Add a Lesson Learned

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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

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

Power in the Slab

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: 163
Impact: Cost, Schedule


Lesson Learned/Best Practice

Power was identified in the slab when scanning for coring after walls were framed. Required relocating walls, plumbing fixtures and rework of overhead sheetrock activities.


Suggested Actions for Future Projects

This facility is unique in that most of its normal power circuits are run in the floor slabs.  During planning/EDI efforts, it would be beneficial to scan particular areas of the floor plan to determine if power is present prior to finalizing floor plans.


Keywords

Rough-In, Scanning, EDI, Floor Slab, Electrical

Facility Protection Protocol

Facility name: Ocala Regional Medical Center

Project name: OCALMC-092018M-Vertical Bed Expansion
Location: OCALA, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3092700031
Lesson Learned number: 160
Impact: Safety, Scope


Lesson Learned/Best Practice

Vertical Expansions are high risk regarding patient environment of care and to the physical care of the facility itself. Inspections and checklists should be reviewed constantly as the jobsite and structure are continuously changing at a rapid pace. One of the biggest, if not the most risk on any Vertical Expansion projects is water intrusions. From the moment you set the first column, you have the potential to expose the facility to water. 


Suggested Actions for Future Projects

We have developed numerous forms and checklists that cover all trade accountability and ensure that we leave the site knowing we are protecting patients and faculty. 

Along with the facility checklists and permits, we developed the Facility Protective Measures (FPMs) and Temporary Roofing Measures (TRMs).

Facility Protective Measures  – (Pre Task) This form lists out work being completed below the Vertical. It lists out the subcontractor performing the work, specific work to be completed, if work will affect patient care, department head approval, facility manager approval and a pre-task checklist before work is to be performed. (Post-Task) This form follows the work completion described in the “pre-task”. General Contractor and Subcontractor managers in charge sign-off sheet to verify that there are no hazards to the facility. 

Temporary Roofing Measures -This form lists trades working on the rooftop, weather conditions on site for the day, expected weather conditions for the following day, Close of business signoff check list includes rooftop and existing operational floor. This form is monitored and signed off by an onsite manager for all subcontractor managers and the general contractor manager.


Keywords

water intrustion, incidents, checklists, vertical expansion

Creative solution for maintaining agricultural exemption

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: 144
Impact: Cost


Lesson Learned/Best Practice

JEDUNN came up with an innovative solution for agricultural exemption that the facility was going to pursue. The innovative solution was to introduce bee hives for honey harvesting. This allowed the facility to maintain farm exemption on track of land that was diminished in size due to hospital expansion.


Suggested Actions for Future Projects

Pursue with facility to come up with innovative solutions for any exemptions the facility is pursuing. Inform the facility of this type of action when a facility expands into an existing agricultural area.


Keywords

Exemptions

Documentation of Light Renovation Rooms

Facility name: P-SL Medical Center

Project name: PRSTLK-022017P1-Surgery Renovation
Location: DENVER, CO
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 2720000020
Lesson Learned number: 142
Impact: Schedule, Quality


Lesson Learned/Best Practice

Per the CD’s, Layton asked the end user where they would like their wall mounted fixtures and equipment mounted in their “light renovation OR’s”. However, the end user requested that the fixtures and equipment be installed in their original locations. Unfortunately, the end user did not know where the original locations were. This caused Layton and the end user to spend additional time identifying where fixtures and equipment should be located. 

 

 

 


Suggested Actions for Future Projects

Ensure that photos or videos of light renovation rooms are taken to document locations of fixtures and equipment. 

Mock State Health Inspection Rehearsal

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: 141
Impact: Schedule, Quality


Lesson Learned/Best Practice

Run mock state health inspection that simulates the final inspection to ensure team is fully prepared and rectifies any issues prior to the inspection day. 


Suggested Actions for Future Projects

Team to determine appropriate time for mock inspection to allow enough time to resolve any issues that come up prior to the inspection.  Coordinate who from HCA, the facility, construction and design team will be present for the actual inspection and ensure key members are involved in the mock inspection.  Team to develop a checklist of items the inspector will be looking for during the actual inspection (ie fire/life safety system, nurse call system, FGI requirements, accessibility, C of O, flame spread data, and all required paperwork/documentation).  Facility to confirm equipment is properly placed and in alignment with FGI requirements.  Contractor to ensure nurse call vendor is available for inspection.  Architect and facility to review functional program and plan review comments submitted to the State.


Keywords

Mockup, State, Health, Inspection, Rehearsal

Improved Lab Equipment Information

Facility name: Swedish Medical Center

Project name: SWEDIS-052018M-Hybrid OR Renovation
Location: ENGLEWOOD, CO
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 2710000029
Lesson Learned number: 133
Impact: Cost, Quality, Scope


Lesson Learned/Best Practice

The existing Lab Equipment (model numbers, infrastructure hook-ups, technical requirements, etc.) has to be assessed with a view to the new layout and design. This exercise is best performed by a Lab Equipment expert. At Swedish, ESa was asked to perform this equipment accounting function. It was not efficient, and it could have been more effective were a consultant or the Facility/Owner involved. 


Suggested Actions for Future Projects

HCA Equipment Manager shall quantify existing equipment and coordinate with the Architect/Engineer on the new layout. 


Keywords

Specialty Consultant, Lab Equipment, Equipment Layout

EDI Cost Tracking and Goal Setting:

Facility name: Lawnwood Regional Medical Center

Project name: LAWNWD-062019M-New Tower and CEP
Location: Fort Pierce, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3093200010
Lesson Learned number: 105
Impact: Cost

Cost impact: $600,000


Lesson Learned/Best Practice

A detailed cost management log was developed in Smartsheet that showed current cost updates for duration of EDI. This tool was valuable for tracking, recording, and updating costs.  An advantage of this was transparency within the team, readily available lists of action items, and accurate cost counts for the target cost goal and savings cost goal. The team was able to beat the target cost goal and the savings goal for the design phase. The initial EDI savings goal was $76,000, but the total savings equaled $130,000.  The total project goal was 7.58 million and the team helped to save close to $600,000 or about 10% of the project.


Suggested Actions for Future Projects

It’s a best practice to use a collaborative and transparent cost management log (TVD log) during the EDI process. Because all parties have access to up to date costs, this will ensure that the job remains on budget and will hit EDI cost savings goal.


Actions Taken / Current Status

HCA comment:  Best practice for tracking cost savings during the EDI process.

Eliminating the team’s Top 3 biggest concerns:

Facility name: Lawnwood Regional Medical Center

Project name: LAWNWD-062019M-New Tower and CEP
Location: Fort Pierce, FL
Project classification: Hospital – Vertical Expansion
Project type: Acute Care
Project number: 3093200010
Lesson Learned number: 104
Impact: Quality, Scope


Lesson Learned/Best Practice

At the EDI kickoff meeting, each person brought their top 3 biggest concerns/issues for the project. This was all documented in Smartsheet and countermeasures were also discussed. To ensure everyone’s concerns and constraints were completed, they were added into the main action item list on Smartsheet. As the items were completed, they were checked off. This was done for everyone; this took time but everyone’s concerns were heard and resolved.


Suggested Actions for Future Projects

Encouraging everyone to bring up their concerns and constraints early in EDI, and then creating an action item list off of this with responsible people, ensures that these concerns are taken care of.


Actions Taken / Current Status

HCA comment:  This is a best practice for facilitating the EDI process.


Keywords

Big Room, facilitation, constraints, concerns


Related files. Click to view/download.

File 1:
9067Top3Concerns.jpg