About four years ago, executives at MaineGeneral Health, which has served the people of the Kennebec Valley since 1891, realized that they faced a classic decision: Should they renovate their two primary facilities, one in Augusta, the state capital, the other 20 or so miles north in Waterville, or start all over?
“Just to keep up those two facilities would have cost $100 million, and it would have been another patchwork renovation that could not give us the quality we needed,” recalled MaineGeneral President/CEO Chuck Hays. “To set us up for the future, a new site was the way to go.”
Having successfully built a new cancer center in 2007 under a collaborative project model, Hays, an engineer, and his team set out to build a new hospital at a central location in Augusta, using integrated project delivery. To implement their vision, they asked the Building Team of contractors Robins & Morton and H.P. Cummings Construction and design firms SMRT and TRO JB to enter into an IPD agreement that would guarantee fixed costs and completion imperatives, quality of patient care through evidence-based design (EBD), and operational efficiencies via sustainable design and Lean principles.
GOLD AWARD
Project SummaryAlfond Center for Health
Augusta, MaineBUILDING TEAM
Submitting firm: Robins & Morton (GC), joint venture with H.P. Cummings Construction
Owner: MaineGeneral Medical Center
Architect, interior architect, MEP engineer: SMRT and TRO JB
Structural engineer: SMRTGENERAL INFORMATION
Project size: 644,000 sf
Construction cost: $312,000,000
Construction period: August 2011 to August 2013
Delivery method: Integrated project delivery
It became immediately apparent that the chief stumbling block to the IPD agreement was the insurance. In the words of John Milbrand, PE, Construction Manager for MaineGeneral, “Insurance companies don’t know how to act when the parties agree not to blame each other.” After weeks of negotiation, MaineGeneral put together an owner-controlled insurance policy to cover worker’s compensation and other liabilities.
In early 2011, with the IPD firmly in place, the team began engaging 250 MaineGeneral staff, plus community members, patients, and patient advocates, in design discussions. They toured new hospitals across the country to gather ideas.
Before any work could get started, however, MaineGeneral’s financing was held up, and the Building Team faced the prospect of losing months of warm-weather construction time. Under a typical design-bid-build contract, no work would have been allowed to proceed; but with the IPD, the site work subcontractor was able to start moving dirt without waiting for change orders.
Then, in August 2011, just as crews were starting to roll, Hurricane Irene deluged the site, threatening the protected streams on the property with damage from runoff. The Building Team worked with the state Department of Environmental Protection to pump runoff from containment ponds into tanker trucks and transport it to a DEP-approved disposal area, thereby saving the streams from excess turbidity.
The Building Team’s entrepreneurial creativity, spurred by the IPD and inspired by a forward-thinking client, went well beyond the norm.
As a key component of evidence-based design, all 192 patient rooms are private to reduce hospital-induced infection. Each room has a family area with a sofa bed and a table that pops up for sharing meals, a patient lift, and a handrail between the bed and the bathroom to prevent falls. PHOTO: ANTON GRASSL/ESTO
For example, when the team put out RFPs for drywall/acoustical ceiling work, it became clear that the four local subcontractors would be bidding against each other on the biggest such job in the state. This put MaineGeneral’s management in an awkward position.
Instead of awarding the job to a single subcontractor, the hospital invited the four companies to operate under a single contract for the drywall work. This had never been done before, and it posed grave financial risk to the companies—not to mention to the hospital—but they made it work. In fact, of $172 million in subcontracts on the hospital, $167 million (97%) went to firms based in Maine, and 90% of the 3,000 jobs created by the project went to state residents.
To gain time and be as lean as possible, the Building Team set up an assembly line in an onsite basement, where they produced headwalls and bathrooms for the patient rooms. This shaved 25% off the delivery time for installing these components versus stick-built construction. Exterior wall panels were prefabbed and shipped in from a warehouse factory 60 miles from Augusta, in Portland, which allowed the building envelope to be closed in early, saving the owner thousands of dollars in temporary heating costs.
Construction of the Alfond Center for Health was completed in 24 months, nine months ahead of schedule, at a price below the validated target cost. Some of the savings went back into the project in the form of value-added improvements, including a 4,000-sf facilities building and a redundant data center.
Daylight floods the reception area at the 644,000-sf replacement hospital. It was originally programmed to attain LEED Silver certification, but the Building Team was able to earn it LEED Gold status. Environmental components include a 140,000-sf reflective roof, outdoor healing gardens, rainwater collection, and a heat-recovery system. The Building Team used mockups to test the functionality of patient rooms and exterior façades. PHOTO: ANTON GRASSL/ESTO
At 192 beds—all single-occupancy, a key element of EBD—the $312 million facility surpassed its planned LEED Silver certification to achieve LEED Gold. Sustainable elements include a heat-recovery system, rainwater collection and reuse, ice production to offset peak electrical use, LED lighting, a 140,000-sf white roof, and the use of natural gas instead of fuel oil for heating. Paul Stein, MaineGeneral’s COO, calculates that these initiatives will cut the hospital’s utility bills in half, to $3.27/sf, compared to $7.80/sf at the facilities it replaced.
