Case Study: Henry J. Carter Cost & Schedule Acceleration

Case Study: Schedule Acceleration A Deeper Look Healing spaces for specialty care takes expertise in planning and design, as well as a well-coordinated effort with a multitude of subconsultants and building trades. In the case of the Henry J. Carter Specialty Hospital & Nursing Facility, the well-coordinated effort extended into the development and management of a plan to accelerate the project completion to allow patient move-in 16 months ahead of the original schedule while maintaining the project budget.

New Beds in a Better Location LTACs and SNFs

CHALLENGE

On July 2, 2010, New York City Mayor, Michael Bloomberg, announced at the closing of North General Hospital that the building would continue to house critical health care services for the Harlem community and all of New York City. The New York City Health and Hospitals Corporation (NYCHHC) would be converting North General Hospital into a nursing care facility. Since the

A city block in Harlem, slated for a new 6-story and a renovated 7-story patient tower needed to move at an accelerated pace, maintain the original budget and be broken into 20 construction bid packages to facilitate long-lead item ordering.

SOLUTION

NYCHHC knew they would eventually move into North General, they contracted Manhattan Maintenance to minimally maintain and operate the building.

In April 2011, Array started visioning and design meetings to re-locate Coler-Goldwater Specialty Hospital and Nursing Facility from Manhattan’s Roosevelt Island to the Harlem area of New York City. The $285-million-dollar project would be divided into two stand-alone projects. The Long Term Acute Care Hospital with 201 beds would be located in the 270,000 square feet of renovation space, the former North General Hospital. The Skilled Nursing Facility with 164 beds would be located in an adjacent 185,000 square feet of new construction, previously the hospital’s parking lot.

In a tribute to Hank Carter, the founder and CEO of Wheelchair Charities, the NYCHHC Board of

A successful coupling of public funding and Integrated Project Delivery methods brought this 365-bed patient care facility to fruition in 28 months, allowing for the previous location to be developed into a technology hub.

Directors gave approval on June 28, 2012 to name the new facility the Henry J. Carter Specialty Hospital and Nursing Facility. The original completion date was scheduled for March 2015.

In December 2011, after the Coler-Goldwater project began, Cornell University and its partner, the Technion-Israel Institute of Technology, announced its new applied sciences and technology campus be built on the south end of Roosevelt Island, the location of Coler-Goldwater Specialty Hospital. Construction of the Cornell NYC Tech campus, announced to begin in 2014, required the demolition of the Specialty Hospital.

PAGE 2 | case study: cost and schedule acceleration \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\

Due to Coler-Goldwater’s expedited demolition date, the

release of information in bid packages, award of contract and start

completion and patient move dates were adjusted to November

of construction. Each project issued 13 early release packages,

2013, reducing the schedule by 16 months. To accomplish this

which included demolition, early MEP, structural, elevator, long

acceleration, the entire project team needed to re-evaluate the

lead MEP equipment, major medical equipment, exterior & core

project schedule and staffing, client expectations and budget.

and shell, LTAC lower & upper floors of the LTAC, architectural

The first step, model the project team to Integrated Project

finishes and furniture packages.

Delivery strategies, including collocation of team and incentive

The Client, Contractor and Design team spent a full day in a page-

program. The strategy of collocation was to implement full team

turn review of each package, incorporating any revisions prior to

collaboration with accelerated decision-making. This facilitated

final submission. The Client reviewed the packages for design

the ability to quickly identify questions or concerns, and define

intent and approval, and participated in the value management

agreement on solutions. The traditional documentation in RFI

discussions. The Contractor reviewed specific scope to confirm

response or revisions to construction documents, many times,

information matched expectations of bid packages and made

followed the completed installation.

recommendations on value management. When the bids were

The second step, streamline the schedule. One time-saving method completely eliminated the design development phase.

For this to be successful, several full-team strategy meetings were held, including a team page-turn review of contract

returned, the design team and consultants reviewed to confirm that scope was correctly included, as well as evaluate any additional value management opportunities.

documents to evaluate design, details, material availability and

Array performed admirably and all of the

possible value management prior to final submission. The client

employees were true team players and each

was instrumental in keeping to the schedule and making quick decisions related to operational issues and building functionality.

The third step divided the two projects into multiple bid packages, which provided specific scopes of work. This facilitated the quick

helped complete the project on time.

- Emil Martone, former Vice President NYC Economic Development Corporation

\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\

case study: cost and schedule acceleration | PAGE 3

\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\ be grandfathered, locating the 10% ADA rooms in the new construction on the east side of the building. Mold on the gypsum board and rusted studs behind the showers compromised the structural integrity of the wall and blocking required for grab bars.

The project team, an environmental remediation engineer and the Mayor’s office carefully evaluated solutions and recommendations. City Hall was able to confirm that if all of the gypsum board and studs were removed for this remediation, the area would not be considered as “remaining as existing” and therefore would no longer be grandfathered. If these patient rooms could not be re-used and ADA rooms needed to be included, the Lean/IPD team organizational strategies included collocation, weekly pull planning, value-based decision making, real-time access to building model and monthly principals meetings.

