Vaya con Dios, mi amigo!

This week is Intern Timmy's last week at Design Associates. Timmy managed to get an interview over at the firm that Jacqueline (for DA architect, worked on Pomme de Terre, for those of you who remember) is at now, and he scored a great position with a respectable increase in salary. We're taking him to lunch this week, of course, and while I'm sad to see him go, I'm excited that he's going off to some new challenges at a smaller firm for more cashola.

It's not just the money, though. With less work in the office, Howie has become a control freak/micromanager extraordinaire, and it's killing those who must work with him. The money is what made Intern Timmy's new job offer irresistible, but the fact that his boss has become a grand mal pain in the ass was the straw that broke the camel's back. As I hear it (firsthand and secondhand), both Liz and Ingrid, two long-time members of Team Howie, would love to GTFO and work somewhere they weren't being micromanaged constantly, but there's still not a lot of hiring out there right now. (Timmy found a position that happened to perfectly fit his skills as an intern who's taken a couple of the ARE exams and is extremely good with Revit.) Myself, I know that I'm lucky to have been working for the past few months with Mr. Lassez-Faire himself, aka Sven, on Gestalt HMO's projects. That's probably why I'm still sane and not chewing off my own tongue.

Sadly, though, I understand from Timmy that Intern Kimmy is about to have to finish the CA on TCMC, which Timmy worked on in DDs and CDs and part of CA. Thing is, I worked on TCMC in DDs and CDs, but Howie didn't ask me to do squat on it. This is likely because the project's fee is really low, and Intern Kimmy will cost the project less than me, an architect. Now she has to deal with the mania that is Howie on a much more involved basis.

Working for Howie isn't awful, per se. He's clear and specific, and that can ultimately make one's job (and worklife) easier. But if he doesn't have enough to do, he puts way too much attention on too few tasks, and suddenly he won't get out of his employees' way and let them do their jobs. If he's not careful, he's going to run off a lot more than Intern Timmy.

I'm not finished, but I'm done.

Seriously. I'm there.

I'll spare you the gory details because they make me so angry, but my structural consultant on TCMC (who's never given me a bit of trouble in nearly ten years) hasn't really looked at the drawings in a month until his QC guy noticed that we were removing a bunch of walls that he needed to remain in order to carry some roof loads. He notices this on Monday, and then he notices again on Wednesday when I called him to ask him about his final revisions to his plans that were due later that day. He blamed the lack of oversight on a tight budget, but come. on. We removed five exterior walls from this area of the building in the drawings two months ago. Spend half an hour with the drawing set and I think that would become clear pretty quickly.

Thing is, architecture is done, and structural is done. We're waiting on mechanical to reconfigure their ductwork with all these new walls and beams suddenly in the space where they weren't before. Mechanical has not impressed me so far on this project...well, up until now. They've really stepped up after the contortions that structural gave us so late in the game, and I appreciate it like hell. And Howie says we're probably going to owe them a li'l cash when this is over. Rightfully so--I'm sure they've gone way over their fee for reasons that were completely out of their control. But the fee thing is killing everyone these days. In order to get jobs, we're all getting paid less because every client wants a deal, like they're buying their plans at Costco or something. But the project is at the point where no one can afford to work on it, which sends it into a death spiral of poor quality, and if we do a crappy job we won't get hired again, and then we won't get work....

Furthermore, I've had it with Howie on this project. He believed that when my structural guy called up all surprised about these walls that were "suddenly" missing, I should have called him on it and made him admit that he didn't look at my drawings. I didn't do that for two reasons: one, I had problems to solve. We can point fingers later, but right now I need everyone's cooperation in order to solve it in the short amount of time we have to get this done. And second, the engineer already admitted inadvertently that he hadn't looked at my drawings--he did so on Monday when he said, "I just the report back from my QC guy, and it appears that you guys are all of a sudden now taking out all the exterior walls in this area--is that correct?" It wasn't all of a sudden; the walls have been gone for about two months. And also, your QC saw this, not you? Busted. So no, Howie, I didn't give him grief when he said it, because I used my "psychic female intuition," which is commonly called "listening" and "making logical conclusions" to figure out in about 2.3 nanoseconds just exactly how this got missed. I didn't need to engage in your particular brand of a macho-man pissing contest in order to make him admit guilt. It doesn't satisfy me the way it does you. now get the fuck out of my way and let me finish this project.

