Time is Money 150,000 sf Hospital in 8 ½months Concept through Construction

Transcription

1 Time is Money 150,000 sf Hospital in 8 ½months Concept through Construction Dr. Glenn Mitchell, Mercy Health, Retired Dave Hitchcock, Aspen Street Architects Charlie Walden, Walden Structures Inc.

2 Learning Objectives: 1. Address Modular building myth s. 2. Evaluate the potential for making/saving money using modular healthcare construction. 3. Assess the Mercy Hospital Joplin project. 4. Explore: Is modular the right solution for upgrading, replacing or expanding your facility?

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4 Glenn Mitchell, MD, MPH CMO, Mercy Health (retired)

5 Resumption of medical care Immediate: Emergency care center in intact alternate site By end of week one: State disaster hospital on site (36 bed tent facility) Decision to stay By end of week two: Need more permanent solution!

6 A Community s Worst Nightmare! May 22, 2010 In Joplin: 161 dead, 1371 injured, 4380 homes destroyed, 3884 damaged in 22 mile long, ¾ mile wide path Deadliest since 1947 At Mercy: 158 patients plus visitors and staff evacuated in less than 45 minutes (5 deaths)

7 Selection Process Challenges Mercy could not immediately select a fabricator (Walden) because of required bid issue from FEMA Background process Worked with ASAI to start concept design work Understood construction method with Charlie's help Business considerations (market share, staff retention, reimbursement, insurance assistance) Attractive time and cost estimates for interim solution Met with ASAI in Joplin to kick off the replacement project. Improved care delivery process underway!

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9 Dave Hitchcock, President Aspen Street Architects, Inc.

10 Challenge to the Owner First Hours or Days Within hours or days Immediate response to local healthcare need Response Set up in community center Tent hospital Less than one week Reimbursement Standard sources NONE Emergency sources possible

11 Challenge for the Owner After the Immediate Emergency Get out of tents Reestablish standard income flow Retain loyal patient base Support and retain staff / providers Stabilize the hospital image

12 Challenge for the Owner After the Immediate Emergency Get out of tents Retain loyal patient base Support and retain staff / providers Enhance the hospital image Reestablish standard income flow All economically important

13 Challenge for the Owner After the Immediate Emergency Get out of tents Retain loyal patient base Support and retain staff / providers Enhance the hospital image Reestablish standard income flow All economically important All tied to rapid construction

14 Why did Mercy fly to the West Coast and Choose Modular Construction? ASSUMPTIONS $100Mil project Stick vs Modular equal cost Materials same Concept / Design / Approvals same Stick construction, no adverse weather 3 years Modular Construction 1 year

15 Why did Mercy Fly to the West Coast? To gain 2 years of reimbursement, expanded services and enhanced income Instead of 2 years of construction payments with no income Simply a sound business decision

16 Building Summary 150,000 sf 60 med surg rooms, each sized for private or semi private occupancy 10 LDRP rooms 6 Pediatric rooms Compounding Pharmacy Regional Lab 132 Person Lobby Full dietary department w/seating for 140 persons Gift shop 23 bed ED 18 bed ICU 4 700sf+ Ors 2 Cath labs Radiology 2 Cat Scan 1 MRI 2 RF 2 Nuc Med 2 Ultra Sound PET/Litho

17 Design Response First 2 Weeks Mobile Hospital installed in one week Temporary Facility Panelized Design on the fly Approvals phased by week Identify panel building concept 13,000sf ED, Med Surg, Diagnostics, Support Spaces

18 Design Response First 2 Weeks Hospital Replacement Modular Owner s Scope Owner s Program Research Site Funding Approval process 150,000sf identified

19 Design Response Weeks 3/4/5 Temporary Facility Panelized Design on the fly Approvals phased by week Concept panel design completed w/builder Mercy contract with panel builder signed

20 Design Response Weeks 3/4/5 Hospital Replacement Modular Review by Owner Review by Users 150,000sf concept design completed RFP out to manufacturers

21 Design Response Weeks 6/7/8 Temporary Facility Panelized Design on the fly Approvals phased by week Installation of panel building started on site

22 Design Response Weeks 6/7/8 Hospital Replacement Modular Design Development Code review with Local and State Agencies Receive Bids for Modular building Vet bids General site design

23 Design Response Weeks 9 15 Interior shots of Johnson building Temporary Facility Panelized Design on the fly Approvals phased by week Week 9 10,000sf commissioned 8/10/11 Week 13 10,000sf commissioned 9/6/11

