Add a Lesson Learned

Constructability (means & methods)

Vibrocompaction Footing Size Change

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: 185
Impact: Schedule, Scope


Lesson Learned/Best Practice

In EDI, we found that the original specified vibro-compaction and smaller footings directly adjacent to the hospital would cause too many issues with the existing facility, so we wrote an RFI to change the footings to larger ones and eliminate the vibrocompaction at those footings. This is to avoid the effects of the vibration to the hospital. Footings are oversize to remove need for vibro underneath.


Suggested Actions for Future Projects

When planning to use vibro-compaction, consider proximity of existing facilities.


Keywords

Vibro, Vibrocompaction, footings, foundations, existing


Related files. Click to view/download.

File 1:
501735.pdf

Isolation Pad Requirement Clarity

Facility name: The Medical Center Aurora

Project name: MCAURO-032018M-CMP-New Tower
Location: AURORA, CO
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 2740000009
Lesson Learned number: 184
Impact: Cost, Schedule


Lesson Learned/Best Practice

Clarity on isolation pad requirements for AHU’s.


Suggested Actions for Future Projects

Clearly designate on plans if isolation is required, and if so the job specific locations.  Use notes on mechanical schedule clearly indicating if isolation is required for equipment.  Scope should be identified on architectural, structural and mechanical documents.


Keywords

Isolation Pad requirements, AHUs

ADA Shower Pans

Facility name: Mercy Hospital

Project name: MERCYH-032019M-Inpatient Rehab Expansion
Location: MIAMI, FL
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 2611000022
Lesson Learned number: 183
Impact: Cost, Schedule, Quality


Lesson Learned/Best Practice

1. The existing dimensions in the contract drawings were incorrect for the bathroom walls. By the time we set the shower bases the walls were framed and hung. We had to add an additional ½” layer of tile backer to accommodate, and now we have a bump out detail that had to fill with thinset in order to hide the error in dimensions. 2. The tile substrate specified was 3/8” thick instead of the ¼” as on the Inpro details. This caused some issues with the alignment of the tile finish face and the finish of the vertical barriers of the shower base. We had to leave the tile backer further back and have our tile guys build out the delta in order to have the 3/8” material line up flush. 3. Inpro has a unique detail on their installation instructions showing a 1” air gap from the bottom of the tile backer to the receiver on the shower bases. Only the wall finish extends down to sit on the tile ledge of the shower pan. We had to reach out to Inpro to confirm if the air gap was needed and question if this could be an intrusion point for moisture. They advised us to disregard the air gap and said that that detail was only to be followed if we were using the solid surface paneling provided by Inpro as a wall finish material.


Suggested Actions for Future Projects

Conduct infield coordination meeting with all of the trades. Vendor (i.e. Inpro) to provide specific specs to the project. 


Keywords

Shower Pans, Inpro

Improvements in Third Party Owned Buildings

Facility name: Ogden Regional Medical Center

Project name: OGDNMC-012020M-New Rehab Unit
Location: OGDEN, UT
Project classification: Hospital – Shell Buildout
Project type: MOB
Project number: 3441500009
Lesson Learned number: 182
Impact: Cost, Schedule, Quality, Scope

Cost impact: $65,000 Schedule impact: 10 days


Lesson Learned/Best Practice

For HCA Tenant Improvement Projects located in 3rd Party Owned Buildings, verify existing construction is suitable to allow work to start and avoid schedule delays.


Suggested Actions for Future Projects

HCA Design and Construction, the Design Team, and the Contractors should walk the area as soon as access is available to review the existing construction conditions.

At any point during planning, design, or pre-construction that a non-compliant issue arises, it should be communicated to all parties so solutions can be determined prior to planned construction start.

Example

New 3rd Party Owned Medical Office Building utilizing Fiber Mesh Concrete Reinforcement in slabs which lead to severe cracking and fiber “residue” in existing slab. Cracking is a structural issue that needs review by a structural consultant. “Residue” of Fibers on the face of the slab affects flooring installations and required a planned solution.


Keywords

3rd Party Owned Buildings, Severe Slab Cracking, Fiber Mesh Reinforcing Residue, Renovation

OR Ceiling Height

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: 180
Impact: Cost, Scope


Lesson Learned/Best Practice

Renovations involving OR hard lid ceiling prevent the ability to review above ceiling conflicts in advance.


Suggested Actions for Future Projects

Account for more contingency room due to unknown ceiling conditions. Where existing structures are cast in place, above ceiling existing structure should be evaluated before establishing finished ceiling heights.


Keywords

OR Ceiling, Renovation

Minor Renovations

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: 179
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

“Minor Renovation” OR rooms become full demo rooms if more than cosmetic upgrades are performed.


