Holy Redeemer Hospital Meadowbrook, PA€¦ · Construction Management 4 Senior Thesis Executive...

Resource Center Holy Redeemer Hospital

Meadowbrook, PA

Brad Pietropola

Architectural Engineering Construction Management Option

Spring 2004

Resource Center Holy Redeemer Hospital Meadowbrook, Pa

Project TeamOwner – Holy Redeemer Health System

Occupant – Holy Redeemer Hospital

Architect – Francis, Cauffman, Foley, Hoffmann

Contractor – P. Agnes Inc.

MEP Engineer – Wick, Fisher, White

Project Overview•Renovation of areas of an existing hospital

•20,000 sq ft

•1.7 million dollars

•Expected completion date May 2004

•1 story project

•Hospital will remain open during construction, so many codes need to be followed. (ICRA)

Mechanical•One new AHU added on roof

•19,000 cfm for present use

•24,000 cfm for future use

•Some mechanical risers remaining and need to be coordinated with new construction.

•Variable Air Volume system.

Electrical•Switchgear reduces power to 480/277V

•10 new panelboards added

•5 are 480/277V 3 wire 4 phase

•5 are 208/120V 3 wire 4 phase

Plumbing•3 pumps added

•One has 140 gpm capacity

•One has 290 gpm capacity

•Pipes need to be relocated to coordinate with new mechanical equipment

•All plumbing fixtures to be replaced

Lighting•Fluorescent and incandescent lighting

•Combination wall and ceiling mounted as well as direct and indirect fixtures

Brad Pietropola

Construction Managementhttp://www.arche.psu.edu/thesis/2004/bwp113/

Current HospitalCourtesy of Holy Redeemer Hospital

Structural•Steel Structure

•Non-Bearing Brick and glass Façade

Resource Center Holy Redeemer Hospital Meadowbrook, PA

Brad Pietropola Spring 2003 Construction Management 3 Senior Thesis

Table of Contents

Executive Summary………………………………………………………………........... 4 Acknowledgements…………………………………………………………………….... 5 Proposal Letter…………………………………………………………………………... 6 Introduction and Project Background…………………………………………………. 7 Existing Conditions……………………………………………………………………… 9 Estimate Summary………………………………………………………………….. 12 Summary Schedule…………………………………………………………………. 13 Cash Flow Curve……………………………………………………………………. 15 Investigation Areas…………………………………………………………………….. 16 Depth: Re-Phasing………………………………………………………………….. 16 Breadth: Mechanical Redesign...………………………………………………….. 37 Breadth: Construction Coordination.…………………………………………….. 41 Conclusions.........................................………………………………………………….. 47 References...…………………………………………………………………………….. 48 Appendix A...…………………………………………………………………..……….. 49



Executive Summary Enclosed is my thesis project on the Resource Center at Holy Redeemer Hospital in Meadowbrook PA. This is phase one of a master plan to update the hospital facilities and bring it into the technology age. Holy Redeemer Health Services selected Francis, Cauffman, Foley, Hoffmann as the architect on the project. P. Agnes was selected as the general contractor of the project. The project is a 1.7 million dollar project and is scheduled to be completed in 10 months. This report represents a yearlong study into the construction of this project. The first section outlines the parameters in which the project was planned, designed and constructed. This section is the existing conditions of the construction project. The second section analyzes the project in terms of cost, constructability, schedule, and minimal disruption to the operating hospital. These areas were investigated and compared to the existing conditions and construction procedures in the first section. Topics Research and applied to this thesis:

• Infection Control Risk Assessment (ICRA). • Re-Phasing the project • VAV boxes compared to remote reheat coils • Better construction Coordination Plan

I chose to re-phase the project to help with the ICRA steps that must be taken. This re-phasing created a cost savings of $26,827, as well as a 12-day reduction in the project’s duration. I next took a look into re-designing the mechanical system. I chose to replace the some of the re-heat coils with variable air volume boxes. Although the cost of materials and installation are very similar with the two materials, I believe a greater comfort level can be achieved with the VAV boxes. The final analysis in this report looks into a construction coordination plan. The current productivity of the project is below what they expected. I believe this is due to a lack of coordination. With a better coordination contractors will no longer have to work around other contractors materials on the site, which will result in a cost and time savings.



Acknowledgements I would like to thank the following people. Without their help and support thesis would not be possible.

• Penn State Faculty o Dr. David Riley o Dr. Moses Ling

• P. Agnes.

o Joe Osifchok o Sue Harkins o Kevin Cahill

• Holy Redeemer Health Services

o Jack Dempster o Gail Latimer o Esther Malazita

• Francis, Cauffman, Foley Hoffmann

o Ken Granderson

• Wick, Fisher, White o Bruce Gessner

• My family for their love and support throughout my educational career.

• My friends in and out of AE for being there when I needed them.



