Suggested Actions for Future Projects

–          This approach proved to be successful for the team, and is being utilized on Lawnwood as well.

–          It does require some focused attention and extra work to keep the units dry.

–          Two steps the team took were: 1) Re-boat wrapped some of the bathrooms to keep them dry until we set them when the exterior was complete. 2) Leaving the 1’ of drywall off the bottom of the headwalls (see other lessons learned for this)


Actions Taken / Current Status

HCA comment:  The General Contractor is advised to check with the local AHJ to insure they will accept this practice.

Fire Alarm Code Issues

Facility name: Kendall Regional Medical Center

Project name: KENDAL-New Tower
Location: MIAMI, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3594100019
Lesson Learned number: 112
Impact: Cost, Schedule


Lesson Learned/Best Practice

During the permitting process the following items arose.

  • High rise requirements for fire alarm systems.
    • Initially the AHJ required the Kendall fire alarm system be upgraded to cover high rise guidelines. A building is considered a high rise if any floor above 75′ is continually occupied. ICT and the AHJ discussed this and finally came to the conclusion that the building did not have to be upgraded. 
    • Though this did not require a re-design (which would have been costly), it did delay the permitting process.
  • Pull station at helipad vestibule was required.
  • Smoke evacuation system is controlled by the fire alarm system and needed to be added. However, the design is by the mechanical controls contractor. 
  • The review process itself is slow.

During inspections a couple of items arose.

  • Pull station at helipad vestibule was required.
  • Spacing between smoke detectors was exceeded in some instances.

Suggested Actions for Future Projects

Bringing the fire alarm vendor on at EDI would allow them to assist with design and code verification. The fire alarm vendor could then produce shop drawings during the EDI process that could be included as part of the CD set. This would make the shop drawings part of the initial building permit application and not a separate application after the permit is obtained. Therefore speeding up the fire alarm system local jurisdiction approval process. 


Actions Taken / Current Status

HCA comment:  The best practice is to bring the Fire Alarm vendor in during the EDI process at the appropriate time based on the design schedule for a given project.

Fire Alarm Integration with Other Systems

Facility name: Kendall Regional Medical Center

Project name: KENDAL-New Tower
Location: MIAMI, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3594100019
Lesson Learned number: 111
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

Fire alarm systems integrate with access control, fire suppression and HVAC systems. Many times the design for these other systems are not complete or not represented on the drawings until after the EDI process. During the Kendall Bed Tower Expansion and Temporary Helipad the following issues arose due to lack of information or drawings.

  • Relays for automatic doors we not included.
  • Relays for hardware power supplies (vertical rods in double doors) were not included.
  • Relay for access control head equipment was not included.
  • Not enough heat detectors included in the elevator machine room and top of the elevator shaft. There must be a heat detector within 24″ of a sprinkler head. The fire sprinkler drawings were not available during pricing.
  • Relays for exhaust fans. Not all the fans that required shutdown relays were shown as requiring them.

These were all changes that required RFIs, drawing revisions and re-submittals to the county for permitting. 


Suggested Actions for Future Projects

Information for a full design needs to be available during the EDI process. Bringing fire alarm, access control and fire suppression on board at the beginning of EDI would eliminate most of the scope gaps, change orders, drawing changes and delays. Therefore eliminating delays during construction. 


Actions Taken / Current Status

HCA comment:  The best practice is to bring in the Fire Alarm and Controls vendor early during the EDI process based on the design schedule specifics for a given project.

Smoke Evacuation System

Facility name: Kendall Regional Medical Center

Project name: KENDAL-New Tower
Location: MIAMI, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3594100019
Lesson Learned number: 110
Impact: Schedule


Lesson Learned/Best Practice

In Miami-Dade County the smoke evacuation system requires a separate permit. This permit must be pulled by the mechanical contractor even though the work required is mainly electrical. Most jurisdictions do not require a separate permit. 


Suggested Actions for Future Projects

Verify with the local permitting department prior to permit submission. 


Keywords

high rise

Backflow Preventor in EVS Room

Facility name: Mountainview Hospital

Project name: MTVLAS-102018M-Rehab Expansion
Location: LAS VEGAS, NV
Project classification: Hospital – Shell
Project type: Rehab
Project number: 3281900024
Lesson Learned number: 109
Impact: Cost, Quality, Scope

Cost impact: $1,725


Lesson Learned/Best Practice

At time of user move-in, Sunrise Hospital Engineers requested dedicated backflow preventer to the soap dispenser in the EVS room, so the mop sink and faucet only gets turned on when the mop sink is being used. When this was presented to HCA as a change order they asked Layton document as a Lesson Learned so that HCA design and construction could implement as a standard. The Mountain View project was designed before the lesson learned was documented at Sunrise. The attached picture is what was recommended for the MountainView project and was accepted by the Design team and the facility.


