Add a Lesson Learned

Plumbing (Div 22)

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

Central Energy Plant (CEP) Temporary Plant

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: 164
Impact: Cost, Scope

Cost impact: $64,000


Lesson Learned/Best Practice

Air-cooled chiller rental agencies have their own operational standards for their equipment which do not always match manufacturer operational standards. A temporary variable primary chilled water system was the basis of design for this project to match the existing chilled water plant configuration. The design team worked with the temporary unit manufacturer to ensure proper operation was being met. However, the rental agency would not allow for the operation of the chillers in a variable primary system. This resulted in added piping and pumps. In addition to this, the rental agency did not provide a control interface for the rental units. This caused for additional control wiring/sequencing for the temporary units.


Suggested Actions for Future Projects

When providing a temporary chilled water plant that utilizes rental air cooled chillers, provide a primary/secondary pumping configuration. Additionally, provide the temporary control system sequence as part of the design. Review the system configuration with the contractors and rental agency to ensure that their internal operational standards are being met and controls can be accomplished.


Keywords

temporary chilled water plant, rental

Rooftop Piping Across Existing Structures

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: 162
Impact: Scope


Lesson Learned/Best Practice

Pipe routing seems to often be left to the installing contractor.  When rooftop piping is used, the support frames are done by the installer as a deferred submittal, but the underlying structure has to be reviewed by the design team. Field investigation should be performed to identify/incorporate existing structure components/limitations into the design documents. 


Suggested Actions for Future Projects

Large diameter piping being routed over existing roof sections needs to have those existing roof sections surveyed prior to the completion of design. The survey should identify the structural make-up of each roof section, so appropriate routing and pipe stands can be coordinated/designed into the construction documents with the structural engineer’s approval. 


Keywords

Pipe racks, Roof piping, Bar joists, pipe supports

Central Energy Plant (CEP) Replacement Coordination and Phasing

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: 161
Impact: Cost, Schedule, Scope

Cost impact: $15,000


Lesson Learned/Best Practice

During construction the team was able to coordinate the installation of the new utility lines in a way that minimized the overall duration of the temporary CEP services. During this process multiple phasing plans were developed to tackle the existing utility layouts that were uncovered. A complete mapping of the existing systems would have prevented the back and forth of multiple phasing plans and expedited the overall underground installation process. 


Suggested Actions for Future Projects

How to minimize the duration of a temporary CEP:
– A complete interior and exterior mapping and phasing plan should be developed prior to construction. This is advised in order to reduce potential impacts once construction begins.
– How much existing roadway/sidewalk will need to be removed/replaced to accomplish the phasing of both demo and replacement? 
– Schedule of when each existing and new item is to be removed/installed.


Keywords

CEP, Temp Equipment, 3D Mapping

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

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

Vavle Location Maps and Tags

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: 140
Impact: Cost, Schedule, Quality, Safety


Lesson Learned/Best Practice

It has been stressed by our HCA construction manager to inform all on site personnel of the location of shutoff valves in case of an emergency. Layton took it upon ourselves to create a map that is hung in different areas throughout the construction space that shows the location of all shutoff valves in our construction area. We have also implemented valve tags that hang down so the valves can be easily identified.


Suggested Actions for Future Projects

At the beginning of the project create a map that identifies shutoff valve locations and hang valve tags so that shutoff valves can be easily identified. 


Keywords

shutoff valve, valves

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

MEP PreAudit

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: 131
Impact: Cost, Schedule, Scope

Cost impact: $10,000


Lesson Learned/Best Practice

Perform audit of all mechanical, electrical, plumbing systems & security systems., including complete T&B audit prior to start of any work in renovation areas. This will help ensure full scope of mechanical renovations is captured early


Suggested Actions for Future Projects

Perform a pre-audit of any MEP systems that are to remain in place. Should be completed during design phase. This can weed out issues such as water not heating up quick enough or security systems not working. Conduct an audit of mechanical systems during design phase if possible. At a minimum, conduct measurement of existing systems prior to starting work.

Coordinate with the design team to verify connections and capacity capability of existing equipment (VAVs, etc) will support proposed design.  


Keywords

Test & Balance, Exiting utilities, Air changes, Air Exchanges