Sutter Health, Eden Medical Center
Scope

George Bischalaney, President and CEO, Eden Medical Center

By George Bischalaney, President & CEO, Eden Medical Center

Health care reform is on the agenda, again. The stakes are high, but our President is determined to make some significant changes. As the discussion moves from general to specifics, special interests are staking out their positions. None of the stakeholders—hospitals included—wants to feel the impact or be at a disadvantage.

Amidst the demand for cost reduction and health care coverage for all, there is and must be continued investment in care. Physicians demand it. They expect to be able to practice with state-of-the-art equipment and facilities to produce outcomes that meet national, state and local quality standards. Patients demand it. They want to know that their local hospital has the right number of well-trained staff as well as the latest diagnostic and treatment equipment, and contemporary facilities.

With this backdrop of conflicting needs, Eden Medical Center is about to begin a three-year project that will result in the replacement of the Castro Valley hospital. The project cost is estimated to be $320 million. The current 55-year-old building is anything but contemporary. With few private rooms, small operating rooms and inadequate support space for clinical services, a new hospital is very much needed.

Eden Medical Center has served the community well, but it was not designed for patient comfort and needs, more for staff needs and functionality. While our project may seem ill timed given the uncertainty of hospital reimbursement, we are required to meet California legislated standards for seismic safety in hospitals. And it truly is needed.

We’ll celebrate our long sought goal with a ground-breaking ceremony on July 1st. Then we’ll spend the next three years continuing the investment in the new buildings and equipment, while observing and hoping that decision makers do not enact legislation that essentially penalizes us for the commitment we are making. When we celebrate the grand opening and our new beginning early in 2013, it should be with the same hope and dreams as those who celebrated the first ceremony in 1954.

Campus View from Main Entry

By Cassandra Clark, Project Communications Director

After what has seemed like a very long journey, we now have permits in hand, and contractors have already mobilized on the Eden Medical Center campus to get it ready for construction of the highly anticipated new hospital. We want to keep you informed about the project, and let you know what you can expect in the next week and throughout the month of July.

Fencing around the perimeter of the construction area is almost complete! The fencing goes along our property line on Stanton Avenue, through our campus, and along the adjacent apartment buildings. We are also installing a gate at one of our Stanton Avenue entrances to limit access to the area only to construction vehicles.

Tree stump removal on the future helipad site will begin later this week.  The new site is approximately 150 feet north of the present location, as close as possible to the Eden Medical Trauma Center. Two days have been allocated for this work. Grading of the new helipad site will begin as early as June 26th, and will take up to three weeks to complete.

Demolition of the vacant Pine Cone Apartments on Stanton Avenue will begin July 1st. The structure will be demolished in one day, and it will take about two full weeks to break down and remove the debris.

Hours of work will be from 7:00 a.m. to 3:30 pm, Monday through Friday, but is subject to change as work moves into subsequent phases.  We will keep you posted on construction schedules.

The Alameda County Fire Department has requested use of the vacant Pine Cone Apartment building for training purposes on June 29 and 30, prior to demolition. Firefighters in training often use vacant buildings to practice search, rescue and simulated fire control.  You will see firefighters on site on these dates, using smoke generators (no real fire) and equipment. Their life-saving work is a benefit to the community and we are proud to support their efforts.

If you have any questions or concerns about the preparation phase of construction, please comment on our blog, and we will respond promptly.

By Cassandra Clark, Project Communications Director

To follow up on the May 12, 2009 Alameda County Board of Supervisors meeting, the decision to certify the final Environmental Impact Report (EIR) has been delayed to June 9th to address concerns raised about San Leandro Hospital, which is leased and operated as part of Eden Medical Center, but owned by the Eden Township Healthcare District (the District).  For more information, please see our previous blog post.

