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Chinese Hospital Progress Update. Planning and Design for the New Chinese Hospital May 7, 2008. Jacobs Carter Burgess with ARUP Mazzetti Associates FW Engineers SJ Engineers Herman Miller for Healthcare Davis Langdon Associates Treadwell Rollo WeAreSure KCA DPR. Chinese Hospital?.

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planning and design for the new chinese hospital may 7 2008

Chinese Hospital Progress Update

Planning and Design for theNew Chinese HospitalMay 7, 2008

Jacobs Carter Burgess

with

ARUP

Mazzetti Associates

FW Engineers

SJ Engineers

Herman Miller for Healthcare

Davis Langdon Associates

Treadwell Rollo

WeAreSure

KCA

DPR

slide2

Chinese Hospital?

  • Born November 27,1940
  • at Chinese Hospital
slide3
Epidemic outbreaks caused by the state of atmosphere or poor sanitary conditions affecting local atmosphere. Chinatown with its “foul and disgusting vapors” was the primary cause for atmospheric pollution in San Francisco.
chinese american history
Chinese American History
  • Health in Chinatown
  • Board of Health demanded that the Chinese Six Companies clean up overcrowded boarding houses and residences, and “take their sick countrymen outside the city limits.” Chinese continued to be denied care at hospitals.
  • Chinese Six Companies leaders resolved to build a hospital on the outskirts of the city, but the City Council denied the plans, because they questioned the effectiveness of Chinese medical treatment and hospital care.
  • 1876 - Smallpox epidemic hit San Francisco. Public health officials traced the source of smallpox to “unscrupulous, lying and treacherous Chinamen” and “their willful and diabolical disregard of our sanitary laws.” Chinatown was more than a slum, it was “a laboratory infection.”
health in chinatown
Health in Chinatown
  • 1900 City Officials were reluctant to finance any health services for the Chinese population even though viewed as a “laboratory infection.”
  • Chinese Consolidated Benevolent Association spearheaded efforts to provide health care services for the Chinese community. They were able to fundraise $26,000 to build the first health care dispensary.
slide6
Chinatown After San Francisco’s 1906 Earthquake
  • City Officials proposed to relocate Chinatown to a less desirable location away from the center of the city.
chinese hospital history
Chinese Hospital History
  • 1906 Tung Wah Dispensary was rebuilt after the Earthquake
  • 1918 Demand outgrew capacity of Tung Wah Dispensary. Fundraising committee formed to expand and remodel the building. The remodeling plan was suspended when the committee decided to build a completely new hospital at a different site.
  • 1922 Fifteen local Chinatown community organizations participated in a fundraising drive for the construction of the hospital. One representative of each organization later became the Board of Trustees of the hospital. Donations came from the Chinese throughout the U.S. as well as internationally from Hong Kong and Shanghai.
  • 1923 Approval of hospital project by the city’s Board of Supervisors
  • 1925 The opening of Chinese Hospital
chinese hospital history8
Chinese Hospital History
  • Chinese Hospital opened on April 18, 1925 at 835 Jackson Street with sixty patient beds.
integrated delivery system
Integrated Delivery System

CH

IDS

CCHCA

CCHP

Three partners form a “fourth” enterprise and jointly share in its success independent of individual operations

slide11

“It's not the plan that is important, it's the planning. “Graeme Edwards”Plans are nothing; planning is everything.”Dwight D. Eisenhower

the trouble with the future is that it usually arrives before we re ready for it arnold h glasgow

“The trouble with the future is that it usually arrives before we're ready for it.” Arnold H Glasgow

our approach
Our Approach
  • An Integrated Design Approach
  • Process Mapping
  • Target Costing
  • Systems Integration and Optimization
  • Decision Management
goals
Goals

To Provide Affordable New State Of The Art

Facilities From Which Chinese Hospital Can

Efficiently Meet It’s Role And Mission In The

Community

goals15
Goals

To Recognize Site Limitations and Optimize Site Use

goals16
Goals

To Optimize Construction Value Through Optimization of Engineering Systems, and the Building Envelope

goals17
Goals

To Develop the Smallest Code ConformingWorkable Spaces and Use Modular and Movable Systems Where Appropriate

goals18
Goals

To Use Proven and OSHPD Approved Materials, Assemblies and Systems Without Frills

goals19
Goals

To Minimize Cost Escalation by Using Integrated Project Delivery and Lean Practices to Reduce Time and Wasted Efforts

goals20
Goals

To Respect the Unique Nature of Chinese Hospital and Its Relationship to the Community and Between the Hospital, Health Plan and Physicians

the planning and design process
The Planning and Design Process
  • Integrated Planning and Design
  • “Inside Out and Upside Down”
  • Over 280 Meetings and Work Sessions with hospital staff, nurses, and physicians
the planning and design process22
The Planning and Design Process
  • Integrated Planning and Design
  • “A Mixture” vs “A Solution”
slide23