Suggested Actions for Future Projects

Determine during design if Minor Renovation OR rooms are truly appropriate/desired, because if anything other than cosmetic upgrades are required, the cost impact will meet or exceed a full renovation.  Replacing/relocating existing HVAC equipment, adding new lights, and installing a stainless steel package requires a tremendous amount of demolition.


Keywords

Planning, ORs, Renovation

Long Lead Items on Accelerated Schedule

Facility name: Ogden Regional Medical Center

Project name: OGDNMC-012020M-New Rehab Unit
Location: OGDEN, UT
Project classification: Hospital – Shell Buildout
Project type: MOB
Project number: 3441500009
Lesson Learned number: 178
Impact: Schedule

Schedule impact: 25 days


Lesson Learned/Best Practice

For Projects with Accelerated Schedules and no time for Early Release of Long Lead Time Materials, verify materials can be obtained in time to meet the required schedule during Preconstruction.


Suggested Actions for Future Projects

Plan for Early Release of Long Lead Time Materials, Equipment (Contractor and Owner Provided including Equipment , IT&S and Unified Communications), review the need for these items early in the project development to review options for obtaining items in time to meet the required accelerated schedule.  Ensure to review these potential early items with DM and CM during RFP and design phases.


Keywords

Accelerated Schedule, Review Long Lead Material Items during Preconstruction, Request Substitutions during Preconstruction, Rehab

In Dapt Needs from Steris for Rough In

Facility name: Menorah Medical Center

Project name: MENORA-092018M-Bed Tower Expansion
Location: OVERLAND PARK, KS
Project classification: Hospital – Horizontal Expansion
Project type: Acute Care
Project number: 0972300007
Lesson Learned number: 175
Impact: Schedule


Lesson Learned/Best Practice

Prior to In-Dapt starting their initial prefab install for the OR ceilings the Steris mounting plates and med gas pigtails are needed onsite.  During install In-Dapt will attach the mounting plates and pigtails to their ceiling system.


Suggested Actions for Future Projects

By means of the OFE Delivery Schedule worksheet, add a line item to identify the “needed on site by” date for delivery prior to In-Dapt Installation and include in pull planning schedule.


Keywords

OR Ceiling, Steris, In-Dapt, Schedule, OFE

Finish Upgrades Scope of Work

Facility name: Woman’s Hospital Of Texas

Project name: WMHOTX-122018P1-5th Floor Ante-Partum Buildout & Renovation
Location: HOUSTON, TX
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 3431900010
Lesson Learned number: 167
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

Scope not clearly defined on plans but required to perform specified activities; drywall touch up/finishing, removal of existing electrical devices to remain, plumbing fixtures needed to be removed prior to new flooring install, grab bars, mechanical grilles, sprinkler head relocations to accommodate new ceiling layout.

Finish plan shows new ceramic tile flooring and wall tile at existing patient room bathrooms. However, demo plan did not provide specific notes to remove all existing fixtures and division 10 items and reinstall for new finishes.


Suggested Actions for Future Projects

At a minimum, provide more detailed notes and callouts on construction documents, particularly on the demo drawings, where removal/reinstallation of existing items to remain should be picked up.  Best practice would be to walk each area and create a specific detailed plan showing all items and their locations for further detail and clarity.


Keywords

Finishes, Renovation, Demolition, Minor, Cosmetic, Fixtures, Existing to Remain

Central Energy Plant (CEP) Temporary Plant

Facility name: Orange Park Medical Center

Project name: ORPKMC-102018M-Kitchen Expansion & Renovation
Location: ORANGE PARK, FL
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 3091300034
Lesson Learned number: 164
Impact: Cost, Scope

Cost impact: $64,000


Lesson Learned/Best Practice

Air-cooled chiller rental agencies have their own operational standards for their equipment which do not always match manufacturer operational standards. A temporary variable primary chilled water system was the basis of design for this project to match the existing chilled water plant configuration. The design team worked with the temporary unit manufacturer to ensure proper operation was being met. However, the rental agency would not allow for the operation of the chillers in a variable primary system. This resulted in added piping and pumps. In addition to this, the rental agency did not provide a control interface for the rental units. This caused for additional control wiring/sequencing for the temporary units.


Suggested Actions for Future Projects

When providing a temporary chilled water plant that utilizes rental air cooled chillers, provide a primary/secondary pumping configuration. Additionally, provide the temporary control system sequence as part of the design. Review the system configuration with the contractors and rental agency to ensure that their internal operational standards are being met and controls can be accomplished.


Keywords

temporary chilled water plant, rental