Photos by Greg Aragon

At the $455-million Replacement Hospital project at Camp Pendleton (above), the design-build team has flexibility to design around complex medical equipment, such as MRI rooms (below).

The U.S. Navy's new $455-million Replacement Hospital project in Oceanside, Calif., is not only $100 million under budget and six months ahead of schedule but also one of the first major U.S. design-build projects of its kind to use a unique 100% turnkey equipment procurement process, according to the project team.

Clark/McCarthy Joint Venture is performing the design-build contract with full medical planning, including all equipment procurement, coordination, installation and training. "We are not aware of another major health-care facility where the same entity was responsible for design, construction and medical equipment all under the same contract umbrella," says Carlos Gonzalez, project director.

The turnkey delivery method is the reason for the project's cost and time savings, Gonzalez says. "It gave us full visibility into all of the equipment decisions, and we could then adapt when needed or provide good advice to our client about the consequences of making one decision versus another," he adds.

Located on 73 acres at Camp Pendleton, the 500,000-sq-ft hospital is scheduled to complete this December. It will contain 62 beds, 10 operating rooms, 26 emergency-room beds, 205 exam rooms and 200 procedure rooms.

Designed by Dallas-based HKS, the project will meet LEED Gold standards and features healing gardens, green roofs, expansive atriums for daylighting and a 170-kW photovoltaic system.

Combining design-build and medical planning "allows the project team to save time and work more efficiently," says Cmdr. Dude Underwood, the resident officer in charge of construction.

Underwood says design-build is "atypical" for Navy medical projects, but the client went with it because of time and money.

"As a Recovery Act project, we had a compressed schedule on the funds, which expire this September," he says. "And that time line was significantly shorter than we would have been able to deliver using a traditional deliver method." He estimates that, without using design-build, the project would have taken 18 months longer.

Because of the equipment procurement process, Underwood and Gonzalez say the hospital will be finished with less than 2% in change orders, accounting for a big part of the project's savings.

Gonzalez says the idea of the design-builder in charge of the procurement process is particularly useful when it comes to hospital areas such as MRI rooms, which can be the most complex to build.