Proposal Letter Brad Pietropola 709 W. College Ave. State College, PA 16801 April 5, 2004 Jack Dempster Holy Redeemer Hospital 1648 Huntingdon Pike Meadowbrook, PA 19046 Dear Mr. Jack Dempster: I appreciate the opportunity to submit these proposed alternatives for the Resource Center project. Many considerations were taken when analyzing the schools current system. The analysis began with a look into the Infection Control Risk Assessment requirements and steps. I look into providing a different phasing plan to reduce the steps that need to be taken on this project. During the analysis I took into account the hospital operations. I found that by re-phasing the project you could reduce the cost of the project as well as shorten the duration of the project. I also looked into providing more comfort for the hospital employees, patients and visitors of the hospital. This was achieved by redesigning the mechanical system of the hospital. Variable air volume boxes instead of the current reheat coils will provide individual control for each room. Although the cost of the proposed system is a bit higher I believe it will be offset with the added comfort and control of the system. Finally I analyzed the construction on the project. I believe a construction coordination plan will increase the workers productivity. This plan will require a couple of easy steps, as well as all the contractors’ cooperation. This plan will increase the productivity, which in turn will save time and money on the project. I hope you are pleased with the thoroughness of this report, and take into consideration my proposed alternatives. If you have any questions please do not hesitate to contact me. I look forward to working with you and Holy Redeemer Hospital. I want to thank you again for considering these alternatives Sincerely

Brad W Pietropola Brad Pietropola



Introduction and Background Building Name Holy Redeemer Hospital Project Name Resource Center Location Meadowbrook, Pennsylvania Site The Resource Center is a renovation of an area of a hospital. Holy Redeemer hospital is located on an urban site outside of Philadelphia. There is also a medical center located on the site, which is connected to the hospital. The renovation area is located in the current hospital. Occupancy The building contains a hospital. The Resource Center project is a renovation of an old kitchen and cafeteria that are no longer in use, and areas surrounding it. They are constructing many different spaces in this area. The main areas they are constructing are a resource center, which can be used for research. They are also constructing a medical library for the hospital, and a computer room for use by visitors and patients. Another area of the project includes renovating an existing auditorium. They will also remodel the preamble to the auditorium. Size 20,000 sf will be remodeled Dates of construction November 2003 – August 2004 Actual Cost Information Total project cost approximately 1.7 million. Project Delivery Method Design-Bid-Build Design and Functional Components The purpose of the renovation is to provide some areas that the hospital is currently lacking as well as upgrade some current areas. The auditorium will be upgraded with a new stage and new seats. The walls and floors will also be renovated. In the other areas of renovation, a resource center, computer rooms, and a medical library will be constructed. These areas are made with materials such a cherry wood trim, cherry wood



doors and cherry panels in many areas. The hospital wants this area to look very elegant and nice. Codes ICRA (Infection Control) – Since the area to be renovated is part of the building many precautions must be taken so that the hospital doesn’t become contaminated. One of the major precautions taken to insure infection control is that at all times during the project the area being renovated will be at negative pressure compared to the hospital. This prevents the air from the renovation area to move into the hospital. Some other requirements during the renovation are minimal noise and to minimize vibration. Project Team Purchase Order Stipulated Sum Basis: AIA B141 Basis: AIA A101 1997 The bidders were narrowed

down to two firms then the final price was negotiated

General Contractor P. Agnes Inc Joe Osifchok

Architect Francis, Cauffman, Foley, Hoffman

Ken Granderson

MEP Engineer Wick, Fisher, White

Bruce Gessner

Owner Holy Redeemer Health Services

Jack Dempster



Existing conditions This project is the renovation of an existing hospital. The Resource Center project is a renovation of an old kitchen and cafeteria that are no longer in use, and areas surrounding it. They are constructing many different spaces in this area. The main areas they are constructing are a resource center, which can be used for research. They are also constructing a medical library for the hospital, and a computer room for use by visitors and patients. Another area of the project includes renovating an existing auditorium. They will also remodel the preamble to the auditorium. The project is currently a 3-phase project. The project also has a phased occupancy by the hospital. This makes staying on the schedule very important. They have many activities that can’t be rescheduled and will need the use of the facilities in the construction area. Phase 1 Phase 1 consists on renovation of the hallway areas. There are many offices that can only be accessed by these hallways being renovated. The intention of the hospital is to have all these offices occupied. Some of the offices along this hallway to be renovated will be receiving minor modifications. An example of this is one of the offices is having a wall reconfigured. This will require the office to have new carpet ceiling and a new coat of paint. During phase 1 of the construction, hospital personnel will occupy Phase 2 and Phase 3. Personnel working inside the construction area, which includes the phase 2 and phase 3 as well all of the offices along the hallways being renovated, have a lot of issues with the construction. These scheduling issues will be worked out on a case-by-case basis. Figure #1: Phase 1 in yellow.



Phase 2 Phase 2 consists of construction the resource center and medical library for the hospital. This phase will begin construction after Phase 1 is complete. This area consists of a total renovation. Figure #2: Phase 2 in yellow.



Phase 3 Phase 3 consists of the remodeling of the hospital auditorium. Along with this remodeling they will be destroying a brick wall, which was the exterior wall of the original hospital. They will also be removing the steel stage that is currently in place and replacing the current chairs. The stretch fabric system that is being installed on the walls must be watched carefully because if dust is present it can be caught in the fabric and jeopardize the IAQ of the hospital. Figure #3: Phase 3 in yellow.

