Digby Christian

The Sutter Medical Center Castro Valley project has been recognized throughout the construction industry as a unique project in design and approach, catching the interest of architects and builders throughout the world. We sat down with Digby Christian, Sutter Health Project Manager, for a closer look at what makes this project unique.

Q. Why is this project different than other projects you and the team members have been involved in?

One of the unique features of the project team is that we have an 11-party contract, with the non-owner members putting all of their profit at risk. I’m very confident that’s a unique set-up in the United States.

Another unique feature is that the trade contractors involved in the design and construction of the new hospital have a goal of achieving a fully coordinated, constructable, affordable design, complete with fabrication drawings, before the facility is even built. We do not want to resolve issues in the field during construction. We want to resolve them all as part of completing the design rather than in the field during construction when change orders are costly and time-consuming.

Q. There is a lot of emphasis on the team approach to this project. Who participates in the regular project team meetings?  How do they work together?

The Project Team is managed by a six-member team called the Core Group. I’m on it representing Sutter Health, as is Bryan Daylor, Eden’s Vice President of Ancillary & Support Services, representing Eden Medical Center. The other four members are from DPR Construction (general contractor), Capital Engineering (mechanical and plumbing design), Devenney Group (architectural design), and J.W. McClenahan (plumbing). We meet every two weeks to ensure the project is managing all the risks as optimally as possible. All decisions are required to be unanimous, and for the two years that we’ve been meeting, we have met that requirement.

A much larger group comprising all the designers, builders and specialty consultants meets at least every two weeks to resolve any strategic issues affecting the whole project. There are also subgroups that meet almost daily to keep information flowing fast and efficiently through the project team.

What are the benefits of this team approach?

You get a fully informed designed. You get an efficient plan for construction. But the main thing you gain is certainty about scope, cost and completion date.  These large projects traditionally go a long way over budget and finish very late and with compromises to the goals that the owner had. We worked hand in glove with each other for close to 18 months to get the cost of the project down without altering any of the goals for the building, and now for at least a year I have been completely confident of our ability to get the triple victory of on budget, on time, and with all the goals intact. That’s a tremendous difference from traditional delivery of these complex, expensive, long duration projects.

What have you learned by this approach?

That it works. To make it work requires that a very large team of people works very hard all day, every day for years. But if the owner’s goals are clear, and the team is working under a contract that puts their interests completely in alignment with the owner’s interests, that that monumental level of effort is exactly what you can get out of a team.  Hospital construction in California is some of the most complex, most strictly regulated, construction in the world and it is extraordinarily unforgiving of oversights and errors. To deliver a hospital on time, on budget with no compromises to what the owner and community want is about as ambitious as it gets in construction at this stage in our industry’s evolution.

How has this changed construction projects for the system? For the industry?

It’s been a tremendous proof of concept for how Sutter Health would like to deliver its projects.  And because the project has been written about in various trade publications and has now won two awards for its delivery model, it does have the potential to be a game-changing project in the industry. I would like it to be just that. Our modern society deserves a rock-solid reliable delivery method for these critical facilities, and until now, in my opinion it has not had that.

If you have any questions for Digby or any member of the team, please feel free to let us know or send us your comments.

By Digby Christian, Project Team Leader

We are proud to tell you that on April 7, 2009, the Sutter Medical Center Castro Valley (SMCCV) project team received the 2008 FIATECH CETI Award at the award gala held in Las Vegas.

FIATECH is an industry consortium within the building industry. Its primary mission is to get all the “players” involved in capital projects to adopt new ways of thinking and new technologies to deliver higher value for the funders and end-users of construction projects.

Here is why our team won the award…

As most of our readers know, California’s deadline for retrofitting or building earthquake-proof hospitals from scratch is 2013, less than four years from now. The hospital project in its current form was validated as viable in August 2007, and design work was authorized to start in October of that year, leaving us just over five years to have the building be ready and open for business. Typically, in California, it takes at least seven years for a project of this magnitude.

So the team had to throw out all historical concepts of how design is done and come together as a wide-ranging, multi-company team involving the owner, the designers and the builders, and transform the design and construction process to drive two years out of the schedule. The team is now on track to achieve just that and did it primarily by redesigning the design process in a rigorous and unrelenting fashion, so that it no longer bears any real resemblance to tradition!

