Kaiser Permanente, one of Californias largest healthcare providers, began plans for a major new Replacement Hospital on a green field site in the City of Downey to replace the aging Kaiser Bellflower Medical Center. The team of Kaiser Permanente, HMC Architects, and McCarthy Building Company began in 2003 with a traditional design/bid/build process, but quickly embraced a much more integrated project approach; long before integrated project approaches became main stream. The result of this collaboration is a state-of-the-art hospital that was completed three months ahead of schedule and approximately 17% under budget without changing the project scope. Even more impressive is that this was accomplished during a period when construction costs, materials costs, and labor shortages were escalating at unprecedented rates.

A partnership was quickly formed between Kaiser, HMC, and McCarthy with real-time project scheduling and project cost estimating a top priority for all. Master plans, programs, and schematic designs were quickly developed. A web-based program allowed for over 50 participating companies to work on and review one set of documents, where they could obtain current backgrounds, review project criteria, and maintain control of the each project simultaneously. A plan was coordinated with the Office of Statewide Health Planning and Development to submit the package for approval in nine increments for the hospital, the site, and the central plant projects. This allowed for a staged submittal and review process that corresponded with the construction schedule, allowing the project to move at a much faster pace. This was one of the first times OSHPD allowed this to occur, and its success is evident by the number of projects utilizing this same process today.

Upon completion of the design development phase, a plan was developed to subcontract the MEP package for design/build. This idea was a first for Kaiser and their project team. The result was a much-improved, value-engineered MEP package for the hospital which led to considerable cost savings.

Another advantage realized in the design-build MEP package was the ability to incorporate 3-D modeling. While BIM was still in its infancy, the team was able to run clash detections for the MEP systems, as well as for the fire sprinklers and the pneumatic tube system, prior to permit, therefore identifying and resolving system conflicts and interferences. Vertical plumbing system and overhead utility coordination identified beam interferences and wall location adjustments that required HMC to resolve these issues, which was done with the least impact to the program.

This presentation will explore the innovative solutions the team developed due to unforeseen circumstances, enabled by real-time work on the project and in the construction field. Honesty, integrity, and a team of senior architects, engineers, and contractors working together on site every day provided the success for this new flagship hospital for Kaiser Permanente and its members.