Infection Control Risk Assessment Since the project is a renovation of an existing hospital, infection control becomes a major concern of the project. Most patients are very susceptible to disease due to their weakened immune systems. Steps must be taken to ensure that these patients are not affected by the construction taking place in areas of the hospital. They can’t be coming in contact with the air-borne dust or other air-borne bacteria generated from the construction activities. There are special regulations that all hospital renovations must follow to ensure the patients safety. The Department of Health (D.O.H.) has established an Infection Control Risk Assessment (ICRA) rating that is used on all hospital renovations. This rating determines the amount



of precautions that must be taken due to a number of circumstances. The area of the hospital where the construction is to take place, the type of patients in the area, and the type of construction activities determines the rating class assign to the renovation. Once the class of the project is determined there are certain regulations that must be completed for each class of project. These regulations require certain steps to be taken before construction can start, during construction, and when construction is complete. Estimate Summary Chart #1: Estimate Summary

Description Of work Value General Conditions $162,834Demolition $77,500Architectural Woodwork $116,010Roofing $7,339Caulking $1,420Doors/Frames/Hardware $52,075Glazing $13,000Drywall $170,450Ceramic Tile $98,480Carpet $31,700Painting $11,300Toilet Partitions $2,875Toilet Accessories $1,700Floor Mat $985Wall Protection $52,301Blinds $2,790Marker Boards $1,550Projection Screen $2,050Folding Partitions $11,438Fabric Panels $20,675Cut/Patch $5,000HVAC $542,000Sprinkler $20,158Electrical $264,000Patching - Allowance $2,500Seating - Allowance $5,000Elevator Doors - Allowance $7,500Permit $26,670TOTAL $1,711,300



Summary Schedule Figure #4: Summary Schedule.



Figure #4: Summary Schedule (cont’d)



Cash Flow Curve Figure #5: Cash Flow Curve

The cash flow has a spike during the month of January. The main reason for this is because the air-handling unit is being delivered during this month. This adds extra costs to the construction activities going on. This is also the month where most of the work for Phase 1 is taking place. March is a low month because during this month one phase is being completed and the next one started.



Investigation Areas Depth Study: Re-Phasing The Resource Center Project is a Phased project. The main focus of this analysis is re-phasing the project with ICRA requirements in mind. I am looking to reduce the cost of these ICRA requirements by re-phasing the project. Currently the project is a three-phase project with all phases being Class III. With my analysis I am going to make the project a two-phase project with one phase remaining Class III while the other will be reduced to a Class II. This will allow for both a cost savings and a schedule reduction. When re-phasing the project I also took into account hospital operations and activities as well as minimizing disruptions. Infection control has become a very important issue in the renovations of hospitals and other healthcare facilities. Some patients with weakened immune system have a high death rate when they come into contact with certain bacteria. The cost of the ICRA steps is very minimal to the costs that would be inferred due to the lost of a life of a patient at the hospital. Infection Control Risk Assessment Since the project is a renovation of an existing hospital, infection control becomes a major concern of the project. Most patients are very susceptible to disease due to their weakened immune systems. Steps must be taken to ensure that these patients are not affected by the construction taking place in areas of the hospital. They can’t be coming in contact with the air-borne dust or other air-borne bacteria generated from the construction activities. There are special regulations that all hospital renovations must follow to ensure the patients safety. The Department of Health (D.O.H.) has established an Infection Control Risk Assessment (ICRA) rating that is used on all hospital renovations. This rating determines the amount of precautions that must be taken due to a number of circumstances. The area of the hospital where the construction is to take place, the type of patients in the area, and the type of construction activities determines the rating class assign to the renovation. Once the class of the project is determined there are certain regulations that must be completed for each class of project. These regulations require certain precautions to be completed before construction can start, during construction, and when construction is complete. ICRA Class and Precautions There are four different classes that a project can be. The higher number the project the more steps that must be taken to ensure infection control. To help determine which class a project will be there is a matrix of charts that can be used. With these charts there are a



number of steps to determine what class your project is and what precautions must be taken. Step #1: Use Chart #2 to identify the type of construction project activity. Step #2: Use Chart #3 to identify the patient risk groups that will be affected. Step #3: Use Chart #4 to match the type of construction project activity with the patient risk group to find the construction project type. Step#4: Use Chart #5 to determine the required Infection Control precautions by Class. Step #1: Resource Center Type of Construction Project Activity. Chart #2: Use the following chart to identify the Type of construction Project Activity

The Resource Center Project is a complete renovation. They are replacing both the floor and ceiling tiles. They are also demolishing the walls and construction new ones. They are also installing a new AHU and the ducts that will serve the area. With these activities taking place the Resource Center Project is a Type C project.



Step #2: Resource Center Patient Risk Group Chart #3: Use the following chart to determine the Patient Risk Group

*If more than one risk group will be affected, use the higher risk group. The resource center is renovating an office area. There are no patients located in the area. This makes most of the project a Low Risk Patient Group. However on the first floor where the construction project is taking place is the hospital’s Cancer Care Unit where patients are located and treated. Since this area borders one part of the construction project that area of the project is considered a High Risk Patient group. Therefore the project has 2 different risk groups and the higher risk group must be used. Step #3: Resource Center Construction Project Type Chart #4: Use the following chart to match the type of construction project activity with the patient risk group to find the construction project type.

The Resource Center Project is a Type C project. It also has HIGH Risk Group located next to the one area. If you match these two up in the chart it says the project will be a Class III or Class IV project. Since the High Risk patients are bordering the project and not located in the construction area, the Resource Center Project was classified as a Class III project.



