Bryan Daylor

By Bryan Daylor, Vice President, Ancillary & Support Services, Eden Medical Center

In my previous posts, I described how our “user” team approach to planning the new hospital Those of us who head up different functional areas at Eden worked in teams (consisting of managers, supervisors, staff and physicians) to determine the best way to improve the delivery of patient care in the new hospital by implementing industry best practices.

Our focus all along has been on patient safety and quality of care, efficient patient flow and effective use of skilled resources. This work has been an important opportunity to design a building that supports the process of care and enhances the experience for patients and caregivers. We were challenged with the puzzle of creating work space and flow in a new building, but in the end we feel we have achieved an excellent design for the new hospital.

While the construction teams are busy working on the visible sign of progress, we are planning for what goes inside the new building. Our teams are working with the project engineers and architects and some of the key users on what fills the space that we have so carefully designed: the structures and equipment that will be in each room of the new hospital. This space planning includes reviewing the elevations of casework, cabinets, counter tops and work surfaces to ensure that the work areas and surfaces align with work flow and support functions.

Although we have not selected the final medical equipment, we must plan for the equipment that goes into every room. We are taking inventory of the equipment needed and documenting the space allocation and utility needs (electrical, plumbing, data, cooling and ventilation) required for every piece of equipment in every room. There are more than 8,500 pieces of equipment inventoried for the new hospital that must be accounted for in the room-by-room layouts. Over the past four weeks, the team has worked together to review each floor to ensure the drawings are accurate and inclusive of the specific details required to support the equipment and functionality of the space.

The group is also researching and evaluating technological advancements in every discipline to anticipate changes and ensure that, when the new hospital opens, we will have the most up-to-date equipment for our staff and our patients.

I welcome you comments and questions.

George Bischalaney, President and CEO, Eden Medical Center

By George Bischalaney, President & CEO, Eden Medical Center

Health care reform is on the agenda, again. The stakes are high, but our President is determined to make some significant changes. As the discussion moves from general to specifics, special interests are staking out their positions. None of the stakeholders—hospitals included—wants to feel the impact or be at a disadvantage.

Amidst the demand for cost reduction and health care coverage for all, there is and must be continued investment in care. Physicians demand it. They expect to be able to practice with state-of-the-art equipment and facilities to produce outcomes that meet national, state and local quality standards. Patients demand it. They want to know that their local hospital has the right number of well-trained staff as well as the latest diagnostic and treatment equipment, and contemporary facilities.

With this backdrop of conflicting needs, Eden Medical Center is about to begin a three-year project that will result in the replacement of the Castro Valley hospital. The project cost is estimated to be $320 million. The current 55-year-old building is anything but contemporary. With few private rooms, small operating rooms and inadequate support space for clinical services, a new hospital is very much needed.

Eden Medical Center has served the community well, but it was not designed for patient comfort and needs, more for staff needs and functionality. While our project may seem ill timed given the uncertainty of hospital reimbursement, we are required to meet California legislated standards for seismic safety in hospitals. And it truly is needed.

We’ll celebrate our long sought goal with a ground-breaking ceremony on July 1st. Then we’ll spend the next three years continuing the investment in the new buildings and equipment, while observing and hoping that decision makers do not enact legislation that essentially penalizes us for the commitment we are making. When we celebrate the grand opening and our new beginning early in 2013, it should be with the same hope and dreams as those who celebrated the first ceremony in 1954.

We could really use your support! The Alameda County Board of Supervisors will meet this Tuesday, June 9th, at 1:00 p.m. to make the final decision whether or not to build the new hospital to replace Eden Medical Center and pass the FEIR (Final Environmental Impact Report). We all know the value of having a hospital in our own backyards.

The meeting starts at 1:00, but Sutter Medical Center Castro Valley is on the agenda at 2:00 p.m. The meeting will be held at the Administration Building, Board Chambers, 1221 Oak Street, 5th Floor, Room 512, in Oakland.  If you would like to read the Board’s agenda in advance, please click and download the PDF file here (see page 2).

We are also still taking signatures on the online petition, if you want to add your name and comments there. Additionally, your comments are always welcome here on this blog.

