Add a Lesson Learned

Openings (Div 08)

Fire alarm for powered doors

Facility name: Regional Medical Center Of San Jose

Project name: RMCSAJ-052017M-ASC(OP Surgery)
Location: SAN JOSE, CA
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 0838500026
Lesson Learned number: 187
Impact: Cost, Schedule

Cost impact: $8,500 Schedule impact: 7 days


Lesson Learned/Best Practice

On this project the fire alarm was designed prior to bid and the completed fire alarm shop drawings were part of the bid package and not created as a deferred submittal by the fire alarm subcontractor.  We had numerous doors with auto operators, and the fire alarm shop drawings didn’t capture the code-required relay that triggers those powered doors to close when the alarm activated.


Suggested Actions for Future Projects

Ensure fire alarm design that is included in the Permit/OSHPD documents identifies rated openings and auto operators and include the required Fire Alarm Integration, relays, etc.  If fire alarm design is a post Permit/OSHPD approval (like an OSHPD deferred approval), then note this requirement within the specification for integration with the project fire alarm system.


Keywords

Fire Alarm, Doors, Operators

Sliding doors at Isolation Rooms

Facility name: Regional Medical Center Of San Jose

Project name: RMCSAJ-052017M-ASC(OP Surgery)
Location: SAN JOSE, CA
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 0838500026
Lesson Learned number: 186
Impact: Quality


Lesson Learned/Best Practice

Rooms with sliding glass ICU/CCU doors sometimes have Isolation Rooms with differential pressure monitors.  These doors do not typically come with bottom sweeps, and these rooms will not meet pressure relationships without them.  At this project, due to limited width of the door opening, the ICU door was specified as a 3-panel door instead of a 2-panel door.  This made it especially problematic to meet the pressures.  The gaps between panels were doubled, and the middle panel became a difficult location on which to apply a sweep without interfering with the roller in the bottom needed for the breakaway function.


Suggested Actions for Future Projects

Limit design to 2-panel ICU doors in rooms with pressure monitoring.


Keywords

ICU, Doors, pressure monitoring, sliding, breakaway doors, hardware, sweeps

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

Keying and Coring

Facility name: Woman’s Hospital Of Texas

Project name: WMHOTX-122018M-LDR, C-Section & Support Space Renovations
Location: HOUSTON, TX
Project classification: Hospital – Renovation
Project type: Acute Care
Project number: 3431900019
Lesson Learned number: 169
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

Existing facilities keying/coring system did not match the Allegion master specs. Required replacing levers and cylinders to integrate with facility’s existing keying system.


Suggested Actions for Future Projects

Review with facility during design prior to issuing Construction Documents. Design team to confirm with Design Manager direction.  Incorporate existing keying requirements in the specs on the front end should HCA determine that is the best course of action.


Keywords

Doors, Hardware, Keying, Schedule, Allegion

Exterior Door Details vs. NOA/FPA

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: 154
Impact: Quality


Lesson Learned/Best Practice

NOA/FPA requirements for exterior doors located on elevated decks may differ from the details included in the construction documents resulting in additional RFI’s and added scope


Suggested Actions for Future Projects

Once FPA/NOA’s are confirmed for exterior doors, a meeting should be conducted between the contractor, design team, and envelope consultant (if engaged) to review details against the FPA/NOA


Keywords

Exterior Frames, FPA/NOA

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

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

MRI Closet Ventilation

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: 125
Impact: Scope


Lesson Learned/Best Practice

MRI closets require adequate ventilation between the penetration panel and the MRI space. Louvers were cut into the door after installation to meet this requirement.


Suggested Actions for Future Projects

Design documents should include louvers at MRI closet doors.


Keywords

MRI Ventilation

HM Frame Returns for SV Rooms

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: 123
Impact: Quality


Lesson Learned/Best Practice

Best Practice: Any room with sheet vinyl should have the HM frame constructed with a 3/4″ HM return to ensure adequate space is provided for the cove base.


Suggested Actions for Future Projects

Design documents should incorporate a 3/4″ return for any HM frame installed in a room with Sheet Vinyl


Keywords

HM Frames

Exterior Finishes Selection

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: 103
Impact: Cost, Schedule


Lesson Learned/Best Practice

During the EDI process there was a lot of emphasis put into the main skin finish selection, for precast and EIFS, while the metal panels, louvers, curtainwall, and misc. finishes were not selected.  The intent was for the exterior finishes to match the existing building but was not noted as such in the Construction Documents.  This caused the GC and architect to spend a lot of time reviewing samples in order to find the appropriate color for the exterior finishes.  The result of this process was added cost, and lead time for material procurement, due to selecting a custom color.


Suggested Actions for Future Projects

When new construction is tying into an existing building exterior finishes should be selected during design.  For an accurate color match, and to appropriately account for associated cost, the CDs should indicate the manufacturer and color to match.


Actions Taken / Current Status

HCA comment:  The preferred method is the design team details matching or coordinated colors with existing building exterior finishes for the new finish details when possible.