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1 Technical Report Due: December 3, Surgery Expansion Andrea Klein Construction Management Advised By Dr. Messner

2 Technical Report 3 Table of Contents Executive Summary 2 A. Critical Industry Issues....3 B. Critical Issues Research Method C. Problem Identification..9 D. Technical Analysis Methods. 0 E. Weight Matrix..

3 Executive Summary Technical Assignment #3 is a preliminary stage to writing my thesis proposal. It includes a summary and study of the sessions held at the PACE Roundtable held on October 25 th, 2007, a discussion of my chosen research topic, the problems with my thesis building that could provide breadth topics, the topics chosen to be studied for an in depth analysis, and a weight matrix for the planned report next semester. The topics discussed at the Roundtable were prefabrication, building information modeling (BIM), and the current labor workforce. Each topic was presented by a panel and with questions from the conference participants resulting in a large brainstorming session. By examining the current situations in the construction industry the attendees were able to grasp new concepts and come up with ideas for solutions and changes for the future. I particularly enjoyed the discussion on prefabrication and have chosen it for my research topic. Narrowing the focus of prefabrication, I would like to examine prefabrication in hospital renovations with a primary interest in how it can be tied to the Infection Control Risk Assessment (ICRA) regulations. The selected analysis topics were a reevaluation of the mechanical system and acoustical design of the operating rooms. Evaluating the mechanical system for possible prefabrication, schedule reduction and cost savings through reusing materials will require research into current design and construction methods and possible redesign of certain elements. The acoustical analysis will be used as value engineering for schedule reduction and cost savings in future projects when delicatee procedures and patient recovery will not be disturbed by construction or repair work in neighboring areas. 2

4 A. Critical Industry Issues A brief summary of three panel discussions held at the 2007 PACE Roundtable in State College, PA. Prefabrication Prefabrication is defined, primarily, as the act of constructing pieces of an assembly before they are installed. The main types are prefabrication, pre-assembly, and on versus off site construction. Other factors include residential construction as opposed to commercial construction, and lean construction. Industry leaders have many concerns with prefabrication in its implementation and application. Implementationn is the largest hurdle to conquer, due in part to how slowly the construction industry adapts to change. Many feel prefabrication will limit the creativity of architects and engineers. There are also differing opinions of when in the design process to begin considering prefabrication. It is the general consensus of the PACE Roundtable that the earlier prefabrication is considered the better. By designing a project with the intention of using prefabricated materials, time and money can be saved. The application of prefabrication in construction is also a large issue. While many trades use prefabrication already, when an entire project is using prefabricated materials, the question of who will be in charge is difficult to answer. Should the general contractor have control, or the trade contractor requiring the most prefabricated materials? Coordinating the efforts of the teams both on and off site would take a great deal of time and care, and labor presents an important issue. Another application issue is how to meet current code and inspection requirements when pieces of a building are put together in alternative locations. Transportation to the site is also a concern with large, heavy loads being moved once they are assembled off site and damage caused by the transportation, and how they will be put together once on site. Benefits of prefabrication include higher quality of assemblies, with smaller tolerances, less cost for labor, and the inherent benefits which make it ideal for green construction. Assembling off site will reduce VOC emissions, dust contamination, and will force assembly to be conductedd within a locall zone to minimize travelling distance. Overall, many obstacles lie in the way of prefabrication. While it may equire an overhaul of the entire industry and its current thinking, prefabrication has a future in construction. It will take the effort of many, but with standardized procedures and general practices, prefabrication will become more widely accepted and used. Building Information Modeling (BIM) BIM is a current hot topic in industry worldwide. Not having a completely formalized definition, BIM is the use of intelligent multidimensional models to integrate the design and construction analysis of a building. It uses new technologies, which require new skill sets and training, and it also takes a different type of thinking. The main goal of BIM would be an integrated design and delivery, without reduction 3

