Add a Lesson Learned

Design

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

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

Keying and Coring

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: 169
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

Existing facilities keying/coring system did not match the Allegion master specs. Required replacing levers and cylinders to integrate with facility’s existing keying system.


Suggested Actions for Future Projects

Review with facility during design prior to issuing Construction Documents. Design team to confirm with Design Manager direction.  Incorporate existing keying requirements in the specs on the front end should HCA determine that is the best course of action.


Keywords

Doors, Hardware, Keying, Schedule, Allegion

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

Finish Upgrades Scope of Work

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: 167
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

Scope not clearly defined on plans but required to perform specified activities; drywall touch up/finishing, removal of existing electrical devices to remain, plumbing fixtures needed to be removed prior to new flooring install, grab bars, mechanical grilles, sprinkler head relocations to accommodate new ceiling layout.

Finish plan shows new ceramic tile flooring and wall tile at existing patient room bathrooms. However, demo plan did not provide specific notes to remove all existing fixtures and division 10 items and reinstall for new finishes.


Suggested Actions for Future Projects

At a minimum, provide more detailed notes and callouts on construction documents, particularly on the demo drawings, where removal/reinstallation of existing items to remain should be picked up.  Best practice would be to walk each area and create a specific detailed plan showing all items and their locations for further detail and clarity.


Keywords

Finishes, Renovation, Demolition, Minor, Cosmetic, Fixtures, Existing to Remain

Oxygen Park Vendor Coordination

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: 166
Impact: Quality


Lesson Learned/Best Practice

Design team is typically asked to work with the O2 vendor when replacing the existing O2 park. However, the vendor does not work for the design team and is not typically willing to assist in a timely manner. 


Suggested Actions for Future Projects

If there is a need to replace the O2 park and the design team and facility are not getting timely responses from the vendor, HCA Engineering and DFM should be asked to step in and help facilitate the process.


Keywords

O2 park

Kitchen Exhaust Hoods

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: 165
Impact: Quality


Lesson Learned/Best Practice

Careful attention should be considered regarding the design of the exhaust hoods for kitchen equipment. Typically this scope of work is handled by an outside vendor that designs the system. We have experienced one of our hoods over the serving line Grill, that does not fully exhaust the heavy hamburger smoke, causing small amounts of smoke to roll out of the corners of the exhaust hood and out into the open serving area. Months of investigative efforts have resulted in adjustments/modifications to the system to correct this.


Suggested Actions for Future Projects

Any large smoke producing equipment should be kept against a perimeter wall that goes full height up to the exhaust hood. This approach is likely to reduce the possibility of a similar issue. 


Keywords

kitchen exhaust, smoke producing equipment

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

Rooftop Piping Across Existing Structures

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: 162
Impact: Scope


Lesson Learned/Best Practice

Pipe routing seems to often be left to the installing contractor.  When rooftop piping is used, the support frames are done by the installer as a deferred submittal, but the underlying structure has to be reviewed by the design team. Field investigation should be performed to identify/incorporate existing structure components/limitations into the design documents. 


Suggested Actions for Future Projects

Large diameter piping being routed over existing roof sections needs to have those existing roof sections surveyed prior to the completion of design. The survey should identify the structural make-up of each roof section, so appropriate routing and pipe stands can be coordinated/designed into the construction documents with the structural engineer’s approval. 


Keywords

Pipe racks, Roof piping, Bar joists, pipe supports