Add a Lesson Learned

Project Phase

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

Motorized Dampers at Louvers

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: 181
Impact: Cost

Cost impact: $49,705


Lesson Learned/Best Practice

CEP mechanical drawing required a quick opening motorized damper at the louvers on the north wall of the CEP and requires that the dampers are interlocked with the generator.  The louvers at this particular location in the CEP were specified to be architectural louvers by Construction Specialties as CS Model DC-9614 and were provided accordingly. The CS Model DC-914 louver does not require motorized dampers to achieve the specified wind driven rain performance.

There are other smaller mechanical louvers in the CEP and louvers with motorized dampers in the CEP that were provided by the mechanical contractor and were specified as Pottorff Model ECD-545-MD in the mechanical specifications, which require a motorized CD-51 damper option to achieve wind driven rain performance.  These louvers that include the motorized dampers were interlocked with their respective equipment as specified. 

Based on the specification noting the use of motorized dampers at the Pottorf  louvers for wind driven rain performance, the mechanical contractor assumed the CS Model DC-9614 would also come equipped with the motorized dampers and therefore did not carry the motorized dampers required to interlock with the generators per sheet M1.02. Cladding Systems who provided all CS Model DC-9614 louvers did not carry any motorized dampers as the louvers did not require it.


Suggested Actions for Future Projects

Our lesson learned is to ensure that anytime louver scope is being divided between mechanical and architectural specifications, ensure all components of the louver system are properly reviewed for coverage and gaps do not exist. We specifically studied and coordinated quantity, location, finish, blank-off panels at louvers with no mechanical connections / purpose and louvers with ducted O/A connections to ensure there were no scope gaps and were successful on these items, however, the project team did not vet the motorized dampers which were specified only at a couple locations on the entire project.


Keywords

dampers, louvers, coordination, motorized damper, architectural louver, elevation, outside air, interlocks

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

Shipping and Storage Fees

Facility name: CJW Medical Center

Project name: CJWJWC-122018M-ORTHO/NICU Expansion (Johnston Willis)
Location: RICHMOND, VA
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 3463200010
Lesson Learned number: 177
Impact: Cost

Cost impact: $4,100


Lesson Learned/Best Practice

It is critical for the General Contractor to do a better job of communicating with the Vendors and the assigned HCA Medical Equipment Manager when they know there is going to be a construction delay.  In the case of this project, the General Contractor notified the Furniture Vendor the evening before the delivery/installation was to occur the site was still not ready to receive the Furniture.  The Furniture had already been loaded into the delivery trucks and resources had already been allocated.  Because of the delay, a $4,100 handling fee was accrued, which the General Contractor will have to pay.


Suggested Actions for Future Projects

 General Contractor should ensure all parties, including vendors, effected by construction delays are properly notified in a timely manner. GC is responsible for any shipping or storage fees that might be issued due to a lack of early communication. 


Keywords

Medical Equipment, ITS, Unified Communications, vendor , schedule, delays

Neopod Shut Off Valve Access

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: 176
Impact:


Lesson Learned/Best Practice

It was identified during the installation of the Neopod Staff Toilet Rooms, that access to the shut off valves was missing. The shutoff valves are located on top of the Toilet Room and are inaccessible through the gyp board that goes to deck. All of the Neopod Patient Toilet Rooms have shut off valves located in the corridor and have adequate access.


Suggested Actions for Future Projects

Coordinate required access for shutoff valves, etc to be outside of any prefabricated unit foorprint and add access panels as required..


Keywords

Neopod, BLOX, coordination, shutoff valves, water, access panels

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

Sound Testing Renovation Space

Facility name: P-SL Medical Center

Project name: PRSTLK-022017M-Pre-Op & Recovery
Location: DENVER, CO
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 2720000019
Lesson Learned number: 174
Impact: Cost, Schedule, Quality


Lesson Learned/Best Practice

When renovating existing space, recommend walking area before starting and if there are any noisy areas, take pre-sounds readings to show it was existing issue so can be addressed before end of project


Suggested Actions for Future Projects

When renovating existing space, recommend walking area before starting and if there are any noisy areas, take pre-sounds readings to show it was existing issue so can be addressed before end of project

 If there are existing systems that feed a space, obtain air readings prior to the start of construction in order to have air comparisons after final TB is conducted. In addition to traverse readings, it is necessary to test the entire system at all diffusers, VAVs, and even AHU itself for pressure testing, air exchanges, and sound levels. This is inclusive of all areas associated with the same air system, even outside the construction space. This is an important step in Design Development but even more crucial throughout each Phase of a project to obtain readings in locations that would not have been accessible during EDI. 


Keywords

Sound, Testing, Renovation, Pre-testing, Noise

ITS Equipment List

Facility name: Angel Medical Center

Project name: ANGLMC-032019AR-25 Bed Replacement Hosp
Location: FRANKLIN, NC
Project classification: Hospital – New
Project type: Planning
Project number: 2762500001
Lesson Learned number: 173
Impact: Quality, Scope


Lesson Learned/Best Practice

The IT&S Manager provided an equipment list in schedule/matrix format that was generated from the Architectural Profile and demonstrated all of the pertinent IT&S equipment that needed to be located & coordinated on the plans. This list was extremely helpful in ensuring that all IT&S equipment was accounted for properly. It allowed our engineers to make sure that adequate power & data were provided in the appropriate locations and should help in procurement, delivery, and installation at the end of the project.

 

Please note: I have the file that I can share. I tried to upload it with my first attempted submission but it gave me an error message. I will not try that again. Please reach out to kennethb@esarch.com if you would like to see this file.


Suggested Actions for Future Projects

Consider providing a similar IT&S equipment list to the Design Team on all future projects.


Keywords

IT&S, Equipment List, OFE, Owner Furnished Equipment