The owner of Palomar Medical Center (PMC)—a 10-years-in-the-making, new-build project that cost just under $1 billion—has never been shy about its ambitions. When Escondido, Calif.-based Palomar Health (PH) realized that the state’s seismic upgrade requirements would have been cost-prohibitive to implement in the old PMC building, CEO Michael Covert took the opportunity to build not only a new facility, but a new organization.
“This was a chance to really look at evidence-based research and incorporate as many of the advances as we could find,” says Dr. David Tam, chief administrative officer of PH’s Pomerado Hospital and head of facilities maintenance and construction for the entire organization. “Michael’s goal was to build a new, technologically advanced hospital that would require our employees to reinvent how we deliver healthcare for the 21st century.”
The process of building the “hospital of the future” started with standard industry buzzwords—building information modeling (BIM), integrated project delivery (IPD), evidence-based design (EBD), and sustainability—that were then cranked to 11 on a massive scale. PH partnered with CO Architects (Los Angeles) and the San Diego office of DPR Construction, among others, to get the job done on this 288-bed, 740,000-square-foot hospital, which opened for business in August 2012.
Banking on BIM
The timing of the PMC project, says Tom Chessum, principal, CO Architects, “corresponded really well to the timing of BIM coming to a level of maturity where we could actually support a model of that size. The more we got into the capabilities of what BIM could offer in terms of efficiencies throughout construction, the more it seemed obvious to move to integrated project delivery.”
Though the PMC project team used a construction management multi-prime delivery method with separate contracts between PH and both the builder and designer, those contracts included provisions that function in an IPD fashion regarding relationship, risk, and incentives. Tam asserts, “It was the only way to go, in order to have the flexibility to make changes and have the entire construction and design team fully engaged.”
Operating with a budget of $956 million, the project team’s goal was to file for a temporary certificate of occupancy on April 9, 2012, with heads in beds on Aug.19. PH informed the project leaders that if PMC finished on time and on budget, the owner would split any contingency with everyone from the architect to the electrical contractor to the drywall and steel folks.
BIM was critical to the success of meeting that goal. Tam shares an example of how, after many meetings with the foremen out in the field, he learned that one of their biggest challenges was dealing with the time it took to get requests for information (RFI) through all the right channels. “So if they had a problem where a pipe didn’t look like it would fit, it took forever to get an RFI to the trailers, to the engineers and architects, then to the owner, and then all the way back down,” he explains.
The solution was to trick out a construction site job box with a computer, printer, and wireless, which key people would accompany out into the field on days when work was being done on decision-intensive, construction-intensive areas.
“So when the foreman says, ‘This pipe is going to interfere with that,’ we could take a look at it on the BIM model, realize he’s right, and then huddle together: ‘How do we correct that? Plumbers, what do you think? Electrical? Inspector of record, would you be OK if we did XYZ?’ And then we could print out the new spec right there,” Tam says.