Add a Lesson Learned

Finishes (Div 09)

ADA Shower Pans

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

Long Lead Items on Accelerated Schedule

Facility name: Ogden Regional Medical Center

Project name: OGDNMC-012020M-New Rehab Unit
Location: OGDEN, UT
Project classification: Hospital – Shell Buildout
Project type: MOB
Project number: 3441500009
Lesson Learned number: 178
Impact: Schedule

Schedule impact: 25 days


Lesson Learned/Best Practice

For Projects with Accelerated Schedules and no time for Early Release of Long Lead Time Materials, verify materials can be obtained in time to meet the required schedule during Preconstruction.


Suggested Actions for Future Projects

Plan for Early Release of Long Lead Time Materials, Equipment (Contractor and Owner Provided including Equipment , IT&S and Unified Communications), review the need for these items early in the project development to review options for obtaining items in time to meet the required accelerated schedule.  Ensure to review these potential early items with DM and CM during RFP and design phases.


Keywords

Accelerated Schedule, Review Long Lead Material Items during Preconstruction, Request Substitutions during Preconstruction, Rehab

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

Resinous Flooring in Coolers/Freezers

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: 155
Impact: Scope


Lesson Learned/Best Practice

On projects where a resinous flooring is specified for a kitchen space, typically the same product is specified for the coolers/freezers if these units do not come with flooring installed. The standard flooring product will not adhere properly in a cooler environment.


Suggested Actions for Future Projects

A separate product should be specified for cooler/freezer floors to prevent cracking and delamination in cooler temperatures.


Keywords

Flooring, Kitchen

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

Hire Cauliking contractor sole source

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: 146
Impact: Quality, Scope


Lesson Learned/Best Practice

This comment is for Behavioral Health construction only, Utilize only one pick proof caulking for all phases of the project, this includes vendor items that are installed at the end of the project that will require pick proof caulk.


Suggested Actions for Future Projects

Develop a specific specification requiring pick proof caulk, and reference drawings for specific locations coordinated with security provisions plan. Require contractor to buy out pick free caulk as a specific scope of work, have broken out in bid package. Pick free caulk to be by sole source provider.  

Submittal process for prefabricated headwall units

Facility name: P-SL Medical Center

Project name: PRSTLK-022017M-Pre-Op & Recovery
Location: DENVER, CO
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 2720000019
Lesson Learned number: 89
Impact: Schedule


Lesson Learned/Best Practice

Start the submittal process for prefabricated headwall units at the start of the project.  Headwall units were not submitted and approved by the time they were ready to be installed resulting in out of sequence work for the patient bays. Because the headwall units are required when walls are being framed they need to be submitted and approved as soon as possible because they have a significant lead time.


Suggested Actions for Future Projects

For trade fabricated headwalls, trade subcontractor must coordinate with the design team upon award to ensure that shop drawings are developed, submitted and approved in a timely fashion to avoid schedule delays.


Keywords

submittals, prefabricated, headwalls, facility, design team

Planning Construction Barriers

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: 53
Impact: Cost, Schedule


Lesson Learned/Best Practice

When a new construction phase overlaps into an existing room, where at all possible, take that entire room rather than subdividing it with a new temporary wall.  Maintaining or upgrading existing partitions is cheaper and faster than building a new wall, and those impacted rooms are rarely left with enough function to be usable when subdivided.


Suggested Actions for Future Projects

Review construction phasing with an eye to trying to utilize existing walls wherever possible, rather than constructing new temporary walls.

Sheet vinyl flooring installations

Facility name: Trident Regional Medical Center

Project name: TRIDET-102017M-Cardiovascular Stroke Addition
Location: CHARLESTON, SC
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 3400100016
Lesson Learned number: 52
Impact: Quality


Lesson Learned/Best Practice

Sheet vinyl flooring was installed and then wall protection added afterwards.  This showed gaps in between the cove base and the wall protection, which aesthetically, looked like poor workmanship.  To correct this, we had the flooring contractor pull back the cap and cove and reapply to the wall protection’s straight edge.


Suggested Actions for Future Projects

Before installing sheet vinyl floors and the cove base associated with it, install the Acrovyn Impact Sheet Wall Protection first.  This will eliminate gaps between the cove base and the wall protection.  The cove base is never level, while sheet goods have factory level cuts and are laid out by a laser in the field for precision.


Actions Taken / Current Status

Sent to Design Management team for follow-up action.

Considerations for planning temporary walls

Facility name: Methodist Texsan Hospital

Project name: METHTX-112016M-Master Plan ED & Lab Expansion
Location: SAN ANTONIO, TX
Project classification: Hospital – Horizontal Expansion
Project type: Acute Care
Project number: 2610900001
Lesson Learned number: 40
Impact: Quality


Lesson Learned/Best Practice

When planning and building temporary walls for expansions/renovations, if possible place them where you can build the new scheduled wall in front of it.


Suggested Actions for Future Projects

Plan for the depth of the permanent wall and try to locate the temporary wall to accommodate building one side of the permanent wall in front of the temporary on so as to not have to take down the temporary wall and disrupt patient care twice (once to build temp wall and once to take temp wall down while patient care space is still needed).


Actions Taken / Current Status

We agree this makes sense if site conditions can accommodate it.