The largest hospital in western Massachusetts, Baystate Medical Center serves the community of Springfield, MA, performing an estimated 29,000 medical procedures a year. After many years, the aging surgical facilities no longer met the needs of the community. DPR worked with designer Perkins&Will to provide a much-needed upgrade.

Strategically located on the second floor of the MassMutual wing, between the Emergency Department on the first floor, and the ICU, PICU, pediatric cancer center, and the Davis Family Heart & Vascular Center on the third floor, the build-out of the 135,770-sq.-ft. surgical operating and interventional suites was like performing surgery in and of itself.

Given the close quarters and the project being partially below grade, all materials had to be brought into the building through a single 8 ft. by 8 ft. “incision” window. DPR created a custom exterior elevator to deliver material from the trucks to the construction site on the second floor.

Traditionally, when a conflict between construction and design arises, the whole team gathers in the field to find a resolution.

“Given the tight space in which to work, DPR used extensive modeling efforts so that teams were able to resolve the conflicts by viewing the room virtually for the entire team,” said DPR’s Josh DiGloria. “The issues would be resolved on the model and the fabrication would occur on site, keeping the schedule moving.”

The team modeled all the devices, such as electrical equipment and med gas valves, on the wall for consistency and standardization. That way, all walls could be duplicated quickly and installed at a faster pace than normal.

To ensure alignment within the existing space, DPR laser scanned the structure and developed a model for coordination with the wall locations and the MEP tie-ins configured. DPR strategic partner Digital Building Components worked in concert with the design team and DPR to develop the drawings for the panels. All prefabricated wall systems and MEP in-wall units were modeled for each stud, conduit, pipe and backbox. Through the modeling process, DPR and the design team resolved potential issues that would have been found in the field, saving time and improving quality to both the product and the process.

“With prefabrication, we can bring in interior wall panels that had the medical gases, voltage and electrical conduits roughed in off-site,” said DPR’s Steve Sheahan.

All MEP systems ran through the occupied space, which also had to be constructed in sections to not disrupt hospital operations. Those MEP systems were put into place prior to the spaces being built out, so that as construction teams moved from section to section, systems were already roughed out, meaning construction crews did not obstruct the surgical spaces.

“We were able to complete 10 rooms per day and have all the med gasses done to the hospital standards,” said DiGloria.

As work is taking place on the hospital’s occupied surgical floor, emergency department and other sensitive areas, DPR met with hospital staff weekly to discuss Infection Control Risk Assessments (ICRA) to provide clarity on the plan and movement of construction activities to ensure a continuously safe environment for both patients and hospital staff. One-third of the building was active operating rooms, post-op rooms and occupied surgical space.

There were more than 40 phases of construction across nine different levels and three zones of the hospital. Surgical clinician team, ICU, emergency department teams, pediatric infusion units all surrounded construction.

The team met with each of the affected departments to understand their work requirements and hours of critical operations. Each user group had unique requirements that had to be accommodated to ensure consistent patient care; for example, the ICU had a set schedule for rounds, drilling on the floor below had to stop to facilitate those needs.

“We were trying to pretend like we weren’t even there,” said DPR’s design integration manager Mike Christiansen.

Another tool the team utilized to help communicate necessary noise and vibration was to conduct a “mock-up” of a noisy activity, like drilling of expansion anchors below a pediatric unit. The team would drill and install one anchor for the pediatric department to evaluate how this type of ongoing work would affect their clinical requirements.

“Through the mock-up, we determined that anchors could be drilled only between 2:00pm and 4:00pm each afternoon,” said Sheahan.

This type of close communication allowed for all stakeholders to not feel impacted by otherwise high-impact work.

“Part of the process is talking the language between the design team, the owner and the trades that do the work,” said Christiansen. “To get through the means and methods of what’s unknown, what’s documented and actually be able to plan is a huge undertaking.”

Dr. Mark A. Keroack, president and CEO of Baystate Health, commented “I am grateful to our many health care team members who brought their dedication and expertise to every area of planning for the new operating rooms and interventional suites from design to execution, and to the many construction workers who were provided jobs during this enormous multi-year project.”