Providence Health and Services: Scott Anderson: Vice President of Construction Project Management

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In June of 2011, the Cymbaluk Medical Tower at Providence Regional Medical Center in Everett, Washington, will open. It is the largest capital project that Providence Health and Services—a 150-year old, five-state organization—has ever undertaken. The enormity of this project, which will result in an additional 16.3 acres of floor space for the hospital, is impressive even for a hospital system of this size.

“Although it is a hospital addition, it’s essentially a replacement of all the acute-care aspects of the current hospital. It is a 12-story project with 700,000 square feet, five floors of inpatient care, 368 new beds for inpatient care, two floors dedicated to invasive procedures with 28 rooms that are either OR, cath labs, or interventional radiology. The rooms are designed on a 700 sf module for technological flexibility,” Scott Anderson, vice president of construction project management, said.

Start with the Right Team and Flexible Design Standards

“The real trick to a successful project of this size is to put a comprehensive design and construction team together before you get into schematic design,” Anderson said.

He had his general contractor, mechanical and electrical subcontractors, and the whole design team assembled before the architect began schematic design. It was a constant process of constructability review and value engineering.

From the end of master planning to occupancy, the project will have taken about six years. A lot can change in that time, especially in regards to technology.

“Both technology and clinical practice are continually evolving,” Anderson said. “You have to be able to anticipate and respond to that in the design process. One way we do that is to try to develop design modules for basic clinical functions that maximize flexibility and work toward the universal room concept.”

Because technology changes often affect the volume of a particular healthcare procedure, such as the need for cath labs, flexibility in design is crucial. An example of this is the two floors for invasive procedures. They are designed for a combination of conventional surgery and all kinds of imaging-enhanced surgery.

“We picked a module that we could fit any of the technologies into. Our volumes change over a six-year period, as well. It allows us to have rooms that could have been cath labs, but are now going to be something else,” Anderson said. “Trying to keep everything that accommodates the hard aspects of the hospital as flexible as you can is really all you can do. I know five years down the road some of those rooms—very expensive rooms—we’re going to be doing something totally different to them.”

Examples of Flexibility

In the beginning, the tower was designed with the idea that every inpatient room would be adaptable to both private and semi-private conditions.

“Everybody would like to have all private rooms, but as your census changes radically, there are points of time in your growth where that is not realistic,” Anderson said.

Also, the initial goal was that every room could be converted into an ICU when needed (acuity adaptable). Reality, of course, is that flexibility of this type is expensive. Because of the 2008 economic downturn, they had to go back and figure out where they could take $50 million out of the half-a-billion dollar project after the project was under construction.

“We got to a point where we looked at these rooms and decided we couldn’t afford to build all of them to the prime level of flexibility, so we picked a percentage that we were comfortable with,” Anderson said.

Now one of every two wings has acuity-adaptable rooms and 14 percent of the rooms can swing from private to semi-private.

“First you have to identify what your ideal is, then you have to compromise to keep within your budget,” Anderson said.

The Path to End Design and Utilization

An added element to the design process was the input and involvement of people who were to be the end users. This included  design input from a patient and family advisory council, as well as  medical directors who were given a stipend to attend numerous design meetings and represent the physician and patient’s needs for the design process.

“It’s created a much better design and also helped with integration of the clinical needs with the patient and family experience,” Anderson said. “Some areas of healthcare take a lot of effort to get the end result right.”

-by T.M. Simmons

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{ 1 comment… read it below or add one }

Elizabeth May 18, 2011 at 7:50 pm

This is some really great info. Thanks for posting!


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