Issue 4 of 2015

Planning for the new St. Jude Medical Center Northwest Tower in Fullerton, Calif., began in 2008. At that time, the plan was to build the much-needed building on the southeast corner of the Center’s campus. While that location seemed to be the best option, upon investigation the design-build team discovered that the site would require that the new tower be two towers, dividing operations and compromising efficient layouts. For this reason and – upon further investigation realizing that maintaining the required cost and schedule in addition to continuing activities in the rest of the Center, the team decided upon using the opposite – northwest – corner of the campus would be the best location.

With the site selected, the team could assemble and begin working. From the very beginning, the emphasis was on teamwork and collaboration. The challenges were many – the campus was mostly built up, so space was limited. The change in location required significant changes in scope and budget, but the schedule could not be extended. Logistics and phasing would require constant collaboration and communication. And any facility would have to comply with the stringent requirements of California’s Office of Statewide Health Planning and Development (OSHPD).

In addition, with the existing facilities operating, the team would be working in the midst of medical personnel who focused on patients’ wellbeing with little understanding or regard for the needs of the construction crew. And, as a long-term project, keeping the historical knowledge of the team throughout would be imperative. But the client/owner – St. Joseph Health Systems with Petra Integrated Construction Strategies – was familiar with the design-build process and with the design-builder, McCarthy Building Companies, Inc., which established the necessary environment of trust from the beginning. St. Jude and Petra chose design-build delivery not only to maintain their budget and schedule, but because they knew it would bring a higher level of accountability.

And the entire team worked together, accepting that accountability. McCarthy chose team members using a best-value approach, assembling them at the start of the conceptual design phase. The team leaders worked with Petra and St. Jude to establish a design charter that captured and prioritized contributions from the diverse constituencies. This charter was worked on to establish criteria that would meet the needs of all end users, both medical personnel and patients.

As design and construction proceeded, significant changes in the scope of work emerged. New technology developed and needed to be accommodated in the design. Additional operating rooms had to be added and some 50,000 square feet of space intended to accommodate future needs had to be built out. The team accepted these needs and, working together, met them.

Every possible tool and many DBIA Best Practices were utilized to ensure a successful final result and collaboration throughout the process. At the very beginning, McCarthy was included in the early phase demographic review and healthcare system business case meetings. This direct involvement provided McCarthy with understanding of the healthcare system’s needs, allowing them to anticipate those needs and include them in the designs.

Team members co-located to make communication – and camaraderie – more likely. Everyone on the team was brought together at the beginning – subcontractors and end users had a voice in decisions, which meant that details of specialties were taken into account and the final project would meet the needs of those who would be working in it. And technological tools kept everyone on the same – metaphorical – page at all times. The team used an Electronic Plan Room, available on iPads, in kiosks and all workplaces, which kept everyone informed of the latest versions of the project plans. In addition to keeping everyone informed, this system allowed a “punch as you go” approach, with the goal of zero items on the punch list at the substantial completion stage.

To make sure that the facility, when built, was a workable environment, the team constructed sample rooms, complete down to surface finishes. Actual end users were able to move around in those sample rooms, act out how they’d be using them, feel how the layouts worked for them. This gave the design-build team a chance to make any modifications needed to give hospital staff and patients the best possible facility.

Results

The project finished five months before the scheduled completion. One remarkable accomplishment was the speed of commissioning and turn over: it took only 30 days from substantial completion and Construction Final – an unheard-of accomplishment for a California OSHPD project. In addition, the 11-month warranty walk had fewer than five items for the team to address. The project came in well under budget – even with the expansion of the scope of work and all the necessary changes, in addition to the early completion, the project came in almost $30 million under the contracted amount. The savings were shared among the team periodically and at the end when the final GMP was accepted, another aspect of true teamwork.

And, in addition to the time and money saved, the project owner realized the advantages that a collaborative team provided. Jim Bostic, Vice President Operations, Petra-ICS, said in his letter, “Most importantly, we value the strong and collaborative relationships we have built within all levels of your organization.” He continued with, “While our experiences with other general contractors have been that they can certainly ‘talk the talk’, McCarthy has proven that they can ‘walk the walk’. … You provide the realistic view, honesty, hard work and much-needed expertise to achieve success with difficult site logistics, complex OSHPD projects, interface, communication with campus staff and most importantly, collaborative use of cutting-edge technology in leading design and construction teams.”

In recognition of the project’s quality, it was honored with a National Design-Build Merit Award in the Healthcare Category; the process won it the Excellence in Teamwork Award from the 2015 Awards Jury.