Add a Lesson Learned

Site Logistics

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

Landscape design

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: 147
Impact: Cost, Quality, Safety


Lesson Learned/Best Practice

BH concerns with Landscaping design and coordination with camera location to take into consideration – tree locations, rose bushes, camera views, very specific to behavioral facilities


Suggested Actions for Future Projects

Include final landscape design, to include specific types of vegetations, sizes and not just locations, and overlaid with final security camera locations.  Key considerations; potential camera review by landscaping for potential obstructions, possible patient safety or elopement considerations due vegetation sizes and location. Required attendees for review, corporate security, designated facility point of contact, design team including landscape architect.


Keywords

Behavioral Health, landscaping, security cameras

Utility exploration

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: 145
Impact: Schedule, Quality, Safety


Lesson Learned/Best Practice

Utilization of extensive utility exploration limited any interruptions due to interferences with existing underground utilities, utilized extensive hydro-vac excavation, survey was coordinated into BIM, early mobilization in anticipation of city permit.  Was able to accomplish a lot of the actions because was an EDI project. 


Suggested Actions for Future Projects

As possible integrate as many of the same methods for future projects.  Key is early mobilization to be able to take advantage of any mobilization or relocation due to unforeseen utilities identified.


Keywords

Pre construction site survey

Vavle Location Maps and Tags

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: 140
Impact: Cost, Schedule, Quality, Safety


Lesson Learned/Best Practice

It has been stressed by our HCA construction manager to inform all on site personnel of the location of shutoff valves in case of an emergency. Layton took it upon ourselves to create a map that is hung in different areas throughout the construction space that shows the location of all shutoff valves in our construction area. We have also implemented valve tags that hang down so the valves can be easily identified.


Suggested Actions for Future Projects

At the beginning of the project create a map that identifies shutoff valve locations and hang valve tags so that shutoff valves can be easily identified. 


Keywords

shutoff valve, valves

Construction noise impact on hospital operations

Facility name: Regional Medical Center Of San Jose

Project name: RMCSAJ-052017M-ASC(OP Surgery)
Location: SAN JOSE, CA
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 0838500026
Lesson Learned number: 83
Impact: Schedule


Lesson Learned/Best Practice

Prior to bidding, find out distances to other departments to see if there are undisclosed noise sensitivities.  Even better would be for this to be part of schematic design, and have it be accommodated in the construction documents.  Have the designers review this during schematic design.


Suggested Actions for Future Projects

Determine in design phases if measures need to be taken for noise and vibration mitigation due to work associated with the current project. Design will ask the Architect and Engineer to engage appropriate consultants to preform this work and will be submitted as a DCA. In renovation work assure that sound attenuation is addressed per applicable codes


Actions Taken / Current Status

Sent to EDI improvement team for consideration


Keywords

noise, hospital operations, schematic design, sound, vibration, sound attenuation

Steel erection and soil conditions

Facility name: Aventura Hospital & Medical Center

Project name: AVENTU-New Tower
Location: AVENTURA, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3092000015
Lesson Learned number: 63
Impact: Schedule, Scope


Lesson Learned/Best Practice

Building in south Florida due to the soil type, the structural columns are set below grade two foot or greater. Due to the weather (mostly rain) we constantly fought to keep the sand from washing down around the columns after they have been cleaned out.


Suggested Actions for Future Projects

Review steel erection plan then get phasing plan set for all columns prior to steel erection beginning. Once work commences set columns, plum column, tighten all bolts, weld washer (as required). Then form up three of four sides, grout all base plates and then finish forming the fourth side. Let steel erection complete so if any pulling is required to connect beams there is play but the columns are formed up so no dirt can wash around prior to concrete pedestals poured.

Set up a coordination meeting with structural steel and concrete subs to layout a phasing plan to dig around, grout base plate, and form up the columns as to avoid have the earth wash back down around the column prior to pouring the column wraps below grade.

