Identify the ‘Right Thing’

At the beginning of a renovation project we often times hear the phrase, “we want to do the right thing.”   It is admirable – in the face of any situation thrown your way in the course of a project – to always take the high road and not cut corners or shoot for the lowest common denominator.  However, many design and construction teams neglect to identify what the right thing actually is. This is understandable.  The right thing is always a moving target and is dependent upon the person’s perspective.  Ask clinical staff and they may talk about patient care and staff efficiency; both good ideas. Talk to facilities staff and they may talk about completing the work with the least amount of shut downs or working within the con-fines of what the existing infrastructure can provide.  How can you argue with that?  Fi-nally, talk to administration and the discus-sion typically starts and stops with on-time and on-budget but we can’t forget that they ‘want to make the docs happy.’

So the real issue in identifying the right thing is being able to navigate the murky waters of competing interests.   Keeping the docs happy may require the least amount of shut downs which could mean more phases which likely will make the staff unhappy with decreased efficiency.  Or,   to keep the project on-time, an entire wing may need to be shut down which may not make the docs happy.    Bottom line is there needs

a short list of things which could derail a project before it starts:

Beware of the ‘thick walls’.  All the walls in plan are shown at 5” thick.  Why is a particular wall shown at 12” thick? Could it contain a plumbing structure; wind brace or one-off column?

Don't assume the structure. Many Hospital buildings are a combination of several construction methods: steel frame, hbrid concrete and steel or post tension slab, etc, etc. Even more challenging is when a project spans several construction types.

What is the capacity of the roof top unit(s)? A new program in an existing space poses challenges on many levels.  With the latest requirements for CFM, many times the old equipment cannot be up-fitted with new motors or pulleys.  They simply cannot manage the increased cooling and CFM loads.

Is this a critical program?  Beyond being able to put together a logical functional program for the State, knowing if the project is critical. may also trigger many other changes.  Emergency power requirements go up when the project is critical and roof top equipment my need to be screened if the project is critical.

     An ounce of due diligence is worth a pound of construction.  Knowing the detailed physical parameters of a proposed and several decades old?  What if each previous project only considered itself and not any future changes?  Sound familiar?

     It is not good enough to simply say, "you can do anythign with enough money."  Early in pre-planning it is extreely important to say, "does this ake sense" or "does the building really want to be altered that way?"  It is a hard line to take; to be the dissenting opinion in a room full of people who are pushing a project agenda.  However, when the costs per square foot come in astronomically high or the amount of disruptions and shut downs are so aggravating that people are looking for scape goats, where might the fingers point?

     Buildings - especially hospital buildings - are complex 'things'.  The structual systems, corridor systems and infrastructure systems are the skeletal bones of the hospital.  If a proposed project seeks to so dramatically change the skeleton such that it is unrecognizable, maybe it is time to ask, "does the building really want to do this?"

     Healthcare renovation will test the full range of skill-sets of the design and construction team.  Pre-planning is understanding where to look and what to look for and will greatly add to your team's chances for a successful renovation project.  The important points to consider noted above will give your team a solid foundation on which to base decisions going forward.