The Planning and Design Process

To Choose Optimal Solutions and Maximize Value Establish a Value for Each Decision Choose the Sequence with the Highest Maximum Value

an integrated delivery process26
An Integrated Delivery Process

Programs and Medical Systems

Architectural and Building Systems

Civil and Structural Systems

MEP Systems

Interiors / Modular Systems

Cost Model Reconciliation

Decision Point # 1: Confirm decision process, communications, protocols, meetings

Decision Point # 2: Confirm all current conditions, project budget elements, project schedule, and quality expectations

Decision Point # 3: Confirm process maps, room diagrams, equipment lists, floor plates, building exterior, and cost model

Decision Point # 4: Reconcile and confirm space program, architectural finish, massing and floor plates, and parking scheme

Decision Point # 5: Conduct and confirm “building level gaming,” location of all major building systems, all departments, exiting, and reconfirm cost model

Decision Point # 6: Conduct and confirm “departmental gaming,” layouts for all departments, and reconfirm cost model

Finalize Preliminary Design

Design Documentation

On Site Construction

the planning and design process27
The Planning and Design Process
  • Integrated Planning and Design
  • “Inside Out and Upside Down”
  • Process Mapping
  • Room Diagrams
  • Equipment Lists
the planning and design process28
The Planning and Design Process

ICU

Single Patient Room

the planning and design process29
The Planning and Design Process

Exam Room

Operating Room

R/F Room

Offices

Office Cubicles

the planning and design process30
The Planning and Design Process
  • Integrated Planning and Design
  • Systems Optimization
  • Structural Systems
  • Mechanical Systems
  • Electrical Systems
  • Plumbing Systems
  • Building Envelope
mechanical systems
Mechanical Systems
  • Integrated Optimization Concepts
  • Use 100% outside air, two duct system to reduce the amount of ductwork.
  • Use multiple vertical drops on the perimeter of the building for the plumbing system to minimize above ceiling conflicts and allowing for prefabrication of risers.
  • Use a prefabricated mechanical plant on the roof. The plant will be fabricated off-site and lifted into place in three stages, substantially reducing the on-site construction work and speeding the construction process.
  • Alternate the Electrical Rooms on the floors with IT Rooms.  This allows the reduction of space consumed for these functions on each floor, and has allowed the connection at all levels.
  • Use a exhaust fans on each floor eliminates the need for a central exhaust system which consumes floor space for shafts and reduces the number of ducts.
relatively short floor to floor heights
Relatively Short Floor to Floor Heights

Careful Coordination with Structural Systems

13’6” and

one floor at 12’0”

the planning and design process36
The Planning and Design Process
  • Decision Management
  • Target, Scale and Value
cost comparisons
Cost Comparisons
  • The Benefits of Cost Targeting and Control: More Space
  • $775 per square foot compared to estimated costs of well over $900 per square foot for other hospitals in California and San Francisco
  • The cost per bed is approximately $2 million per bed compared to estimates of up to $3 million per bed on other projects in San Francisco and California
the planning and design process39
The Planning and Design Process
  • Integrated Planning and Design
  • Architectural Image
  • Context
  • Community
  • Sustainability
the work continues
The Work Continues

Dependent Decision Logic

Criteria

Calculation

“Component”

Anchorage

DPR Added To Team

status
Status
  • Challenges
  • Eliminate all deferred approvals
  • Integrate detailing
  • Continuous Cost Targeting
  • Team growth
  • Intuitive and counter intuitive
  • Habit and culture
  • Sharing all information early and often
activities
Activities
  • Acquire and Integrate
  • Sub-contractors
  • Vendors
  • BIM models
  • Decision management
  • C-VSM (continuous VSM)
slide50
LEED

2 points to Gold!

activities51
Activities
  • Other Important Owner Decision Related Initiatives
  • Mock-up Rooms
  • Equipment Analysis and Selection
  • Transitional Space
considerations
Considerations
  • Scariest Statements (FEARS)
  • “Regularly Scheduled” Meetings
  • “Tell me what to do.”
  • “When you’re through, send me the drawings and I will review them right away.”
  • “Let’s keep going, it should be OK.”
  • “Why are so many people involved?”
the planning continues
The Planning Continues

My interest is in the future because I am going to spend the rest of my life there.Charles F. Kettering 1876-1958Before beginning, plan carefully. Marcus T. Cicero c. 106-43 BCA man who does not think and plan long ahead will find trouble right at his door. Confucius 551-479 BC

slide54

Chinese Hospital?

  • Born November 27,1940
  • at Chinese Hospital
thank you

Chinese Hospital Progress Update

Thank You

Jacobs Carter Burgess

with

ARUP

Mazzetti Associates

FW Engineers

SJ Engineers

Herman Miller for Healthcare

Davis Langdon Associates

Treadwell Rollo

WeAreSure

KCA

DPR