Step #4: Resource Center Infection Control Precautions Chart #5: Use the following chart to determine the required Infection Controlled precautions.

This chart lets you determine the precautions you must take on your construction project depending on what class your project is. Since the Resource Center is a Class III project there are many projects that must be taken during and after construction.



Infection Control Construction Permit For Class III and Class IV projects, the Department of Health must be notified about the details of the renovation. To notify the D.O.H. you must submit an Infection Control Construction Permit (Figure #6) to the Department of Health. It is also required that they come inspect that the proper precautions are taken on the site before construction can start. During this inspection they determine that all required precautions listed in Chart #4 are completed. If all precautions are fulfilled the inspector will sign the permit. This permit must be completed and approved by the D.O.H. before the construction project can begin.

Figure #6: The permit that must be submitted to notify the Department of Health of the construction project that will be taking place.



Current Phasing Plan Currently the Resource Center is a 3-phase project. The project is going to have a phased occupancy. When one phase is finished it will be opened up for use by both hospital employees as well as visitors. The renovation is a complete renovation with all the floors, walls, and ceilings being replaced. There is also a new AHU being install, which will serve the area. The air ducts in the area are also being replaced. Phase 1 Phase 1 mainly consists off all the hallways in the area. In this phase the new AHU will also be replace. Most of the work completed in this phase is the ductwork that is running through the hallways. Many of the offices along these hallways will remain occupied by employees of the hospital. Their doors will remain shut to minimize dust spreading into the offices. Phase 2 Phase 2 consists of constructing a new resource center and medical library. This area used to be an old kitchen that served the hospital cafeteria. There are many windows and wood finishes that must be installed during this phase. Phase 3 Phase 3 consists of renovating an existing auditorium as well as the break out area. The main operation taking place in this area is breaking through a wall, which used to be the exterior of the hospital, to create a door into the auditorium. They are also installing a new high tech audio/visual system in the area. As with the resource center area, the auditorium will also have a lot of elegant wood finishes. ICRA There are many steps that must be taken for the entire project in terms of the ICRA requirements. Steps taken during Construction:

• Remove or isolate HVAC system in area where work is being done to prevent contamination of duct system.

o On the resource center project they must cap the ductwork as it passes between a phase that is completed and one that is still under construction.

• Complete all critical barriers, i.e. sheetrock, plywood, plastic, to seal area from non-work area or implement control cube method (cart with plastic covering and sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins.

Figure #7: 6-Mil polyethylene sheeting



o For the project they are using 2 sheets of 6-mil clear polyethylene sheeting, which is run from floor to ceiling and completely sealed around the edges. They must place this barrier around the current phase to completely enclose the construction area (Figure #7). Doors that won’t be used must also be sealed with duct tape to ensure that no air-borne particles pass by it.

• Maintain negative air pressure within work site utilizing HEPA-equipped air filtration units.

o The project has 2 2000 CFM HEPA filter exhaust fans, which are run to keep the project at the required negative pressure.

• Contain construction waste before transport in tightly covered containers. • Cover transport receptacles or carts. Tape covering unless solid lid. Steps taken after construction is complete: • Do not remove barriers from work area until completed project is inspected by the

owner’s Safety Department and Infection Control Department and thoroughly cleaned by the owner’s Environmental Services Department.

• Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction.

• Vacuum work area with HEPA-filtered vacuums. • Wet mop area with disinfectant. • Remove isolation of HVAC system in areas where work is being performed.

Figure #8: Current Phasing Plan



Proposed Phasing Plan Phase 1 The main reason for the re-phasing of my project is the ICRA requirements. The proposed phasing plan is a 2-phased project. The first phase will consist of phase 2 of the old phasing plan as well as half of phase 1. This phase of the project contains all areas close to the cancer care unit. This unit will still be a Class III ICRA project and will require all the precautions for that class. Phase 2 This phase of the project contains the auditorium, which is phase-3 of the current plan as well as most of the hallways. It was split up this way because this area has a lower patient risk group. Since the Cancer Care Unit or any other patients are located near this area the Patient Risk group is now a low risk group. If you go back to Chart #3 you can now see that this phase can be classified as a Class II project. This will require fewer precautions to be taken during this phase. Figure #9: Proposed Phasing Plan



ICRA The requirements that must be fulfilled during phase 1 of the proposed phasing plan are the same that must be fulfilled during the entire project in the current phasing plan. The advantages for the ICRA requirements are very numerous during phase 2 of the project. Since phase 2 is only a Class II project there are less requirements. With the proposed new phasing plan the ICRA steps must be fulfilled. The two attached floor plans for phase 1 and phase 2 show the ICRA precautions for each phase. Steps taken during construction: • Provide active means to prevent airborne dust from dispersing into atmosphere.

o The use of 1 sheet of polyethylene sheeting from the floor to the ceiling in various locations will be enough to prevent airborne dust from spreading throughout the hospital.

• Water mist work surfaces to control dust while cutting. • Seal unused doors with duct tape.

o Although most of the doors will be in use by employees or visitors there are a few that will be sealed shut with duct tape.

• Block off and seal air vents. o On the resource center project they must cap the ductwork as it passes between

a phase that is completed and one that is still under construction. • Place dust mat at entrance and exit of work area • Remove or isolate HVAC system in areas where work is being performed.

o On the resource center project they must cap the ductwork as it passes between a phase that is completed and one that is still under construction.

