Florida Hospital Waterman

Brasfield & Gorrie is Three Months Ahead of Schedule on $76 Million Contract

By Scott Judy

Florida's healthcare construction boom can be seen from one end of the state to the other, and seemingly everywhere in between. In rural-but-rapidly growing Lake County, for example, one of the state's leading health-care contractors, Brasfield & Gorrie, is ahead of schedule on its $76 million Florida Hospital Waterman Tavares Replacement Facility contract in Tavares. With an overall cost of roughly $129 million, this project is proof positive that Florida's health-care providers are serious about meeting the very real needs the state has for improved, expanded and additional health-care facilities, no matter where they may arise.

Lake County, emblematic of a simpler, more rural life that some Floridians are discovering, is definitely showing an increased need for health-care services. Peyton Robertson, who's been working as Brasfield & Gorrie's senior project manager at the Tavares facility for about two years now, described the area's growth as "berserk."

By later this year, the area's residents should have a fully modern hospital at their disposal. In fact, Robertson, who's been building hospitals for about 10 years now, said of his latest project: "You'd have a hard time categorizing it as anything but state-of-the-art."

The hospital should be able to handle Lake County's emerging needs without a problem.

It will feature dedicated orthopedic operating rooms, as well as two other operating rooms set for general surgery, with cardiac-care capabilities being built into these two ORs. The project team has installed two catheterization labs, and a nearly fully automated laboratory - operated through computers, robotics and just two technicians - is being built in the facility's 80,000-sq.-ft. basement. Three nuclear-imaging rooms will be installed, with patients able to choose between an open or closed MRI.

"Some of the fastest CT scanners available are being purchased for the project," said Robertson. He added that the replacement facility's emergency room is designed to handle approximately 50,000 visits per year, with further expansion capability built into the design. Such expansion is also being built into the six-story bed tower, which is currently being built out to the fifth floor only.

Additionally, Brasfield & Gorrie is building a stand-alone cancer center at the front of the hospital, under a separate contract with Florida Hospital.

The Tavares project is actually being built as a replacement facility for a hospital in the neighboring town of Eustis. It involves the renovation of an existing medical office plaza and 430,000 sq. ft. of new construction. When complete, it will provide 204 beds for now, with an additional 60 whenever the owner moves to build out the ready-to-go sixth floor.

Brasfield & Gorrie started work in September 2000 with the construction of a new 450-car parking lot, as well as the relocation of the existing energy plant. Foundation work began in February of 2001, and by July the team received authorization from the Agency for Health Care Administration - the state agency that oversees all health-care projects - to go vertical.

On July 27, this work started with the construction of the first elevated decks and the columns at the slab-on-grade. By February 2002 - about four weeks faster than expected - the team had topped out the new structure. Brasfield & Gorrie achieved this mostly by using some overtime and working longer hours.

The new facility is mostly a skip-joist, poured-in-place concrete structure, with three mechanical penthouses built of structural steel on top. Brasfield & Gorrie also built a two-story lobby that serves as the entrance to the hospital and connects the renovated and new structures. The interior portion of this space is built of structural steel, much of which will remain exposed upon completion.

A tensile-fabric structure, designed and supplied by New York-based BirdAir, will cover this atrium area, sloping from above the lobby area down and out to serve as a canopy for the main drive-up entrance. Another, smaller tensile-fabric structure performs similar duty at the ER/ambulatory entrance.

The new building's exterior consists of structural studs and stucco with ribbon windows in the bed tower. This was a main focus for the project team.

Per AHCA building requirements for all state health-care facilities, this project had to meet Miami-Dade County hurricane and wind-storm standards for airborne missiles. This meant that Dade County had to review and approve the ability of the project's window system to stand up to airborne missiles. AHCA mandates this requirement because of its findings that many of the facilities that failed during Hurricane Andrew did so because of the loss of window systems or openings in walls and roofs.

"That's a very long process," Robertson said of the approval. For that reason, Brasfield & Gorrie released this part of the project in one of its first packages.

It's also expensive. For these reasons, Brasfield & Gorrie opted to obtain a project-specific Notice Of Acceptance from Miami-Dade County. This required less testing than for a non-project-specific NOA. To reduce testing costs further, the team minimized the number of different window systems to three.

Crawford Tracey Corp., Fort Lauderdale, served as a consultant for the initial design stage, and also engineered and constructed the final window systems, using Viracon glass for the entirety of the project. The contractor chose the Fort Lauderdale firm because of its extensive experience with the Dade County code.

Test samples were then sent to American Testing Laboratories for third-party testing. This involved shooting numerous objects at the prototype models, including large wood items, as well as radically altering the testing environment's air pressure. These results, and their videotaped documentation, were then sent to Miami-Dade County.

Because of the project's aggressive schedule, the team actually began fabrication prior to receiving a Dade County NOA. Though done at risk, Brasfield & Gorrie opted to move forward only when it became confident they would receive the NOA.

"Crawford Tracey was very confident [of] their testing and their knowledge of Dade County as what was going to be required," Robertson said. As it worked out, the systems were approved as is, and the team obtained the NOA in May 2002 - within one week of the original schedule.

The architectural firms of Jonathan Bailey & Associates and FDS Architects, two Dallas-based firms working as a joint venture, designed the rather unique circular layout of the patient rooms, which puts nurse stations and patient rooms closer together, and minimizes the number of necessary hospital staff. (RTKL Associates, Dallas, later acquired FDS and then took over as project architect.)

On standard floors, there are 60 private rooms per patient floor, or 30 rooms per side. Pie-shaped, the rooms are clustered into three 10-bed sections, forming a semi-circle. Robertson said this layout was challenging, because of the attention to detail required.

"The layout of the rooms was not extremely difficult," he said, "just different than your standard square rooms where you're trying to run square ductwork and other things that are generally much more easily fabricated in square manners - running down hallways and turning sideways and that kind of thing. Nothing extraordinarily difficult, but not as simple as a square building, which is a more common feature of health care."

The segmenting of all of the bed tower slab edges to match the segmenting of the windows and the stucco panels was one challenging area, Robertson said.

"Just a little more attention to detail is required than would be on a square building," he said. "There's no room for forgiveness if you're off in one of the areas. You can't make it up somewhere else. All of your tolerances have to be taken up in each segment going around each cloverleaf."

Overall, Robertson said, "We've had only minimal instances where slab edges had to be adjusted to allow for the tolerances. The construction of the bed tower … went substantially without incident."

Getting several key trades involved prior to the completion of construction documents allowed the team to avoid many problems. One example of this was the placement of the kitchen's air-handling units. Originally destined for a mechanical penthouse above the emergency room, the Harper Mechanical staff suggested creating a mechanical room in the basement, adjacent to the kitchen, and placing them there.

"Due to the amount of rough-ins necessary to build a code-compliant ER, there's not a lot of access above ceiling space," Robertson explained. "It would have been extremely difficult, if not impossible, to get the major ductwork … off of these air-handling units down to the kitchen. There wouldn't have been room above ceiling for the ductwork.

"By being able to move that unit downstairs and create a mechanical room, we saved on ductwork," Robertson continued. Additionally, this caused almost no increase in cost, due to the ability to downsize the ER-area mechanical penthouse.

Robertson credited such subcontractor involvement for the overall success of the project to date.

"We've been blessed with a very strong electrical, mechanical, plumbing and drywall team on our job site," he said. "Those contractors alone are almost half the project. Without that kind of support, it is difficult to succeed, if not impossible."

The project is scheduled for completion in April 2003.