24 Design Response Weeks 9 15 Hospital Replacement Modular Continued Design Development Owner / FEMA / Corp of Engineers legal and funding reviews Contract for modular hospital 9/25/11

25 Design Response Weeks Temporary Facility Panelized Completion of 31,000sf panelized hospital 13 weeks after contract 6/29/11 10/2/11

26 Design Response Weeks Hospital Replacement Modular Construction document engineering and production State and local plan approvals Construction, installation, licensing and commissioning Sept 25 April weeks after contract

27 Considerations for Owners & Designers Architects Design fees can be lower (con docs by mfg) Designer s Insurance liability lower This is a purchase not a design project much like a design build few if any change orders Owners can use own architect or modular experienced consulting architect Design considerations: Design and Shipping Height Design and Shipping Width Structure Columns Floor and roof loads Finishes Multi floor construction

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29 Charlie Walden, President Walden Structures October 2, 2012

30 The Mercy Challenge: To re establish Mercy s acute care hospital in Joplin: I.Shortest possible time frame II.Code Compliant III.150,000 sq ft building to be delivered, installed, and commissioned by April 12,

31 Our Involvement Brand Reputation Recommendation Mercy visits Reedley, CA to tour existing modular hospital Mercy issues RFP July 2011 Mercy visits Walden during an intensive vetting process Contract dated Sept 25,

32 Code Compliant JCAHO 2006 IBC, IMC, IPC 2008 NEC State of Missouri Health Services State of Missouri Fire Marshall (i.e. elevators) City of Joplin Building Department City of Joplin Fire Marshall Occupancy I 2 Combination of Type 2A (1 hr) & Type 2B (non rated) construction Non combustible 32

33 Timeline of Events Nov 18, 2011 July 2011 Sept 23, 2011 Oct 19, 2011 January 26, 2012 Mercy visits Walden Structures Mercy approves patient room prototype 1 st Units Shipped to Joplin, MO April 12, 2012 Opening Day Production began 100,000 sq ft erected 33

34 Logistical Hurdles 1. Timeliness of Materials 2. Transportation of units 1664 miles to site 3. Thanksgiving, Christmas, and New Years holidays 4. Winter travel season 5. Multiple States Heavy Hauler Wide Load Permitting and Routing 34

35 The Solution: Multi Phase Construction Process 35

36 Design/Fabrication Synergy Phase I : 2 story Med Surg Wing Design Phase I Design 1 (Aug Nov) Fabrication Ph 1 (Sept Dec) Site: Foundation Prep Site Prep / Install Ph 1 Sept 25th Nov Jan Apr 12 Factory: Fabricate Structural Components 36

37 Design/Fabrication Synergy Phase 2 : Pharmacy, Lobby/Admin Design Phase 2/3 Design (Nov Dec) Fab Ph 2 (Nov Jan) Install Ph 2 Sept 25th Jan Apr 12 37

38 Design/Fabrication Synergy Phase 3/4 : Lab, Surgery, Radiology Design Phase 4 (Structural) Dsgn 4(Jan 1 14) Fab Ph 3/4 (Dec Jan) Install Ph 3 Sept 25th Jan Apr 12 38

39 Design/Fabrication Synergy Phase 4/5 : ICU, Emergency Design Phase 4/5/6 Dsgn (Jan 14 24) Fab Ph 4/5 (Jan Feb) Install Ph 4 Sept 25th Jan Apr 12 39

40 Design/Fabrication Synergy Phase 6 : Dietary, Receiving Phase 1 Turn over to Owner Site Interior Finished Site Exterior Fabrication Design Complete Fab Ph 5/6 (Jan Feb) Inst. Ph 5/6 & Finish Sept 25th Jan Apr 12 Equipment / Furniture Installation 40

41 Exterior/Interior Finishing Roofing TPO Roofing over ISO Exterior Cladding EFIS State Certification April 12, 2012 Interior Finish Walls, Ceilings, Floor coverings, Med gasses, Headwalls Cafeteria, OR, Cath Labs, Imaging, ICU, and ER Furniture, Fixtures, Equipment Owner provided, delivered, and installed 41

42 Project Statistics # of People at the Plant 350 # of People at the Site 400 Top Transportation Week (Jan 9 th, 2012) Shipped 35,000 sq ft 42

43 Questions?

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45 Benefits of Modular Construction Reduces construction time Enables concurrent site construction & factory production Environmentally controlled production lines Factory construction promotes safety, quality, and efficiency On site construction crews reduced by 50 70% Ideal solution for sites with limited accessibility Streamlined building deliveries 45