Steps taken after construction is complete: • Wipe work surfaces with disinfectant. • Contain construction waste before transport in tightly covered containers. • Wet mop and/or vacuum with HEPA-filtered vacuum before leaving work area. • Remove isolation of HVAC system in areas where work is being performed.



Figure #10: ICRA steps for proposed phase 1



Steps no longer required during phase 2: • The airtight barriers around the construction site that are required in a Class III project

are no longer required. This will save on both time and money to install and maintain these.

• The project area doesn’t need to be kept at a negative air pressure. The HEPA filter exhaust fans will no longer need to be run for this phase of construction. These fans require constant monitoring. The filters also must be changed frequently depending on the type of activities being performed and how much dust they generate.

Figure #11: ICRA steps for proposed phase 2



Advantages There are many advantages that will result from my proposed phasing plan • The reduction from 3-phases to 2-phases will reduce the number of inspections that

must take place. This is turn will be a result of a schedule reduction. With the ICRA requirements there are a number of inspections that must take place before and after all phases of construction and having them only occur twice instead of 3 times will result in a reduction

• The current phasing plan has most of the mechanical ducts and piping run during

phase 2. This will allow the mechanical contractor to get most of his work done continuously which will be more effective than having him come back during all phases of construction. Although he will still have mechanical work to do in other stages he will get the long duct runs and connecting to the AHU done during one mobilization.

• The effect on visitor and employee traffic is less extreme. With the current phasing

plan all the elevators in the section of the hospital where the construction is taking place will be closed during phase 1. Along with the elevators all of the hallways are also being renovated during the same time. With the new phasing plan at least two of the elevators will be able to stop on the floor of the construction. This will ease the visitor and employee circulation throughout the floor.

In the new phasing plan all of the hallways aren’t being completed at the same time so the pedestrians will be able to circulate more. When most of the hallways are being complete the project is only a Class II project. In a Class II project the project doesn’t have to be completely closed off and people are able to walk through the project, which will allow visitors to continue to use these hallways although they are under construction. This may be detrimental to the workers of the construction project, but minimal disruption to the hospital operations is the number one objective.



Cost Comparison The analysis of cost savings is mainly going to focus on the ICRA precautions that must be taken. This cost analysis will also only look into the bigger cost savings items. The new phasing plan will result in small cost savings with the polyethylene sheeting required around the construction site. With the project being reduced from a 3 phase to a 2-phase project, there will be less sheeting to be placed and removed. Also in a Class II project you only need one layer of sheeting and it doesn’t need to be maintain and watched as closely as a phase 3 project. The cost of a 10’ x 100’ of clear polyethylene sheeting costs $34.19. With a 2 million dollar project these material cost savings are very minimal. There will also be saving occurred due to other steps that won’t be required. These savings will mainly occur in timesavings due to not having to complete the tasks. These tasks include covering all material before transporting as well as changing the filters in the HEPA exhaust fans. HEPA Vacuums On an ICRA regulated project the site is required to be vacuumed by an HEPA filtered vacuum. • Class III projects the construction area is required to be vacuumed daily. • Class II projects the construction area is only required to be vacuumed at the

completion. The HEPA vacuum used on this project is a 55-galloon wet/dry vacuum. The rental costs of these vacuums are: • Daily……………...$36 • Weekly……..…... $108 • Monthly………… $325 HEPA Filter Exhaust Fans A class III ICRA project requires the project to be kept at negative pressure throughout the construction project. On the resource center project this is done using 2 HEPA Filter Exhaust Fans. These fans are 2000 CFM units. The rental cost for these units are $450/month each plus the cost of the pre filter and HEPA filter. • The cost of a pre-filter is $30/each. • The cost of a HEPA filter is $180/each.

Figure #8: HEPA filter exhaust fan



Depending on the demo/type of project that is being done the filters get changed out often. It is hard to estimate per job the change out schedules. For this cost analysis I estimated they would get changed once per week. Chart #6: Cost comparison for the ICRA precautions.

• Total Current Phasing Plan…………………………….. $30,310 • Total Proposed Phasing Plan………………………….......$9663 • Total ICRA Savings with Proposed Plan……………..$20,647 These cost savings by changing phase 2 to a Class II project are very significant. Most of these savings are occurred because the HEPA filter exhaust fans are no longer needed. It is a major cost to keep the project at a negative pressure.



Schedule Comparison This comparison is going to look into the timesavings of reducing the project from a 3-phase project to a 2-phase project. There are a lot of extra steps that must be completed during an ICRA regulated job. These steps add duration onto the project length • Each phase requires Temporary Protection and ICRA requirements to be set up.

o This setup is 5 days in length for each phase to be started. • Each phase requires inspections by the hospital before construction can begin

o The hospital inspections duration is 2 days. • Each phase requires inspections by the Department of Health to ensure ICRA

precautions before construction can begin. o These inspections take a day to complete

• The D.O.H must also inspect the project after a phase is complete and the area must be turned over to the owner

o This inspection and owner turnover takes 1 day. • Each phase also requires a thorough cleanup at the end of each phase to prepare for the

D.O.H. inspections. During this cleanup time no work can be completed. o The final cleaning depends on the size and type of work taking place in the

phase.



