Prescription: Plan, then plan some more

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Presbyterian Hospital in Matthews is facing a daunting task: adding a floor to a four-story building while still trying to run a hospital.

Adding a level to a functioning hospital is not a one-time affair for Novant Health, Presbyterian’s owner: It’s been doing that very thing at Presbyterian facilities in Huntersville and the Elizabeth neighborhood.

But no matter how many expansions a hospital system has under its belt, such projects remain complex.

Temporary elevators have to be built on the outside of buildings so construction crews won’t have to traipse through the hospital.

Notices have to be sent every day to hospital personnel to keep them informed about the next 24 hours’ worth of construction activities.

Patients could be irritated by the sounds of construction. To help them block out noise, Presbyterian has to keep earplugs and iPods at the ready.

Infection-control barriers have to be used to protect operating rooms.

Construction crews have to stay in direct contact with hospital staff.

Doug Armstrong, director of facilities planning, design and construction for the Presbyterian Hospital system, said the addition of a floor to a working hospital has to be done “very carefully.”

“It doesn’t matter whether it’s a $1,000 project or one costing a million dollars. It’s about coordination and communication and a lot of planning so as not to impact patient care.

“We’ll spend a year meeting with staff making plans, well before we drive in the first nail.”

Work began in May on the $17 million Matthews addition, the facility’s first major expansion since it opened with 117 beds in 1994.

Charlotte-based Rodgers is the general contractor for the 26,000-square-foot floor, which will have 20 patient rooms and 20 observation rooms and focus on oncology services. It will also house a relocated intensive-care unit.

Meanwhile, the finishing touches are being put on the Huntersville project, and work is ongoing for the $58 million expansion in the Elizabeth area.

The Elizabeth project included a 100,000-square-foot, four-story expansion of the F wing above Presbyterian Cancer Center. It opened in the spring of 2012. Last fall, the G wing expansion – a three-story, 41,500-square-foot addition – was finished, although construction continues on the renovation and expansion of the operating room suite.

At two floors, the Huntersville addition was a larger project than the one in Matthews, and it involved building above functioning operating rooms. That presented its own set of challenges:

A lot of construction had to be done in the evening, when operating rooms were not being used. If construction required the hospital’s water to be turned off, it would be done at night, when there would be less demand for water.

Also in the Huntersville project, infection-control barriers had to be built between the operating room’s ceiling and the floor above. Every night, when construction ended, the hospital had to sterilize the operating room area.

The additional floor at the Matthews hospital is being built over patient – not emergency – rooms, which have less equipment in the ceilings than in operating room ceilings. While that makes the Matthews project somewhat less of a challenge, construction can’t take place when patients are in rooms, Armstrong said.

“And patients never go away,” he said. “They are there seven days a week.”

To deal with that dilemma, a few rooms are closed at a time so construction to take place.

Then there’s the issue of parking. Construction crews can eat into a hospital’s parking spaces. To make sure that doesn’t happen at the Matthews site, a separate gravel lot had to be built for construction workers.

Finding a place for construction crews to park is one thing. Another is figuring out where to place construction materials.

“The logistics of getting material and personnel to the project are different when working on an occupied campus, as well as staging the material to be placed on the site,” Rodgers spokesperson Lisa Perkins said.

“We’ve learned that you can’t plan or communicate too much.”

ON THE JOB

A look at the general contractors for the Presbyterian hospital-expansion projects

ELIZABETH: Rodgers

HUNTERSVILLE: Vannoy Construction

MATTHEWS: Rodgers

Source: Mecklenburg Times staff research