2000/2001 Texas Healthcare
Construction Review
Construction Communications Goebel Construction LTD.:
North Central Baptist Surgery
Center
William Massingili, AIA, chief operating officer and
project manager for Polkinghorn Group
Architects, Inc., the project architect for the North Central Baptist Surgery
Center, said the ambulatery sugery addition was "a challenge from day
one."
Early in the construction process, he said, workers found an underground cavern
"in the nearly solid limestone outcropping on which the complex is located."
The project manager for The Goebel Corporation,
the project's construction manager / general contractor, said, "The foundation was an
extremely technical aspect of the project, due to existing soil conditions and caverns
found on the site. The site is located directly over the Edwards Aquifer, a subterranean
lake that feeds water to the city of San Antonio. The foundation had to support a
substantial building structure because the soil couldn't do it. You don't want to stack a
lot of weight on caverns."
Architects and engineers designed the foundation to support the weight of current
construction as well as future expansion, Goebel said. The facility can be expanded
"anywhere from two to four floors above the existing structure," which is made
of steel reinforced by concrete piers. Gunnite(TM), a concrete product spray, was sprayed in the caverns in order to deter
subterranean erosion.
Initially, the project was designed as a free-standing facility to be loosely connected
to the hospital.
Due to programmatic changes expanding its size, the design and overall master plan were
changed to fit "a less efficient but more integrated layout. We were able to minimize
some of the front-end construction costs by integrating into several existing hospital
systems," Massingill said.
The result is an up-to-date facility that's totally integrated into the hospital's
existing telephone, data, nurse call and security systems, he added.
The ambulatory surgery center features four operating suites and does not offer overnight
stays. Up to three more suites could be added.
 Ambulatory surgery can be
accessed from two points. One, an entrance at the building's east end, "creates a
light-filled, multi-story entry portal to the overall complex. It also has a
sterile corridor that allows access from the hospital's existing surgical wing into the
new surgical suites," Massingill said.
The building fits in with its surroundings. "It is designed to blend seamlessly
into the Spanish architectural style of the hospital," Massingill said. "A
palette of basic materials such as blended-face brick and clay tile roof elements are
accented with the introduction of new forms and surfaces, such as a continuous
limestone-colored concrete block base and a contemporary gabled porte cochere that serves
as a new entrance to the hospital complex."
Spaces are planned so that staff members can engage in multiple tasks. For example,
pre-operative and recovery areas can be covered by the same staff. This "reduces
staffing requirements through the adjacencies of clinical functions," Massingill
said.
"The facility represents the integration of the design team's extensive healthcare
experience in this particular space -- ambulatory surgery -- with the client's
time-tested, system-wide practices. The design team incorporated several techniques that
minimized construction costs."
HVAC systems were divided into clinical and non-clinical compartments. "That
allowed for the use of economical climate control systems for the non-clinical
spaces," he said. "The sophisticated clinical and surgical systems are only in
those spaces where required by code." This also "allowed the addition of further
temperature and climate controls not required by code but necessary to accommodate the
physicians' needs." |
 More attention
was paid to the finishes in patient care areas, such as the waiting room, preoperative and
recovery areas, Massingill said. Extended step-down rooms, designed for patients  whose surgeries
require more than three hours of recovery time, are like nice hotel rooms. Operating suites are designed to be very flexible. Five-foot-wide doors senre as
an entry point for each suite, allowing any type of general surgery to be handled there,
he said. The operating bed can be turned in any direction to meet the requirements
of individual surgeons and surgical procedures.
Goebel said the custom doors are suspended using a complete piano hinge
on the door jam side. The size of the doors will make it easier to maneuver patients on
gurneys into the rooms.
Air flow is a major concern in surgical suites, he said. "At all
times, there has to be positive air pressure inside the surgical and sterile areas. Air
doesn't have time to stagnate. Germs cannot survive or land anywhere.
One of the construction challenges of the project involved connecting
the new center to the hospital's systems, such as the two-pipe chilling system. It is more
efficient to cool structures 50,000 feet or larger in this way than by using a standard
air-conditioning system. Goebel said the system uses steam to heat the facility in
the winter and chilled water to cool it in the summer. It also utilizes a glycol coolant
similar to antifreeze.
One thing that made this difficult was that the boiler for the hospital
has to stay on at all times, according to Goebel. Construction workers had to tap the line
while it was under pressure in order to hook up the new ambulatory surgery center,
following standard safety protocol for conducting a live tap.
Emergency electrical circuiting is critical to the facility's ability to
function. "The facility has an onsite power plant Genset unit," Goebel said. It
utilizes a V-8 Caterpillar(TM) engine run by
diesel fuel to power huge generators. During a power outage, "these generators
automatically come on and power the structure. It's a mini power plant." The
entire process takes less than a minute, so "in the event of an operation procedure,
a loss of power is an extremely temporary setback."
Construction of the 16,000-square-foot facility took place from December
1998 through December 1999. The guaranteed maximum price (GMP) was approximately $4
million. "The priority was more on the necessity than the price," Goebel added.
Massingill said the building drawings were completed in June 1998 rather
than February 1998 due to design changes. The facility was originally scheduled to open in
November 1999, and it opened in February 2000.
"We were under extreme pressure to make up lost time," he
said. "It was difficult during construction, but I think they've got a beautiful
facility. I think the end result justified the journey and how we got there."
"You have to learn that these systems have certain requirements and
how to make it work and be a functional space. It takes a lot of attention to detail --
especially the technical detail," Goebel said.
"It was a wonderful job, including the technical expertise that was
involved and from an aesthetic standpoint," he said. "The design and quality of
construction was impeccable. It's a state-ofthe-art facility from the lights on
down."
-- A.S.
Article reprinted from:
2000/2001 Texas Healthcare Construction Review
www.constructionreviews.com/ |