In the days prior to the May 12th meeting, after many rounds of public commentary, and after the EIR and related land use entitlements were approved by the Castro Valley MAC (Municipal Advisory Council) and the Alameda County Planning Commission, several community members and labor representatives raised last minute concerns about parts of the EIR. Those opposed to the EIR certification claim that there was not an adequate assessment of the impact of any possible closure or change of services at San Leandro Hospital, despite the fact that the EIR consultant and County planning staff have stated that the EIR is complete and the issues around San Leandro Hospital, while not related to the project, have no impact on the project. Supervisor Nate Miley made a motion for the Board to meet again to make the decision on June 9, 2009, which would provide attorneys for Alameda County an opportunity to examine these claims in more detail.

Supervisors Miley and Haggerty voiced their concerns about speakers making false or misleading allegations as a political tactic, in order to delay the EIR approval process, thereby “holding the Sutter Medical Center Castro Valley project for ransom,” which he and the other Supervisors warned could endanger the future of both Eden and San Leandro Hospitals. While there has been no decision by Sutter Health or the District on the future of San Leandro Hospital, the issue remains a topic of community discussion.

Eden Medical Center President & CEO George Bischalaney and other Sutter and Eden project team members emphasized the urgency of not going beyond June 9th to approve the EIR, as the delay of even a month could significantly hold up construction and may cause Sutter Health to withdraw its support from both hospitals. Sutter Health has already promised the $320 million to pay for the completion of the new Sutter Medical Center Castro Valley.

At the conclusion of the May 12th meeting, the four Supervisors present, with Supervisor Keith Carson absent, voiced their support for the new hospital project and the need to rebuild Eden Medical Center. They also are concerned about the future of San Leandro Hospital, and that concerns over San Leandro should perhaps be discussed in another forum, unrelated to the land use entitlements for Eden.

As our project team discussed in previous articles and blog posts and at the hearing, any delays in approvals and construction have serious repercussions, in terms of meeting state deadlines to rebuild, in creating a safe environment for patients and staff, and in funding this major project. The new hospital must be rebuilt, or it will close as an acute care facility effective January 1, 2013. We now have before us a fully funded hospital project—without public funding or taxes—that will secure the future of Eden Medical Center, preserve jobs and bring nearly 1,000 construction jobs to the region at a time when the economy is depressed and construction is drying up.

As I stated before, the issues around San Leandro Hospital are complex and important.  The community has a right to know what is happening. But the information being discussed now is no different that it has been for the past several years: the hospital is struggling and must be reinvented to bring value to the community and ensure that it can sustain itself over time.  It is clear to me that the residents of San Leandro desire a full service community hospital, yet the majority of them will never use it. The community and local elected officials have known that this is a concern, and yet this last minute effort to stop the EIR based on what some claim to be “new information” is not justified. San Leandro Hospital, its employees, physicians and patients need to be part of the solution for the hospital, to be discussed in its own forum with regional providers who can bring truth and substance to the discussion.  It should not be used as a political maneuver to stop Sutter Health from rebuilding Eden.

Please speak up, let our Board of Supervisors know they must not delay any further.  These delays put both hospitals in jeopardy. I encourage you to stand up and let your voice be heard on this issue.  Don’t just wait for the next hearing, but instead pick up the phone or send a letter to the Board and let them know you support the new hospital project, and encourage them to certify the EIR so the project can move forward before it’s too late.

Call today!

Supervisor Nate Miley — 510-272-6694

Supervisor Alice Lai-Bitker — 510-272-6693

Supervisor Gail Steele — 510-272-6692

Supervisor Keith Carson — 510-272-6695

Supervisor Scott Haggerty — 510-272-6691

By Cassandra Clark, Project Communications Director

YOUR HELP IS NEEDED!

We are only a week away from the Alameda County Board of Supervisors hearing in which the Board will consider the Final Environmental Impact Report, zoning changes, and Castro Valley general plan changes. We are asking for your support at this critical step.

Local groups and some residents of San Leandro are applying fierce political pressure on the Board members to deny approval. Their reason? The future of San Leandro Hospital is unknown, and therefore they are pressuring the Board of Supervisors to require Sutter Health to keep San Leandro Hospital open as a condition of approving the land use for the new hospital in Castro Valley.

What wrong with this?  First of all, the Board of Supervisors are not voting on the future of San Leandro Hospital—they are having a public hearing on the land use entitlements and certifying the EIR. To delay or deny approval based on pressure about San Leandro is wrong.

