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April 16, 2010
Construction is on schedule with about 80% now complete as workers begin to tackle the array of projects on their to-do list, which is also known as a punch list. Basic construction has largely been completed, though workers are still doing some ceiling and wall work in the medical labs on the second floor, and in the imaging area on the first floor. Finishing work like flooring and painting are well underway. We are beginning the fit-out stage (which simply means getting the space ready for its intended use), and turning on some major hospital-wide systems. Several air handlers have been switched on; next will come the chilled water systems, then the steam and boiler systems. These are all part of climate control. At this point we are still using a supplemental climate control system to ensure that heat and humidity stay within an acceptable range, but as we roll out the new systems over the next month we’ll be able to stop using the supplemental system.
The electrical system is also being rolled out, including our emergency power system, fire alarms, security, etc. Workers are also ensuring that all electrical outlets and computer/phone ports are up and working.
While construction is moving right along, the real excitement centers on the transition planning—the logistics of moving an entire hospital’s worth of patients, equipment, supplies, and staff (click here to learn more about two key players). The transition planning team is finishing the start-up schedule, which lists by floor and department the activities that will need to take place. They’ll manage each step we need to take to get ready to move patients into the new facility in December.
Equipment, of course, is a huge part of the picture. Hospital staff will identify each piece of currently-used equipment that will need to be disassembled, moved, and reassembled. Purchasing also will play a large role, as we complete purchases of new major pieces of equipment that were planned for the new facility, and prepare the space to start receiving items that need installation.
February 25, 2010
The new hospital is now over 65% complete! Workers are busy hanging drywall, installing cabinetry, and framing the operating room, emergency department, and radiology department. At any given time, there are about 500 workers in the building.
With the help of Lesley and Associates, our transition team and other staff are working to begin the logistical plans for moving to the new site. Part of that plan is to create a new data center at Robinwood Medical Center in preparation for the hospital move. Information services move a whopping 180 servers plus communications equipment to the new center and then will install a network within the hospital that will support all personal computers and printers. About 6,000 cables will run through the new medical center to connect all the devices.
January 28, 2010
Surgical suites are one of the most needs-intensive areas to construct in a healthcare facility—especially when it comes to equipment and building materials. The new hospital’s operating area will house the largest single-purpose air handler. It took seven truckloads of unassembled parts to create an air handler the size of an average house. This ventilation system will blow treated air into sixteen operating rooms, filtering out microscopic impurities.
Now that the operating room's walls are closed in with medical gases, power lines and data lines, a final layer of synthetic stone-like material will cover the walls. The material is manufactured in four foot sheets designed to reduce the number of wall seams, resulting in a nearly moisture-free enclosure.
Infusion Nurses Station
Until recently, construction on Imaging and the Emergency Department lagged behind other units. Now that imaging equipment vendors have been selected, their shop drawings will detail how each piece of equipment should be laid out. Construction crews will cut into the concrete floor, creating troughs for the electrical wiring that will power the imaging equipment.
In the Emergency Department, physicians and nurses created a final floor plan based on process improvements for triage and patient intake. Now, the fifty-two treatment spaces and the CT and radiology area are extensively framed out with in-wall placement of medical gases, power, and plumbing.
Typical Nurses Station
The wall closings and ceilings are completed throughout the new facility for all nursing care units. With the exception of the second and third floors, the millwork has been installed in the nursing stations and surrounding floor workstations. Starting from the fifth floor and working downward, painting and hallway tiling are well underway.
November 12, 2009
An incredibly wide variety of work is taking place in and around the new hospital. Outside the hospital, the site has been cleared as much as possible to help keep dust down. In addition, workers have done some landscaping around the chapel and cancer center. On the east face of the building, an exterior lift is still in place in order to move heavy or cumbersome equipment to the upper floors; but soon we’ll have a permit to operate from one to three elevators inside the building. Once that happens, the exterior lift will be removed and that space can be finished.