Suggested Actions for Future Projects

Make sure that a backflow preventer is added to the soap dispenser in EVS room for future projects. 


Actions Taken / Current Status

HCA comment:  This practice only applies to facilities that have the soap dispenser in line with the main water system.


Related files. Click to view/download.

File 1:
11725EVSRoomSoadDispandBackflow1.pdf

Security Camera Placement

Facility name: Brandon Regional Hospital

Project name: BRADON-052017M-Lakeland FSER
Location: BRANDON, FL
Project classification: Free Standing Emergency Room
Project type: FSED
Project number: 3091700021
Lesson Learned number: 108
Impact: Safety


Lesson Learned/Best Practice

Final placement of the security cameras with the generator yard was not ideal.  The view of the entrance door was blocked by the height of the generator itself.  Camera had to be shift toward the center of the enclosure to get a better view.


Suggested Actions for Future Projects

Review the security camera placement with HCA.  Then double check that there are no obstructions to that view (generators, trees, other large landscaping items, ceiling bulkheads, etc).  


Actions Taken / Current Status

HCA comment:  The best practice is to have HCA’s Physical Security staff to check the cameras after placement for obstructions.


Related files. Click to view/download.

File 1:
49743SecurityPlan.jpg

File 2:
94053ViewfromCamera.jpg

File 3:
60238ViewofCamera.jpg

Afternoon Prefab Deliveries

Facility name: East Florida Division Office

Project name: DAVHOS-102018M-New Hospital (NOVAMC)
Location: Davie, FL
Project classification: Hospital – New
Project type: Acute Care
Project number: 3597900001
Lesson Learned number: 107
Impact: Schedule, Safety


Lesson Learned/Best Practice

Even though the hospital project had 3 tower cranes, dedicating a crane full time for a day for BLOX deliveries was not optimal. The team elected to start the first BLOX delivery after 3:30pm, when normal production work for the day was wrapping up. This would allow for uninterrupted use of a tower crane and ensured less overall traffic on the floor. This helped to lower congestion on the jobsite during the day and created a calm environment to move multiple 3500lb prefabricated units onto the floors of the hospital. The team saw the multiple benefits of delivering the BLOX units after hours and continued this practice for the rest of the job with great success.


Suggested Actions for Future Projects

Consider bringing in prefab components after normal working hours, to insure most efficient install and minimal congestion. This is especially true when there is heavy use of the project cranes throughout the days.

Penetration Fire Caulking

Facility name: P-SL Medical Center

Project name: PRSTLK-022017P1-Surgery Renovation
Location: DENVER, CO
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 2720000020
Lesson Learned number: 106
Impact: Cost, Schedule, Quality


Lesson Learned/Best Practice

Due to penetrations not being fire caulked as they were being roughed-in, some penetration became blocked by ductwork and fire caulking was missed or had to be re-caulked.


Suggested Actions for Future Projects

Fire caulk all penetrations as they are made instead of at the end of the rough-in stage.

EDI Cost Tracking and Goal Setting:

Facility name: Lawnwood Regional Medical Center

Project name: LAWNWD-062019M-New Tower and CEP
Location: Fort Pierce, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3093200010
Lesson Learned number: 105
Impact: Cost

Cost impact: $600,000


Lesson Learned/Best Practice

A detailed cost management log was developed in Smartsheet that showed current cost updates for duration of EDI. This tool was valuable for tracking, recording, and updating costs.  An advantage of this was transparency within the team, readily available lists of action items, and accurate cost counts for the target cost goal and savings cost goal. The team was able to beat the target cost goal and the savings goal for the design phase. The initial EDI savings goal was $76,000, but the total savings equaled $130,000.  The total project goal was 7.58 million and the team helped to save close to $600,000 or about 10% of the project.


Suggested Actions for Future Projects

It’s a best practice to use a collaborative and transparent cost management log (TVD log) during the EDI process. Because all parties have access to up to date costs, this will ensure that the job remains on budget and will hit EDI cost savings goal.


Actions Taken / Current Status

HCA comment:  Best practice for tracking cost savings during the EDI process.