Swedish Medical Center: Open for Business During Renovations

BUILDING DIALOGUE

Functioning as a hospital first and a construction site second has become a mastered art form at the 100-year-old Swedish Medical Center in Englewood. An acute care hospital with 368 licensed beds, Swedish cares for more than 200,000 patients with a team of 2,000 employees, 500 volunteers and more than 1,300 physicians.

Diane M. Miller
Senior Business Development Director, JE Dunn Construction

As one can imagine, this leads to a significant amount of foot and vehicular traffic. However, that has not slowed down the ongoing construction activity. The process to manage the planning and development phase for a new project typically averages 11 to 12 months before funding occurs.

“There is a tremendous amount of thought and discussion prior to an investment,” stated Marc Brisebois, senior construction manager for HCA Design & Construction Group, responsible for overseeing all HCA facilities in the Denver area. “Our in-house planning department and capital asset management team work closely with the Swedish staff to understand the business needs. It’s my responsibility to ensure a qualified and experienced team can provide viable solutions for a 100-year-old campus with infrastructure dating back to the 1920s, 1950s and 1960s.” The recently completed projects were the patient tower expansion to add a ninth and 10th floor, the fourth-floor renovation, construction of a Critical Care Unit lobby, a chiller replacement and replacement of the emergency power system in the existing central utility plant.

Julie Frazier, senior health care manager for Perkins+Will Architecture, led the design team through the process of surveying existing conditions and evaluating Swedish’s operating procedures to complete a thorough due diligence prior to the beginning of construction work. When asked about unique challenges Frazier replied, “This campus has space constraints which narrow down the options and considerations. Patient flow is a big component of our work and we studied solutions to minimize cross traffic and improve wayfinding.”

As a leader in the field of neurology and neurosciences and the treatment of stroke, Swedish captured the opportunity through this project to further its brand expertise in the neurology field by creating new critical care beds and medical surgical beds, as well as adding advanced imaging capabilities.

Nurse’s station on the new 10th floor addition of hospital tower

“There is never a good time to do construction work in a top-performing hospital,” Brisebois said. “The team has to be very customer-oriented and remember we’re a hospital first and construction site second.” In March 2015, JE Dunn Construction began construction of the vertical expansion on the patient tower, which added two floors and a rooftop mechanical room. Orchestrating the on-site construction activity for the vertical expansion was Adam Gross, superintendent for JE Dunn. “Ensuring we had a good logistics plan was critical to maintaining the client experience,” said Gross. “All the work was overhead, so safety for patients below was a big concern.” Crews installed a 20-foot-tall canopy to create a 2,000-square-foot area for pedestrian safety and to create a drive lane and sidewalk for access. We  installed a temporary roofing system to prevent rain and moisture intrusion as the ninth and 10th floors were constructed. After evaluating schedule options, HCA elected to close off the entire adjacent lower floor of the patient tower for an eight-week period to allow for the work to be completed quickly instead of keeping the floor operational and extending the construction duration of the vertical expansion. Concurrently, the team began replacing the entire emergency power system while keeping patient care operational. Crews demolished a portion of the existing central utility plant to create a much larger footprint to accommodate three 2,500 kVA generators. Sequencing of utility shutdowns and decommissioning of the existing switch gear coincided with installation of new equipment. During the most critical switchovers, the schedule was managed on a minute-to-minute basis.

“We rely heavily on a team mentality and we involve our trade partners on how to overcome the toughest issues,” said Gross. “We are very fortunate that HCA values early involvement of subcontractor input.” The team replaced one of the existing chillers during the winter when there was no demand for service. The new 600-ton chiller was shipped in sections due to space constraints in the chiller room. The new chiller was then reassembled on site by the mechanical contractor so it could be easily maneuvered into the chiller plant.

JE Dunn was also tasked with the infill of two floors below the Critical Care Unit of the hospital, which totaled 21,000 sf of core and shell space. The area was in-filled in what was the old valet parking lot. To the west of the infill area was the current loading dock, and on the east is tColorado Real Estate Journalhe main exit from the front door of the hospital. In order to keep access and egress to the hospital in service, the crews constructed a temporary road to route traffic through the north half of the CCU while also rerouting and tying in the facilities’ city ditch to the perimeter of the building. All construction activities were strategically scheduled around Colorado’s water season and our other site activities to avoid project delays. To maintain the hospital’s high expectation toward its clients’ experience required strategic planning of all the logistics.

“We really had nowhere to go, so getting the trades to buy-in into odd schedules (days and hours) was necessary for timely completion,” Gross stated. “Our ask to the trade partners is to think about the patient first and the work second.”

Critical Care Unit lobby on the newly renovated fourth floor in the main building

The newest and future construction activities for Swedish are well underway. Most health care projects will typically involve an addition or expansion in the effort to expand their bed count. “The work the team is completing today is rare,” Brisebois said. “It’s a major interior renovation which touches several floors concurrently and the hospital is not adding a single bed.” Brisebois feels very fortune to have an experienced team that understands the drill with health care work and is extremely customer-oriented. He has a deep understanding of the complexities project teams must deal with from his days on the contractors’ side of the table working with HCA as his client. In response, Brisebois said, “The first day is always very simple because you go in with a plan, but inevitably the plan will change.”

As the Perkins+Will team members discuss the future master planning for the Swedish campus, they keep an adaptable and flexible attitude. Frazier leverages the team’s on-site knowledge to gain an understanding of what happens day-to-day, hour-by-hour as she leads the next major planning efforts for HCA.

“You can’t know the existing issues until you’re in it,” Frazier said. “You just stare into another solution on the fly and be as resilient and adaptable with problem solving.”

Published in the September 2017 issue of Building Dialogue.