At the front of the hospital, the entrance is complete, although it doesn’t look that way. The writing visible in the photo is printed on an adhesive paper that protects the metal surface underneath from scratches.
The major goal for workers now is to get the mechanical systems in place. It’s necessary for the building to have climate control to limit humidity in the spring, and it’s both cheaper and more efficient to use our own systems to do so. That’s no small task given the amount of ductwork and the sheer size of the air handlers. The largest handler will move air throughout the first floor of the hospital, and it’s about forty-seven feet long, twenty-four feet wide, and eighteen feet high.
The next priority is to finish patient units in the south, west, and east towers, as well as the north addition. That will cover the majority of patient beds. The finishing requires ceiling and wall wiring work to be done, as well as other systems that reside in the ceilings and walls. Then workers can insulate the walls before closing it in on both sides with drywall.
Second floor construction
October 14, 2009
You may notice less dirt at the construction site these days. That’s because extra stockpiles of soil have been removed, leaving only the topsoil that will be needed for the final grading and landscaping of the site. If it seems like there are more parking lots, that’s due to recent paving activities. Now 75% of the parking lot paving is complete; the roads will not be paved until next year.
Work on the external features and structure of the new hospital is essentially complete. The roof membrane is installed, brick and stone masonry are nearly complete, and window installation is almost finished. In addition, the concrete for the helipad has been poured.
Inside the hospital, workers are roughing in the operating areas, where the equipment and light supports have already been placed. Light fixtures have also been installed in the patient rooms. Work for Information Services is nearly complete, and the installation of ductwork, drywall, and metal studs continues. On the fifth floor of the south tower, ceramic tilework has been finished and painting is underway.
Boom and light supports in the Operating Room
October 1, 2009
A great deal of progress has been made on the inside of the new hospital. Roughly three-fourths of the framing for the internal space of the new hospital is complete—by the way, that internal space measures 510,000 square feet. Also complete is installation of much of the above-ceiling mechanical, electrical (both high and low voltage), and plumbing throughout the major areas of the building.
The in-wall placement of medical gases, power, and plumbing in the inpatient, outpatient, and specialty care areas (operating rooms, invasive labs, etc.) is also well underway. In the inpatient care areas, we’ve made quite a bit of headway in installing drywall and closing up the walls, and the finish process has begun by painting, installing flooring, and installing the major bathroom fixtures.
The duct work you see entering the building on the south and west towers is a temporary means for heating and cooling the activities in those inpatient areas. Currently the front-end work needed to get permanent heated and cooled air flowing through the building. Equipment procurement activities are also well underway.
With the help of the transition planners at Lesley & Associates, a number of health system staff have begun to focus on those critical steps which will consume the final months of the project: equipment arrival and placement, testing of equipment and systems, intensive staff orientation to the space together with equipment and system training, as well as process simulation, the move itself, and post-move activities.
September 1, 2009
For most people, gazing at a garden has a calming, soothing effect. That's why gardens will be an essential part of the landscaping around the new hospital. This landscaping work will begin very soon, starting adjacent to the link and close to the chapel. The landscaping work is part of the clean-up happening around the edge of the building, where workers are also grading the dirt in preparation for paving next year.
In the main hospital, all the brickwork has been completed and all of the windows have been installed. Also notice the stonework at the main entrance; it marks the exterior of the cafeteria area as well. Eventually visitors will be able to see the stonework continued on the interior walls of the cafeteria.
The louvers for the mechanical room are in place. The yellow visible around the main entrance is an undermaterial that will be covered by aluminum strips with a clean, modern look. Workers are also busy installing several elevators; once one is working, they'll be able to remove the exterior elevator that had been installed to move building materials to the upper floors. The roofing for the main building is about 90% complete.
