We’ve been master planning for a small hospital east of Wheatlands, and we just had a sit-down with a contractor who will price the master planning options that we designed. The little hospital presently has two buildings—one from 1970 and one from 1991—that are connected one right to the other. They need to update their facility in order to better treat patients as well as get new patients and expand their services, and they need to know what expansion plan is the best bang for the buck. Howie and I ended up with four options for them:
- Keep the existing buildings and just remodel parts of the 1970 building in stages in order to meet building and healthcare codes.
- Add onto the 1991 building and keep it mostly intact; remodel part of the 1970 building and demolish the other part.
- Add onto the 1991 building and keep it mostly intact; demolish the entire 1970 building.
- Build an entire new hospital and ditch both old buildings (sell, give to the city or county for their use, whatever)
We come up with some really schematic plans of how this would look, and the contractor figures out a per-square-foot cost for those options. A schematic plan involves rectangles and shapes filled with color and big print in them: Kitchen, Clinic, ICU, Surgery. There are no doors our countertops or beds or equipment or any of that drawn in, just general sizes and shapes. And it’s not just plopping down some colored shapes and calling it a day—the shapes have to be laid out so that it’s somewhat buildable as well as useable. For example, we have to show the imaging suite in close proximity to the emergency department as well as the clinic so that patients from either can easily get an x-ray or a CT scan. Another for example is working out how people arrive at the patient room wing—a visitor should have to walk past a check-in desk of some sort before they get to a patient room.
The schematic plans also have to be able to work on at least a general level with building, ADA, and healthcare codes. For instance, hallways in inpatient sleeping and treatment areas must be eight feet wide. Hence, when Howie and I are plopping colored rectangles onto plans, we have to make sure that we allow eight-foot-wide spaces to get through and between them. Also, the various codes require that any patient room has to have a window in it, so when we’re a-ploppin’ spaces, we can’t just smoosh the Clinic up against an existing outside wall of a patient wing because it’ll block the windows. Also, building codes require that if exterior walls of buildings are within a certain distance from each other, they have to be fire rated, and that includes the glass in the exterior windows. Fire-rated glass starts at $100 per square foot. So, putting some space between new and existing exterior walls can save you money in construction costs.
So, there’s a method to our really-schematic madness. It looks simple, but we can’t just draw some circles and squares and color them in and tell the contractor ‘vaya con Dios'. After the meeting today, we realized that we need to check into a few more concerns, such as:
- At what point of a remodeling project do you have to update everything in a building? Is that amount/standard the same amongst all the codes?
- How much of the building can be a business occupancy versus an institutional occupancy? Business occupancies require much less fireproofing and mechanical/electrical stuff, so they're generally cheaper to build than an institutional (hospital) occupancy.
- How much of the existing building is really out of compliance with present codes? If we make a plan and bullet-item list describing what's noncompliant, we can show that to the owner later on down the line when they complain about costs or get frustrated with the process. They'll say "why are we doing this shit again?" and we'll pull out the plan and the bullet list and say, "This is why; because we have a 30"x42" plan and a seven-page list of stuff that's against code in your old building, that's why."
Hopefully, we'll have pricing back from the contractor in a couple of weeks, but we'll see. What's been frustrating about all this is that we let the owner really beat us down on fee, so we've run through our fee but there's still work to be done. So, in one breath Howie says, "Look this up, do this, draw this," and in the other breath he says, "Don't spend a lot of time on this." Mmkay. Which one is it? As Liz used to say while working on Pomme de Terre, it takes as long as it takes to do a job right. No one's dragging their feet or piddling, but dammit, good work takes some time. However, I've only got a couple more days to get some stuff together for the contractor on this, so I guess the pressure's on.