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Renovation Program - Design/Build

This program provides guidance and protocols for renovation projects in fully operational acute hospitals.  Team building is essential to quality control and Precision Constructors personnel have extensive experience building relationships with healthcare facility Administrative, Engineering, and Staff groups. Precision Constructors specializes in renovations of fully operational hospitals with emphasis on patient and staff safety and comfort.  We employ very stringent Interim Life Safety and Infection Control programs in full compliance with JC and CMS. Our Design/Build program is highly recommended for these types of construction projects.

 

GENERAL DESIGN/BUILD RENOVATION

Precision Constructors provides pre-construction surveys of the building and systems within the hospital to provide to the Architectural and Engineering Designers that take into consideration the type of project, location, level of construction activity, and the risk group classification for the types of patients under care. The following program outline is an example of an interior renovation Design/Build project involving potential high levels of dust from construction activity in an environment caring for high risk patients. Precision Constructors manages and coordinates all disciplines involved in the renovation to ensure Quality Control and continuous compliance with IC,  ILSM, Safety, and Operations.

 

PROGRAM

Site Survey

 

  • Evaluate the design requirements relative to the American Institute of Architects (AIA) Design Guidelines and pertaining to the local and state AHJ codes and regulations. 
  • Perform a physical inspection with the Architectural and Engineering team (A/E) to determine all existing conditions including layout & dimensions, and mechanical, plumbing, electrical & lighting systems. Include a usage survey of all surrounding spaces. 
  • Conduct an operational survey to determine traffic flow patterns, and the expected occupancy of spaces adjacent to the proposed work areas. 
  • Establish all operational requirements with the Owner. 

 

Design 

 

  • Select Architertural and Engineering Design team.
  • Referencing the functional program develop initial schematic drawings.
  • Review schematic drawings with owner.
  • Develop Design Drawings.
  • Coordinate with the Owner and all equipment suppliers to establish new equipment specifications and site specific drawings as required. 
  • Perform 50%, 80% and 95% complete design reviews and work with the A/E team to complete Full Construction Documents to the Owners Requirements. 
  • Coordinate the completion of the final set of permit ready construction documents. 

 

Pre Construction project Evaluation

  • Project plan review to determine the extent and scope of work to be performed 
  • Location study to determine the use of all spaces impacted by the construction activity 
  • Development of an Infection Control Plan appropriate to the level of construction activity 
  • Evaluation of project impact on Life Safety and emergency egress routes 
  • Develop a project Contact List and determine individual responsibilities 
  • Establish and coordinate all local and internal Permit requirements 
  • Evaluate the Project Schedule duration and phasing opportunities

 

Implementation

Precision Constructors will coordinate a formal Preconstruction Meeting between the healthcare facility’s Safety, Quality, Infection Control, Engineering, and Administrative representatives and our Project Manager, Superintendent, Safety, and Subcontractor representatives. At a minimum, the following tasks and responsibilities will be covered: 

  • Facility access, orientation, and security requirements for all contractor personnel
  • Facility policies for parking, smoking, and designated bathroom facilities for contractor personnel
  • Review of permits and permit requirements from the Local Authority Having Jurisdiction (LAHJ)
  • Review of the Project Schedule
  • Coordinate the requirements of the Infection Control Permit with hospital personnel
  • Determine requirements for other internal permitting including Above Ceiling Permits and Hot Work Permits
  • Propose a plan for implementing Infection Control precautions that will satisfy the requirements of the facility’s Quality Manager and those outlined in the Infection Control Permit
  • Plan locations for temporary dust control barriersIC Barrier Plan
  • Establish the methods and equipment required to place the work spaces under negative pressure to prevent dust and fumes from escaping through temporary barriers
  • Establish safe demolition and debris removal methods, routes and dumpster location
  • Discuss in detail the requirements of the Interim Life Safety Measures and when they will be placed in effect
  • Provide Flame Spread data sheets and Material Safety data sheets for all construction materials that will be used on the project
  • Coordinate a plan for relocating staff and patients as needed to complete the work and develop required phasing plans
  • Prepare a schedule for receiving and incorporating Owner supplied materials and equipment if applicable
  • Discuss the importance of a clean job site. Coordinate routine construction cleaning, final cleaning, and terminal cleaning responsibilities
  • Set a date for Mobilization

 

Infection Control

Precision Constructors will coordinate with the facility’s Quality Control Manager by developing an Infection Control Permit with recommendations for Infection Control methods and materials:

 

  • Provide a detailed description of the location and level of Construction Activity
  • Identify one of four levels of Construction Activity
  • Identify one of four levels of the Infection Control Risk Group based onInfection Control Permit the location of the work and the types of patients under care
  • Cross reference the level of Construction Activity with the Infection Control Risk Group to establish specific Infection Control Precautions required for the project
  • Review with staff the proposed Infection Control Precaution methods, barrier locations, and all materials & equipment that will be used
  • Review the Infection Control Permit form for completeness and accuracy 

 

Interim Life Safety MeasuresEmergency Egress Plan

Precision Constructors will provide recommendations for instituting specific Interim Life Safety Measures for the duration of the project, working closely with the facility’s Safety Officer and Engineering Director. Key aspects to Interim Life Safety:

  • Ensuring free and unobstructed exits, egress routes, and access for emergency services
  • Ensuring fire alarm, detection, and suppression systems remain in proper working order throughout the project
  • Ensuring that temporary barriers are smoke tight and built of materials that will not contribute to the development or spread of fire
  • Providing additional fire fighting equipment and ensuring that staff and contractors are trained in its use
  • Prohibiting smoking throughout the facility and in or near construction areas and if required prohibit smoking on the hospital campus entirely
  • Developing and enforcing storage, housekeeping, and debris removal practices that reduce the facility’s flammable and combustible fire load to the lowest feasible level
  • Establishing an increased minimum number of fire drills required per shift and per quarter throughout the duration of the project
  • Increasing hazard surveillance of buildings, grounds, and equipment with special attention to construction areas
  • Training staff to compensate for impaired structural or compartmental features of fire safety
  • Conducting hospital wide safety education programs to promote awareness of life safety building deficiencies, construction hazards, and Interim life Safety measures 

Pre-construction Inspection

Precision Constructors personnel will coordinate and document a thorough Pre-construction Inspection prior to commencing work. This is performed in conjunction with our Project Manager and the facility’s Engineering, Safety, and Quality Control representatives. Several essential inspection points:

  • Evaluate the work spaces for the presence of hazardous materials, chemicals, asbestos, confined spaces, etc.Precon Inspection Form
  • Document the status of all utilities, mechanical systems, fire safety & detection systems, and other operational life safety systems
  • Review the Infection Control Plan and any other procedures that will reduce the risk of injury and illness
  • Review and document the erection and location of temporary barriers and methods of dust and fume control
  • Assess the efficiency of dust barriers and negative pressure exhaust systems
  • Review the plan for debris removal with the facility
  • Provide documentation of the Preconstruction inspection to all responsible parties and Safety Committees

 

Daily Monitoring

Daily monitoring of safety measures and infection control is a vital part of the successful completion of healthcare facility renovation projects.  Precision Constructors will provide coordination, documentation, and a chain of accountability for the daily monitoring of the project. A daily checklist would include:

  • Clear unobstructed exits and egress routes
  • Appropriate posting of signage indicating construction areas and Interim Life Safety Measures that are in effect
  • Ensure life safety equipment and fire safety systems are in proper operating condition or a temporary equivalent system approved by the facility and the LAHJ is operationalDaily Monitoring Form
  • Fire Safety and employee training has been maintained and current status is established for hot work, fire watches, smoking policy, etc.
  • Status of general safety including hand & safety rails, clean work sites, construction material storage practices, and proper documentation for all required agencies (OSHA forms, MSDS, etc.)
  • A thorough check of all Infection Control barriers and exhaust systems 

 

Project Closeout

Precision Constructors continues collaborative coordination with the facility staff all the way to final occupancy of the spaces:

  • Observe functional testing of all newly installed systems and equipment
  • Ensure spaces are ready for terminal cleaning by the facility’s housekeeping services
  • Coordinate a Notice of Substantial Completion with the Architect 
  • Coordinate certifications of all critical systems including but not limited to emergency power systems and transfer equipment, fire alarm systems, smoke & fire damper systems, fire sprinkler systems, nurse call systems etc. 
  • Coordination of final project documentation including facility Maintenance & Operations Manuals and As-Built Record Documents
  • Monitor closeout of all local and internal permits, final inspections, and Certificate of Occupancy inspection(s) by the LAHJ
  • Provide a formal turnover to the facility’s Engineering representative 
  • Final turn over of the completed project to the Owner with Certificate of Occupancy