Bringing the Design-Build Advantage to Healthcare Construction

January 1, 2010
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An inside look at some projects achieved with today's hot delivery method

Glendale Adventist Acute Care Facility in Glendale, California, one of California's first hospital construction projects to implement design-build delivery

Completed on time and on budget, the Glendale Adventist Medical Center Acute Care Tower is a 192,000-square-foot, seven-story hospital incorporating emergency services, operating rooms, and 72 acute-care beds including a surgical intensive care. Among the design and construction challenges: The new tower had to be situated on a steep plot of land on the existing campus and construction could not disrupt the operation of existing hospital facilities.

According to the satisfied owner, the Center meets these goals and more, providing the latest in technology, techniques, comfort, and convenience while meeting operational objectives, including a 16% increase in acute discharges and a 22% increase in emergency admissions.

In DB project delivery, integration is not just an abstract concept; it is a concrete reality reflected in the contractual relationship between the DB team and the owner agency. In fact, DB is also referred to as “single-source” delivery because even when the A/E team and the construction company are distinct entities they contract for a DB project as one team, and there is singular responsibility. The “design-builder” can take several forms; a joint venture between designer and contractor, a contractor-led team with the designer in a subcontractor role, or a designer-led team with the constructor in a subcontractor role.

When Meadville Medical Center built the Yolanda G. Barco Oncology Institute in Vernon Township, Pennsylvania-Western Pennsylvania's first diagnostic and cancer care facility-DB made adhering to budget and an aggressive 13 month construction schedule possible. In the case of this architect-led project, early intervention brought the project into the black after initial plans came in over-budget. When a linear accelerator purchased by the hospital after construction began required changes in the location of electrical conduits, the design-builder, Astorino, of Pittsburgh and southern Florida, was able to accommodate the change even though it came on the eve of a major concrete pour.

Louis P. Astorino, leader of the firm's DB division explains the benefits of DB this way: “Instead of just contractors and architects looking out for their own hides, we're concentrating on making it more seamless for the building's owner and giving the owner the best value. When you are truly one team, you solve problems as a team.”

Meeting schedule, time, and budget are easily tracked but healthcare facilities must cater to the immeasurable but very human needs of patients and caretakers. A project in Vermont is a case in point. Health Care and Rehabilitation Services of Southeastern Vermont (HCRS) is a multifaceted, nonprofit, community mental health agency with major programs in mental health, substance abuse, and developmental disabilities (figure 2). HCRS currently serves more than 4,500 Vermonters each year.

Health Care and Rehabilitation Services of Southeastern Vermont is a multifaceted, nonprofit, community mental health agency with major programs in mental health, substance abuse, and developmental disabilities

HCRS's facility project was complicated not only by the need to accommodate diverse populations but also by the fact that the staff had been treating patients in several small buildings-old houses for the most part-throughout two counties. Breadloaf Corporation, the design-builder, was charged with creating an environment that served clients and supported a sense of community among the staff.

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