If you are familiar with the classic design process, you’ll know that it’s typically abbreviated as “SD-DD-CD”: Schematic Design (broad concepts typically discussed and agreed to by the owner and the architect exclusively); Design Development (often a General Contractor might have some involvement in this); and Construction Drawings (some trades might be brought on board to inform how these are put together). Then, the work goes out to the building community and those companies develop what are known as Shop Drawings. These drawings show in detail how every little and large item in the building will be fabricated, i.e., the structural elements, including steel, metal, glass, concrete, etc.

On the SMCCV project, all of the people who typically are brought in at the end are already on board, and most of them have been on board since August 2007. By the time this project completes its approval process through the County and State we will already be at the Shop Drawing stage. The building is being designed for fabrication now, while the design approval process is underway.

While this concept has been discussed for the last few years within the industry, and parts of the above have been implemented on other projects, no project has implemented this concept as broadly and as deeply as the SMCCV project; certainly not on a project this large and this complex. It is one of the reasons our project won the FIATECH award!

The other primary reason we won the award is because of how thoroughly the building has been designed in three dimensions (as opposed to the typical two dimensional paper drawings we are used to seeing). There are many very attractive shots of 3D design that you can find on websites, and in trade magazines but you can’t tell if the designs are any good—all you know is they look “cool.” But on the SMCCV project, we bring the entire team together at least every two weeks to work through the coordination effort. It’s painstaking and difficult, but utterly critical to a successful outcome in a shorter timeframe.

What is not often understood outside the industry, and to some extent even within the industry, is that different design disciplines use different software, and they can’t see each other’s work in real time while they are designing. Each company has to either import a converted file of each other’s work or send both files to a third package, such as Autodesk Navisworks, to see both designs at the same time. So it’s all too easy to have a poorly coordinated, unbuildable, three dimensional design—no different in fact than having a poorly coordinated, unbuildable, two dimensional design.

In addition, we have focused the team on the larger goal of designing for fabrication rather than the industry convention of designing to produce the construction documentation, which is then coordinated by the construction team. The team’s goal to design for fabrication means we are swimming against the tide. We are allowing our companies to each use their own best-in-class software and then developing a process that allows a high level of coordination and constructability to ensure that what is being designed is actually what we will build.

The above might seem dry and technical; however, by a) having a multi-company team involving all the construction trades from day one; b) throwing out the baggage of a poor design process and starting from scratch to build a better one; and c) having a goal of designing for fabrication will allow us to build a new hospital on schedule, within budget, and without any last minute compromises on the finished product.

On the Sutter Medical Center Castro Valley project, we are breaking new ground ahead of any other project in the country in the way such projects are handled. That, in essence is the reason why the team that is building your hospital won the 2008 FIATECH CETI Award.

In addition to the Sutter Health project team, I want to personally thank The Devenney Group, DPR Construction, Capital Engineering, The Engineering Enterprise, TMAD Taylor & Gaines, GHAFARI Associates, J W McClenahan, Morrow Meadows, Superior Air Handling, MPS Project Management, Navigant Consulting, Greenwood & Moore Engineering, Herrick Steel, Otis Elevators, Strategic Project Solutions, Royal Glass, Clark Pacific, Candela, Sparling, and numerous other specialty trade vendors for making it possible to receive this award—and to meet our 2013 deadline!

For all you construction buffs, or for anyone who is interested, check out FIATECH at http://www.fiatech.org/.

I welcome your questions and comments!

Jesus Armas

By Jesús Armas, Government Affairs Liaison

As we discussed in previous posts, acute care hospitals must meet certain earthquake standards by 2013. Failure to meet these standards means that hospitals must cease operations. Recognizing the critical role Eden Medical Center plays in meeting the health care needs of the community, Sutter Health previously expressed its commitment to build a new, state-of-the-art hospital in Castro Valley. Yet, this important project can move forward only if it obtains certain approvals from the County.

We are pleased to report that this project is getting closer to becoming a reality as a result of important decisions by the Alameda County Planning Commission.

