Add a Lesson Learned

Conveying Equipment (Div 14)

Evolving HCA standards

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: 148
Impact: Cost


Lesson Learned/Best Practice

With HCA’s ever evolving design standardization there needs to be a fixed point where design is frozen for each specific project. 


Suggested Actions for Future Projects

Document date and version of HCA standards utilized within CD drawing set,  validate HCA standards with planning manger, design manager, HCA engineering and construction manager.


Keywords

HCA Standards, MEP guidlines

MEP PreAudit

Facility name: North Austin Medical Center

Project name: NRTAUS-022019M-Rehab/Peds Relocation
Location: AUSTIN, TX
Project classification:
Project type: Acute Care
Project number: 0822400025
Lesson Learned number: 131
Impact: Cost, Schedule, Scope

Cost impact: $10,000


Lesson Learned/Best Practice

Perform audit of all mechanical, electrical, plumbing systems & security systems., including complete T&B audit prior to start of any work in renovation areas. This will help ensure full scope of mechanical renovations is captured early


Suggested Actions for Future Projects

Perform a pre-audit of any MEP systems that are to remain in place. Should be completed during design phase. This can weed out issues such as water not heating up quick enough or security systems not working. Conduct an audit of mechanical systems during design phase if possible. At a minimum, conduct measurement of existing systems prior to starting work.

Coordinate with the design team to verify connections and capacity capability of existing equipment (VAVs, etc) will support proposed design.  


Keywords

Test & Balance, Exiting utilities, Air changes, Air Exchanges

Coordination of steel and shell packages complete at DD

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: 49
Impact: Schedule, Quality


Lesson Learned/Best Practice

During the EDI process it was decided by the integrated team to start BIM processes after the completion of the steel shop drawings.  This decision was based primarily on avoiding rework of possible changes due to misc steel and bracing and any changes that may occur during design up until the ERP steel package.  This allowed for two additional months compared to pulling from hanger setting and prefab which would have resulted in the coordinating starting later.  The net effect however was that the BIM coordination took longer than expected and the project resulted in having BIM signed off model just in time for prefab and embed coordination.

Two main root causes involve the contractual requirements for multiple bids on steel asbuilts necessary for the steel shops and the steel shop review process coming still late in the process compared to ideal.  The ideal time for steel shops to be complete is closer to DD.  This would allow BIM coordination (re: MEP and electrical) to occur prior to CD’s being complete.


Suggested Actions for Future Projects

Emphasize the locking of the steel and shell packages by DD.


Actions Taken / Current Status

See attached Process Improvement Memo #3 regarding new steel procurement process.


Related files. Click to view/download.

File 1:
53206HCAHealthcareProcessImprovementMemo3_SteelProcurement12192019.pdf

Early Design Involvement (EDI) team transition from design to construction

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: 30
Impact: Scope

 


Lesson Learned/Best Practice

Begin the transition earlier in the design process or incorporate more field personnel earlier in the design process if available; Beneficial for trade partner field staff (foremen) to be involved early in page turn/quality pauses; conduct quality pause/Big Room at location to allow field staff to attend more frequently when cluster groups start meeting (during DD).


Suggested Actions for Future Projects

 

BIM modeling on Early Design Involvement (EDI) projects

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: 3
Impact: Quality, Scope

 


Lesson Learned/Best Practice

Incorporating BIM Modeling early in design was a huge benefit. Steel and beam sizes were changed based on needs arising from BIM coordination (not typical for traditional BIM process); the expectation of having a fully coordinated model was unrealistic; Menorah had a 70% coordinated model at CD; Wins:  rotated steel, changed structural geometry, stacked electrical room, OR walls


Suggested Actions for Future Projects

Continue in the future; look at using BIM 360 Design for future projects; allowed trade partners to plan for prefabrication; EDI at its best, but is only possible with this leveling of modeling by the  MEP trade partners.