Building Team Awards jurors appreciated the team’s attention to detail. “The patient rooms were well thought out,” said judge Terry Fielden, LEED AP BD+C, Director of K-12 Education at International Contractors, Inc. Prototype rooms were mocked up so that patients, their families, and hospital staff could make suggestions. Rooms were laid out with a handrail between the head of the bed and the nearby entrance to the bathroom. “You can see the evidence-based design in the patient rooms,” said judge Susan Heinking, AIA, NCARB, LEED AP O+M, VP and Sustainability Leader at VOA Associates.
Related Stories
Government Buildings | Mar 24, 2023
19 federal buildings named GSA Design Awards winners
After a six-year hiatus, the U.S. General Services Administration late last year resumed its esteemed GSA Design Awards program. In all, 19 federal building projects nationwide were honored with 2022 GSA Design Awards, eight with Honor Awards and 11 with Citations.
Transportation & Parking Facilities | Mar 23, 2023
Amsterdam debuts underwater bicycle parking facility that can accommodate over 4,000 bikes
In February, Amsterdam saw the opening of a new underwater bicycle parking facility. Located in the heart of the city—next to Amsterdam Central Station and under the river IJ (Amsterdam’s waterfront)—the facility, dubbed IJboulevard, has parking spots for over 4,000 bicycles, freeing up space on the street.
Healthcare Facilities | Mar 22, 2023
New Jersey’s new surgical tower features state’s first intraoperative MRI system
Hackensack (N.J.) University Medical Center recently opened its 530,000-sf Helena Theurer Pavilion, a nine-story surgical and intensive care tower designed by RSC Architects and Page. The county’s first hospital, Hackensack University Medical Center, a 781-bed nonprofit teaching and research hospital, was founded in 1888.
Project + Process Innovation | Mar 22, 2023
Onsite prefabrication for healthcare construction: It's more than a process, it's a partnership
Prefabrication can help project teams navigate an uncertain market. GBBN's Mickey LeRoy, AIA, ACHA, LEED AP, explains the difference between onsite and offsite prefabrication methods for healthcare construction projects.
Women in Design+Construction | Mar 21, 2023
Two leading women in construction events unite in 2023
The new Women in Residential + Commercial Construction Conference (WIR+CC) will take place in Nashville, Tenn., October 25-27, 2023. Combining these two long-standing events aligns with our mission to create an event most impactful for women in the $1.4 trillion U.S. commercial and residential design and construction industry.
Mass Timber | Mar 19, 2023
A 100% mass timber construction project is under way in North Carolina
An office building 100% made from mass timber has started construction within the Live Oak Bank campus in Wilmington, N.C. The 67,000-sf structure, a joint building venture between the GCs Swinerton and Wilmington-headquartered Monteith Construction, is scheduled for completion in early 2024.
Sports and Recreational Facilities | Mar 17, 2023
Aurora, Colo., recreation center features city’s first indoor field house, unobstructed views of the Rocky Mountains
In January, design firm Populous and the City of Aurora, Colo. marked the opening of the Southeast Aurora Recreation Center and Fieldhouse. The 77,000-sf facility draws design inspiration from the nearby Rocky Mountains. With natural Douglas Fir structure and decking, the building aims to mimic the geography of a canyon.
Architects | Mar 16, 2023
HKS launches partner diversity program to create a more diverse workforce and partnership network
Design firm HKS has launched a new partner diversity program that will work to build a more diverse AEC ecosystem. The HKS xBE program will give xBE firms (a term encompassing all disadvantaged businesses) and their members “access to opportunities to build relationships, pursue new work, and bolster innovation within the architecture and design professions,” according to HKS.
Sustainability | Mar 16, 2023
Lack of standards for carbon accounting hamper emissions reduction
A lack of universally accepted standards for collecting, managing, and storing greenhouse gas emissions data (i.e., carbon accounting) is holding back carbon reduction efforts, according to an essay published by the Rocky Mountain Institute.
Sports and Recreational Facilities | Mar 15, 2023
Georgia State University Convocation Center revitalizes long-neglected Atlanta neighborhood
Georgia State University’s new Convocation Center doubles the arena it replaces and is expected to give a shot in the arm to a long-neglected Atlanta neighborhood. The new 200,000 sf multi-use venue in the Summerhill area of Atlanta is the new home for the university’s men’s and women’s basketball teams and will also be used for large-scale academic and community events.