Figure #9: Current Schedule.



Figure #9: Current Schedule (cont’d).



Figure #10: New phasing plan schedule.



Figure #10: New phasing plan schedule (cont’d).



Total duration during each phase for ICRA regulations Temporary Protection……………………………….5 days Hospital Inspection………………………………… 2 days D.O.H. Inspection before construction…………….. 1 day DOH Inspection after completion………………….. 1 day Phase Cleanup……………………………………… 3 days Total Time Saved…………………………………. 12 days The time saved due to reducing the number of phases from 3 to 2 is over 2 workweeks. Since this project is only an 8-month project this schedule reduction is very significant. This timesaving of 2 weeks will also result in a cost savings for the general conditions. The general conditions total cost is $132,824 without the ICRA equipment and precautions included. I am not including these in this cost savings because the cost savings of them is already discussed in the previous section. The general conditions can be broken down into a weekly cost of $3090/week. The cost savings of this reduction will then be $6180.



Additional Reduction The new proposed schedule also includes more schedule reduction. The current project schedule has a completion date of August 27th 2004 The proposed project schedule has a completion date of July 29th 2004 With these two dates the project schedule also has been reduced by an extra 9 days above the ICRA savings. This reduction is due to the changing of the critical path. The areas of the hospital are now included in different phase, which cause the critical path to change for the better. These savings are not as guaranteed due to the uncertainty of the percentages of work completed in each stage. I have just estimated the amount of work that will be done in each stage from the drawing and the current schedule. Although these are certain there is a strong possibility that some of this reduction will be realized. Timesavings might also occur due to the fact that contractors will only have to mobilize 2 times instead of 3 times. They will be able to increase the amount of work done each time they are on site, which will result in better productivity and possibly a schedule reduction. Recommendation My recommendation for the project is to adopt the proposed phasing plan. The new plan realized both a cost and schedule reduction. The total cost savings are $26,827, which includes the savings from both the ICRA precautions as well as the schedule reduction. The schedule reduction solely due to the decrease in the amount of inspections and ICRA steps is 12 days. Cost Savings……………………….. $26,827 Schedule Reduction………………... 12 Days Although there is both a cost savings and schedule reduction with the proposed phasing plan there are other issues that may cause this phasing plan not to work. One of the main issues is the hospital operations. Switching the time frame that the different areas will be able to be occupied may conflict with the hospital operations. The auditorium is used often by the hospital for presentations and guest speakers. Since some of the people that are speaking come in from all over the world their schedule must be adhered too. Another issue with my proposed phasing plan is the two different classes of phases. To allow one phase to be a Class III, while the other is a Class II they have to be submitted as two separate construction projects. This requires more paperwork to be submitted to the D.O.H. as well as many other organizations and companies.



Breadth Study: Mechanical Redesign The current Mechanical system has a constant volume Air Handling Unit being installed. The area of the construction, except for the auditorium, will be connected into this AHU. The auditorium is served from an AHU that is located on the floor below and will not be included in the analysis. The mechanical system is a re-heat system. It has remote reheat coils located throughout the construction area to provided comfort to the different rooms of the hospital. These re-heat coils are supplied with hot and cold water pipes. I am proposing that these re-heat coils be replaced with Variable air volume (VAV) boxes with re-heat coils and electronic controls. There are already 2 VAV boxes in the break out area of the hospital. I believe this switch won’t result in any cost increases for the hospital, but will greatly increase the individual comfort for the individuals occupying the different areas. The cost of some of the VAV boxes will also be less that the cost of the reheat coils. This will help offset the high costs of the larger VAV boxes. Replacement Areas Since some areas would not be advantageous to change because they are not well suited for VAV boxes, there are only certain areas that I am changing. Some of the areas I am not changing are: • The corridors.

o VAV boxes don’t work well in these circulation spaces and will be better served by the re-heat coils.

o It is tough to analyze these spaces because you can’t assign an area or volume to the individual box will supply.

• Areas with exterior exposure o With exterior spaces you have to be very cautious with over cooling do to heat

loss to the outside. The entrance area to the hospital is one of these rooms where you have to be greatly concerned with overcooling.

Replacement System Currently on the resource center project there are two VAV boxes. These boxes are Carrier model 35E. This model is a single duct unit with hot water reheat and electronic controls. The unit also has an attenuator to help reduce the sound of the system. I believe this is a very important feature due to the patients that will be on the floors above as well as to the comfort of the individuals occupying the room. Attached in Appendix A are some specifications on the Carrier 35E model along with some sizing information.



The areas that are going to be served have a variety of different requirements. If you refer to the attached Mechanical Plan you can see the re-heat coils I plan on replacing. I have marked these units with numbers to correspond to Chart #6 and Chart #7. Chart #7: Room requirements for areas that are going to be switched to VAV boxes

Room Requirements

Room Room

Designation Replacement VAV Number

Room Area SQ. FT

Room Volume (CU.FT)

Min. Supply Requirements

Actual Supply (CFM)

Office 1010 8 459 3672 None 425 Help Desk 1014 6 189 1732 None 165 Resource Center 1015 & 1017 5 1042 9029 None 1220 IT Office 1016 4 200 1700 None 175 IT Training 1022 1 625 5729 None 1050 Medical Library 1020 & 1021 2 624 5850 None 600 Meeting Room 1013 7 665 5985 None 1000 Bathroom 1018 & 1019 3 312 2496 None 90

The rooms have a variety of different supply needs. Each room varies in dimensions and supply requirements. Although none of these areas have a minimum supply requirement if necessary the 35E boxes can be set to have a minimum supply volume above zero. Chart #8: Carrier VAV boxes sizes that will be used in the various areas.

