The $88-million University of Arizona Cancer Center at Dignity Health St. Joseph’s Hospital and Medical Center in Phoenix provides a state-of-the-art treatment facility exemplifying a patient-centric design-build philosophy.

The project, which originated in 2010 but did not break ground until 2013, posed a strategic challenge for the design-build team as it had to coordinate with both owner/developer University of Arizona and tenant Dignity Health to ensure the final product met the needs of each department that would operate in the facility.

“A public owner and private entity conduct business differently,” says Blake Christian, Hensel Phelps project manager. “The private entity had 29 different departments that we had to coordinate with, so that was a significant challenge on the structural level.”

The design-build team overcame this hurdle by regularly coordinating with Dignity and University of Arizona staff and medical professionals, says Marcia Gruber-Page, vice president of oncology services for the center.

The economic downturn further complicated the project as the university decreased its initial $100-million budget to $74 million in 2012. The project team had to scale down the budget while still adhering to the inter-governmental agreement between the university and the city of Phoenix, which included the submission for permit within three months and start of construction in four months.

The design-build team cut the $26 million within three months by analyzing more than 160 value engineering items and by restacking, reprogramming and re-laying out the entire building. The team removed a sixth floor, took out a partial basement and added some space on Levels 1 and 2 by removing an atrium that went through part of the building and adding floors in.

Other changes included leaving the fifth floor unimproved, which reduced some administrative services that had been planned for that space.

“Because the building wasn’t starting up at 100% on Day 1, [and] because it had some planned growth in it, we were able to accommodate some of the administrative spaces dispersed throughout the remainder of the floors closer to their departments,” says Christian.

In the end, Hensel Phelps and ZGF reduced the square footage by roughly 9% without losing any of the scope or making significant changes to the envelope.

Four months after the initial budget reduction, Hensel Phelps began foundation work on the now 220,000-sq-ft facility.

Designers had patient experience in mind while designing the building, and in some cases looked past hospital norms. For instance, the radiology department occupies the first floor instead of being located in a basement because studies have shown that walking through a basement’s dark concrete maze can make cancer patients feel fearful, says Christian. Instead, the radiology room sits behind a 26,000-lb sliding shielding door located in a well-lit, bright space with wood and copper panels.

Chilling With BIM

The Cancer Center also utilizes chilled-beam technology rather than a traditional HVAC system; it was the largest chilled beam project in Phoenix at the time of construction. Overall, the project required 453 chilled beams.

Traditional HVAC requires large air-handling units to move air and deliver it to every floor. With chilled beams, the team was able to reduce the floor-to-duct pipes, perform less ductwork in attic space and reduce the height of the overall building. Subcontractor Bel-Aire Mechanical ran much smaller ducts and did not have to run very large supply ducts down shafts to floors and was able to do it with smaller air delivery systems.

From there, Hensel Phelps and subcontractors faced the challenge of delivering the facility on an accelerated time line while also making sure it met the extensive utility needs and many points of connection for the required medical equipment, including two linear accelerators.

“To be more successful, the end user has to pick and commit to those pieces of equipment early on so the designers can design in all of the utilities [and] then do BIM to coordinate all of utilities in advance of construction,” says Christian. “The end users did commit to equipment early on, and designers rapidly incorporated them in documents.”

BIM experience was also one criterion Hensel Phelps used when selecting contractors.

“I always say BIM is all or nothing, so you get what you give,” says Robert Dustman, senior project manager with Bel-Aire Mechanical. “We had all the trades interested in providing information to insert into the 3D model, because again you can’t really model what you don’t incorporate into the model. We had 100% trade participation, which is really a great feat on a project like this.”

In order to accommodate the unknowns of the equipment, Hensel Phelps reengineered the slab on grade to use macrofibers instead of conventional reinforcement so that when workers had to come back in and trench for underground utilities, they did not have to tear up the whole slab.

Safety Secured

The University of Arizona Cancer project also earned an award of merit for safety because of the team’s dedication to safe practices despite an expedited working schedule. The project had zero OSHA recordable incidents with no lost-time accidents in 602,210 total worker hours.

Overall site and worker safety was a major focus for the design-build team. Hensel Phelps held job-wide safety meetings on the first of every month for every person on site and also recognized individual workers with safety excellence awards.

“All of the contractors pulled together early in the project and decided that we would hold regular routine safety award recognition luncheons. Bel-Aire alone had well over 100,000 worker hours without a lost-time injury,” says Dustman.

With its own trades (which maxed out at around 40 at peak), Hensel Phelps held half-hour to hour-long safety training meetings every Monday. It also operated an internal safety training program that all craftworkers were required to go through, along with a mandatory two-hour safety orientation for all employees before they started work.

Every employee also had to sign off on an activity hazard analysis designed for their aspect of the project.

“What we saw is people learning how to do activities in a better way,” says Christian.

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