The owner’s desire to synchronize the expansion with a major remodeling of its original 1960 patient tower on its main hospital campus in downtown Albuquerque drove the construction plan. This meant the new beds at the Rio Rancho campus were needed as quickly as possible.
To meet the tight schedule, McCarthy coordinated the drawings using building information modeling (BIM) and some aspects of lean construction.
“We are able to build the model and coordinate in real time as well as take the model into the field on iPad tablets to verify installations,” says Ford.
In the tower, three floors of patient rooms will be built out, and two levels of shell will accommodate the final 48 beds as needed. On the first floor of the tower, a 21,500-sq-ft cancer center houses a linear accelerator and space for a second unit. The linear accelerators have concrete walls and roofs, made from high-density aggregate, as thick as 6 ft.
D/P/S modeled the square-in-plan patient towers to ensure proper alignment of all the elements. “Without BIM, it would have become very difficult to visualize how these would all come together easily,” Laur adds.
“From the functional perspective, we wanted to keep the public and transport elevators in the same core but separate their user-access paths,” he says.
Modeling helped with plugging in the new patient tower to the D&T. The original master plan arrangement provided that as each patient tower was added, a connection point for it was required at the “spine” in the D&T block.
“In response to this, a first-floor extended area, next to the emergency department, was constructed to facilitate the tower connection but not built out internally due to lack of current need,” Laur adds.
The plug-n-play concept should reduce challenges, says Eric Cornish, Presbyterian real estate and development project manager. “With power and other mechanical and plumbing infrastructure valved and sized for projected expansion, shutdowns that impact current operations should be reduced or eliminated,” he adds.
For example, existing electrical switchgear and distribution systems included provisions to add future generators and buildings as the campus grows, says Mike Dexter, mechanical engineer with Bridgers & Paxton Consulting Engineers.
“These same concepts were employed in [this expansion] to avoid disruption to existing facilities and implement a true plug-n-play concept,” he says.
McCarthy is using a lean construction goal-setting approach called pull planning. Under the approach, the team creates out a schedule by working back from the completion date for an element or a system. The idea is to ensure all team members are working together efficiently and as expeditiously as possible toward the same end.
“By using the pull-planning method, we are able to better plan manpower in areas, discuss predecessors, keep and update on deliveries, reroute emergency vehicular and pedestrian traffic, ensure safety on an occupied campus and address an issue before it causes unnecessary delays and, most importantly, track milestones to ensure an on-time finish,” Ford says.
During an early pull-planning session, Bridgers & Paxton was told by facility personnel that high silica content in water was causing scaling in plumbing and kitchen equipment in the original buildings and causing some plumbing components to malfunction.
To solve the problem, “an innovative high-frequency water-conditioning device was installed as a test and proved beneficial in addressing these problems,” Dexter says. The expansion “implemented this solution on a wider scale.”
With an area population that is expected to double to almost 200,000 by 2035, a future third phase is planned. At build-out, Rust Medical Center will become a 300-bed facility with three towers.