Design – HCA Healthcare | Capital Deployment

Fire alarm for powered doors

Leave a Comment / Permitting, Construction, Design, MEP, Local AHJ

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: 187
Impact: Cost, Schedule

Cost impact: $8,500 Schedule impact: 7 days

Lesson Learned/Best Practice

On this project the fire alarm was designed prior to bid and the completed fire alarm shop drawings were part of the bid package and not created as a deferred submittal by the fire alarm subcontractor. We had numerous doors with auto operators, and the fire alarm shop drawings didn’t capture the code-required relay that triggers those powered doors to close when the alarm activated.

Suggested Actions for Future Projects

Ensure fire alarm design that is included in the Permit/OSHPD documents identifies rated openings and auto operators and include the required Fire Alarm Integration, relays, etc. If fire alarm design is a post Permit/OSHPD approval (like an OSHPD deferred approval), then note this requirement within the specification for integration with the project fire alarm system.

Keywords

Fire Alarm, Doors, Operators

Sliding doors at Isolation Rooms

Leave a Comment / Design, Constructability (means & methods)

Facility name: Regional Medical Center Of San Jose

Lesson Learned/Best Practice

Rooms with sliding glass ICU/CCU doors sometimes have Isolation Rooms with differential pressure monitors. These doors do not typically come with bottom sweeps, and these rooms will not meet pressure relationships without them. At this project, due to limited width of the door opening, the ICU door was specified as a 3-panel door instead of a 2-panel door. This made it especially problematic to meet the pressures. The gaps between panels were doubled, and the middle panel became a difficult location on which to apply a sweep without interfering with the roller in the bottom needed for the breakaway function.

Suggested Actions for Future Projects

Limit design to 2-panel ICU doors in rooms with pressure monitoring.

Keywords

ICU, Doors, pressure monitoring, sliding, breakaway doors, hardware, sweeps

Vibrocompaction Footing Size Change

Leave a Comment / Design, Planning, Constructability (means & methods)

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

Leave a Comment / Design, Constructability (means & methods)

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

Leave a Comment / Design, Construction, Constructability (means & methods), Vendors

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

OR Ceiling Height

Leave a Comment / Design, Constructability (means & methods)

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

Leave a Comment / Planning, Design, Constructability (means & methods)

Facility name: P-SL Medical Center

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

Neopod Shut Off Valve Access

Leave a Comment / Construction, Design, Prefabrication

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

Leave a Comment / Construction, Design, Prefabrication, Constructability (means & methods)

Facility name: Menorah Medical Center

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

ITS Equipment List

Leave a Comment / Design, IT&S - Delivery / Installation, IT&S - Design, IT&S - Procurement, IT&S

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