“From the very beginning, the purpose of the project was to see the hospital through the original master plan,” says Ken Priest, GS&P senior vice president and principal-in-charge on the project. “Prior to being selected for this project, we completed a master plan update for MVHS that organized general growth patterns for the campus. The addition of an inpatient tower had always been a part of the hospital’s long-range plan.”
To help MVHS meet its long-term goals, a significant level of collaboration between the owner, designer and prime contractor was key. With speed to market a primary focus, the integrated team worked together to utilize multi-trade prefabrication and a unique parallel document delivery system (PDDS) to ensure that design and construction was completed efficiently and effectively within an 18-month window. This involved breaking construction documents into six work packages based on construction milestones. By using PDDS to issue design documents, the six work packages would serve as a continual method of accountability to ensure that design documents and construction milestones were completed on time, and that contractors received the information in sequence.
This integrated team approach throughout each phase of the project also included meeting a shared set of goals, and having each team member build toward a unified vision. The entire team—including subcontractors and the commissioning agent—were brought on board at the early design stages to assist with these goals which included: creating new reputable service lines; efficiency in design and construction; flexibility of design; increasing the quality of patient care; and speed to market.
To meet these fundamental objectives in a reduced amount of time, each team component divided into specific planning and constructability groups. This distinctive approach facilitated new ways to use tools such as multi-trade prefabrication, BIM and streamlined coordination to achieve the hospital’s vision for creating what it referred to as the “WOW” experience for its patients.
“Striving for the ‘WOW’ factor helped define the key goals for the project,” says Jevon Ritchey, GS&P architect and project team member. “Essentially, it meant creating an atmosphere and experience that will impress both patients and visitors. The existing campus is beautiful, and we were tasked with continuing the hospital’s aesthetic and keeping the ‘WOW’ element that already existed. And because the big push on the project was time, we had to do that within 18 months, which was an extremely aggressive schedule.”
“The challenge was not only designing and building the bed tower addition within budget and in such a short time frame, but also staying true to what had been designed prior to the expansion, and making it look like it had always been a part of the original design,” adds GS&P senior architect David Stewart. “Before this expansion, the hospital was basically a bedless facility, and the big component that was missing was an inpatient tower. Premier Health Partners wanted to make it into a full-service facility, and our responsibility was to create an addition that made it look as if Miami Valley had always been a whole hospital.”
Staying True to Form
To remain faithful to the hospital’s original design, the GS&P team explored a number of design options to produce a look and feel for the new inpatient tower that would be similar to that of the existing campus.
“The main hospital building was right beside the planned addition and they were both five stories,” says Stewart. “So one of the ways we visually blended the two structures was by using the same brick and precast concrete, as well as color and materials that tied into the original facility. We also spent a lot of time going through the 12-story patient tower that had recently been constructed at Miami Valley Hospital’s downtown campus. We toured the facility with staff, and ultimately applied some of the lessons learned from that project to this new inpatient tower.”
“Whatever we did, it had to gel with the original master plan,” adds Priest. “Part of that plan actually located the bed tower, so we generally knew where it needed to be positioned.”
To ensure the new tower was properly located, the design team had to employ a somewhat unorthodox but necessary approach to determining the building’s placement.
“There was a little concern about getting the tower too close to the existing building,” says Stewart. “We wanted to be able to determine what the right distance was, so we actually stood in the middle of a field and acted as the corner of the buildings.”
“We were like human batter boards,” adds Priest, “and we ended up pushing the building back because of that. When you’re standing in an open field you have a sense of scale. And we were out in the field with the COO and a couple of other people making sure everything was parallel. It’s one thing to show your plans as a BIM model, but they got to see the inpatient tower as the ultimate virtual plan.”
Efficiency in Design and Construction
By utilizing multi-trade prefabrication, multiple building components—such as patient room bathrooms and headwalls; MEP corridor racks; vertical mechanical duct mains; and operating room ceilings—were constructed in an off-site, temperature-controlled warehouse while the bed tower was under construction. These vital pieces were trucked in and installed as soon as the building structure was ready to receive them. By prefabricating the components off-site, the team was able to drastically reduce the amount of noise, dust and vibration at the hospital, as well as eliminate a significant amount of construction traffic. Constructing the components in the warehouse also provided a safer work environment, allowing more construction to be fabricated at waist-height, and significantly reducing the number of trips up a ladder. The entire prefabrication process—along with PDDS—resulted in an estimated seven-month savings on the overall project schedule when compared to conventional construction.
“With traditional construction, you have to wait until all of the building structure is ready to go and then you start building out the walls and everything else,” explains Stewart. “Using prefabricated components allowed everything to get started much faster, and that speed ultimately reduced the overall construction schedule and cost.”
Flexibility of Design
As part of the updated master plan, shell space on the tower’s second and third floors was programmed to accommodate 48 additional inpatient rooms. Along with 48 private rooms that are situated on the building’s top two floors, the new tower features decentralized work spaces on its patient floors. Located adjacent to patient rooms (so nursing staff and physicians can work together in close proximity to patients), these decentralized areas enable better care, more efficient communication and improved patient safety.
At the end of each 16-foot wide corridor on the patient floors, a large curtain wall of glass floods the space with natural light, creating an open and healing environment. Private rooms are also filled with daylight and feature three levels of electrical shade control allowing patients to adjust the room to his or her needs.
“The way we’ve organized these units is fairly atypical,” says Stewart. “In your traditional hospital, you have your patient rooms on either side of each corridor, and your staff support space is in the center at the hub. With this design, instead of situating the caregiver stations in the center, they’re dispersed along the corridors with the supply alcoves, so it makes the corridors much wider and gives them a far more open feeling.
“We also slightly off-centered the patient rooms so that you don’t have a direct line of sight into an adjacent room,” adds Priest. “Having that level of privacy obviously increases the quality of the overall patient experience.”
Subtle details throughout the inpatient tower seek to neutralize the stress that hospitals often evoke. These details include graphics of nature; frosted glass that masks work areas; and artistic glass used to represent flowing water. In order to unite the new building with the hospital and seamlessly combine the wayfinding systems, an existing landscaped area was modified and enlarged to become a courtyard. The stunning enclosure can be viewed from almost all public spaces, promoting a simple means of wayfinding.
“The public corridor is wrapped around this beautifully landscaped courtyard that’s surrounded by glass, which really became a wayfinding feature,” says Priest. “Instead of walking down a hallway that you think is going to last forever, you have the courtyard to look out onto, and before you know it, you’ve arrived at your destination.”
Adding 220,000 square feet to the existing hospital, the five-story bed tower addition at Miami Valley Hospital South blends seamlessly with the original campus, and helps meet the ever-increasing demands of the surrounding community.
“This project is a speed to market success story,” says Priest. “Not only did we meet the aggressive construction schedule, but we also delivered a Class A, quality facility. It’s one of those places that just feels good when you walk in the door, and it’s extremely gratifying to know that you’ve had something to do with that.”
“GS&P exceeded our expectations and performed far and above our typical architects on the projects at MVHS,” says Kate Whistler, owner’s representative for construction at Premier Health Partners. “We provided them a fairly significant schedule challenge right out of the gate, and they proposed a fair fee while also being able to staff the project at our fast pace. GS&P had approximately three months to design early packages before groundbreaking, and continued at a brisk pace while under construction. The entire 220,000-square-foot facility was designed and constructed in just 16 months!”