Ark. Makes Largest Health Care Investment in 10 Years

Tue April 15, 2014 - Southeast Edition
CEG

Nicole Frakes, NEA Baptist photo
Hoar Construction crews use multiple man lifts during construction of the NEA Baptist Hospital.
Nicole Frakes, NEA Baptist photo Hoar Construction crews use multiple man lifts during construction of the NEA Baptist Hospital.
Nicole Frakes, NEA Baptist photo
Hoar Construction crews use multiple man lifts during construction of the NEA Baptist Hospital. Nicole Frakes, NEA Baptist photo
Hoar Construction crews perform site work, foundations and underground utilities. Nicole Frakes, NEA Baptist photo
During the planning process for the new structures, officials paid extra attention to both safety and green initiatives. Nicole Frakes, NEA Baptist photo
Described as the largest health care investment in Arkansas in the last decade, the new NEA Baptist Memorial Hospital and Clinic is expected to have a significant impact on the Jonesboro, Ark., community. Nicole Frakes, NEA Baptist photo
Portions of the facility are five stories. Hoar Construction photo
The facility represents the single largest investment in a community by Baptist Memorial Healthcare, at a total price tag of $400 million.


Described as the largest health care investment in Arkansas in the last decade, the new NEA Baptist Memorial Hospital and Clinic is expected to have a significant impact on the Jonesboro, Ark., community. After months of construction — employing more than 700 workers at peak — the campus has officially opened to the public.

"Both health care and our community are constantly changing, and we saw the need to make adjustments to best meet the growing needs in our community," said Brad Parsons, NEA Baptist Hospital CEO and administrator. "Guided by our commitment to providing high-quality care to the people of northeast Arkansas, we realized the needs of our community included access to a higher level of care right here at home. Building a new hospital would allow us to increase the number of hospital beds available in the community, while a new specialty clinic building has allowed us to recruit and hire specialized physicians and to offer new and expanded service lines."

Following the merger with Baptist Memorial Health Care in 2007, support grew for a new facility. Original plans for growth began with an expansion to existing facilities. However, it was decided a new campus was the only solution, based on the health care needs of the community in the next 10 years and beyond.

"We also wanted to create a space that allowed cancer patients the opportunity to stay closer to home for treatment and an environment that promoted healing and hope. In addition, the technology that we’ve been able to acquire for all levels of care will further support our ability to provide for our patients."

NEA Baptist Clinic physician offices are connected to each floor of the hospital, allowing for ease of access. The clinic portion of the facility is five stories and houses the medical specialty offices. The hospital has larger patient rooms and operating suites. The NEA Baptist Cancer Center, a 34,000 sq. ft. (3,158.7 sq m) facility situated on the north side of the campus, completes the project.

During the planning process for the new structures, officials paid extra attention to both safety and green initiatives.

"In order to make the hospital as earthquake-proof as possible, a new technique was used in construction that involved the driving of more than 1,500 foundation pillars in the ground at an average depth of 55 feet," said Parsons. "The pillars are tied together with a large capstone. The building is not connected to the pillars and capstone. Instead, it rests on top of them. This means that if there were an earthquake, the building would float on top of the capstone, not shift with the ground. This extra measure goes beyond area earthquake standards and offers patients an added layer of safety.

"All of the lights on the campus are LED and work off of motion detectors to save energy when a room is unoccupied and not in use. Energy efficient heat and air systems are set to a certain parameter to prevent unnecessary energy use, and all elevators are counterweighted for efficiency. It’s been said the average household toaster uses more energy than it takes for one of the elevators to travel three floors. We also paid special attention to any new technology or equipment that could increase efficiency. Our emergency rooms and operating rooms have very little equipment on the floor. They were designed so the necessary equipment could hang from the ceiling and could easily be moved to allow for better patient care."

The operating rooms were created with areas that can be stocked from outside the room. These were equipped with new inventory software that allows the staff to know exactly how many of each item is on hand. This allows operating teams to move patients through the surgical process more quickly and focus more attention to care. Anti-microbial air filtration systems were added during construction, along with a pneumatic tube system that allows various departments to send lab specimens and medications quickly throughout the facility.

Parsons said the entire medical campus was designed with the patient in mind.

