Add a Lesson Learned

Finishes (Div 09)

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.

Existing room dimensions verification

Facility name: Doctors Hospital Of Augusta

Project name: DOCAUG-112017M-New Tower(Surgery Expansion)
Location: AUGUSTA, GA
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3100300014
Lesson Learned number: 35
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

1.  Design team to field verify existing room dimensions at new building to existing building tie-in locations and GC to confirm dimensions on existing room as early as possible by conducting field measurements as soon as possible.  The accuracy of as-built dimensions should not be assumed and all as-builts should be field verified.
2.  During phasing discussions, portions of the facility which would be preferred to remain in operation should have plans in place in case unforeseen field conditions dictate the preferred portions need to be relocated/ taken out of operation.


Suggested Actions for Future Projects

Confirm dimensions of existing rooms at exterior walls focusing on locations of building tie-ins for future construction. Possibly develop plan early to relocate existing specialty rooms to other locations in the facility if feasible.  Facility should maintain up-to-date as-built drawings and field verify for confirmation.

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