Fast-Track First-Aid

Manhattan Revives a Halted Health-Care Project

By Bruce Buckley

For physicians and caregivers, success can be measured in their ability to save lives. For the planners of the new Scott & White Center for Advanced Medicine in Temple, success is measured in their ability to save the project's lifeline - its $148 million budget.

The vision for a new 500,000-sq.-ft. hospital has gone through a series of stops, redesigns and restarts during the past four years, but crews are honing in on completing the facility by December and staying within budget.

Ground was first broken on the project in January 2003, but as the fast-track schedule proceeded, costs began to mount. Scott & White made the decision to stop work and go back to the drawing board.

Architects PageSouthlandPage of Austin came back with a redesign, and the team decided to tear down portions of what had already been built and start again.

"It made more sense, as tragic as it was, to remove some of what we had in place, keep some on the lower level and come back with a building that was more in line with our budget," said Scott Liles, associate executive director of facilities at Scott & White. "Even after the costs for the first building, we're keeping this one on budget."

Bovis Lend Lease was replaced by Manhattan Construction Co. of Houston in January 2005 as general contractor to get the project back on track. Manhattan had to hit the ground running to meet an aggressive 23-month schedule.

"There were already some foundations and walls, so we were ready to build and start punching piers right away," said Bruce Bruning, Manhattan's project manager. "There was almost an immediate need for materials right after we signed the contract. In lieu of the one to two months that you normally have to get your contracts in place for materials, it was a jumpstart from day one."

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Existing foundations and three 18-ft.-tall basement walls made up nearly one-third of the redesigned 530-ft.-long by 200-ft.-wide ground level. Manhattan added to the existing structure, punching 196 piers, ranging from 24 in. to 48 in., into the mostly rock site. By laying a new design over the previous one, Manhattan had to carefully work around utilities and trenches abandoned from the earlier project.

Among the value-engineering efforts, designers had to find ways to upgrade the existing central plant and run pipes 400 ft. around the back of a neighboring building to the new building.

"One of the biggest challenges was moving the chilled water all the way through," said Ron Pauley, project architect at PageSouthlandPage. "We had to find the most effective and least-impact pathways through the building."

The team did a lot of work in designing the superstructure to help save time and money, such as creating consistent beam depths.

"By doing that, there were only a few setups for the concrete guys and they could do their work rapid fire," Liles said.

The new center is being built as two towers - one five stories and the other eight connected by a central atrium. The first design given to Manhattan >> called for the south tower to be four stories instead of five. But with work progressing ahead of schedule, planners decided to add an additional 3,500-sq.-ft. floor in August.

"The decision to add the floor came just prior to when we had columns poured and had started decking for the roof," Bruning said. "We stopped working on the south tower, put our forces on the north tower for four weeks and came up with a new design."

With more than 22,000 cu. yd. of concrete poured and 215,000 person-hours logged by Manhattan's crews, the project topped out in October.

Exterior work has progressed through much of the year, with stone cladding the first three levels and metal panel on the remaining floors. The stone, much of which was retained from the previous project, is primarily limestone mixed with red and cast stone accents. The metal panels are copper and zinc.

The design helped save time and money because it didn't require scaffolding the entire building. Ground scaffolding was used for the stone work, while suspended scaffolds - similar to window washers - were dropped to install the metal panels.

On the interiors, great care was given to vertically match up the departments and to work within the existing column widths for optimum layouts. Approximately one-third of the ground floor is a pump room for the major mechanical systems. A hub room for the building's IT and the main switch room are also on the ground floor. The remainder of the floor houses emergency services.

The first floor includes a consolidated cardiology center with a pacemaker clinic, three catheterization labs and two electrophysiology labs. The second floor is the intensive-care unit. The third floor includes delivery rooms and nursery, while the fourth floor houses the children's hospital. The remaining upper floors are patient rooms.

Each floor has its own mechanical room, which minimized the amount of ductwork.

Manhattan worked carefully with system's provider Siemens on the interior. Siemens is under contract directly with the owner - not Manhattan - to provide systems equipment such as building control, nurse call, fire alarm, security and major electrical. In many cases, Manhattan provides the rough-in work and Siemens oversees the final installation.

"It makes it interesting to coordinate with an owner's vendor instead of our own, when we normally have more control over that coordination," Bruning said.

As the project nears completion, the focus will shift toward creating a healing environment for patients. The facility features large private rooms with space for patients, family and staff. Designers are also trying to give it a homey feel with warm colors, woods and floor patterns.

A healing garden is also being added adjacent to the building.

"I don't like white paint," Liles said. "On our list of colors, you don't see white. When you go to a resort, you don't see white walls. We want people to be comfortable."

Liles said a main goal of the project was not only to address existing needs, but to be prepared for future ones as well. Plans have already been drawn up to accommodate three additional floors on top of the five-story south tower. "We're taking the next step toward where the next building goes after this," he added. "Where do we go 20 years from now and how does this building fit into that scheme? We think we've come up with something that will be quite flexible."