The future of San Leandro Hospital is not and should not be tied to the new hospital. Indeed, San Leandro Hospital is a critical issue that must be addressed—and it requires a regional solution, more careful planning, and a separate focus than this project.  It’s an important issue that cannot be overlooked, for the sake of the staff, physicians and patients. But the complex issues at one hospital should not be tied to the land use entitlements for the new hospital project.

Simply stated, by delaying plans for the new hospital, the Board will jeopardize the future of Eden AND San Leandro hospitals.

I am asking you to attend the Board of Supervisors meeting on May 12 and SPEAK UP in favor of our new hospital. Speakers are limited to 3 minutes, but a simple 30-second statement is powerful. The Board needs to know that residents of Castro Valley and surrounding communities want and need this new hospital, without delays.

Meeting details:

Tuesday, May 12
1:00 p.m.

Board of Supervisors Meeting Chambers
1221 Oak Street, Oakland

If you cannot attend the meeting, we need to you to contact the Alameda County Board of Supervisors and have you voice your opinion. It is so important that the Board hears from everyone, especially since the majority of people in our community support this project (an astounding 80% of community members are in favor according to recent polls!).

Call your Supervisors today!

Supervisor Nate Miley — 510-272-6694

Supervisor Alice Lai-Bitker — 510-272-6693

Supervisor Gail Steele — 510-272-6692

Supervisor Keith Carson — 510-272-6695

Supervisor Scott Haggerty — 510-272-6691

Thank you for your continued support!

As always, we also appreciate your comments and questions on this blog, and we’ll respond as quickly as possible.

Main Entrance at Twilight

The new Sutter Medical Center Castro Valley, which will replace Eden Hospital.

By Digby Christian, Project Team Leader

We are proud to tell you that on April 7, 2009, the Sutter Medical Center Castro Valley (SMCCV) project team received the 2008 FIATECH CETI Award at the award gala held in Las Vegas.

FIATECH is an industry consortium within the building industry. Its primary mission is to get all the “players” involved in capital projects to adopt new ways of thinking and new technologies to deliver higher value for the funders and end-users of construction projects.

Here is why our team won the award…

As most of our readers know, California’s deadline for retrofitting or building earthquake-proof hospitals from scratch is 2013, less than four years from now. The hospital project in its current form was validated as viable in August 2007, and design work was authorized to start in October of that year, leaving us just over five years to have the building be ready and open for business. Typically, in California, it takes at least seven years for a project of this magnitude.

So the team had to throw out all historical concepts of how design is done and come together as a wide-ranging, multi-company team involving the owner, the designers and the builders, and transform the design and construction process to drive two years out of the schedule. The team is now on track to achieve just that and did it primarily by redesigning the design process in a rigorous and unrelenting fashion, so that it no longer bears any real resemblance to tradition!

If you are familiar with the classic design process, you’ll know that it’s typically abbreviated as “SD-DD-CD”: Schematic Design (broad concepts typically discussed and agreed to by the owner and the architect exclusively); Design Development (often a General Contractor might have some involvement in this); and Construction Drawings (some trades might be brought on board to inform how these are put together). Then, the work goes out to the building community and those companies develop what are known as Shop Drawings. These drawings show in detail how every little and large item in the building will be fabricated, i.e., the structural elements, including steel, metal, glass, concrete, etc.

On the SMCCV project, all of the people who typically are brought in at the end are already on board, and most of them have been on board since August 2007. By the time this project completes its approval process through the County and State we will already be at the Shop Drawing stage. The building is being designed for fabrication now, while the design approval process is underway.

While this concept has been discussed for the last few years within the industry, and parts of the above have been implemented on other projects, no project has implemented this concept as broadly and as deeply as the SMCCV project; certainly not on a project this large and this complex. It is one of the reasons our project won the FIATECH award!