Inside the hospital, construction is being done from the top down to keep finished areas as clean as possible. In the south tower, workers are building out two patient care units. The drywall there is in place (although no ceilings yet) and painting has started. A key factor as construction continues will be humidification. After the permanent humidification system is in place, workers will be able to install millwork, cabinets, and flooring. Until then, there is too much potential for the materials to warp due to changing humidity.
August 7, 2009
Work is underway on the engineering building, which is technically part of the hospital but in some ways a world in itself. The ceilings in the engineering building will be twenty-four feet high, leaving plenty of room for the huge amount of equipment that will be housed here. That includes a great number of pipes, some of which are about two feet in diameter. They’ll pump steam and hot water—heated by three boilers—throughout the facility, as well as chilled water (part of the air conditioning). In addition, the area will house a power plant with substations and air handling units.
You may notice some paving has been done. It might seem early yet, but this serves an important purpose: helping keep dust down.
Much progress has been made on the link between the hospital and Robinwood. When completed, one side of the link will be all glass, providing a garden view. A bit of the bright white roof is visible on the webcam. The white color is part of the entire facility’s energy-efficient design, as white will reflect heat away from the roof instead of absorbing it, as much asphalt-style roofing does. Altogether there are thirty-seven “pieces” of roof being placed.
For the hospital itself, steel work, concrete pouring, and precast placement have all been completed, and the brickwork is nearly done. Note the red design element in the windows—it matches the red color on the roof of Robinwood Medical Center.
July 8, 2009
The main entrance is taking shape, and workers have made significant progress on the link adjacent to it. The precast exterior panels that form the façade of the hospital now have wall foam installation. And in the east tower, masonry work continues along with window installation.
Meanwhile, important interior works continues: ductwork installation, metal stud and drywall installation on all floors, plumbing and electrical rough-ins on all floors, and setting of door frames. In addition, the center area and elevator penthouse are complete, although some metal work and detailing remain.
Perhaps most dramatic is the “curtain wall" in the center tower, which has been framed. This will consist of windows, creating a bright and interesting focal point from inside or outside the building.
Curtain wall being installed
June 4, 2009
You’ll see big changes in the structure of the hospital these days, perhaps the most striking being the work done to bridge the gap between it and Robinwood Medical Center. The “link” will house a number of services, including the Wound Center, Cardiac Rehab, Health Management, and Behavioral Health Services outpatient care. In addition, Volunteer Services, the Medical Library, Spiritual Care, and other offices will be part of this area. The area of the link where the steel appears a bit higher will be the roof of the chapel.
In the rest of the building, progress continues with both exterior and interior work. Brickwork has been completed on three towers, and glass is being installed in the windows. Inside, rooms are being roughed in.
Meanwhile, a mock patient room has been created in a separate building on site. Built to size, the room will be used to fine-tune the locations of furniture, grab bars, televisions, etc. With a furnished mock room, nurses and other healthcare staff can try out different arrangements of movable items to determine which arrangement will best meet their needs and patients’ needs in the final design. Workers will then be able to install these items quickly and efficiently for optimal use of the space.
The bridge attached to Robinwood at the Cancer Center
West tower exterior
Framing a typical patient room
May 6, 2009
Have you noticed that the construction site is down to just one crane? It will be used to start erecting the last of the steel later this month. In the meantime, the elevator tower is taking shape, with workers finishing up its coverings.
There is a metal shaft running alongside the elevator tower that’s used to carry brick. Unlike the other towers, which are covered in a combination of brown and cream-colored bricks, the elevator tower will have a red brick exterior.
Window frames are now going in as well, and the window glass is scheduled to arrive next week. The largest area of windows in the medical center will be located adjacent to the elevator tower, between the red and brown bricks.
April 30, 2009
The exterior of the new medical center is well on its way to what will be its final external appearance. All of the precast panels have been installed—227 in total, covering 30,000 square feet. In addition, the masons have completed laying brick on the south tower, as well as part of the west tower. In addition, two towers now have roofs, and a third roof is underway. The towers should be “dry” (meaning sealed from the elements) in mid-summer.
