Robins & Morton photo.
With a targeted completion date of 2018, crews in Port St. Lucie, Fla., are carrying out construction plans that will double the size of the community’s private 90-bed, acute care hospital.
With a targeted completion date of 2018, crews in Port St. Lucie, Fla., are carrying out construction plans that will double the size of the community's private 90-bed, acute care hospital. In 2015, officials from Martin Health and other local leaders took part in the groundbreaking for Phase II of Tradition Medical Center.
Martin Health System is adding 170,000 sq. ft. (15,793 sq m) and three stories to the facility. Matt Kelly, Martin Health's director of planning, construction and real estate, said the expansion is crucial in order for the hospital to continue serving the area.
“The medical center has exceeded projections since opening its doors on December 18, 2013. During the first 18 months of operation, it was at full capacity two to three days every week, and had a total of 9,000 admissions, 53,000 emergency room visits, 4,000 surgeries and 2,200 births. We are expanding to meet the needs of one of south Florida's fastest growing communities.”
An acute care facility, Tradition Medical Center is a 201,184-sq. ft. (18,690 sq m) structure located on the Tradition Center for Innovation Campus, at the southwest corner of Tradition Boulevard and Interstate 95. The hospital offers emergency services, as well as an intensive care unit, general and specialized surgeries, inpatient oncology, diagnostic imaging, endoscopy, clinical research, inpatient rehabilitation, an infusion suite and a number of physician offices.
“While patients will receive the same high quality care they expect from Martin Health System, this expansion is designed to meet the needs of the Tradition community into the near future. The added capacity will enhance our patients' experience, and should reduce wait times for emergency care and procedures,” said Kelly.
As the project reaches its anticipated completion, Martin Health expects to add approximately 400 new jobs at the medical center, with a combined annual earnings of approximately $22 million, according to Kelly.
“This will have a significant impact on the local economy, with growth in consumer spending projected to be $18 million. In addition to professional jobs, the hospital also brings an influx of physicians, patients and visitors to the area.
“Martin Health is fortunate to be able to take on this expansion less than three years since opening the hospital's doors. One reason for this is the flexibility that was built into the hospital's initial phase — the mechanical mezzanine level was located below the patient floors, rather than above. This forward-thinking design allows for an easier and less costly expansion of the bed tower, so we can stay in step with Port St. Lucie's projected growth. We are committed to quality, as we continue to grow,” said Kelly.
The general contractor for the expansion is Robins & Morton, with HKS serving as project architect. According to Ryan Van Dyke, Robins & Morton superintendent, work on the project began back in September, and should be completed by March, 2018.
Currently, crews are working on a two-story horizontal expansion, the vertical expansion and construction of a parking lot. Teams have already completed a temporary neonatal intensive care unit (NICU) away from the vertical expansion, along with the removal of the precast exterior for the structural tie-in. Wind was a concern throughout the removal process.
Some key tasks yet to be carried out include extending the elevators up through the vertical expansion and performing a hard tie-in structurally at surgery/ED. Also, the vertical expansion exterior skin must be 100 percent dry to remove the existing roof.
For the tower expansion, workers are extending the structure three stories over occupied labor and delivery. The project also calls for interior renovations.
“They are difficult,” Van Dyke said. “Infectious control is of utmost concern, with constant cleaning of areas, workers and equipment. We have pharmacy, lab, imaging, med surgical and NICU.”
In order to build new patient rooms, a great deal of coordination and scheduling is required. The detailed planning of cranes, lifting of equipment, quality control and other matters had to be addressed in a timely fashion.
Van Dyke said expanding a medical facility differs from other construction projects, because the hospital runs 24/7.
“The facility is 100 percent occupied at all times. There is no option of coming in at night or weekends or shutting down a wing to work. Infectious control and job site cleanliness is also a top priority.”
Because the mechanical mezzanine level is located on the third floor rather than the roof, it allows for a more efficient vertical expansion. One advantage is that crews don't have to relocate any of the air-conditioning equipment that's generally situated on the rooftop.
Equipment being used on the job includes two crawler cranes, several excavators, loaders, forklifts, man lifts, a buck hoist and scissor lifts. Some of the main materials being utilized are approximately 450 tons (408 t) of rebar and 6,360 cu. yds. (4,862 cu m) of concrete.
The biggest setback to date has involved the weather, said Van Dyke.
“We are having an extremely rainy winter. It doesn't get cold enough in Florida, so we are lucky in that regard. We just have to deal with hurricanes in the summer, which we have a pretty extensive plan for preparing the job sites.”
Robins & Morton has teamed with skilled craft workers to handle drywall, concrete and low voltage issues. In addition, crews are in the process of relocating a sewer main that goes under the footprint of the horizontal expansion. Johnathan Peavy, Robins & Morton project manager said the relocation of the sewer required heavy coordination to reroute the traffic and the main entrance of the hospital.
“It also ran across staff parking, which created constraints during shift change.”
Because of the project's sensitive nature, workers also must be aware of noise and vibration during construction. Peavy said soil conditions are another concern.
“The soils are very marshy and swamp-like. This poses a problem, because after heavy rains, the site does not drain.”
Ernie Palmer, AIA, vice president, HKS, said his firm's vision for the project focused on patient-centered care and sustainability. The chief challenges for the design team involved maintaining day-to-day operational needs, while expanding the building infrastructure, including the vertical expansion above the active labor and delivery unit.
“We hope the expansion will complement and grow the excellent depth of services established in Phase I,” Palmer said. “The nature surrounding the existing lake was the inspiration for both the exterior color palette and the interior finishes and art work.”
The structure was influenced by modern hospitality, while respectful of the Tradition community master plan. Among the building's features are state-of-the-art health care services and the healing garden with its colorful soothing fountains.
As far as sustainability, Phase I of the Tradition Medical Center received LEED Gold, according to Palmer.
“Much of the green aspect of the facility can be attributed to the highly efficient MEP systems. The building also has highly efficient glazing and thermal insulation systems critical in the Florida environment.”
CBRE Healthcare was awarded the contract for the Phase II expansion. According to Megan Donham, CBRE project manager, “CBRE Healthcare has been retained to provide program management/owner's representation. During the course of our engagement, we will manage and track the program budgets, schedule, owner furnished equipment/furniture fixtures equipment, coordinate with the project team and represent the owner in all aspects related to the project.
“Construction on the original hospital was a greenfield project. The expansion will be on a live/active hospital, which involves more dynamics and presents completely different challenges. We must be cognizant of not only the hospital staff, but also patients, families and visitors. We will continually assess all phases of construction to determine the impact on those occupying the building. Certain measures must be taken for the expansion that were not a part of the original construction such as ICRA, noise control, patient satisfaction measures, etc.”
Donham said the impact on the entire community will be significant.
“Even though it just opened, Tradition Medical Center is currently at capacity. Given the growing population in Port St. Lucie and surrounding communities, the expansion is warranted to ensure that residents are able to receive care locally.”
CBRE Group Inc. is one of the world's largest commercial real estate services and investment firms, serving real estate owners, investors and occupiers worldwide. Martin Health System is a not-for-profit, community-based health care organization offering preventive, primary and acute hospital care, along with a variety of other services. Martin Health System operates three hospitals and 10 outpatient sites throughout Martin and St. Lucie counties.
(This story also can be found on Construction Equipment Guide's Web site at www.constructionequipmentguide.com.) CEG