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
Multifamily Housing | Feb 11, 2023
8 Gold and Platinum multifamily projects from the NAHB's BALA Awards
This year's top BALA multifamily winners showcase leading design trends, judged by eight industry professionals from across the country.
Multifamily Housing | Feb 10, 2023
Dallas to get a 19-story, 351-unit residential high-rise
In Dallas, work has begun on a new multifamily high-rise called The Oliver. The 19-story, 351-unit apartment building will be located within The Central, a 27-acre mixed-use development near the Knox/Henderson neighborhood north of downtown Dallas.
Sustainability | Feb 9, 2023
New guide for planning, designing, and operating onsite water reuse systems
The Pacific Institute, a global nonpartisan water think tank, has released guidance for developers to plan, design, and operate onsite water reuse systems. The Guide for Developing Onsite Water Systems to Support Regional Water Resilience advances circular, localized approaches to managing water that reduce a site’s water footprint, improve its resilience to water shortage or other disruptions, and provide benefits for local communities and regional water systems.
Office Buildings | Feb 9, 2023
Post-Covid Manhattan office market rebound gaining momentum
Office workers in Manhattan continue to return to their workplaces in sufficient numbers for many of their employers to maintain or expand their footprint in the city, according to a survey of more than 140 major Manhattan office employers conducted in January by The Partnership for New York City.
Giants 400 | Feb 9, 2023
New Giants 400 download: Get the complete at-a-glance 2022 Giants 400 rankings in Excel
See how your architecture, engineering, or construction firm stacks up against the nation's AEC Giants. For more than 45 years, the editors of Building Design+Construction have surveyed the largest AEC firms in the U.S./Canada to create the annual Giants 400 report. This year, a record 519 firms participated in the Giants 400 report. The final report includes 137 rankings across 25 building sectors and specialty categories.
University Buildings | Feb 8, 2023
STEM-focused Kettering University opens Stantec-designed Learning Commons
In Flint, Mich., Kettering University opened its new $63 million Learning Commons, designed by Stantec. The new facility will support collaboration, ideation, and digital technology for the STEM-focused higher learning institution.
Sustainability | Feb 8, 2023
A wind energy system—without the blades—can be placed on commercial building rooftops
Aeromine Technologies’ bladeless system captures and amplifies a building’s airflow like airfoils on a race car.
Codes and Standards | Feb 8, 2023
GSA releases draft of federal low embodied carbon material standards
The General Services Administration recently released a document that outlines standards for low embodied carbon materials and products to be used on federal construction projects.
University Buildings | Feb 7, 2023
Kansas City University's Center for Medical Education Innovation can adapt to changes in medical curriculum
The Center for Medical Education Innovation (CMEI) at Kansas City University was designed to adapt to changes in medical curriculum and pedagogy. The project program supported the mission of training leaders in osteopathic medicine with a state-of-the-art facility that leverages active-learning and simulation-based training.
Multifamily Housing | Feb 7, 2023
Multifamily housing rents flat in January, developers remain optimistic
Multifamily rents were flat in January 2023 as a strong jobs report indicated that fears of a significant economic recession may be overblown. U.S. asking rents averaged $1,701, unchanged from the prior month, according to the latest Yardi Matrix National Multifamily Report.