On the inside, all of the towers now have concrete floors, and the mechanical and electrical workers are continuing their installations. The next major indoor challenge will be installation of the air handlers, the first of which will be delivered in late June. The handlers connect to the ductwork and will keep clean air circulating throughout the medical center. It’s a big job, which explains why each of the eight handlers is big enough to fill an office.
April 2, 2009
Work is picking up even more as the number of workers onsite doubles from 125 to 250. There is now activity in every part of the new medical center except the link between the hospital and Robinwood Medical Center, which will be completed later in the process. Forty masons are hard at work laying bricks, and the mechanical and electrical workers are making their installations.
Interior work has begun in the south tower, where the ductwork is finished and wall studs are going into place. With a building this large, the ductwork is of considerable size as well—the largest ducts are about nine feet wide.
In the center of the three towers, the elevator hoists are being installed, and the motors will be brought up by a crane. There will be nine elevators altogether: three for patient movement, three for materials management (hospital supplies), and three for visitor use.
March 23, 2009
Working our way around the towers, workers have been putting pre-cast slabs in place on the west tower, where the floors have now been poured. Around the main entrance to the new hospital, workers are erecting steel for the future admitting area and concourse to the elevator towers.
What’s more interesting is that work is beginning on the brick façades that will fill in some of the gaps in the precast slabs. Scaffolding is up for the south tower so that workers can begin applying the bricks there. The center section will also include large windows. Workers will be able to lay between four and five feet of brick each day before pausing so that the mortar can set.
The structure will actually be much more complex than it looks. Behind the brick are yellowish boards; these panels repel water. Behind them is a thin layer of rubber, then drywall. The wall studs will be stuffed with insulation, then there is a final layer of interior drywall. So while in the end you’ll see only brick on the outside and drywall on the inside, there are really five layers of material in place. In addition, the brick façade will incorporate valves at the bottom to drain any water that gets through.
March 6, 2009
Yesterday we celebrated a milestone when the placement of a special steel beam marked the completion of steelwork in the three main towers of the new medical center.
This particular beam is very special. First, it represents an important point in the construction process and is a visible symbol of our progress. Secondly, it’s covered with signatures. The beam was painted white with a special fireproofing paint, and individuals who made donations for the new hospital were invited last weekend to add their signatures to the piece.
During the topping off ceremony a crane lifted the beam and placed it on the elevator tower, at the highest point in the medical center, which is eighty to ninety feet above grade.
It was a great celebration—we enjoyed nice weather and a good crowd, including many of the hospital’s major donors who have helped make this project possible.
February 27, 2009
South – west – east: that’s the order of construction tasks for the three main towers, and construction is proceeding smoothly on all three.
The south tower now has a good number of concrete slabs in place, but the last of the slabs won’t be affixed to the structure until more materials have been delivered into the space. After all, it’s a lot easier to move large items into a building without solid walls.
The pre-cast slabs are made in a factory off site and can weigh anywhere from 1,600 pounds to 13,000 pounds. In spite of their considerable weight, they can still catch the wind if it rises above twenty miles per hour, so in windy conditions, slab placement must stop temporarily.
Fireproofing continues in the west tower, along with pouring the floor slabs. In the east tower, workers are working on the floor slab that’s on grade, meaning on the ground. This is both the most difficult and critical slab in the tower. It will be thicker than the slabs for other floors, and problems now could mean breakage over time. The difficulty lies in the fact that it’s poured over dirt and a compressed stone base, so it’s exposed to ground moisture. In contrast, the other floors have metal decking that functions like a giant tray. The concrete is poured into this decking at a particular thickness, and it’s a more controlled environment.
There is some steelwork still underway in the two-story structure that will house the hospital’s main entrance and admitting/registration areas. Altogether there will be 3,000 tons of steel in the new hospital, with 2,000 of those tons in the three main towers.