On April 6, the Commission voted unanimously to recommend to the Board of Supervisors that it certify the Environmental Impact Report (EIR) and modify various General Plan and zoning regulations to allow this project to advance closer to the start of construction.

During the Commission meeting some public speakers expressed concern about the future of San Leandro Hospital.  While the Commissioners acknowledged the points expressed by the speakers, they also expressed their unwavering support for this project, and stressed the importance of not imposing obstacles to the start of construction.

With a favorable recommendation from the Commission, project consideration now advances to the Board of Supervisors.  UPDATE: On May 12th, the Board will hold a public hearing on the project (postponed from the original date of April 28th).  At that time, the Board will be asked to approve the project based on overwhelmingly favorable public testimony to date, and positive recommendations not only from the Alameda County Planning Commission but also the Castro Valley Municipal Advisory Council and County Planning Staff.  Assuming a favorable Board action, site work will commence this summer.  Overall, construction will take between 24 and 30 months.

We will update this blog with additional information about the Board of Supervisors meeting on May 12th when we are notified. As always, we welcome your questions, concerns and comments.  

Rendering courtesy of the Devenney Group

By Cassandra Clark, Project Communications Director

This week, the Alameda County Planning Department presented the final Environmental Impact Report (EIR) for Sutter Castro Valley Medical Center and related documents to the Castro Valley Municipal Advisory Council for review and approval. The Council is an advisory board of seven community members who work on behalf of the unincorporated town of Castro Valley and serves as advisor to Alameda County Supervisor Nate Miley.

This is one more essential step toward approvals to allow the new hospital project to move forward. The meeting drew a large crowd interested in the future of Eden Medical Center and in health care in the region. Many audience members spoke highly of the project and showed their support for Eden and the new hospital.

There were several members of the audience in attendance who voiced their concerns about the future of San Leandro Hospital, located 4.5 miles from Eden and struggling to survive in these tough economic times. The 93-bed hospital is part of Eden Medical Center and provides services to the San Leandro community.

There has been much discussion about the future of this hospital due to significant financial losses and decreased utilization. While the future of San Leandro Hospital is still unknown, it is clear that it cannot continue as it is today.  Sutter Health and the Eden Township Health Care District (the owner of San Leandro Hospital) are working toward a solution for the hospital so that it continues to provide health care services in a way that meets the needs of the community.

While members voiced their concerns about San Leandro Hospital, they moved forward and approved the issue before them: the land use entitlements and EIR for the Castro Valley project. There was no opposition based on the merits of the project, the land use, nor the environmental impact. What the Council did ask was for the Board of Supervisors, in their approval process, to consider if San Leandro Hospital’s future has an impact on this project.

The next step in the approval process is the Alameda County Planning Commission (April 6) and the Board of Supervisors (April 28)—and both of these are opportunities for us to address how this project will serve the region’s health care needs. But without these land use approvals, the Castro Valley project cannot move forward. And, as we have stated so many times before, this essential project must advance on an accelerated timeline in order to meet the state-mandated deadline of January 1, 2013. After that date, the existing hospital can no longer function as an acute care hospital and must close its doors.

Solving health care problems requires intensive and collaborative efforts. It’s a regional issue, not one that can be solved by one organization alone. What is certain is that we have a new hospital project before us that is fully funded, without tax or public funds, and the first to come forward in Alameda County to meet the State’s earthquake safety standards. It is an amazing project, and one that should not be held back while health care providers in the region work toward a viable solution for San Leandro and other hospitals that are struggling to survive.

We’ll have more information on these issues as they evolve, from experts far more experienced than me. So, in the meantime, I encourage you to view the video prepared for the Castro Valley Municipal Advisory Council by our architects, the Devenney Group. The animation is a fly-over and fly-through of the new hospital and campus. Enjoy!

We’re hosting another Community Open House on Wednesday night, March 18th, from 7:00-8:30 p.m., at the Eden Hospital Conference Center, 20103 Lake Chabot Road, in Castro Valley, California. You’ll be able to see more of the architectural renderings of the beautiful new Sutter Medical Center Castro Valley and get an update on our progress. You’ll learn more about the proposed schedule for construction, and get answers to your questions and concerns. We’ll be serving refreshments, and members of our project team will be available to talk with you. We look forward to seeing you there!

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