Add a Lesson Learned

Electronic Safety & Security (Div 28)

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

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

Landscape design

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: 147
Impact: Cost, Quality, Safety


Lesson Learned/Best Practice

BH concerns with Landscaping design and coordination with camera location to take into consideration – tree locations, rose bushes, camera views, very specific to behavioral facilities


Suggested Actions for Future Projects

Include final landscape design, to include specific types of vegetations, sizes and not just locations, and overlaid with final security camera locations.  Key considerations; potential camera review by landscaping for potential obstructions, possible patient safety or elopement considerations due vegetation sizes and location. Required attendees for review, corporate security, designated facility point of contact, design team including landscape architect.


Keywords

Behavioral Health, landscaping, security cameras

Sign-off for Shutdown Process

Facility name: Aventura Hospital & Medical Center

Project name: AVENTU-New Tower
Location: AVENTURA, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3092000015
Lesson Learned number: 139
Impact: Quality, Safety, Scope


Lesson Learned/Best Practice

Ensuring that all existing utilities are up and fully functioning after shutdown is complete


Suggested Actions for Future Projects

Add line items on MOP form/paperwork for facility approval and completion of work. Prior to the shutdown occurring walk existing space with facility management personnel and have form signed at the beginning of the shutdown. After the work is complete and GC/sub believe the hospital should be back up and running re-walk all spaces with facility management personnel to confirm and have them sign off on the form saying they have walked and verified that the work is complete

Existing Security review

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: 128
Impact: Cost, Scope


Lesson Learned/Best Practice

Perform Site-Walk / Audit to determine adequacy of infant abduction system, door hardware, and security shown on drawings.


Suggested Actions for Future Projects

Owner’s infant abduction vendor needs to get involved during design phase if possible or as early as possible and verify that all systems integrating to the system are designed to function with the system. Coordination with facility to verify that each door is secured as needed would be beneficial.


Keywords

security, infant abduction system

AHCA – Aiphone Power Supplies

Facility name: UCF Lake Nona Medical Center

Project name: Lake Nona-102018M- New Hospital
Location: TALLAHASSEE, FL
Project classification: Hospital – New
Project type: Acute Care
Project number: 2689500001
Lesson Learned number: 126
Impact: Scope


Lesson Learned/Best Practice

AHCA requires that any piece of electrical equipment that is preassembled carry a UL listing or be field listed. Aiphones do not carry a UL listing and cannot be field listed without a Class “2” power supply. A Class II power supply is not permited.


Suggested Actions for Future Projects

Low voltage subcontractor should carry cost to swap out power supplies from Class II to Class 2 for any projects in Florida.


Keywords

AHCA, Aiphone

Fire Alarm Integration with Other Systems

Facility name: Kendall Regional Medical Center

Project name: KENDAL-New Tower
Location: MIAMI, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3594100019
Lesson Learned number: 111
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

Fire alarm systems integrate with access control, fire suppression and HVAC systems. Many times the design for these other systems are not complete or not represented on the drawings until after the EDI process. During the Kendall Bed Tower Expansion and Temporary Helipad the following issues arose due to lack of information or drawings.

  • Relays for automatic doors we not included.
  • Relays for hardware power supplies (vertical rods in double doors) were not included.
  • Relay for access control head equipment was not included.
  • Not enough heat detectors included in the elevator machine room and top of the elevator shaft. There must be a heat detector within 24″ of a sprinkler head. The fire sprinkler drawings were not available during pricing.
  • Relays for exhaust fans. Not all the fans that required shutdown relays were shown as requiring them.

These were all changes that required RFIs, drawing revisions and re-submittals to the county for permitting. 


Suggested Actions for Future Projects

Information for a full design needs to be available during the EDI process. Bringing fire alarm, access control and fire suppression on board at the beginning of EDI would eliminate most of the scope gaps, change orders, drawing changes and delays. Therefore eliminating delays during construction. 


Actions Taken / Current Status

HCA comment:  The best practice is to bring in the Fire Alarm and Controls vendor early during the EDI process based on the design schedule specifics for a given project.

Security Camera Placement

Facility name: Brandon Regional Hospital

Project name: BRADON-052017M-Lakeland FSER
Location: BRANDON, FL
Project classification: Free Standing Emergency Room
Project type: FSED
Project number: 3091700021
Lesson Learned number: 108
Impact: Safety


Lesson Learned/Best Practice

Final placement of the security cameras with the generator yard was not ideal.  The view of the entrance door was blocked by the height of the generator itself.  Camera had to be shift toward the center of the enclosure to get a better view.


Suggested Actions for Future Projects

Review the security camera placement with HCA.  Then double check that there are no obstructions to that view (generators, trees, other large landscaping items, ceiling bulkheads, etc).  


Actions Taken / Current Status

HCA comment:  The best practice is to have HCA’s Physical Security staff to check the cameras after placement for obstructions.


Related files. Click to view/download.

File 1:
49743SecurityPlan.jpg

File 2:
94053ViewfromCamera.jpg

File 3:
60238ViewofCamera.jpg

Behavioral Health Card Reader

Facility name: Tristar Division Office

Project name: TRISTR-032018M-New Freestanding Behavioral Health Hospital (Maury)
Location: BRENTWOOD, TN
Project classification: Hospital – New
Project type: Psych
Project number: 3103000003
Lesson Learned number: 92
Impact: Cost, Quality, Safety


Lesson Learned/Best Practice

Team worked to identify a product during construction that was a vandal resistant, ligature resistant card reader and keypad combo unit. The keypad adds an additional layer of security if a card reader is stolen or grabbed from a staff member.


Suggested Actions for Future Projects

Include critical design decisions, lessons learned and HCA approved specs as part of the Behavioral Health Guidelines currently under development


Keywords

behavioral health, card reader


Related files. Click to view/download.

File 1:
49679bhcardreader.jpg

OSHPD Plans – Fire Alarm Design

Facility name: Regional Medical Center Of San Jose

Project name: RMCSAJ-052017P1-IP Surgery Dept. Reno
Location: SAN JOSE, CA
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 0838500028
Lesson Learned number: 43
Impact: Cost, Schedule


Lesson Learned/Best Practice

Include temporary heat detection in plans for construction bidding and OSHPD approval.  On renovation projects the existing fire alarm has to be removed for construction.  Preserving smoke detectors is problematic, because the dust of construction sets them off.  We typically use heat detectors for temporary fire alarm, but this requires an ACD approved through OSHPD.


Suggested Actions for Future Projects

If the fire alarm design is in the documents, having temporary heat detectors indicated within them ensures that this is captured in pricing, and is pre-approved by OSHPD so there’s no installation delay.