The other primary reason we won the award is because of how thoroughly the building has been designed in three dimensions (as opposed to the typical two dimensional paper drawings we are used to seeing). There are many very attractive shots of 3D design that you can find on websites, and in trade magazines but you can’t tell if the designs are any good—all you know is they look “cool.” But on the SMCCV project, we bring the entire team together at least every two weeks to work through the coordination effort. It’s painstaking and difficult, but utterly critical to a successful outcome in a shorter timeframe.

What is not often understood outside the industry, and to some extent even within the industry, is that different design disciplines use different software, and they can’t see each other’s work in real time while they are designing. Each company has to either import a converted file of each other’s work or send both files to a third package, such as Autodesk Navisworks, to see both designs at the same time. So it’s all too easy to have a poorly coordinated, unbuildable, three dimensional design—no different in fact than having a poorly coordinated, unbuildable, two dimensional design.

In addition, we have focused the team on the larger goal of designing for fabrication rather than the industry convention of designing to produce the construction documentation, which is then coordinated by the construction team. The team’s goal to design for fabrication means we are swimming against the tide. We are allowing our companies to each use their own best-in-class software and then developing a process that allows a high level of coordination and constructability to ensure that what is being designed is actually what we will build.

The above might seem dry and technical; however, by a) having a multi-company team involving all the construction trades from day one; b) throwing out the baggage of a poor design process and starting from scratch to build a better one; and c) having a goal of designing for fabrication will allow us to build a new hospital on schedule, within budget, and without any last minute compromises on the finished product.

On the Sutter Medical Center Castro Valley project, we are breaking new ground ahead of any other project in the country in the way such projects are handled. That, in essence is the reason why the team that is building your hospital won the 2008 FIATECH CETI Award.

In addition to the Sutter Health project team, I want to personally thank The Devenney Group, DPR Construction, Capital Engineering, The Engineering Enterprise, TMAD Taylor & Gaines, GHAFARI Associates, J W McClenahan, Morrow Meadows, Superior Air Handling, MPS Project Management, Navigant Consulting, Greenwood & Moore Engineering, Herrick Steel, Otis Elevators, Strategic Project Solutions, Royal Glass, Clark Pacific, Candela, Sparling, and numerous other specialty trade vendors for making it possible to receive this award—and to meet our 2013 deadline!

For all you construction buffs, or for anyone who is interested, check out FIATECH at http://www.fiatech.org/.

I welcome your questions and comments!

revised-rendering-1-1.jpg
Main Entrance at Twilight

 

 

 

 

 

 

 

 

 

 

 

We’re hosting another Community Open House on Wednesday night, March 18th, from 7:00-8:30 p.m., at the Eden Hospital Conference Center, 20103 Lake Chabot Road, in Castro Valley, California. You’ll be able to see more of the architectural renderings of the beautiful new Sutter Medical Center Castro Valley and get an update on our progress. You’ll learn more about the proposed schedule for construction, and get answers to your questions and concerns. We’ll be serving refreshments, and members of our project team will be available to talk with you. We look forward to seeing you there!

You can also stay informed by reading this blog regularly, especially if you subscribe by email or RSS feed. Just click on the orange RSS icon on the right side of the blue bar above for simple subscription instructions.

If you’re on Twitter, Facebook, LinkedIn, YouTube, FriendFeed, or other social networks, you’re invited to connect with us online. The links to our social network communities are in the right side bar. Our blog is also now featured in Alltop, in the Health section!

Please let us know if you’re a member of another online neighborhood, health care or business network that members of our project team might join to discuss plans for the new medical center. We would be glad to participate!

Jeff Moore

By Jeff Moore, Co-Owner, Greenwood & Moore, Inc., Civil Engineering

Many of you may be wondering why we chose the existing site of Eden Medical Center to build the replacement hospital. In Chapter V of the Environmental Impact Report, the project architect and environmental impact report consultant (ESA) prepared and analyzed alternative sites and concluded that 20103 Lake Chabot Road was still the best choice for building Sutter Medical Center Castro Valley, an affiliate of Sutter Health.

However, building a new hospital next to an existing one presents some interesting challenges. The construction and design teams had to come up with a multi-phased approach to building the medical campus while keeping the existing Eden Medical Center in full operation. The construction of the hospital is to occur in seven main phases. So, it is necessary to provide seven sets of civil construction drawings where one set is normally provided!

