One of MDA's goals was to get IR into a surgical environment. "From the building perspective and the longevity of imaging, we always try to design our spaces thinking not about today but about tomorrow," Sisolak says. "It's very hard with diagnostic imaging because things aren't changing incrementally, they're changing exponentially. Trying to forecast what the infrastructure requirements are is very challenging."
The team designed the building to accommodate emerging technologies such as PET/MR, even though the Pavilion isn't utilizing that technology yet, Sisolak says.
"In addition, the interstitial decks of the original structure were steel hung lightweight concrete. They give, they flex-you can walk on them and not disturb the occupants below unless the occupants below happen to have imaging microscopes or something like that which doesn't tolerate vibration at all," she says.
In the new structure, the interstitial decks were stiffened and designed as full slabs. This meant a much shallower floor-to-floor height on those floors, which will make maintenance challenging but will help in hanging the equipment, Sisolak explains.
"The imaging rooms were designed with slab depressions to give some flexibility for future imaging systems as well," Gomez adds.
The delays ultimately increased the project's cost. "It's probably been about a 4% increase overall," Sisolak says. "The whole project is $198 million, and that includes the new construction piece that we're talking about as well as renovation to our third and fifth floors. It's about a 50-50 split on the square footage, but the dollars are a little heavier on the new construction side."
MD Anderson chose design-build for the Pavilion. It has been using that delivery method on many of its projects lately, along with some CM at-risk, Sisolak says.
"One of the reasons I really love design-build is that single point of accountability from the owner's standpoint," she adds. "But I also like that the contractor and the architect are kind of forced to find creative solutions to problems."
Short Space, Tall Hurdles
The Pavilion "is located on the northeast corner of Bertner Avenue and Bates Street and will utilize the remainder of the unbuilt land on the main campus," explains Richard Rucksdashel, vice president at HKS's Houston office. That made site logistics incredibly constrained.
"Current challenges for the design-build team include locating and designing around multiple existing structural and civil restraints, connection to the two inpatient towers and understanding and crafting expansions on the existing surgery and imaging floors that would allow for continuous operation during construction," he adds.
To ensure hospital operations weren't interrupted, the contractor worked slowly, carefully and during off-hours when necessary. For the noisiest portions, "we would work 15 minutes on, 15 minutes off to minimize patient and staff disruption," Gomez adds.
Proactive scheduling combined with consistent communication between the contractor and clinical operations limited disruptions to patients and staff. All work plans were typically submitted 30 days out for coordination with the facilities, Gomez says.