By Cassandra Clark, Project Communications Director

To follow up on the May 12, 2009 Alameda County Board of Supervisors meeting, the decision to certify the final Environmental Impact Report (EIR) has been delayed to June 9th to address concerns raised about San Leandro Hospital, which is leased and operated as part of Eden Medical Center, but owned by the Eden Township Healthcare District (the District).  For more information, please see our previous blog post.

In the days prior to the May 12th meeting, after many rounds of public commentary, and after the EIR and related land use entitlements were approved by the Castro Valley MAC (Municipal Advisory Council) and the Alameda County Planning Commission, several community members and labor representatives raised last minute concerns about parts of the EIR. Those opposed to the EIR certification claim that there was not an adequate assessment of the impact of any possible closure or change of services at San Leandro Hospital, despite the fact that the EIR consultant and County planning staff have stated that the EIR is complete and the issues around San Leandro Hospital, while not related to the project, have no impact on the project. Supervisor Nate Miley made a motion for the Board to meet again to make the decision on June 9, 2009, which would provide attorneys for Alameda County an opportunity to examine these claims in more detail.

Supervisors Miley and Haggerty voiced their concerns about speakers making false or misleading allegations as a political tactic, in order to delay the EIR approval process, thereby “holding the Sutter Medical Center Castro Valley project for ransom,” which he and the other Supervisors warned could endanger the future of both Eden and San Leandro Hospitals. While there has been no decision by Sutter Health or the District on the future of San Leandro Hospital, the issue remains a topic of community discussion.

Eden Medical Center President & CEO George Bischalaney and other Sutter and Eden project team members emphasized the urgency of not going beyond June 9th to approve the EIR, as the delay of even a month could significantly hold up construction and may cause Sutter Health to withdraw its support from both hospitals. Sutter Health has already promised the $320 million to pay for the completion of the new Sutter Medical Center Castro Valley.

At the conclusion of the May 12th meeting, the four Supervisors present, with Supervisor Keith Carson absent, voiced their support for the new hospital project and the need to rebuild Eden Medical Center. They also are concerned about the future of San Leandro Hospital, and that concerns over San Leandro should perhaps be discussed in another forum, unrelated to the land use entitlements for Eden.

As our project team discussed in previous articles and blog posts and at the hearing, any delays in approvals and construction have serious repercussions, in terms of meeting state deadlines to rebuild, in creating a safe environment for patients and staff, and in funding this major project. The new hospital must be rebuilt, or it will close as an acute care facility effective January 1, 2013. We now have before us a fully funded hospital project—without public funding or taxes—that will secure the future of Eden Medical Center, preserve jobs and bring nearly 1,000 construction jobs to the region at a time when the economy is depressed and construction is drying up.

As I stated before, the issues around San Leandro Hospital are complex and important.  The community has a right to know what is happening. But the information being discussed now is no different that it has been for the past several years: the hospital is struggling and must be reinvented to bring value to the community and ensure that it can sustain itself over time.  It is clear to me that the residents of San Leandro desire a full service community hospital, yet the majority of them will never use it. The community and local elected officials have known that this is a concern, and yet this last minute effort to stop the EIR based on what some claim to be “new information” is not justified. San Leandro Hospital, its employees, physicians and patients need to be part of the solution for the hospital, to be discussed in its own forum with regional providers who can bring truth and substance to the discussion.  It should not be used as a political maneuver to stop Sutter Health from rebuilding Eden.

Please speak up, let our Board of Supervisors know they must not delay any further.  These delays put both hospitals in jeopardy. I encourage you to stand up and let your voice be heard on this issue.  Don’t just wait for the next hearing, but instead pick up the phone or send a letter to the Board and let them know you support the new hospital project, and encourage them to certify the EIR so the project can move forward before it’s too late.

Call today!

Supervisor Nate Miley — 510-272-6694

Supervisor Alice Lai-Bitker — 510-272-6693

Supervisor Gail Steele — 510-272-6692

Supervisor Keith Carson — 510-272-6695

Supervisor Scott Haggerty — 510-272-6691

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!