VAV Boxes Max CFM Location Inlet Size

230 3, 4, 6 4515 8 6700 2 7

1160 1, 7 91430 5 10



Cost Comparison Chart #9: Cost of Re-heat coils.

Re-Heat Coils Size Quantity Material Installation Programming Total: All 8 $200 $175 $350 $5,800 Total: $5,800

The total cost of the re-heat coils that are to be replaced is $5,800. This includes the unit itself as well as $175 dollar to pay the sheet metal subcontract to hang the units. It also costs $350 dollars to program the units during air balancing tests. Chart #10: Cost of VAV boxes.

VAV Boxes Size Quantity Material Installation Programming Total 230 3 200 $175 $350 $2,175 515 1 210 $175 $350 $735 700 1 210 $175 $350 $735 1160 2 250 $175 $350 $1,550 1430 1 250 $175 $350 $775 Total: $5,970

The total cost of the re-heat coils that are to be replaced is $5,970. This includes the unit itself as well as $175 dollar to pay the sheet metal subcontract to hang the units. It also costs $350 dollars to program the units during air balancing tests. Advantages/Disadvantages There are advantages and disadvantages between the two different systems. The owner must decide which of these areas are most important to him to make the decision between the two costs. VAV Box Advantages • Individual zone comfort • More ability to provide individual comfort for the room • Less energy costs than reheat coils

o Not as much air has to be re-heated. Reheat coil reheats 100% of the air at all times where with a VAV box

if its only 20% open then the reheat coil in the system only reheats 20 % of the air. See Appendix B for sketch of this condition.



VAV Box Disadvantages • The cost of the VAV system is slightly higher • The VAV boxes don’t work for all areas so you will have a mixed system in the

hospital, which may create problems. • Other areas of the hospital contain the remote reheat coils so the owner is familiar with

that system. • The mixed system requires the air balancing of two different systems, which will take

longer and may add additional time and costs to the schedule. Recommendation I believe that the VAV boxes provide more individual comfort for the areas they are serving. Since most of these areas are individual rooms or offices I believe the occupant will achieve greater comfort with the VAV boxes. Although the cost to install and balance the mixed system will be greater, the owner has expressed that they wants a higher end area. They have wood casework and panels throughout the area. I believe these additional costs will be offset in the long run by the advantages that the VAV system provides.



Breadth Study: Coordination Plan Currently on the resource center project there is no construction coordination plan. There is also not a site coordination plan that show’s lay down areas as well as storage and work areas. There has been a major problem with remaining on schedule because of the productivity of the worker. I believe that with a construction coordination plan these problems will be eliminated. This coordination plan will include lay down and work areas during all times of the project. These laydown areas will change often as contractors move throughout the area. A weekly coordination meeting will help the contractors on the site work together and be more productive. During this meeting you can also determine areas that no contractor will be working in and other contractors can store materials in those areas. ICRA regulations The sloppiness of the materials on site is bad for dust control on the project. Since the area has to be vacuumed daily, it would be best if the hallways were free of materials. While these materials are being stored in the hallway they are also gathering dust. As you can see in Figure #9, there are ducts stored throughout the hallway with contractors working in the distance. These ducts are supposed to be dust free when they are being installed. Not only are they collecting dust being generated, but they also have not plastic or other form of protection to keep dust from getting inside them. Site Congestion

Figure #11: Materials store in hallways The site for each of the phases is very congested. Since the other areas of the hospital are still in operation all the materials must be stored in the phase area that is being constructed. As you can see in the figures the materials are being placed throughout the site and causing congested. Lay down Area The project currently has no lay down area. Contractors are storing their materials in the hallways close to where they will be completing their work. One major problem arising is that the areas where contractors are storing their materials, is the other contractors need to be working in this area. These workers are not performing well due to the fact that they must either work around the materials or take time to move these materials before they start. When these contractors move the materials they are only concerned about themselves, and move the materials into an area where another contractor



will soon be working. The contractor in that area then is required to move the material as well. The double or triple handling of materials is causing not only productivity delays, but it has contractors not working together for the good of the project. This situation is also causing materials to get misplaced. Contractors have to take time to find their materials because they have been moved at least once by contractors trying to work in an area. Although each of these delays is minimal, with a 9-month project they add up to be very important. Coordination Meeting They currently have no coordination meetings between the contractors working on the site. A coordination meeting will be beneficial for all the contractors working on the project. This project can take place either Friday afternoon or Monday mornings. Contractors who will be working on the project during the upcoming week will be required to attend this meeting. During this meeting each contractor will have to submit a schedule of where they will be working during that week. After it is determined where each contractor will be working, it will be possible to set up a site plan and assign areas where each contractor can lay down their materials with minimal disruption to the other workers.



