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Nurse Call Discrepencies

Facility name: Woman’s Hospital Of Texas

Project name: WMHOTX-122018M-LDR, C-Section & Support Space Renovations
Location: HOUSTON, TX
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 3431900019
Lesson Learned number: 168
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

Facility and Division Nurse Call standards differed from HCA corporate standards.  There is no published document detailing division or specific facility standards.


Suggested Actions for Future Projects

Input from Division and Facility is required during design to determine which standard to follow.  Design team should confirm with HCA Telecommunications Manager prior to issuing drawings.  Consideration should be given to any future Nurse Call system replacement projects that may be done at the local level.


Keywords

Nurse Call, Telecommunications, Standards

Casework Hinge Types

Facility name: UCF Lake Nona Medical Center

Project name: Lake Nona-102018M- New Hospital
Location: TALLAHASSEE, FL
Project classification: Hospital – New
Project type: Acute Care
Project number: 2689500001
Lesson Learned number: 153
Impact: Scope


Lesson Learned/Best Practice

A combination of 5-knuckle and concealed hinges were included in the design of the facility resulting in some areas having both types of hinges in a single space.


Suggested Actions for Future Projects

A design standard should be developed and published to ensure all casework hinges are uniform in a single facility.


Keywords

Casework, Hinges

Evolving HCA standards

Facility name: Medical City McKinney

Project name: MCMKNY-102017M-BH & Rehab Relocation
Location: MCKINNEY, TX
Project classification: Hospital – Horizontal Expansion
Project type: Psych
Project number: 3833300011
Lesson Learned number: 148
Impact: Cost


Lesson Learned/Best Practice

With HCA’s ever evolving design standardization there needs to be a fixed point where design is frozen for each specific project. 


Suggested Actions for Future Projects

Document date and version of HCA standards utilized within CD drawing set,  validate HCA standards with planning manger, design manager, HCA engineering and construction manager.


Keywords

HCA Standards, MEP guidlines

Documentation of Light Renovation Rooms

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: 142
Impact: Schedule, Quality


Lesson Learned/Best Practice

Per the CD’s, Layton asked the end user where they would like their wall mounted fixtures and equipment mounted in their “light renovation OR’s”. However, the end user requested that the fixtures and equipment be installed in their original locations. Unfortunately, the end user did not know where the original locations were. This caused Layton and the end user to spend additional time identifying where fixtures and equipment should be located. 

 

 

 


Suggested Actions for Future Projects

Ensure that photos or videos of light renovation rooms are taken to document locations of fixtures and equipment. 

Anti Ligature Toilet Accessories

Facility name: JFK Medical Center North Campus

Project name: WESTPL-032018M-Behavioral Health Expansion
Location: WEST PALM BEACH, FL
Project classification:
Project type: Psych
Project number: 3092300007
Lesson Learned number: 132
Impact: Cost, Scope


Lesson Learned/Best Practice

Anti-ligature toilet accessories (paper towel dispenser, toilet paper dispenser, soap dispenser) were listed as “owner furnish, contractor install” in the design specifications. While it is typical for the facility (owner) to provide toilet accessories, they usually have an agreement through their EVS department to get the accessories at no cost from the vendor who supplies the material goods (paper towels, toilet paper, soap). JFK North’s vendor does not carry anti-ligature accessories, therefore they had to shop around for them. The brought on an unforeseen expense the facility did not account for within their budget.  


Suggested Actions for Future Projects

On Behavioral Health projects, have all anti-ligature accessories be provided by the contractor in lieu of owner furnished, contractor install. 


Keywords

Behavioral Health

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.

Eliminating the team’s Top 3 biggest concerns:

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: 104
Impact: Quality, Scope


Lesson Learned/Best Practice

At the EDI kickoff meeting, each person brought their top 3 biggest concerns/issues for the project. This was all documented in Smartsheet and countermeasures were also discussed. To ensure everyone’s concerns and constraints were completed, they were added into the main action item list on Smartsheet. As the items were completed, they were checked off. This was done for everyone; this took time but everyone’s concerns were heard and resolved.


Suggested Actions for Future Projects

Encouraging everyone to bring up their concerns and constraints early in EDI, and then creating an action item list off of this with responsible people, ensures that these concerns are taken care of.


Actions Taken / Current Status

HCA comment:  This is a best practice for facilitating the EDI process.


Keywords

Big Room, facilitation, constraints, concerns


Related files. Click to view/download.

File 1:
9067Top3Concerns.jpg

Behavioral Health Patient Unit Size

Facility name: Tristar Division Office

Project name: TRISTR-032018M-New Freestanding Behavioral Health Hospital (Maury)
Location: BRENTWOOD, TN
Project classification: Hospital – New
Project type: Psych
Project number: 3103000003
Lesson Learned number: 91
Impact: Scope


Lesson Learned/Best Practice

Based off feedback from facility clinical leadership a contiguous 42 bed adult unit is on the larger side and can present some operational challenges on options to separate varying levels of acuity in the unit.

 


Suggested Actions for Future Projects

Include critical design decisions, lessons learned and HCA approved specs as part of the Behavioral Health Guidelines currently under development


Keywords

behavioral health, patient rooms, acuity

Collaborative EDI Goal setting

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: 69
Impact: Cost, Schedule, Quality


Lesson Learned/Best Practice

During the EDI kickoff meeting, each team member brought 3 goals with them to discuss with the team. Each person was allowed time to talk through their desired goal and how to achieve it. After the session, B&G team collected and organized all the goals, and then collaborated with the rest of the team to agree on 7 top goals with the team. These were tracked in at top of the A3 executive summary each month. At the end of EDI, the team achieved 6/7 goals, including beating the EDI cost savings goal and the final GMP coming in under budget. The last goal was to finish construction early, which could not be measured yet.


Suggested Actions for Future Projects

 EDI goal setting should be a collaborative effort to ensure buy in from the whole team. 


Related files. Click to view/download.

File 1:
269703Goals.jpg

Target Value Delivery Log

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: 34
Impact: Cost

 


Lesson Learned/Best Practice

The target value delivery (TVD) log was helpful to track decisions on an Early Design Involvement (EDI) project.


Suggested Actions for Future Projects

Continue TVD logs but stick with decisions once they’re made.