As healthcare systems look to update and expand their operating rooms to accommodate newer robotic equipment — not to mention growth in the communities they serve — it’s tempting to skip right to the logistics:
When will each OR be turned over?
Which workflows will be disrupted?
How can we protect against infections, especially in today’s COVID-19 environment?
In truth, nearly every concern can be addressed by first putting a team in place that values patient safety and operational continuity above all else — guided by clear communication and consistent quality.
Delivering a quality construction project on time and on budget is certainly paramount, but it’s got to be in service of the greater good: improving health outcomes, one patient at a time.
1. Team dynamics
With countless variables that evolve daily and the underlying importance of infection control, it’s necessary to have a playbook for every scenario when working on a phased renovation within an occupied healthcare campus. For builders, it often feels like you can't work during the day, must be quiet at night, and have to be done by tomorrow. It takes an experienced, flexible and solutions-oriented team to say “challenge accepted.”
Onboarding team members early is key. The general contractor’s/construction manager’s ability to help the owner and architect is optimized if they’re brought on during the preconstruction phase, when the project is still conceptual. Then, they can bring key subcontractors to the table so the architect can specify what is best with respect to speed to market or other metrics of importance to the owner.
Additionally, it helps tremendously to partner with contractors that live in the communities where they build. Having that personal connection strengthens the significance of hospital renovations and their mindset that patients come first because it’s likely their families, friends and neighbors may need care at that facility some day.
2. Patient safety
Delivering a meaningful, empathetic and respectful patient experience should be valued over everything else from a project planning, construction and closeout perspective. Infection control and life safety measures must be maintained, but it goes beyond that to implementing work processes that thoughtfully mitigate any possible disruption to patients, family members, doctors, nurses or facility operations.
Often this means striving for near invisibility onsite. For example, if main entrances aren’t a feasible option for accessing areas of work, consider erecting a tower on the side of the building and crossing over the roof. Go so far as to put down foam board and plywood on the roof to create a designated walking route that doesn’t interfere with any labs and operating rooms functioning below.
In short, when it comes to minimizing risk and disruptions, every activity has to be well thought out and creatively addressed in collaboration with staff.
3. Clear communication
Continuity of communication is crucial given the dynamic nature of healthcare facilities. It helps to have a single point of contact on the construction side—someone who wears many hats, dealing with vendors and user groups as well as working through issues with the owner or design team.
Transparency and honesty are crucial, and it’s important to always be on the lookout for ways to generate a win-win. Use A3 documents to boil down the cost or schedule impacts of big decisions rather than relying on the way it has always been done in the past. That way, everyone has a voice throughout the decision-making process. Regularly surveying the core team members also can be beneficial in terms of measuring the ongoing success (or shortcomings) of goals.
With this approach, there’s alignment on what needs to be communicated and documented, and a willingness to be jointly accountable for solving any issues that arise.
4. Consistent quality
Much like the attention given to patient safety, there must be a disciplined approach to quality that’s tied to the definable features of work.
Performing work correctly the first time means having consistent processes in place to react quickly and resolve issues well ahead of the punch list stage — limiting the need for rework, which has cost and schedule implications, and reducing the likelihood that MEP systems will break down long before they should.
With prep meetings and inspections scheduled in a regular cadence and tracked via customized software, it’s possible to eliminate “what ifs” and get ahead of potential issues. A detailed reverse phase schedule also assists in hitting established milestones and confronting possible barriers at the tail end of the job, such as owner-required inspections and vendor installations.
Across the board, being proactive with regard to potential cost and schedule changes — and especially patient safety—can make a big difference in delivering a construction project that serves the greater good.
Senior Project Executive Tony Stamper and Senior Project Manager Jermaine Barnes are operations leaders for Messer Construction Co.See the latest posts on our homepage