Healthcare Design - August 2013 - 58

C CONSTRUCTION | 08.13
Using design-build to streamline
renovations
Industry pressures are pushing owners to consider renovations in place of new
construction, as design-build emerges as a way to bring even more project
efficiency to the table
By Katherine Blume
Feeling the impact of healthcare
reform and the recession, many
hospital owners are faced with the
difficult task of driving down costs,

www.healthcaredesignmagazine.com 08.13

demand for electronic medical records has created a
constraint on existing IT infrastructure, meaning many
hospitals are looking for creative ways to increase IT
capacity without adding infrastructure.
Early involvement
To overcome these challenges, owners have embraced more progressive methods, such as designbuild. Design-build delivery for renovation work yields
benefits that are not available with traditional project
delivery methods, such as design-bid-build or planand-spec. Too often, traditional delivery methods
lead to siloed workflows that create conflicts and
costly change orders.
On the other hand, design-build enables coordination prior to the start of construction, which can
drive down the cost and accelerate the schedule for
construction. By involving the general contractor and
trade partners during the design phase of a project,
teams can provide a detailed, early site investigation
that offers insight into the location and condition of
existing systems. By collecting information early on
that otherwise would be discovered during construction, teams can develop plans to address the
issue and avoid change orders and schedule delays.

The design-build team at the
helm of renovating the Sharp
Chula Vista emergency department in Chula Vista, Calif.,
took advantage of the early
involvement of all members to
develop a new layout from the
original design that improved
operational flow while decreasing the number of project
phases and reducing the overall
project schedule.

Katherine Blume

SOUTHLAND INDUSTRIES

which can include choosing between
building new facilities or renovating
existing ones. Requiring large capital
expenditures and longer timelines,
the design and construction of new
hospitals isn't always a viable solution. Consequently, the decision to
retrofit and update existing facilities
has become more popular, because
it allows hospital owners to meet
changing needs and increasing
demand with a smaller price tag and
shorter schedule.
In fact, renovations come with a
number of advantages. For example,
existing, underutilized space can be repurposed
to avoid the cost of new infrastructure. Hospital
owners also have the opportunity to review current
operations and provide input into a new design
that modernizes the facility in a way that delivers
the highest quality of care at a lower cost than new
construction. Most importantly, this option allows
existing patient care to continue as upgrades are
performed.
While there are several benefits for hospital
owners opting to renovate existing facilities,
there are unique challenges associated with a
renovation, as well. The greatest challenge often
is achieving uninterrupted hospital functionality,
which requires the construction site, traffic, and
personnel to remain isolated from patients, visitors, and staff. Even if the larger facility remains
operational, some portions may need to be closed
or removed from use in order to allow for the construction of infection control barriers.
Renovation work also presents the unique challenge of bridging new components to existing systems. It's critical that utility services such as medical
gas, plumbing, HVAC, electrical, and fire and life
safety systems are not interrupted. In addition, the

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Healthcare Design - August 2013

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