February 20, 2009
The south tower is the tower to watch this week, because workers are beginning to erect the large pre-cast concrete slabs that will make up the external covering of the tower. This skin has holes where the windows will be placed, but otherwise it provides our first glimpse of the appearance of the exterior of the new hospital.
Behind the south tower will be the emergency department complex, a one-story structure with a landing pad on top for the helicopter. Steel construction for the first half of this area is now underway.
The plastic sheeting that previously encased the south tower has moved on to the west tower so that workers can pour slabs for the floors and complete the fireproofing there. Moving to the east tower, the steel there has been erected, and workers are beginning to put metal decks in place that will serve as flooring until they’re able to pour the concrete slabs. Unlike the south tower, which has five floors with one below grade (underground), the east tower will have just four floors, all above grade. These floors include the future home of the Family Birthing Center and the women’s medical-surgical unit.
In addition, the steel for the main elevator complex has been erected. The elevator shafts have been completed as well, and our new elevators are on order.
February 6, 2009
Well, the plastic sheeting wrapped around the South tower is already starting to come down. That’s good news, actually, because it means that the concrete and fireproofing work in that tower has been completed.
Next up is the west tower, which will be wrapped up for the same reasons. Right now that tower has had about 90% of its steel work done. By the way, of the four cranes currently at the site, three of them are dedicated to erecting steel.
Another important part of the concrete work is mostly complete as well, and that’s the slab for the connector between Robinwood Medical Center and the new hospital. The connector will have a two-story section that connects to Robinwood and a single-story section that connects to the new hospital’s entrance. Steel work on the two-story section is now complete. Ultimately, the first floor of the connector will house the chapel and a number of outpatient treatment areas.
If you happen to drive by the construction site, keep an eye out for large concrete panels being affixed to the outside of the South tower. This “skin” as it’s called will make up the exterior covering of the new hospital.
January 28, 2009
If you’ve driven by Robinwood Medical Center, you might wonder why part of the new construction appears to be gift-wrapped.
The South tower is, in fact, completely encased in plastic sheeting right now. It’s not some form of modern art; the plastic serves a very practical purpose. The wrapping allows the building to be heated, so that the temperature is high enough for concrete to be poured and to set properly. The higher temperature also means that workers will be able to apply fireproofing to the steel. While it’s not exactly balmy weather inside, the construction workers appreciate the warmer temperature and being sheltered from the wind.
The South tower has five floors, with the lowest level below grade. Concrete slabs have been poured for all five floors, and the building has stairs so that workers don’t have to climb ladders to move the fifteen feet from floor to floor.
The plastic will later have to be removed, but by insulating and heating the space, crews are able to keep the project moving forward.
August 8, 2008
Right now, the construction at Robinwood is all about the rock—bedrock. Efforts are focused on locating placements for and pouring the caissons, a type of foundation that is built on bedrock and can support particularly heavy weight.
Caissons are long concrete cylinders that are three to four feet wide and can be forty feet long or even longer. They’ll support the heaviest parts of the hospital, the towers. A total of 150 caissons will be needed for the hospital, and so far about thirty caissons have been poured, all for the south tower.
For stability and strength, it’s critical that caissons be placed on bedrock. In order to reach bedrock, the construction engineers are finding it necessary to drill through limestone—in places, as much as twenty feet of limestone.
Caisson holes are drilled using cylinders four feet across covered in teeth at the bottom. As the drill rotates, the teeth dig into the limestone.
The original construction plans called for using three drilling rigs. However, because of the drilling difficulties, now four drills are being used, with plans to add a fifth.
Once the caissons are in place, then the foundation pieces will be joined together and steel construction will begin.
The time has also come for hospital administration to begin thinking about an alternate use for the current hospital site. The hospital is working with the city, county, and state to determine if an urgent care center or an emergency department would be appropriate in downtown Hagerstown. The state will make the final decision on the type of facility.