5 in quality. While the industry players are making progress in this type of thinking, many owners and users are having trouble understanding the need and use of BIMs. The biggest challenge of BIM is getting started, and getting the project team to buy-into the concept and use it. Owners present one of the major blockades for BIM in the constructionn industry. Most owners are unfamiliar with the technology and how it changes the building process. BIM needs to be a decision made early in a project to provide the full extent of its advantages. As a tool, BIM can be extremely helpful, but the users must understand it first. Owners using it need to be trained to think about the design more, and they need to be prepared to make big decisions earlier than typical. The next major problem with BIM is how to get everyonee on the team involved. Questions such as who has control of the model, authors versus users, how many trades need to be involved in making the model, how detailed the model should be, and what software will be used, create issues from the beginning of a project. Clearly the architectural design team needs to have access to the model, but should all the designers be able to alter the model, or should only one person be in control? If BIM is to help enhance if not replace standard drawings, does everyone need access to them as a user? Certain trades have adopted BIM easily, i.e. the MEP trades, who need extremely detailed drawings to determine if conflicts with other trades are present. Lower trades, i.e. concrete and finishes, might not have as much to gain from using BIM. To be completely successful, the entire project team needs to be on board, and the biggest challenge to industry right now is how to spread the word, and get everyone involved. Perhaps the largest problem for BIM in industry is the lack of standards. Multiple software packages are available however each comes with its own format and is not compatible with all other formats. While there are groups working on creating a standard, there is more than one group, which reduces the benefits of all the attempts. For the time being, resolving this issue falls largely on the owner and design team to make decisions about what software will be used for a project, and what standardss they want to follow or create. Building Information Modeling is going to be a vital part of construction in the future, but right now there is much to be solved about how best to use it on projects. The benefits of BIM outweigh the problems, if a team is ready and willing to work through the issues. As more people become champions of BIM, the industry is becoming more accepting and trying to solve the issues at hand. As an aside, it was nice to see the group at this Roundtable seemed more open to BIM as a whole in comparison with the industry members present at last year s PACE Seminar. Workforce Development Currently the construction workforce is dwindling and it is a bigger issue than many realize. Larger projects are being bid, with fewer laborers to staff them. In the Washington DC area in particular, the problem is especially acute. Several factors attributing to the lack of labor are the baby boomers retiring, the poor reputation of the construction industry, changes in workforce demographics, and fewer people who make a career out of construction. 4

6 Construction needs people, and a large part of this discussion was focused on how to get more people interested in this industry. Before people will seriously consider the construction trades, the reputation of construction workers and management staff needs to improve. The problem has many levels, but one primary issue is the attitude of the workers already in place. A stereotypical construction worker is gruff, abrupt and has a bad disposition. Owners and construction management staff do not fair much better, looking like they are out to make as much money as possible no matter the consequences. This image does not impress many people, and is a limiting factor in generating interest. There is little public exposuree to the new faces of construction with its increased concerns for safety and quality, but there aren t many new faces to find. Ideas to improve the image include televised programs, counseling on alternate career paths within the industry, retraining current employees in behavioral and soft skills and to adapt to the new workforce, and the possibility of recruiting at younger levels of school. This poor reputation is not only a perception of outsiders. Many people who work within the industry would not recommend it as a career to their own children. Options to change this attitude include training management staff to manage people more effectively, and to get owner s to take more interest in the workers conditions. Workers who are trained and in the industry are leaving to seek better wages and better working conditions. If management was more willing to advocate better conditions, work places would be safer, laborers would be working under more reasonable time constraints, and there would be a higher retention rate. A final major component to this issue is the increase of immigrant workers. A large percentage of the population seess this as a reputation ruining factor, when the truth is these immigrant workers can be as effective and skilled as others, if managed properly. To relieve some of the problems suggestions for language development programs on both the laborer and management side have been considered, and in many instances implemented with excellent results. Language barriers are not the only problem with this newer workforce, but also training and job culture. Just like an labor force, a portion of the immigrant workers are trained in useful fields and are qualified to take on different jobs within their companies, and workers without any experience need to be trained to handle responsibilities on site. As a whole, the construction industry could use a facelift, and present a better picture to society. In order to accomplish this goal, and obtain the people needed, the industry needs to undergo a renovation of management techniques and job culture. Key Contacts This Roundtable session proved to be very resourceful and enlightening. I was surprised by how aware many people were of the issues, and how open they weree to new ideas. Part of the cultural change the industry needs is to be able to adapt to and adopt technologies and ideals for a better society. I am interested to see if any of these topics take root in the industry over the next few months until the PACE Seminar in the spring. One of the reasons I am so interested in this industry is to see how I can make my mark and improve the system from within. 5