For example, phase one begins with the demolition of the Pine Cone Apartments at 20004 Stanton Street, and four existing medical office buildings located next door to Eden. Right now, we have no access to portions of the site because certain structures are in the way. Demolition of existing buildings is a logical and intuitive start to the construction process.

Phase two consists of what is referred to as “make ready” work. This is work that must be completed before construction on the main hospital can even begin. A good example of “make ready” work is the relocation of the existing helistop (helicopter landing pad, used for the emergency transport of trauma patients). The existing helistop is located next to the new hospital. Helicopters cannot land safely at the existing helistop location during construction of the new hospital. Therefore, the helistop must be moved just 150 feet before work can start on the new hospital. In order to move the new helistop, we need to level a hill, provide drainage, provide flight path clearance, ensure adequate lighting, etc. And remember, full access to the new or existing helistop must be maintained at all times during the construction process!

Other types of “make ready” work include:

- Construction of a large retaining wall to surround a portion of the site. The wall supports a critical roadway around the new hospital site.
- Construction of a temporary path from the new helistop to the existing Eden Trauma Center so that patients can have access to the existing Trauma Center
- Build a new bridge from the new road to the existing parking garage (where handicap parking will be relocated during construction)
- Finally, demolition of the current helistop.

These are just a few examples of “make ready” work that will need to be performed. As you can see, it can get pretty complicated. The need for significant construction phasing is what creates a lot of the site design complexity.

We estimate that phases one and two will take six to eight months to complete! Hospital construction can begin in earnest upon completion of the “make ready” work.

Where are all the pipes & wires?!

Even more complex than all the preparation to erect the new hospital is figuring out where all the underground utilities are. We’re talking about 50-plus years of modifications of pipes, wires and sewers, some of which have been abandoned and no one knows exactly where they are. The contractor needs to know where all critical utilities are located so they can abandon or re-route them to fit the needs of the new construction. In order to locate them, the contractor needs to “pothole” (dig them up) to make sure that they are located where we think they are. This is an expensive and time-consuming process. We’ll also have to build a temporary storm drain system to capture rainwater during construction. The final storm drain system will not be completed until 2012, with the completion of the new hospital.

Taking Down Eden—It’s Not a Quick Good-Bye!

Demolishing the existing hospital—a process we call deconstruction because of the selective, targeted work involved and the recycling process—won’t take place until the new hospital is up and running and all patients have been safely transferred. Since the main entrance road to the new hospital is just ten feet away from the existing hospital building we can’t exactly get in there with a wrecking ball or explosives! So special safety precautions will be provided by the contractor to ensure that the hospital is removed safely and efficiently. We are all concerned about getting things done safely, so deconstruction will be slow and methodical over a six month period.

Being in compliance with environmental safety laws also presents challenges during deconstruction. Eden’s ripe old age means that there will be a certain amount of hazardous material that needs to be removed and properly disposed of before demolition and recycling of the old materials can begin.

North View When the deconstruction is finally completed, the bottom basement floor will most likely be left in place (to save money) and stay intact since it will be located underground. So you could say, a little bit of Eden will remain forever!

If you have any questions, concerns or comments, please feel free to leave them in the comment box below this post. (Click on the title of the post, and the comment box will appear below it.) We will respond as quickly as possible. We want to hear from you.

Main Entrance By Bryan Daylor, Vice President of Ancillary and Support Services at Eden Medical Center

My name is Bryan Daylor, and I am Vice President of Ancillary and Support Services at Eden Medical Center. I’m also on the “user” team that has had significant input on the design of the new Sutter Medical Center Castro Valley. Those of us who head up different functional areas at Eden worked collaboratively with our respective teams (consisting of managers, supervisors, staff and physicians) to determine the best way to improve the delivery of patient care in the new hospital by implementing industry “Best Practices.”

Our focus is on patient safety and quality of care, efficient patient flow and effective use of skilled resources. This work was an important opportunity to design a building that supports the process of care and enhances the experience for patients and caregivers. We were challenged with the puzzle of creating work space and flow in a new building, but in the end we feel we have achieved an excellent design for the new hospital.

