Rady Children’s Hospital San Diego

Nov. 10, 2009

Seismic retrofitting requires specialists who self-perform Rady Children's Hospital San Diego Suggests Key Selection Criteria

Neonatal Intensive Care Units are among the most challenging construction sites imaginable. Newborns, often in critical condition, are hypersensitive to loud noise, vibration, light and dust, not to mention susceptibility to airborne viruses. Then there are family members, usually experiencing one of the most stressful periods of their lives.

How can a hospital comply with California Senate Bill 1953, which established seismic readiness standards for over 450 California hospitals, while still remaining operational? Pharmacies, labs, operating rooms all need to continue functioning regardless of construction.

Tim Jacoby, V.P. - Facilities Plant Operations, Construction and Planning of Rady Children's Hospital in San Diego, recently supervised a seismic rehab that involved a design/build of the Central Plant (NPC-4) and (NPC-3) seismic retrofit of all ceilings, piping greater than 2-1/2-in. in diameter, fire sprinklers, and anchoring of medical equipment. The work was performed in critical departments such as Central Sterile (Surgery), Radiology, Laboratory, Pharmacy, Cath Lab, MRI and Central Supply.

As the sole hospital in the San Diego area dedicated exclusively to pediatric healthcare, Rady Children's is the region's only designated pediatric trauma center and is one of the nation's most elite children's hospitals according to the 2009 U.S. News & World Report's America's Best Children's Hospitals.

The facility is on the leading edge of what is expected to be a wave of seismic upgrades as hospitals struggle to comply by the deadline. Seismic mitigation at Rady Children's is being conducted in the 261-bed main building as well as the Central Plant which will also provide utility services to the new 84-bed Patient Care Pavilion, which will become the largest children's hospital in the state when it opens in 2010.

Jacoby offers advice to other California hospitals about to face structural and non-structural (NPC-3 and NPC-4) rehab.

Seek Contractors that Self-Perform

Companies that self-perform are high on Jacoby's list. “We required a specially-trained workforce from a company that specializes in healthcare construction. NICU's and operating rooms are particularly difficult and sensitive areas in which to be securing waterlines, medical gas systems, and lab equipment and furniture.

The typical NPC-3 project involves one primary contractor subbing out the infection control, detailed fastening work, drywall, electrical and plumbing. “In the end,” Jacoby believes, “that's a lot of untrained people traipsing through the heart of a hospital.

“A carpenter may know how to drive nails in a casino or strip mall, but not necessarily how to drive nails in close proximity to premature infants. They need to be well-versed in hospital operation,” Jacoby advises.

Rady Children's turned to Essrig Taylor Construction (ETC), a California-based company, because of their specialty in hospital seismic mitigation, and ability to self-perform. Rather than subcontract the work, the company trains its construction crew specifically for the demanding hospital environment.

ETC has a rigorous training and testing program that grants Seismic Bracing Institute of America certification to its hospital construction workers. “They might know how to drill concrete, but that's only 30 percent of the job. The other 70 percent is how they conduct themselves,” said ETC president and CEO Michael Essrig.

“We tour critical care units in advance to impress upon our workers the uniquely sensitive nature of the project. We drill into them HIPAA Privacy regulations to ensure that patient information remains uncompromised. Our trainers instruct how to handle the accidental discharge of sprinklers, how to erect negative air infection control barriers, dampen sound, and especially how workers need to conduct themselves sensitively and with compassion for people who are often facing the most critical days of their lives.

Essrig continues, “Our employees are even told to imagine that a member of their own family is lying in the next room.

“Since we train them well and pay them well, we have the lowest turn-over in the hospital construction business.”

Do They Offer Design/Build Services?

Jacoby suggests that hospitals seek construction firms that also offer architectural design/build services and are experienced in seismic mitigation. “The preference is a one-stop-shop. Otherwise you set yourself up for disaster. There's too much interpretation between designers and contractors, thus leading to delays, expensive change orders, and cost overruns.”

Jacoby adds, “We needed a firm that could begin work on a critical area by 10 p.m., finish by 7 a.m., have it inspected by 9 a.m. and be up and running later the same day. This is usually beyond the capabilities of a run-of-the-mill construction firm, particularly one not involved in the design phase.”

Consider Experience in Seismic Mitigation

Consider the company's experience in seismic mitigation. Above ceiling environments in hospitals are a maze of piping, tubing, and conduit, and the mandated work applies to just a portion of what is found there. Jacoby is impressed with Essrig Taylor because of its thorough phasing, detailed pre-planning and precise execution.

Jacoby also praises ETC for its human touch. The company handed out music players and headphones to patients that might be affected by noise, and transported its Quake Cottage, the world's first mobile earthquake simulator, to the site to train hospital staff about earthquake safety.

“Clearly, there's no good time to disrupt your clinicians as you prepare structural and non-structural areas for an earthquake,” Jacoby says. “But the law dictates that the work has to be completed by 2013. By retaining the right firm and relying on specially trained workers, the job can get done quickly, within budget, and with a minimum of disruptions.”

For more information: Rady Children's Hospital - rchsd.org