Add a Lesson Learned

Special Construction (Div 13)

Neopod Shut Off Valve Access

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: 176
Impact:


Lesson Learned/Best Practice

It was identified during the installation of the Neopod Staff Toilet Rooms, that access to the shut off valves was missing. The shutoff valves are located on top of the Toilet Room and are inaccessible through the gyp board that goes to deck. All of the Neopod Patient Toilet Rooms have shut off valves located in the corridor and have adequate access.


Suggested Actions for Future Projects

Coordinate required access for shutoff valves, etc to be outside of any prefabricated unit foorprint and add access panels as required..


Keywords

Neopod, BLOX, coordination, shutoff valves, water, access panels

In Dapt Needs from Steris for Rough In

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: 175
Impact: Schedule


Lesson Learned/Best Practice

Prior to In-Dapt starting their initial prefab install for the OR ceilings the Steris mounting plates and med gas pigtails are needed onsite.  During install In-Dapt will attach the mounting plates and pigtails to their ceiling system.


Suggested Actions for Future Projects

By means of the OFE Delivery Schedule worksheet, add a line item to identify the “needed on site by” date for delivery prior to In-Dapt Installation and include in pull planning schedule.


Keywords

OR Ceiling, Steris, In-Dapt, Schedule, OFE

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

City of Orlando – BLOX Outlets

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: 135
Impact: Cost


Lesson Learned/Best Practice

BLOX Patient Bathroom lights are fed from critical branch power, per HCA & ICT guidelines, and are fabricated with flex conduit connections. The City of Orlando requires that all critical branch power be ran in rigid conduit


Suggested Actions for Future Projects

If a BLOX design alteration for the City of Orlando is not feasible, the contractor should carry cost to remove flex conduit and install rigid pipe in the City of Orlando.


Keywords

BLOX, City of Orlando

Early install of Interior Prefab Components

Facility name: East Florida Division Office

Project name: DAVHOS-102018M-New Hospital (NOVAMC)
Location: Davie, FL
Project classification: Hospital – New
Project type: Acute Care
Project number: 3597900001
Lesson Learned number: 113
Impact: Schedule, Quality


Lesson Learned/Best Practice

At HCA Davie, the hospital project was a 4 level concrete frame, and the team could not start the exterior walls, interior framing, or overhead MEP until the reshores were removed and the top concrete deck was poured. B&G decided to bring in BLOX components as soon as reshores were removed and layout was complete, creating a unique advantage in sequencing and an early release of subsequent trades inside the hospital. Typically, BLOX components are not installed until the building is mostly dry and the envelope is closed in, so the main risk in bringing in the units this early was keeping the units protected from the elements with no skin on the building. Utilizing additional boat wrap and leaving the bottom 1’ off of the headwalls helped keep the units dry while allowing the early delivery to streamline the prefabricated interior components’ delivery and installation.


Suggested Actions for Future Projects

–          This approach proved to be successful for the team, and is being utilized on Lawnwood as well.

–          It does require some focused attention and extra work to keep the units dry.

–          Two steps the team took were: 1) Re-boat wrapped some of the bathrooms to keep them dry until we set them when the exterior was complete. 2) Leaving the 1’ of drywall off the bottom of the headwalls (see other lessons learned for this)


Actions Taken / Current Status

HCA comment:  The General Contractor is advised to check with the local AHJ to insure they will accept this practice.

Afternoon Prefab Deliveries

Facility name: East Florida Division Office

Project name: DAVHOS-102018M-New Hospital (NOVAMC)
Location: Davie, FL
Project classification: Hospital – New
Project type: Acute Care
Project number: 3597900001
Lesson Learned number: 107
Impact: Schedule, Safety


Lesson Learned/Best Practice

Even though the hospital project had 3 tower cranes, dedicating a crane full time for a day for BLOX deliveries was not optimal. The team elected to start the first BLOX delivery after 3:30pm, when normal production work for the day was wrapping up. This would allow for uninterrupted use of a tower crane and ensured less overall traffic on the floor. This helped to lower congestion on the jobsite during the day and created a calm environment to move multiple 3500lb prefabricated units onto the floors of the hospital. The team saw the multiple benefits of delivering the BLOX units after hours and continued this practice for the rest of the job with great success.


Suggested Actions for Future Projects

Consider bringing in prefab components after normal working hours, to insure most efficient install and minimal congestion. This is especially true when there is heavy use of the project cranes throughout the days.

Vent stack coordination with BLOX bathroom pods

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: 75
Impact: Cost, Schedule, Quality


Lesson Learned/Best Practice

Four inch vent stacks were noted above third floor toilets in area C on labor and delivery BLOX-made bathrooms, however walls of BLOX bathrooms are framed with 3 5/8″ studs that could not accommodate a 4″ pipe.


Suggested Actions for Future Projects

 Review vendor drawings against existing conditions or other design drawings to verify coordination of connections and dimensions.


Keywords

vent stacking, pods, BLOX, early design involvement, EDI, Neopod, plumbing, riser

BLOX Units – Electrical Issues

Facility name: East Florida Division Office

Project name: DAVHOS-102018M-New Hospital (NOVAMC)
Location: Davie, FL
Project classification: Hospital – New
Project type: Acute Care
Project number: 3597900001
Lesson Learned number: 59
Impact: Cost, Schedule, Quality


Lesson Learned/Best Practice

Make sure BLOX tightens all EMT conduit screws and couplers. Failed electrical inspections because conduit screws and couplers were loose on many units. BLOX is having to bring in multiple electricians to repair onsite.  Need to do a root cause analysis with BLOX and HCA on why their QA/QC process missed this.


Suggested Actions for Future Projects

Improve offsite QA/QC.  Bring in local inspectors early once BLOX units are onsite.


Actions Taken / Current Status

Issue has been addressed by HCA Healthcare with BLOX.  Actions have been taken by BLOX to correct the problem.

BLOX components delivery and installation scope

Facility name: Lake Nona Hospital

Project name: Lake Nona-102018M- New Hospital
Location: TALLAHASSEE, FL
Project classification: Hospital – New
Project type: Acute Care
Project number: 2689500001
Lesson Learned number: 39
Impact: Cost, Schedule, Scope


Lesson Learned/Best Practice

A scope gap was identified where labor was not bought out to collect, palletize and load BLOX headwall racks, panelized bathroom racks, rigging gear and mover jacks onto long haul shipping trailers contracted directly with BLOX. 

Ensure BLOX install foreman/subcontractor leadership responsible for loading BLOX hardware/equipment discussed project strategy at BLOX kickoff meeting on site to avoid confusion when BLOX install is complete in an area, phase, floor or project and hardware needs to be returned to BLOX facility in AL.

Ensure the specific phasing of BLOX delivery AND installation (if those two activities do not run finish-to-start) is reviewed in detail during the BLOX pre-mobilization meeting held on site.


Suggested Actions for Future Projects

Update BLOX install playbook to identify this scope responsibility and assign it to the GC to buyout with BLOX component installation.

On future projects, the BLOX install playbook should clearly identify that scope responsibility and the GC should ensure that labor responsibility is included with the installation of the BLOX components.

Cluster or break-out groups in Early Design Involvement (EDI) projects

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: 29
Impact: Quality, Scope

 


Lesson Learned/Best Practice

Incorporate trade break out and/or cluster groups earlier in design; cluster (break-out) groups should be scheduled in coordination with Big Room meetings and started at beginning of project; We suggest the breakout meeting start the Big Room days so that items that are brought up in the breakouts that need to be discussed with the larger group there is still time to it.  Also, this would insure that the breakouts happen.


Suggested Actions for Future Projects