Pre-Planning and Collaborative Approach Help Create Calm during Construction Storm at Expanding Medford, Oregon Hospital Project for Asante Health System

A clearly defined mission, “Continuing to Care as We Build a Healthy Future for our Community,” and more than seven months of detailed pre-planning keep the Rogue Valley Medical Center team on track as they near the halfway mark for the three-year, $76 million expansion and renovation. Having completed the first phase of the project, which includes a 625-stall parking structure and two-level helipad, DPR is kicking off construction on a new six-story tower that will increase the number of staffed private rooms to 94 percent.

The rising need for emergency room services, with the number of visitors increasing an estimated eight percent a year, sparked Asante Health System’s initial plan to upgrade its Rogue Valley Medical Center (RVMC) facility in Medford, OR. According to Mark Powell, project manager for RVMC, several different ideas were evaluated before deciding to rebuild the established circa 1958 hospital.

“The growth in Southern Oregon triggered additional studies and discussions on how we can best accommodate the future healthcare needs of our community,” said Powell. “After looking at a number of concepts, we determined that to make the changes we wanted and bring the facility up to current code the most efficient approach was to build new.”

Efficiency seems to be a consistent theme throughout this complex, six-phase project, called “RVMC Rebuild,” which includes a two-story helipad structure, four-story parking garage, rebuilding site utilities, a four-level bed tower over a new emergency department, bridge to an existing building, expansion of diagnostic services, outpatient lobby and critical care area. Continuing on target for a 2005 completion, the team started working closely together early on to plan out the more than 3,700 specific tasks identified to ensure a smooth delivery.

“For a project of this size and complexity, being an existing hospital where operations need to continue, the DPR team has helped us look at all the issues from a construction perspective and merge that viewpoint with the Asante side of keeping things up and running to provide quality patient care around the clock,” said Powell. “We’ve spent an extraordinary amount of time planning for the construction sequence, and there has been a lot of back and forth communication of good ideas.”

For example, one of the primary concerns during the preconstruction phase, according to Bruce Reid of DPR, was that there were too many activities scheduled at the same time. To alleviate this concern, DPR presented four different phasing options that outlined costs and time impacts to help the team identify the right path to follow. DPR also employed 4-D technology—3-D architectural drawings that incorporate the element of time as the fourth dimension—to help in the process. By building the project virtually, members of the project team, as well as hospital staff and the community, gained a clear picture of RVMC Rebuild and the effect it would have on the functioning medical campus.

“Minimizing the impact of construction on occupied buildings and the surrounding community is a top priority,” said Bill Maibusch, senior project manager for DPR. “With a project the size and complexity of RVMC Rebuild, we’re basically invading an already congested campus with more than 100 construction workers, and we need to be sensitive—keeping in line with our project mission statement of ‘continuing to care as we build a healthy future for our community.’”

Some of RVMC Rebuild team’s initiatives include:

• Team building and partnering sessions with the owner, various department leaders, the architect, consultants and DPR.
• Thorough value analysis to maintain scope and meet the owner’s budget requirements. One example Reid provided was the parking structure and a cost-efficient means for adding 200 spaces for a total of 625 to ensure ample parking. DPR worked with Watry Design to develop several different options that effectively met the city’s building height requirements, as well as allowing for future expansion.
• An informational symposium for all local subcontractors bidding on the project, as well as detailed orientations for every construction worker who comes on site regarding safety and protocol for working on a hospital campus, such as simple reminders to be courteous to the public and provide direction and assistance to patients, staff and visitors to help mitigate potentially frustrating situations.
• Daily 10-minute “stretch and flex” exercises in the morning to loosen up muscles and help minimize soft tissue injuries. Project managers participate as well, so time is also used to discuss the activities for the day and review any logistical changes to the campus.
• Weekly Owner/Architect/Contractor (OAC) meetings to address specific interfaces that are scheduled between construction activities and hospital operations. The team also meets to address any changes in scope (current or planned) and review the overall project. “Our weekly meetings are a good time to check the pulse of the project to make sure we’re still controlling it the way we planned,” said Maibusch, who added that the team has also met with RVMC staff several times to update when and where activities that generate noise and vibration will occur. “By addressing it far enough in advance, the staff can plan around the activities, and they usually discover that it’s not as bad as they were imagining it was going to be.”
• Extensive infection control precautions. In addition to common items, such as using negative air machines and sealing unused doors and air vents in and around sensitive areas, all construction personnel are required to perform pre-task planning for each element of work. This process helps to reduce or eliminate the unexpected and assists in overall efficiency.

Maibusch added that the owner has been very proactive in the community, running local television commercials regarding the RVMC Rebuild project and setting up a toll-free hotline for people who have questions about the expansion. RVMC is also offering free valet parking during all phases of construction. In addition, the team continues to give community groups tours of the model patient room that was finished out in the pre-planning stage so that all of the staff could walk through with the architect to make design changes upfront.

“The model patient room has been an extremely worthwhile effort to ensure that we give the end user what they want and need,” said Powell. “Our goal is to deliver an outstanding project for Asante Health System that will allow them to practice medicine effectively in the future and provide quality care to our community.”