It’s noteworthy that the replacement hospital for Eden will serve as a prototype for “best practices” operating models to be deployed to other Sutter Health affiliates that are building new hospitals of similar size and scope.

In the beginning…

When our user teams initially convened, the project size and scope had already been defined. We were challenged to look at how we do things today, and then be creative in how we could design this building to improve they way we provide care in the future. Some of the key goals of these teams were to look at quality and safety of care, efficiency for providers and an enhanced experience for the patient. All of these concepts had to be balanced with ways to drive down the operational cost of the hospital—hence efficiency! We looked at things like distances traveled by providers, adjacency of departments and services that work together, etc.

Acting as stewards of already-scarce resources, we decided that the hospital building would be designed for predominately clinical and direct patient care services, while almost all administrative functions would be housed in the adjoining medical office building. Hospital space costs more than twice that of regular medical office space to build and operate. So, our goal was to maximize clinical areas within the hospital and minimize the administrative functions. With the convenience of the connecting medical office building, placing the administrative services there helped us meet our budget goals without compromising the project or the future operations of the organization.

We deployed twelve different teams representing the various functional areas of the hospital, each looking at their role along the patient continuum of care and planning the layout of the hospital to support the care process. The user group contributed a wealth of knowledge that was invaluable to the development of the design of functional spaces for patient care.

Staff from all functional areas, including nursing, interventional services (surgery), sterile processing, radiology and imaging, women’s health, emergency and trauma, cardio-diagnostic testing, therapeutics, pharmacy, laboratory, and support services such as plant operations, facilities, food service, housekeeping and shipping & receiving, worked on the design of their respective units and then determined which services fit together. Efficient processing, and patient flow and experience, were key factors considered in these collaborative design sessions. Physicians from the emergency department, surgery, medicine, obstetrics and radiology also participated in the design discussions to ensure the efficiency of their part of the care process.

We worked with architects from The Devenney Group on the rough design of these areas, examining the most effective alternatives for organizing these services with consideration of services that are complementary to one another. The teams worked through several iterations of plans, building on the previous ideas and concepts from team members. The architects revised these layouts several times in draft form before a final schematic design was reached. This collaborative approach brought together years of healthcare delivery experience, as well as years of hospital and operational design experience to result in an efficient and aesthetically pleasing design that met Sutter Health’s project and budget goals.

The management team and physicians are proud of the work they have done and are excited to be a part of building the health care services of the future. Please feel free to comment here, or email me if you have any questions about the internal layout of the new medical center.

Neighbors and Community Members at October 22, 2008 Launch Event

Neighbors and Community Members at October 22, 2008 Launch Event

By Cassandra Clark, Project Communications Director

On October 22, 2008, we invited the community—and particularly the neighbors—around Eden Medical Center to come to the hospital to learn about the new Sutter Medical Center Castro Valley project. We had representatives from the hospital, Devenney Group (the architectural team), Sutter Health, the social media team, and others available to meet our neighbors, hear their feedback and answer their questions. We’ll be posting video clips from the event in the next few days, so keep an eye on our Video Gallery and the featured video box in the right sidebar.

The good news was that the project was well-received, with high praise for the design and sensitivity to the community. We had great questions asked of us, and excellent comments for us to consider as we move ahead (regarding traffic patterns, noise abatement and other important concerns). While we had a very active and interested audience, we hope even more people in the community will join us at future events we plan to host in the coming year. Keep reading this blog, because we’ll announce upcoming community events here.

We realize that people are very busy, and going to the hospital isn’t something most people like to do even when they are healthy! So, we plan to take our presentation on the road, attending events and meetings to hear what folks have to say. We’ll post any future meeting dates and times in our News Room. And, of course, we will use this new blog site to reach a much wider audience, particularly those who live in our community who may not otherwise get involved.

There is a misperception that the people in Castro Valley, San Leandro, Hayward and beyond are not too familiar with social networks, blogs and all the new ways to communicate with each other over the Internet. I hope to change that perception by grabbing new readers and subscribers in our area and far beyond.