Phase 1 I am proposing that they use the entrance area as well the attached atrium area as a storage/work area. This area can be used to both store materials as well as contractors can set up small machines they need to perform their operations. There is also a mechanical room, which will be used to access the AHU on the roof and also house some of the ducts running throughout the area. This room is currently empty and can be used as a storage area for certain contractor materials. Since these areas aren’t big enough for all contractors to store their materials, the weekly coordination plans will be very important Figure #12: Proposed coordination plan for phase 1



Phase 2 Phase 2 is the most restricted of the three phases. There will be many contractors working in this area at one time. If the coordination between the contractors working in this area is not good the time to complete this phase can be greatly increased. The entrance area and attached atrium area can also be used as a storage/work area during this phase too. This area can be used to both store materials as well as contractors can set up small machines they need to perform their operations. The coordination meeting will be essentially important during this phase because of the restricted area. For this phase it will be very important for contractors to try to have their materials delivered to site when they will need them. Contractors can’t be storing a month’s worth of materials on the site. Figure #13: Proposed coordination plan for phase2



Phase 3 For the auditorium phase the area outside the auditorium can be used for a work area. During the day the contractors can set up their machines outside and conduct their work out there. This area is under cover so the weather won’t affect their machines or materials. The weather will also be warmer during this phase. This will be beneficial during this stage because their will be many different trades in the room. During this phase the entrance/atrium will be used solely as storage space for the materials of the contractors. Figure #14: Proposed coordination plan for phase 3



Deliveries Since the project is on a very constricted site, the general contractor should restrict the amount of materials a contractor stores on site. Currently contractors have materials stored that won’t be needed for weeks in advance. The sheet metal contractor had all the ducts that were required for phase 1 there very early in the project and had them stored throughout the halls. I believe that each contractor should have no more than a week's worth of materials on the site at one time. If it is possible for a contractor to get more frequent deliveries of materials, then it should be recommended. Recommendations The coordination plan will be a very good idea for this project. Since the schedule is so short in duration, all delays become more important. There isn’t as much time or profit on this project to offset the delays. The only step that this plan requires is a weekly meeting between all the contractors. This meeting will only last a couple hours at the most, but will benefit the project hourly. The assigned work/storage areas will also be beneficial to the project. This will give the contractors a specified placed where they know they will be able to set up their equipment.



Conclusions My recommendation for the project is to adopt the proposed phasing plan. The new plan realized both a cost and schedule reduction. The total cost savings are $26,827, which includes the savings from both the ICRA precautions as well as the schedule reduction. The schedule reduction solely due to the decrease in the amount of inspections and ICRA steps is 12 days. Although there is both a cost savings and schedule reduction with the proposed phasing plan there are other issues that may cause this phasing plan not to work. One of the main issues is the hospital operations. Switching the time frame that the different areas will be able to occupied may conflict with the hospital operations. The auditorium is used often by the hospital for presentations and guest speakers. Since some of the people that are speaking come in from all over the world their schedule must be adhered too. Another issue with my proposed phasing plan is the two different classes of phases. To allow one phase to be a Class III, while the other is a Class II they have to be submitted as two separate construction projects. This requires more paperwork to be submitted to the D.O.H. as well as many other organizations and companies. I believe that the VAV boxes provide more individual comfort for the areas they are serving. Since most of these areas are individual rooms or offices I believe the occupant will achieve greater comfort with the VAV boxes. Although the cost to install and balance the mixed system will be greater, the owner has expressed that they wants a higher end area. They have wood casework and panels throughout the area. I believe these additional costs will be offset in the long run by the advantages that the VAV system provides. The coordination plan will be a very good idea for this project. Since the schedule is so short in duration, all delays become more important. There isn’t as much time or profit on this project to offset the delays. The only step that this plan requires is a weekly meeting between all the contractors. This meeting will only last a couple hours at the most, but will benefit the project hourly. The assigned work/storage areas will also be beneficial to the project. This will give the contractors a specified placed where they know they will be able to set up their equipment.



References

Bruce Stewart, Pinchin Environmental Ltd, Health Canada Issues Standard for Construction Precautions in Hospitals. http://www.pinchin.net/newsletters/indoor_air/constructionhospitals7.htm Carrier HVAC Systems http://www.commercial.carrier.com/wcs/proddesc_display/0,,CLI1_DIV12_ETI434_PRD49,00.html Health Risk Technologies Inc, PERMIT. http://www.healthcaredesign.com/healthrisk/healthrisktechnologies.html Judene, Mueller, Bartley, APIC Guidelines Committee, APIC State-of the art Report: The role of infection control during construction in health care facilities. http://ordesignandconstruction.com/ic/APIC%20SOAR%20Construction.pdf, Infection Control Risk Assessment: Matrix of Precaution for Construction and Renovation http://www.ordesignandconstruction.com/ic/Infecontrol%20Form2.pdf Wendes, H. Variable Air Volume Manual. Linburn GA. Fairmount Press. Prentice Hall. 1994 William Turner. HPAC Interactive Engineering, Controlling Ventilation During Construction. http://www.hpac.com/member/feature/1998/nov98/9811turner.html#s2



Appendix A















Date post:	26-Jul-2020
Category:	Documents
Upload:	others
View:	4 times
Download:	0 times

Holy Redeemer Hospital Meadowbrook, PA€¦ · Construction Management 4 Senior Thesis Executive...

Documents