One of the last steps was the addition of performance incentives that included shared cost and schedule metrics for both the contractor and design team. This enhanced the team effort, and helped maintain collaboration during critical points in the project.

During this accelerated design and construction process, many potential delays threatened the project schedule and budget. Any one of these items could have adverse effects on the completion

number of available beds would decrease. Even though reducing the number of beds would have been more cost effective and had less impact on the schedule, it was not acceptable to the Owner.

Working with the environmental remediation engineer, a program was implemented to remove a portion of the bottom of the wall so it was no longer directly on the concrete. Rusted studs were also remediated; and air quality testing was performed to confirm mold was remediated. With all parties working together, the cost and schedule impacts were kept minimal and client expectations were maintained.

date and final project cost. However, these issues were controlled

On October 29, 2012, when Super Storm Sandy made landfall at

by:

New York City, the Henry J. Carter Project was half way through

• • •

Careful evaluation of the situation Review of solutions that balance budget and schedule Quick implementation

New York City’s Office of Management and Budget (OMB) is required to review and advise the Mayor on issues affecting the City’s revenues and expenditures. For this project, OMB required the LTAC be reviewed separately from the SNF. Each project review included a week-long work session with outside consultants and advisors, working on the behalf of the City,

construction, with only a year to finish. When Sandy arrived in Harlem, the job site was secured to handle the high winds and torrential rains. As a result, the job site fared very well, with little damage and no flooding. The existing facility on Roosevelt Island, where staff and patients were moving from, was another story.

They experienced extreme flooding and power outages for an extended period of time. The Client’s experience through the aftermath of Sandy posed interesting questions and solutions for the Harlem project.

to evaluate space planning, medical equipment selection, MEP equipment and routing, land planning, estimating, and construction management. One comment included moving the Skilled Nursing Facility to Roosevelt Island. Array was required to provide test fits for the Skilled Nursing Facility on Roosevelt Island to help evaluate the best solution for the project. Another comment reduced the height of the building. To accomplish this and maintain scope of services, the project applied for a mayoral override to increase the lot coverage. Design/Construction team collocation and communication helped monitor this process and maintain the budget and schedule.

The team discovered extensive mold when renovation began at North General, which threatened a cost-savings opportunity to re-use the patient rooms on the west side of the existing hospital.

Re-use provided cost savings and allowed these rooms to

Even with all the construction challenges resulting from unforeseen issues, move-in schedule never changed.

PAGE 4 | case study: cost and schedule \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\

Who We Are ARRAY-ARCHITECTS.COM

We Are Healthcare Architects We are a team of architects and designers with unique backgrounds, but we all have one thing in common - we share a strong desire to use our expertise and knowledge to design solutions that will help people in moments that matter most.

This focus makes us leaders in our field. There’s a degree of compassion, empathy, and sensitivity that goes into every project that we touch. It’s designing a nurse station with sight lines to every patient. It’s building a Behavioral Health facility without corners, so that patients are safe. It’s translating the operational needs through the technical details to fine tune the lighting system in a neonatal unit so caregivers can match the lighting to each baby’s stage of development. It is a deeper understanding, honed through relationships spanning decades.

Although not part of the 500-year flood plain, the Client asked the design team to review storm and flood elevations, as well as provide a list of current redundant power capabilities already

Together, we discover optimal solutions with our clients. It is our four decades of specialization that allows for effective communication, collaboration and precision in the complex, changing world of healthcare.

included in the project. The project team included additional equipment protection, such as re-locating the fuel oil pumps to a higher elevation and elevating critical electrical equipment on higher pads. Additional redundancies in the IT system were included by adding secondary UPS units for each project’s main telecommunication rooms and closets on each floor. Backup air conditioning and flood mitigation added to all elevators. By working with sub-contractors to verify available equipment and coordinate its installation, the hardening of the Harlem campus

Array’s Knowledge Communities We believe strongly in sharing our expertise and knowledge with others. We invite you to explore each of our thought leaders and share your thoughts with the healthcare design community.

Click here to visit our blog.

was able to occur without disruption to the schedule or budget.

Staff and patients moved into their new space in November 2013. The Henry J. Carter Specialty Hospital and Nursing Facility team met its schedule and budget incentives. Basic steps

Click here

to read more about this project on our website

such as understanding Client expectations, constant and open communication and daily documentation updates ensured this project had a successful outcome. Array is now involved in “Day 2” revisions on the Henry J. Carter Campus. Day 2 revisions are possible because funds were available after patient move-in.

Some of the revisions include new scope identified by the Owner after move-in, and inclusion of previously value-engineered scope.

\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\

case study: emergency departments | PAGE 5

Boca Raton / Boston / New York City / Philadelphia / Washington