Add a Lesson Learned

Construction

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

Collaboration between TV Installaer and Hill Rom

Facility name: Brigham City Community Hospital

Project name: BRIGHA-112016P1-ED Renovation
Location: BRIGHAM CITY, UT
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 3441000003
Lesson Learned number: 172
Impact:


Lesson Learned/Best Practice

I was told the Hill Rom  Pillow Speaker was not working correctly with the TV. Hill Rom stated it was the TV Vendor’s fault, and Remar stated it was Nurse Call Vendors fault. The problem was resolved without project delay.


Suggested Actions for Future Projects

Ensure coordination between Nurse Call Vendor and TV Vendor during installations. If possible, schedule installation dates during or near same time frame.


Keywords

Coordination between TV Vendor and Nurse Call Vendor

Smoke Control Inspector and Coordination

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: 171
Impact: Cost, Schedule, Quality

Cost impact: $59,802 Schedule impact: 15 days


Lesson Learned/Best Practice

 Early Owner Buyout of 3rd Party Smoke Control Inspector to prevent delays in Final Inspections and Occupancy.


Suggested Actions for Future Projects

Coordinate 3rd Party Special Inspection requirements for Smoke Control Systems during CD’s. Design Team to send RFP’s for Special Inspection Agencies and Provide to HCA CM for Approval. Schedule review of smoke control requirements with the GC prior to Smoke Control Testing. Perform Site walk with Inspector and Testing of Existing Systems early in project schedule to identify existing deficiencies and items to be addressed by Facility or Construction Team. 


Keywords

Smoke Control, Special Inspections, Life Safety Report, Testing

Power in the Slab

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: 163
Impact: Cost, Schedule


Lesson Learned/Best Practice

Power was identified in the slab when scanning for coring after walls were framed. Required relocating walls, plumbing fixtures and rework of overhead sheetrock activities.


Suggested Actions for Future Projects

This facility is unique in that most of its normal power circuits are run in the floor slabs.  During planning/EDI efforts, it would be beneficial to scan particular areas of the floor plan to determine if power is present prior to finalizing floor plans.


Keywords

Rough-In, Scanning, EDI, Floor Slab, Electrical

Central Energy Plant (CEP) Replacement Coordination and Phasing

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: 161
Impact: Cost, Schedule, Scope

Cost impact: $15,000


Lesson Learned/Best Practice

During construction the team was able to coordinate the installation of the new utility lines in a way that minimized the overall duration of the temporary CEP services. During this process multiple phasing plans were developed to tackle the existing utility layouts that were uncovered. A complete mapping of the existing systems would have prevented the back and forth of multiple phasing plans and expedited the overall underground installation process. 


Suggested Actions for Future Projects

How to minimize the duration of a temporary CEP:
– A complete interior and exterior mapping and phasing plan should be developed prior to construction. This is advised in order to reduce potential impacts once construction begins.
– How much existing roadway/sidewalk will need to be removed/replaced to accomplish the phasing of both demo and replacement? 
– Schedule of when each existing and new item is to be removed/installed.


Keywords

CEP, Temp Equipment, 3D Mapping

Facility Protection Protocol

Facility name: Ocala Regional Medical Center

Project name: OCALMC-092018M-Vertical Bed Expansion
Location: OCALA, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3092700031
Lesson Learned number: 160
Impact: Safety, Scope


Lesson Learned/Best Practice

Vertical Expansions are high risk regarding patient environment of care and to the physical care of the facility itself. Inspections and checklists should be reviewed constantly as the jobsite and structure are continuously changing at a rapid pace. One of the biggest, if not the most risk on any Vertical Expansion projects is water intrusions. From the moment you set the first column, you have the potential to expose the facility to water. 


Suggested Actions for Future Projects

We have developed numerous forms and checklists that cover all trade accountability and ensure that we leave the site knowing we are protecting patients and faculty. 

Along with the facility checklists and permits, we developed the Facility Protective Measures (FPMs) and Temporary Roofing Measures (TRMs).

Facility Protective Measures  – (Pre Task) This form lists out work being completed below the Vertical. It lists out the subcontractor performing the work, specific work to be completed, if work will affect patient care, department head approval, facility manager approval and a pre-task checklist before work is to be performed. (Post-Task) This form follows the work completion described in the “pre-task”. General Contractor and Subcontractor managers in charge sign-off sheet to verify that there are no hazards to the facility. 

Temporary Roofing Measures -This form lists trades working on the rooftop, weather conditions on site for the day, expected weather conditions for the following day, Close of business signoff check list includes rooftop and existing operational floor. This form is monitored and signed off by an onsite manager for all subcontractor managers and the general contractor manager.


Keywords

water intrustion, incidents, checklists, vertical expansion

Exterior Demolition Drawings

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: 159
Impact: Cost, Schedule


Lesson Learned/Best Practice

On future projects requiring demolition provide drawings indicating extent of work at each level.  The scope of the demolition spanned across four levels but no demo drawings were provided for the roof, only Level’s 01-04 and some exterior elevations.  The demo indicated on the drawings occurred but it was quickly identified that there were multiple discrepancies on the drawings at the roof level, and the extent of demo was not clear.  This resulted in multiple RFIs to understand the scope required, structurally and architecturally.  Due to the lack of drawings there were multiple RFIs and cost impacts associated with the extra demo.


Suggested Actions for Future Projects

For each level requiring demolition provide a drawing indicating the extent of demo required.  This will minimize RFIs and potential cost impacts. 


Keywords

Roof Demolition

HVAC Equipment Guy Wire Install

Facility name: North Florida Regional Medical Center

Project name: NRFLMC-032018M-South Tower Vertical Expansion
Location: GAINESVILLE, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3091600012
Lesson Learned number: 158
Impact: Cost, Schedule, Quality


Lesson Learned/Best Practice

Guy wires need to be installed to construction details.  Details site spacing, guy wire angles, and structural/deck mounting requirements.  Having early discussions regarding details with the MEP trades, steel detailer, and structural engineer may result in an install pattern that saves additional steel bracing and provides clearer direction for specific unit installation.


Suggested Actions for Future Projects

Include in shop drawing review for placement and install of guy wire anchors.


Related files. Click to view/download.

File 1:
8880guywiredetail5.pdf

File 2:
1759nfroofinstall3.JPG