Health-care work is feeling fine in Texas, with three of the state's largest hospital expansion projects under way in Dallas, Austin and Houston.

On all three projects, the work includes expansions that involve demolition, structure-to-structure tie-ins and additional floors constructed on top of existing buildings.
Additionally, jobsites are often limited because contractors must assure that their work does not compromise the ongoing operations of the hospitals.

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Medical City Dallas

Bovis Lend Lease is the general contractor for the $80 million first phase of a massive renovation and expansion of Medical City Dallas at Forest Lane and Park Central, one of the busiest intersections in Dallas.

The first phase includes the construction of a six-story acute-care tower; renovation of an outpatient radiology unit; two-story vertical expansion on an existing building; and construction of two separate parking garages, one that will hold about 400 cars and the other for about 320 cars.

Construction started a year ago, with completion of the first phase slated for late November 2005. The onsite limitations made the project challenging, but it remains on schedule, said Monnie Wood, senior project manager for Bovis Lend Lease, a subsidiary of Lend Lease Inc. based in Sydney, Australia.

"This job required a substantial amount of preparation work," he added. "It's a very restrictive site. There's no onsite parking for our employees and our staging and lay-down area is offsite."

Wood expects things to get even more complicated as three tower cranes are moved onto the site. Two cranes will be utilized on the acute-care tower while one will be used on the vertical expansion.

Materials are hauled in on an as-needed basis.

As the prep work was being done to ready the site for the new building and the vertical expansion, Wood said his team first tore into the renovation of the outpatient radiology building. The 10,000-sq.-ft. renovation involved the demolition of the entire space. This portion of the job started in February 2003 and finished in September.

"We had to gut the entire area and then totally rebuild it," Wood added. "It involved removing all the existing walls and partitions, floor covering, ceilings and equipment."

Although no structural changes were made to the space, the construction team got involved in what Wood described as "very high-end finishes."

While the renovation was under way, crews also began construction of a 400-car parking garage that ties to the existing parking deck.

One level of the new structure, which is cast-in-place concrete, is underground, while four additional levels are above grade. Wood said this parking structure should be complete any day.

Construction on the six-story acute care tower construction is scheduled to begin in late spring and the existing parking deck and an on-grade parking area will be demolished to make way for the new structure. Bidding on the new tower began last month.

The new acute-care structure will involve the construction of a new emergency department, an intensive-care unit and a critical-care unit. The building will tie into the existing building at two levels, through the 320-car parking garage and through a connector that runs across a small roadway. Cast-in-place concrete frame work will be used on the new building, and the siding will be precast concrete panels utilizing a curtain wall system, which looks similar to the siding on the existing hospital.

Started in December 2003, the two-story vertical expansion includes the expansion of seven existing elevators and the addition of one new elevator.

The addition is built on top of one of the hospital's existing five-story structures, but the existing building was designed with the addition in mind. The building was finished with steel plates beneath the roof membrane.

Wood said workers will pull the membrane back and stand up columns to frame the structural steel for the two new floors.

The vertical addition will also be sided with precast panels on a curtain-wall system.

Until last February, there were about 75 to 80 workers on the site on a given day, but Wood expects that number to triple when work begins in earnest on the vertical expansion and the tower and parking garage.

Health-care work is nothing new for the Nashville, Tenn., office of Bovis Lend Lease, which for 23 years has been completing work around the world for HCA, the parent company of Medical City Dallas.

St. David's Medical Center Expansion

FCI Construction, general contractor for the $65 million expansion of St. David's Medical Center near downtown Austin, is faced with melding modern-day methods with '50s construction.

The project, which began in January 2003, involves a three-story tie-in addition to the existing hospital.

When complete, the new structure will double the capacity of the hospital's existing emergency room and will give the facility twice as many operating rooms.

The project has involved the demolition of a portion of the existing structure and coming up out of the ground with three floors that will attach to the old building.

Neal Moon, project manager, said one of the biggest challenges on the job was the overhead clearance in the existing building, which was completed in 1953.

"Trying to apply today's standards in floor-to-floor height has been very difficult," he added.

The new 170,000-sq.-ft. addition was topped out late last month. With a cast-in-place frame, the addition will be covered in a brick façade similar to the old St. David's building.

Moon said the expansion and related renovation should be completed by November 2005.

Memorial Hermann Southeast Hospital

With a base construction price tag of $46.4 million, the expansion of Memorial Hermann Southeast Houston Hospital is a substantial job with a variety of distinguishing elements.

Manhattan Construction is the general contractor on the project that involves the replacement of the central plant, addition of a new front entry to the hospital, construction of east and north additions, and a shell bed tower.

Started in March of last year, the project is about 40 percent complete. The target date for completion is April 2005.

Angela Hines, the project manager, said construction is going on all around the existing building.

The east addition involves the construction of a new foundation and a four-story tower with a penthouse on the fourth floor. The fourth floor will remain shell space until a later date. A steel structure on auger-cast piles, the new wing will be clad with metal panels.

The north addition involves the construction of a new foundation and a five-story tower with a penthouse. It is also structural steel on auger-cast piles, but it will be clad in with precast concrete panels.

The front of the hospital will also get a facelift, including an architectural feature that includes a large tower and skylight.

The final element of the project is the addition of a fourth floor to one wing of the existing bed tower.

The new structures are built to tie into the existing structure at column points on each floor.

"It's a challenge to keep the existing structure operational while we're tying into the structure right outside the rooms-especially in the labor and delivery area," Hines said.

"There has been a noise issue, and we've had to stop at times because it's disruptive to patients in labor. There's concrete on the existing structure, and we're having to drill plates that will receive the new structural steel. We've had a couple of instances with noise and vibration problems. It's all part of doing health-care work."

As of late last month, Hines said they are about 90 percent tied in on both buildings, with the concrete deck pouring currently taking place. Workers won't actually break into the existing corridors until the new additions are dried in, which will be later in the year.
"Now that should be really interesting and fun," Hines said.

The new additions will expand the hospital's imaging department and intensive-care units, add hospital beds, and give the facility a new emergency department and a new heart center.

More Projects Planned

Health-care construction should remain a bright spot in the Texas construction industry with major projects on drawing boards in Galveston, the Woodlands and in Austin with the continued expansion of St. David's branch hospitals.

The $150 million National Biocontainment Laboratory at the University of Texas Medical Branch at Galveston is targeted to break ground in early 2005, while St. Luke's Methodist has announced plans to build a new hospital in the Woodlands.

St. David's is expanding both its South Austin and Round Rock hospitals, while there seems to be perpetual expansion at the Texas Medical Center.