7 I met several people who will be good contacts for my thesis research. Stan Carlat: Hensel Phelps Stan s company is known for experiencee in prefabrication and for clean rooms which both relate to my project. James Faust: Turner Construction Turner is a national company with many resources, and Jim s experience in the industry I hope will prove to be invaluable Since the session, I have made several other contacts through interviews and correspondence. Corinne Ambler: Barton Malow Corinne provided two contacts within her company who have experience in hospital construction. Ben Morgan: Barton Malow Leaha Martynuska: Barton Malow 6

8 B. Critical Issues Research Method Problem Statement: Hospital renovations and expansions are an integral part of maintaining the health care systems in the United States. Unfortunately, to meet to the continual needs of the public, these projects must be conducted while the rest of the hospital continues to operate normally. Working in partially occupied spaces is nothing new to the construction industry however the risk of contamination and infection in an occupied hospital is cause for even more concern. While the implementation of Infection Control Risk Assessment(s), ICRAs, in hospital construction has alleviated many of the problems, I feel more can be done to improve the quality of construction and infection control in the healthcare market; specifically prefabrication. It is my goal to research the effect of prefabrication on hospital renovation projects, not only for its cost and labor savings, but also for its benefits to the health and safety of patients in hospitals undergoing construction. Research Goal: The intent of my research over this coming semester is to create a guide with prefabrication ideas to implement on hospital construction projects where infection control is a major concern. There are practices already in place by certain contracting trades which will provide examples and experience to compare to my plans. Hopefully, the guide I create through my research can be used by owners, contractors and facility managers to aid in using prefabrication as a means of reducing schedule time, reducing onsite labor and labor costs, and in better meeting the ICRA guidelines set forth by the American Institute of Architects (AIA). Research Steps:. To obtain a true understanding of the current ICRA regulations. Read the guideline established, and make contract with contractors to ask questions and affirm my conclusions. 2. Research statistics on hospital renovation and expansion projects to create a firm basiss of need and verify my target audience. 3. Make contact with owners and owner s representatives to establish what concerns they have about the ICRA regulations and which issues prefabrication may help address. This will hopefully provide target areas of research to best benefit the end user. 4. Send out preliminary surveys to general and trade contractors to discern what methods of prefabrication are already being used for healthcare projects. These surveys would include the amount and method of prefabrication, target trades for prefabrication and any suggestions for what else it may be of use to. An example of this would be contacting mechanical contractors known for prefabrication to see what expertise and advice they have. 5. Compile data from these contacts to determine how best to format a guide, and to provide further direction on which trades to focus on. 7

9 6. Create the guide for prefabrication in healthcare projects using language friendly to owners, designers, and contractors. The hope for this guide is to create something which can be implemented early in a project for the maximum benefit. 7. Establish credibility of the guide by asking members of the target audiences, both experienced and inexperienced, to review the guide and complete a survey. This survey would include questions about how easy the guide is to understand and implement, and if they would use it in practical applications. 8. Taking the resultss from the surveys and comments from industry members, I would then reevaluate the guide myself and make adjustments as required. Sample Survey Questions: Preliminary Survey to Owners Are you familiar with the 2006 ICRA guidelines established by the AIA? Have you used ICRA guidelines for past or present projects in your facility? Did you have difficulties in maintaining any of the procedures outlined in you program? If so, what were they, and how did you attempt to solve them? Was prefabrication used to any extent during your project? Do you think fabricating materials and systems off site is a viable option to help maintain the ICRA guidelines? Post Guideline Survey Was the guide easy to understand and follow? Did the guide provide sufficient information on prefabrication practices and implementation? Do you feel the topics outlined covered issues prevalent in healthcare construction? Do you feel this guide would be useful to future project owners and construction teams? Do you have any suggestionss for ways to better the guide or the ideas for prefabrication outlined within the guide? Examples: newer technologies, workforce issues, etc Are there any suggestions you wish to make for material the guide is missing? Would you use this guide in future projects either alone or in conjunction with the ICRA regulations? 8