Analysis of complete vs. selective demolition

Facility name: Memorial Health UMC Savannah

Project name: MEMSAV-032018M-Children’s Hospital
Location: SAVANNAH, GA
Project classification: Hospital – New & Renovation (Blend)
Project type: Acute Care
Project number: 2696000002
Lesson Learned number: 62
Impact: Cost, Scope


Lesson Learned/Best Practice

During the pre-construction and bidding process, selective demolition and pour back of an existing 4″ slab on grade was priced to account for plumbing and electrical underground systems. The process of selective demolition, as well as trenching for underground MEP systems, resulted in areas of cracked or unusable slab, which required additional demolition and pour back on a T&M basis. This additional work had minimal to no schedule impact, but did have a cost impact as described below.

5,000 SF of selective demolition and pour back was captured in the original scope of work at $17,242. The additional selective demolition and pour back totaled $23,752 for a cumulative scope cost of $41,476. Conversely, complete demolition and pour back of the entire slab (23,453 SF @ $3.55/SF) would total $83,258. While this cost analysis indicates that selective demolition and pour back is the most cost efficient process, we propose that an allowance be captured in the bidding phase to account for cracked and unusable slab following demolition and installation of MEP underground systems. Factoring such an allowance at the bidding phase will allow for competitive pricing to work in the Owner/GC favor, as T&M work may exceed competitive bidding costs.


Suggested Actions for Future Projects

Perform a cost analysis of complete versus selective demolition on existing slab on grades during the design/bidding process, and if selective demolition is found to be most cost efficient (as is the case here), include an allowance for additional selective demolition in the competitive bidding process.

Mechanical and civil work coordination

Facility name: Lake Nona Hospital

Project name: Lake Nona-102018M- New Hospital
Location: TALLAHASSEE, FL
Project classification: Hospital – New
Project type: Acute Care
Project number: 2689500001
Lesson Learned number: 57
Impact: Cost, Schedule


Lesson Learned/Best Practice

It was discovered after (2) 1750 gallon grease interceptors were set and piped in the loading dock drive area that the tops of the precast box structures would be protruding significantly above the designed civil paving grade elevation as a result of the pipe invert elevation specified on the plumbing drawings forcing the grease interceptor structures to be set high.

Coordination between underground plumbing design and civil grading & drainage should be exercised to ensure any specified pipe invert elevation per a plumbing design drawing coordinates with civil grades to ensure structure and pipe coverage is adequate.


Suggested Actions for Future Projects

During a plan review or plan check opportunity with the Early Design Involvement (EDI) contractor team, the plumbing design scope which engages with the civil design scope should be reviewed to confirm the take over point is properly coordinated and specified plumbing or civil structures which must interact or connect between the two design disciplines do not foul or conflict.

AHJ coordination on site utility installations

Facility name: Parkridge Valley Hospital

Project name: PRKRVH-092018M-ED Addition
Location: CHATTANOOGA, TN
Project classification: Hospital – Horizontal Expansion
Project type: Acute Care
Project number: 3424100002
Lesson Learned number: 46
Impact: Schedule


Lesson Learned/Best Practice

City required excavation of the bio-retention pond and partial storm sewer system installation before to excavating the building pad.  This was not contemplated in the schedules and delayed development of the building pad by three weeks.


Suggested Actions for Future Projects

Have civil engineer discuss excavation and site utility installations prior to completion of construction documents and include any required sequencing or special provisions in the documents.  At a minimum the contractor should meet with the AHJ to ensure a thorough understanding of their requirements.

Temporary fencing in Hurricane-prone locations

Facility name: Orange Park Medical Center

Project name: ORPKMC-092018M-Bed Tower
Location: ORANGE PARK, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3091300035
Lesson Learned number: 41
Impact: Schedule


Lesson Learned/Best Practice

Hurricane prep and recovery was hindered in securing job site security due to having to remove the temporary wood fence panels at OPMC.  If the site fencing was engineered and installed per the attached Hurricane Rated Fence design, the fence could have been left in place with no concerns about flying debris.  Standard wood privacy fence panels are a concern for airborne debris and must be removed and re-installed during hurricane events.


Suggested Actions for Future Projects

Use hurricane rated design when building a wooden site fence for projects in hurricane zones.


Actions Taken / Current Status

This is being sent to the HCA Construction Management team for consideration and follow-up action if necessary.