Shovels turned, and smiles flashed as Lexington Medical Center celebrated breaking ground for a $400 million, 545,000-square-foot expansion on a sunny Monday in May.
Congratulatory handshakes abounded as the planned 10-story tower rose in the imaginations of the hospital and business executives on hand for the ceremony. Making that vision a reality, however, requires navigating a labyrinth of regulations, keeping pace with quickly changing technology and satisfying ever-growing patient expectations on budget.
The first step is assembling the correct cast.
“Not every general contractor is qualified,” said Paul Bouknight, director of facilities at Palmetto Health, who oversaw the construction and 2014 opening of Palmetto Health Baptist Parkridge Hospital in Columbia. “That limits your pool, and that adds to costs.”
Interim life safety measures, for instance, may include an around-the-clock fire watch if renovations to an existing facility require a sprinkler system shutdown. Contractors must also be vigilant against contaminants creeping in through ventilation systems, open doors or foot traffic.
“There are more regulations, but that’s as it should be, as we’ve learned there are certain things that maybe were acceptable 30 years ago that are no longer acceptable today,” said Pat Rodgers, president and CEO of Rodgers Builders Inc., the Parkridge contractor. “We see things through a different lens all the time.”
Birmingham, Ala.-based contractor Brasfield & Gorrie, handling the Lexington Medical expansion, is familiar with the complexities of medical construction. Brasfield & Gorrie vice president Michael Byrd said hospitals make up about 40% of the contractor’s volume.
“The size of the facility, the amount of workers it’s going to take over the project’s duration, the complexity of building next to the existing hospital, all of those make this pretty unique,” Byrd said.
Those factors also have the potential to make a project rather expensive, but “we’re prepared for that,” Byrd said. “The market is very good. A lot of subcontractors, a lot of vendors, are very excited about the project, so therefore the cost is doing really well on holding true to form.”
Byrd joined Gene Griffin, president and CEO of Dynamix Engineering, and Perkins & Will principal architect Richard Herring at the May 9 groundbreaking for the Lexington Medical Center addition, scheduled to be completed in 2019.
Planning’s a team effort
Once the players are assembled, extensive ground floor planning is key to the success of an ambitious medical project.
“This has been in the works for the last couple of years,” said Richard Westbrook, Lexington Medical Center board chairman, who added that the contractors, engineers and architects “have provided drawings and sketches and PowerPoint presentations over and over. Any changes they make, they present it to the board and get the administration’s input.”
A key part of the planning: The budget.
“You need to work very closely with the medical staff and the medical center when you’re formulating your budget and your schedule,” said Rodgers, who added that 50% of her company’s volume is made up of medical projects. “It can be very complex. Each project stands on its own as it relates to the budgeting and the scheduling, unlike an office building or a parking deck or a strip shopping center.”
Factored into the bottom line is scrupulous attention to detail. JHS Architecture: Integrated Design Inc. helped plan every nuance at Parkridge, from the living room feel of the reception area to the cafeteria, where sugary drinks are located farther down the serving line than healthier choices.
“We had a hospital design, and then we stepped back and took a look to make sure it was a user-friendly, inviting facility,” Bouknight said. “We wanted the hospital to look like it grew out of the land rather than being inflicted on the space.”
The natural wood and stone look of Parkridge — which features an open, connective floor plan and includes homey touches, such as rocking chairs on the porch — proves that hospital design need not be medicinal.
“There’s a lot you can do with the facility itself,” Herring said. “There’s more and more research showing how the facility can actually aid the caregivers and improve the healing process.”
Lexington Medical’s bustling labor and delivery unit, where more than 3,700 babies are born annually, will be housed in the new tower. One of the addition’s innovative features will be private special-care nursery rooms for newborns, rooms that have been shown to promote bonding and lower infection rates.
“We work closely with the hospital’s strategic planning group to look at the community, assess what the needs are, and then the facility is built to right size based on those needs,” Herring said. “Trying to keep the facility open and serve customers and clients and the patients well without disturbing them is always a challenge.”
Griffin’s team is responsible for the guts of the building: The heating, cooling, electrical, plumbing, and fire safety systems.
“What we’ve tried to do is lay out a system that’s easy to operate so (hospital workers) can focus on patient safety and patient care,” Griffin said. “We’ve been working hand-in-hand with the contractors to make sure that they understand why we’re doing things. We’ve made them a part of the process, and I think you’re going to see a lot of benefits in the construction.”
Said Rodgers, “There’s no way to overcommunicate on a project like that.”
Eye on the future
Plans are also made with an eye toward both present and future workability.
“We looked at things from a 30-year perspective,” Griffin said. “We kept in mind schedule and budget, but also long-term (factors). One of the keys is just keeping up with the latest technology and the new procedures being done, and finding out how the hospital wants to operate and how they see technology integrating into their future. It’s critical to make sure we understand the long-term goals.”
Keeping abreast of changing technology was also crucial in Parkridge’s construction. And as with all state projects involving advanced technology and a multimillion dollar price tag, the S.C. Department of Health and Environmental Control had to be kept up to date.
“We have checks-and-balance systems in place from the time the budget is developed to completion,” Bouknight said. “It’s not an open checkbook by any means. I have an obligation to deliver the projects according to the budget expectations that have been established. You can make changes, but you have to adjust expectations as you go.”
Patients’ expectations, however, are on the rise. Along with a clean, welcoming facility, patients are increasingly looking for amenities such as private rooms and Wi-Fi. Palmetto Health tries to exceed those expectations by making a lasting positive impression. For example, patients are escorted from the registration desk to examining rooms.
“Our goal is to provide care that we expect for ourselves and our family,” Bouknight said. “You can’t do that by pointing someone down the hall.”
As silver shovels glinted in the afternoon sun, optimism surrounding the experience awaiting patients at Lexington Medical Center soared.
“It is going to be a very proud moment to see the facility open up,” Griffin said. “We take special care with health care facilities to ensure that, if our loved ones were (patients) here, we’ve done all the right things by them.”