In 2014, Houston Methodist began to expand a 40-year-old hospital to better serve the fast-growing Clear Lake region of Texas. The master growth plan includes multiple phases of construction to create more space for physician clinics and offices. Hoar 汇丰国际线路检测中心 has been engaged with supporting this masterplan since 2014, and based on that relationship we’ve completed three projects, with three more underway.
The first phase of expansion included a new central utility plant (CUP). Switchover and commissioning were crucial for patient safety in an active hospital. Our preparation and plan for the hospital’s new CUP was key for handling unexpected incidences.
UNEXPECTED BUDGET CUTS IN OUR PLAN
When awarded the project, the CUP contract value was close to $18 million. Due to the owner’s internal budget cuts, we had to slash the contract amount to $10 million. We used our Preconstruction Cost Item (PCI) log, a comprehensive budget tracking tool, to control project costs. The budget can easily evolve with new changes, so we could redraw within the new contract on schedule. The original scope included an office build-out for the facilities management that was not included in the new contract. However, our team value-engineered to include infrastructure for underground plumbing for a future build-out. Also, the scope included demolition and removal of the old structure and equipment. Our team capitalized by selling the old generator to a second-hand equipment vendor, bringing $88,000 back into the budget. Even though we had to cut our original awarded amount in half, we ended up returning savings to the owner.
A SOLID FOUNDATION
Knowledge of the Houston area clay-like soils is vital for building foundations. The original foundation design was directly on the soil. The hospital has had previous foundations heave from these soils expanding or swelling, costing them millions of dollars. To prevent the foundation of this new structure from heaving, our team partnered with the structural engineer to carton-form the slab. We used 12-inch cardboard-like, honeycomb forms and covered them with Masonite and plastic sheeting and then installed them between the trench and slab to reinforce it. The cardboard ultimately disintegrated leaving just the Masonite behind, which gives the foundation’s reinforcement a 12-inch movement.
RISKY POWER SWAP ON AN ACTIVE HOSPITAL CAMPUS
The swap over from the old transformers to the new transformers is a delicate process. In the case of an operating hospital, there’s no room for error. Our team planned for two power shutdowns with the engineering team, electrical trade partners, and owners. Two months before, our team held a several-hour-long mock shutdowns with project stakeholders and hospital staff. We talked through each process twice, so everyone knew what the actual shutdown would feel like and ensure everyone was comfortable with the plan. If anyone felt uncomfortable about the rehearsal, we addressed it well in advance. Also, we planned a brown-out for the emergency power several weeks ahead of the swap over. This partial reduction in power allowed us to see what would happen during the shutdown and what emergency systems would activate. Our team had weekly meetings with the facility manager, so she could accurately update her staff about the expected date. The input and cooperation from the hospital staff helped us to understand where the challenges were and plan accordingly. Because of this collaboration, the planned brown-out occurred flawlessly.
The Cardiac Catheterization Lab (CATH) suite renovation included upgrading mechanical and electrical systems to support the new equipment. Due to the location of the suite within the hospital, the project team knew this project would require hospital system shutdowns to support the start and finish of the mechanical, electrical, and plumbing system activities. Identifying and coordinating the shutdowns took close planning, communication, and partnership with hospital facilities and staff. Executing the shutdowns allowed the project team and trade partners to begin on time and eliminate the possibility of prolonging the tasks at hand. With pre-planning and communication, this resulted in completing the renovation on time and not sacrificing quality.
CONSTRUCTING SCHEDULE CERTAINTY
The Cardiac Catheterization Lab suite renovation included upgrading mechanical and electrical systems to support the new equipment. Due to the size of the suite, the HVAC grills, lightning, and equipment booms created inconsistent ceiling patterns. Typically, this would require cutting several custom drywall pieces, which would in turn create more dust to mitigate, which did not meet ICRA standards. The project team’s solution was to use 1-inch drywall strips that were pre-measured and cut to the required length. The drywall strips eliminated the dust and maintained the ceiling patterns. This prefabrication process was cost-effective without sacrificing quality.
Hoar uses multiple tools to create schedule alignment such as weekly production meetings, pull planning, and trade partner buy-in on certain schedule activities to ensure no disconnect between the master schedule and trade partner expectations. Due to design changes, the Cardiac Catheterization Lab was tracking 10 days behind schedule. The project team knew the substantial completion date couldn’t be jeopardized because Houston Methodist had committed to having the new CATH Lab open by a certain date. As a part of a weekly OAC meeting, the project team presented a recovery schedule that identified new milestones and coordinated new activity dates with trade partners and the Director of Facilities. Ultimately, every milestone was met on the recovery schedule and the project was completed on time.
BIG STEPS TOWARDS MASTER PLANNING
Our latest project in support of the multi-year expansion planned for the Houston Methodist Clear Lake campus is the new Orthopedics & Sports Medicine Building. The new Houston Methodist Orthopedics & Sports Medicine at Clear Lake is 158,000 SF, 6-story building, with the first two 2 floors dedicated to physical therapy and a sports medicine gym and clinic. Floors 3-6 will be core and shell with the exception of restrooms, storage, mechanical, and maintenance offices. The new medical office building will be complete in early 2021.