The Delicate Nature of Hospital Construction

Awford: “This is extremely sensitive for work within or directly adjacent to emergency/operating rooms, patient rooms, perinatal and birthing centers, behavioral health, research space, cancer centers and other critical areas within an occupied hospital.”

SAN DIEGO—Builders need to understand the intricate details of working within an occupied hospital facility, from safety requirements to phasing, in order to maintain hospital operations, BNBuilders ‘ principal Jamie Awford tells GlobeSt.com. After more than a year of planning and design, the firm has commenced remodeling the obstetrics unit at Scripps Memorial Hospital La Jolla here. Designed by Interspec and Freeman White , the remodel includes upgrades that will enhance the patient experience, provide new technology and security systems and better support for nurses and physicians. The remodel is one of numerous highly technical projects that BNBuilders has undertaken for leaders in the biotech , life-science and healthcare industries. We spoke exclusively with Awford about the special considerations builders need to keep in mind when doing construction on a working hospital. GlobeSt.com: What considerations do builders need to take when doing construction on a working hospital? Awford: Builders need to understand the intricate details of working within an occupied hospital facility, including ongoing hospital operations, infection control and prevention requirements, OSHPD and inspection requirements, as well as safety, security, FF&E, medical equipment, and systems to protect the patients and hospital staff at all times. GlobeSt.com: What problems arise that are unique to this type of construction, and how do you solve them? Awford: Working within an occupied hospital can be more complex than traditional construction, including fire/life safety requirements, phasing to maintain hospital operations, OSHPD review and approval process and containment of construction activities to ensure patients are not exposed. To solve these problems, careful construction planning is integrated during the design phase to develop the optimum approach to prevent problems in the field. We use laser scanning to identify existing conditions, infection control and prevention plans to isolate construction activities, BIM to coordinate systems and facility management after construction is complete and work closely with hospital staff to develop phasing plans to minimize impacts to ongoing hospital operations. This is extremely sensitive for work within or directly adjacent to emergency/operating rooms, patient rooms, perinatal and birthing centers, behavioral health, research space, cancer centers and other critical areas within an occupied hospital. If any shutdowns are required, we work closely with facility staff to develop backup systems and emergency procedures to ensure no impacts to ongoing hospital operations. GlobeSt.com: What trends are you noticing in hospital construction? Awford: A hospital is one of many unique building types that require constant changes and updates due to rapidly advancing medical technologies and progressive surgical procedures. Hospitals can be very expensive and complex to upgrade and/or build new facilities with strict requirements from OSHPD to meet state requirements. With an aging population, we are seeing several healthcare providers making significant investments into their facilities to promote healing environments for faster recovery with specialized equipment and systems for healthcare. Key healthcare trends are to reduce inpatient volumes, patient comfort and recovery; understand the impact of medical technology on design and construction; staff safety and well being; outpatient facilities that can provide healthcare at lower costs; and building flexible/reconfigurable space that can adapt to the changing healthcare environment. To accommodate these trends, we are seeing many hospitals making upgrades to the MEP systems, building automation and controls and infrastructure , as well as the security systems. The acceleration of the development of medical technology will continue to affect the surgical environment and pull it in directions that we can¹t even imagine. GlobeSt.com: What else should our readers know about hospital construction? Awford: Hospital construction continues to evolve to accommodate healthcare trends, with many healthcare providers repurposing existing space to improve workflow, increase patient comfort and convenience and reduce the cost of care. New reimbursement models have changed the way hospitals will choose to spend their budget, so we expect to see more healthcare facilities repurposed vs. new construction, increased outpatient services facilities and more consolidations and mergers amongst healthcare providers, as well as infrastructure improvements to existing hospitals to accommodate future needs.