Healthcare Design - November 2015 - 50

The warm orange hues
and themed artwork used
throughout the GOJO
Outpatient Surgery Center
represent a child's sandbox.
The waiting area features
lockers, vending machines,
and a surgery status board so
families can keep track of their
loved ones' progress.

HCDmagazine.com 11.15

throughout construction and sync the work of the
trades "as if cars in a train, so everyone is moving at
the same speed, as opposed to the traditional approach that is rush-hour traffic," Lichtig says. So, for
example, in the project control room, the strategy for
how the project would unfold was depicted down to
the daily level of planning required, so everyone knew
where the crew would be in the building on a particular day and what would be accomplished by the end
of the shift. "It's a whole production system where you
go from huge boulders in the planning process all the
way down to grains of sand," Lichtig says.
The sense of collaboration that the integrated
model achieved was evident in construction, as well.
In July 2013, as the team was preparing for a massive
foundation pour, Akron was hit by a 100-year rain
storm, washing a massive amount of material into the
excavated site, burying 100 feet of form work, footers,
and walls. "By 3 p.m. the next day, that area was
almost ready to pour again," Oaks says, noting the
laborers, carpenters, operating engineers, and every-

The surgery center was
designed to make routine,
uncomplicated surgeries as
convenient as possible for
families. It's a short walk
from the parking deck, and
families immediately go to an
exam room upon arrival. After
surgery, patients are transferred
to adjacent recovery rooms,
generally discharged within a
few hours.

BLAKE MARVIN/HKS INC.

be addressed in design," Zezulewicz says. "It was
phenomenal to watch the transition from 'I want' to
'we need.'"
Wins in the process included realizing that the
as-designed observation windows for the NICU unit
would be very expensive to construct and allowing
clinicians to choose an alternative solution that ended
up being better and less expensive. Additionally, the
team was able to recognize that a model designed to
increase throughput in the OR was completely wrong
and adjusted it before construction. Leaders also used
the mock-up space to identify immediate needs as
well as what areas might be shelled for buildout later,
reducing built space by about 30,000 square feet.
From the construction perspective, the approach-
especially the user workshops-were especially
fruitful. "Oftentimes we as constructors are given a set
of blueprints and a chunk of dirt or an existing building
and off we go to the races. These workshops made
what we were building more personal, because we
were interacting with the end users during the design
phase," says Patrick Oaks, project executive with
Welty (Akron, Ohio). "It wasn't just a building anymore;
it took on a life of its own."
Lean was used heavily throughout construction, as
well, including prefabrication of the NICU pods, patient
room bathrooms, and headwalls. But its less-common
uses included using a BIM model to design miles of
conduit and duct banks that had to be routed and
using the model to assemble them on-site in large
sections and crane them into place-making a task
expected to take more than 300 hours take only about
100. A drywall and metal stud contractor built exterior
wall panels in a warehouse and brought them to the
site, as needed, one example of the project's just-intime delivery model.
Another major ILPD concept adopted was the idea
of a pull production system to better level workflow

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Healthcare Design - November 2015

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