"We wanted them to feel comfortable when navigating our campus and facilities. We have provided ample signage to assist with this and most of the time they follow signs to either go left or right rather than down a series of confusing hallways. We also wanted to create a calm, healing environment that felt like home, but was still sterile and equipped with the newest technology."

NEA Baptist Clinic physician offices are connected to each floor of the hospital, allowing for ease of access. The clinic portion of the facility is five stories and houses the medical specialty offices.

"The integration of clinic and hospital allows for increased efficiency and communication for our physicians and staff, said Darrell King, CEO of NEA Baptist Clinic. "Each floor of the clinic is connected to the related hospital service line, meaning that a physician can see patients in the clinic building and quickly transition to the hospital when emergency situations arise. This will benefit our patients by reducing wait times and providing a higher level of care.

"Patients will also benefit from the comprehensive care — most of all medical services and specialties are located here, so if they have appointments with multiple doctors, they will not have to drive across town to get to the next appointment. This includes the need for diagnostic testing and services. As we transition to a new electronic health record system later this year, patients will find their experience at NEA Baptist more seamless than ever. Each individual patient file will be combined into one single patient record that can be shared among any Baptist Health Care location and physician."

The entire campus, which will serve northeast Arkansas, southeast Missouri and parts of Tennessee, was designed with shell space for future growth.

"As we began recruiting new physicians and adding specialties, we saw the need to go back and alter some of our original plans, said Parsons. "Different areas that were intended to be shell space were finished out for new physician offices and any new technology that came with their particular specialty. We are currently evaluating plans for future growth."

Parsons said that once plans were in place to build a new campus, they immediately began the process of researching, planning and training for the move to come.

"We visited other hospitals that had previously moved or were in the process of moving to use as a benchmark and to gain valuable information for what worked and what didn’t work. We wanted to be prepared for this day and to be able to make this a smooth transition for both patients and colleagues.

"We formed transition steering committees for both hospital and clinic that met for nearly three years," said Parsons. "As we moved closer to the moving date, we trained new and existing colleagues on new equipment. We also allowed them to tour the facility and walk through their specific departments at various stages of construction to become familiar with the areas. Mock patient moves were conducted to prepare our colleagues for the actual move. The environment the day of the move was cautious, but confident."

Externally, officials used advertisement through television, radio, outdoor and print to communicate to the public. They also created a blog to provide updates on the construction and spoke to individuals and organizations throughout the community. Both emergency departments were open the morning of the move until all patients had been moved from the old facility to the new campus.

As for the cost of the project, the main campus building permit was approximately $200 million. The cancer center was another $34 million. The facility represents the single largest investment in a community by Baptist Memorial Healthcare, at a total price tag of $400 million.

"The $400 million investment in our community refers to the entire scope of the project, including construction, recruitment of physicians and support staff, and the purchase of new technology and equipment," said Parsons. "With a new state-of-the-art campus and advanced technology, we were in a unique position to hire highly specialized physicians. These physicians, who would typically be living and practicing in much larger metropolitan areas, were impressed by our new campus and many of them moved here because of the integrated model of health care we have created."

Philip Talbot of Hoar Construction said crews began their portion of site work, foundations and underground utilities in April of 2011. Substantial completion was achieved in December of 2013 with a small crew remaining on site through the end of Feb. to handle any miscellaneous items that arose or special requests from the owner.

"Hoar was responsible for managing the complete construction process from digging auger-cast pile foundations to the final coat of paint," Talbot said. "Hoar Construction also self-performed the construction of the concrete structure.

"On a project of this size and magnitude, finding and maintaining local work forces can be extremely difficult. We were able to overcome this challenge by utilizing a rather large local workforce that was supplemented by various trades out of the Memphis area. The proximity of Memphis and our positive working relationship with some of the key subcontractors in Memphis helped us to easily overcome this challenge."

Talbot said another key concern was the task of maintaining current project documents.

"With nearly 1,500 plan sheets, over 600 RFIs and countless submittals, keeping the right information in everyone’s hands was a tremendous challenge. Hoar utilized iPads and the app PlanGrid as a means to easily manage, distribute and revise project documents. Superintendent, subcontractors, and the facility management used iPads to easily stay up to date with the large number of documents a project of this magnitude demands."