10 C. Problem Identification The following items are elements of the Surgery Expansion project which could be redesigned or constructed by an alternative method. The goal of this project is to analyze and evaluatee these items to reduce the project cost, the project schedule, or both. They will be evaluated in a later report. Mechanical System: In this renovation project a space is being designed to handle a different and more specialized use than the offices it originally held. These changes required all of the existing mechanical work to be removed and replaced. As the largest valued package on this project, the mechanical work takes a considerable amount of the schedule, and would probably be examined as a breadth topic. The building is not designed to be LEED certified but the use of more efficient methods and equipment may be analyzed to reduce the cost and schedule. Recycling and/or reuse technology would be examined for feasibility. Also, the use of prefabrication is a distinct possibility for the mechanical systems if designed correctly as means of schedule reduction. Acoustical Analysis: Given the sensitivity of the areas surrounding which houses the Neonatal Intensive Care Unit (NICU) and the Critical Intensive Care Unit (CICU), noise during construction is a major concern. Several measures have been taken to isolate construction noise through alternative methods and means, however, given the plans for more renovationn in the future this is an important issue to consider. An analysis of finish materials being put into place, or the use of more materials being placed in the interstitial floors is an option of study. Electrical System: The electrical system for this renovation is critical provided the nature of the work done in the building. Operating rooms are the main focus, and in most cases consume large amounts of energy to keep the life support systems working. Large complex equipment gets hooked up to both the main power supply and emergency power. Examining the design would provide information on energy use and system controls. It is an option for value engineering and cost savings to right-size the equipment and ensure it meets the requirements. Fire Protection: The project is currently having a major issue with fireproofing the operating rooms. It was designed to have spray fireproofing on the ceiling which is unacceptable. The design team has not yet come up with a new design and is delaying further construction in the ORs. A closer look with the system may show possible schedule reductions and reveal constructability issues. 9

11 D. Technical Analysis Methods The following topics were selected for a more in depth analysis to provide possible cost savings, schedule reduction, and constructability. Mechanical System Analysis: Looking specifically at the HVAC system I plan to examinee prefabrication as a means of cost savings and schedule reduction. I want to try to minimize the work done on site to aid in meeting the ICRA regulations and reduce the general congestion of the site. The system would be examined to determine what prefabricating can be done, and if any elements can be redesigned to allow for prefabrication. The effort put into analyzing prefabrication would assist in my research. I also plan to determine if reusing ductwork already in place on the project could prove to save money and fabrication time. An in depth analysis would require calculating how much material is available for reuse, the costss associated with relocating and sterilizing materials, and if the schedule would be impacted at all. Acoustical Analysis: Recognizing the concerns of the, I would like to take a closer look into the acoustical design of the operating rooms. As of now, much of the construction being done in the hospital is creating disturbances in the surrounding areas and causing delays when alternativee methods of construction need to be used from what was planned. The schedule savings would not be relevant to this project, but to future projects who can avoid these problems. My hope is to reevaluate the acoustical properties of the materials used in the operating room designs, and modify them to create a minimum noise penetration. The work being done in these rooms requires extreme focus and concentration, which if disturbed could be fatal for the patients. Knowing more renovations are being planned for this hospital in the future, the value of this redesign lies in creating the best space possible to eliminate future problems. 0

12 E. Weight Matrix Description HVAC System Acoustics of the OR Prefabrication Total Research Value Engineering Constructability Review Schedule Reduction Total