For the design and construction team of the $700-million Kaiser Fontana replacement hospital project, a major occupational hazard faced daily is a severe sense of d�j� vu.

That�s because the 314-bed hospital and accompanying facilities are being built by the exact same team � general contractor McCarthy Building Cos. of Newport Beach and construction administrator HMC Architects of Ontario � that built Kaiser Permanente�s Downey Medical Center in 2009.

Those firms were so successful with the earlier project, saving their client $46 million in construction costs and finishing three months ahead of schedule, that Kaiser chose to use them again for the Fontana complex.

As designed by HMC, the project includes a 490,000-sq-ft, seven-level hospital building featuring a plaster and curtain wall exterior and structural braced-frame core; a 50,000-sq-ft support building; a member and doctor parking lot; and a 23,000-sq-ft central utility plant. The medical center will bring to the region a cardiac surgery department, in-patient dialysis unit, 51-bed emergency department, ICU, labor and delivery department, pediatric and neonatal ICUs and surgery components.

Workers broke ground on the project in May. Although construction is expected to continue through October 2012, officials say McCarthy and HMC have already saved Kaiser more than $30 million and 20 months in build time.

A good portion of the time and dollar savings, says McCarthy Project Manager Lucy Villanueva, can be attributed to the tightly knit crews� efficiency in responding to challenges.

�I think all of us understand the importance of timely decision-making, and how it benefits us all as a team,� Villanueva says. �A lot of people think OSHPD [the Office of Statewide Health Planning and Development] is a big obstacle in completing a hospital project, but if everybody is on board and brings a team environment to completing the job, it�s not.�

As an example of efficient decision-making, Villanueva cites how the design and construction team deals with that most sinister of potential budget killers: change orders.

�The team approach to change orders is key,� she says. �If change orders are issued in a timely manner, docs are reviewed and distributed in a timely manner and crews are able to capture the changes during productions.�

Since change orders usually involve additional work and can often prove costly, a lack of trust between design and construction firms can result in angry recriminations and sometimes even work stoppages. A particularly harsh example of that took place three years ago in nearby Riverside, where more than 550 change orders issued by Caltrans over its 60-91-215 Freeway Interchange project resulted in contractor Washington-Obayashi Corp. first demanding additional compensation and then halting work for three costly weeks when it didn�t receive it.

Having a chance to develop good relationships with his construction-side counterparts at McCarthy has allowed HMC Senior Construction Administrator Jim Rosa to quickly learn � in his own words � that �contractors aren�t crooks.�

�We learn the value of trust and mutual respect � that�s zenith for me,� says Rosa. �They�re good people who want to do a good job. I�ve been in this business for 30-something years, and I know that meetings with the owners and contractors are typically the worst days of the week. But on this project and the Downey one, ours has historically been of the most delightful days of the week.

�I deal with change-order costs, and my meetings with McCarthy over Requests for Costs are always very friendly � not argumentative, not loud, as they�d be at a lot of other projects,� he continues. �If McCarthy finds issue with some docs, they�ll come directly to me. They give us the heads-up, we give them the heads-up. There�s lots of respect. That�s because we�ve had the exact same team now going on five years.