Hoar Construction had two tower cranes on site during the construction of the main structure. After that, countless boom lifts, lulls, man lifts, dozers and backhoes were on site.

"This equipment was used for digging foundations, grading the site, hauling materials, hoisting materials, etc. Having the right equipment is key to the successful completion of any project, whether it’s an 800,000 square foot hospital or a one-room remodel."

The project was separated into two phases. Phase I consisted of the installation of a road around the perimeter of the property, some underground utilities and rough grading. Phase II was the primary construction phase, with the site essentially an open field in which to work.

Weather was a large obstacle during the site work and concrete portion of the project. The area had record amounts of rainfall, which severely hindered overall progress. In addition, to ensure the facility was on the cutting edge of health care, a large revision was made to the owner’s equipment. This resulted in nearly 500 revised drawings, numerous MEP related changes and a few new areas of shell space being built out.

The new campus construction contains nearly every exterior skin material imaginable, including masonry, EIFS, storefront, curtain wall, screen wall, nearly 40 separate roof areas, skylights and glass canopies. Talbot pointed out that building a hospital or clinic is vastly different than other jobs.

"While all projects present their own unique challenges, health care construction carries an added importance," Talbot said. "The health and well-being of future patients greatly relies on the quality of the work the construction team puts in place. The majority of medical equipment requires special requirements and planning during construction. Whether that means recessed concrete slabs for an MRI, a concrete vault for a linear accelerator, proper ceiling supports for operating room lights or simply additional data/electrical outlets, meeting and exceeding the requirements of this equipment is crucial to timely completion construction and future use by patients and doctors."

"The design of the new 181-bed, six-story hospital and clinic was driven by the fact Baptist Memorial had purchased the NEA physician group, and there was the need to integrate the multi-specialty physician practices into the hospital setting," said Harold Petty, architect of Earl Swensson Associates, Inc. (ESa) of Nashville, Tenn. "The integration of the two was designed for the practices to be located on the same floors as the physicians’ respective patients for alignment. At the same time, it was important to design both the hospital and clinic for future growth and expansion.

"Whenever one is working with 100 physicians in different specialty areas, it becomes an interesting challenge to accommodate the needs of the various specialties. All of the physicians had input, and there was the need for consensus. Another challenge was the fact the NEA Clinic wanted its own identity from the hospital. We solved this issue by having a front door for the hospital and a front door for the clinic.

"For aesthetics," said Petty, "we put emphasis on the public spaces. Much of the back-of-the-house and clinical spaces is driven by code, but we add color or other interest when we can to enliven these areas and make them more patient friendly. For example, in the radiation oncology treatment room, containing the linear accelerator of the NEA Baptist Cancer Center, we added a lit scenery panel on the ceiling above the equipment.

"We also integrated brick and stone for warmth. These materials were utilized for both the hospital and clinic, but in slightly different ways so as to distinguish the clinic from the hospital. Natural light fills the two-story atrium lobby that has a transparent feel with the extensive use of glass. Throughout the spaces for the both the hospital and clinic, we incorporated evidence-based design elements, which included bringing natural light into the spaces, included healing gardens, making wayfinding intuitive and designing efficiencies for improved work flow."

ESa also designed the NEA Baptist Cancer Center on campus. The new Fowler Family Center for Cancer Care provides state-of-the-art radiation therapy, chemotherapy, clinical research and support services.

"The 20 infusion spaces overlook an exterior healing garden surrounded by a stone wall," said Petty. "The radiation oncology department includes an HD radiation vault and a CT simulator, the latest technologies in cancer treatment. On-site clinical research will provide patients with the opportunity to participate in research studies. HopeCircle, a free NEA Baptist Charitable Foundation program supporting patients and families, is located in the center.

"We are happy that wayfinding throughout the hospital is intuitive, which helps alleviate stress for the patient, family and staff, said Petty. "This facility’s atrium lobby showcases education, retail, dining, the coffee shop, chapel and monumental stair, all within an easy-to-locate proximity to the main entry and reception desk. The fact this facility doesn’t look like a hospital, but instead projects a patient, staff and family-friendly environment, has accomplished what our client and the community desired."