So, think of this site as our community meeting. Stay informed. Subscribe to this blog to get regular updates by email or RSS feed. Tell us what you think by commenting on individual posts. Together, we have a great opportunity to shape the future of our medical center.

Digby Christian

Digby Christian

By Digby Christian, Senior Project Manager for Facility Planning & Development

My name is Digby—which tends to be a name that people remember and depending on the context that can be a good or a bad thing. There is probably no escaping the fact that people close to this project will have a hard time forgetting that the project manager’s name was Digby and he had a bit of a British accent.

I am the Senior Project Manager for Facility Planning & Development at Sutter Health.

For the Sutter Medical Center Castro Valley project, I am what’s known as the “Owner’s Representative Project Manager,” which means, for my sins, I have day to day responsibility for ensuring that the project:

1) Provides a best-in-class level clinical care concept for absolutely every function required in the acute care setting, as well as the physical design of the buildings (Scope!)
2) Opens for business on January 1, 2013 (Schedule!)
3) Costs not a penny more than the $320 million dollars that have been allocated by Sutter Health. (Budget!)

It’s an interesting balancing act…

While the estimate for the project may evoke responses from the community like, “Costs not a penny more than the, what? Three hundred and twenty MILLION dollars, are you kidding? WOW!” All I can say in reaction are two things:

1) Hospitals are incredibly complex buildings, (you might think your iPhone is complicated but let me tell you, it’s nothing compared to a hospital), built in a way that complies with 10,000 county, state and federal building codes and licensing regulations … building an incredibly complex building that is a half-mile from an earthquake fault-line considered to be “Most Likely to Fail” years and years in a row. So we must build it very very very carefully and very very very well. And that takes a lot of things, but one of them is definitely money.
And…
2) It’s not nearly as much as $700 Billion, and despite that, once it’s spent, you’ll actually have something really nice (and big) to point to and say “oh, so that’s where the money went!”

The $320M is the full cost of the project, fully escalated out to 2013. As well as the new hospital, it covers the cost of the furniture, most of the medical equipment, all of the finishes and all of the exterior landscaping, and the cost of deconstructing and where possible re-using the material of Eden Medical Center. It does not cover the cost of moving everyone from the old hospital to the new, it does not cover the cost of the medical office building.

All three of the overarching goals (Scope; Schedule; Budget) can be problematic for large-scale construction projects. It’s a regrettable fact of life that such projects are typically late, over budget and provide less than what was asked for at the outset.

It is meeting all three goals simultaneously that is my central challenge on this project. Sutter Health has brought together an astonishingly skilled and experienced team of design and construction professionals to allow such a complex building to be designed.

I have no role to play in telling such a team what air conditioning system to pick, what kind of computer cable to run, what the floors need to look like. That is not my role. My role is to assist the team in figuring out how to work together as a fully integrated single team that has the same primary goals of Sutter Health (which I handily summarized above). In doing so I work with the team to pick such diverse beasts as data cabling, ceiling tiles, air handlers, pneumatic tube system, trauma elevators, patient lift system, light fixtures, hi-efficiency windows, CT Scanners, clinical flow efficiencies and on and on so that the primary goals are met. Construction is not a business-as-usual kind of business, let alone healthcare construction.

In the next post I’ll say more about what is so fundamentally groundbreaking about the way in which this project is being designed, and will be constructed. Here’s a preview: one of the interesting techniques that has been brought to bear on this project is keeping the team focused on what’s important, i.e., why do you want this building; what do you want it to do…then having the team figure out what will be needed to meet the goals. This is a very efficient way of keeping a team focused on what’s important, and frankly, oftentimes, to keep me, “the owner” from meddling in stuff I really shouldn’t.

Please ask me questions about construction, design, project management or anything else you think I might be able to answer. Or what you’d like me to blog about. I’d really like to hear from you!


The Future Site. A rendering of the future campus once the new hospital is open and the old building is removed.


Eden Hospital in 1954. The original hospital opened on November 14, 1954 at a total construction cost of $2.9 million


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