So, I'm just done.

Today, we should be getting the mechanical engineer's information, and we'll work with him some to make sure that nothing in his model is colliding with anything important in any other model, and then we'll print the drawings and be done. The submittal to the state health department will have to happen next week by someone other than me, because I'm gone-baby-gone to Georgia for a week. And if those dipshits are lucky, I'll check my email periodically to see if anyone has any questions.

Guess who needs a massage and a nap?

Still here...sorta

My deadline got pushed to Wednesday, so Intern Timmy and I still have one more day of work to do on TCMC. Turns out that our structural engineer hasn't really looked at the drawings for the past two months, and he suddenly realized that we were tearing out a lot more of the load-bearing walls than he originally thought. Plus, we finally heard back from the OR equipment company about where the surgery booms should be placed, which left the MEP engineers very little time to really revise their drawings properly for a deadline today. Hence, the delay in the deadline.

This one-day extension is good and bad. Good in that we've got a little extra time to check things, coordinate stuff, get everyone on the same page. Bad in that everyone was planning on being done today--the engineers had booked their drafters on other projects tomorrow, and Intern Timmy and I are both working overtime and need to take those hours off pretty soon. Further complicating matters is that the delay in deadline means that I have to get a package ready to go to the state health department for review, but it might not be ready to go out until next week...when I'm gone to Georgia.

My sister and I IM'd briefly today regarding our maddening end-of-year schedules, and we came to the same conclusion: we may not be finished, but we're DONE.

Justwaittiltuesday justwaittiltuesday justwaittiltuesday...

Y'all, it appears that I'm going to have to work both days this weekend, both for TCMC's Tuesday deadline and for Mickey's project that I'm helping him with, for which he has to pick up drawings from the office Sunday night to take with him on an early Monday morning flight to an all-week client meeting. And I'm so worn out from changing mental gears but racing along in 6th gear physically (occasionally with m parking brake on) for the past three days that I only have the energy to read catalogs when I get home. Not even magazines, y'all: catalogs.

Hence, I'm not gonna have anything useful or coherent to say on WAD until Wednesday. Please stand by--I'll be back soon after my deadlines have passed. Word.

Check the oven, I think the architect is done

Is it just me, or is everyone ready for the four-day weekend? I had an all-morning coordination meeting today on TCMC, which was followed by another hour-long meeting with Howie over what he wants changed in the drawing set, because gloriosky! we couldn't possibly be done with him changing his mind with less than two weeks to go before final CDs go out. I found myself collapsed in my fancy-schmancy $750 Herman Miller Think chair and drained of all useful thought and energy. It wasn't quite a flu-like feeling, but I'm sure you've felt it. Just wiped. out.

It doesn't help that Howie wants me working no more than 18 hours a week on this project. In order to do a good job on it, I need to be able to work steadily on it in order to answer questions and fix things and look up other stuff while Intern Timmy draws and draws and draws and draws and caters to Howie's graphical whims. Thankfully, I have another project in the office that I can help on, but it seems like they only need help at almost the same time that I have a deadline. Then when I have not much to do on TCMC, they don't need me.

The sound of Howie's voice annoys me. The hum of Revit thinking as it saves back to the central file annoys me. Having to make coffee yet again because someone drained the pot and couldn't for some reason make some more French Roast annoys me. I'm done, D-U-N. I want to go home and eat my mom's Thanksgiving turkey for the first time in seven years. I want to go to the spa with m sister and then go to her little house and snuggy her menagerie of kittehs and chikinz and singular puppeh. I want to enjoy a little humidity and goof off time with my cutie pie Guy.

Meh. One more day of drawing and I'm Audi 5000. The office should be a ghost ship today, so maybe I'll actually get something done for a change.

The price is (almost) right

Earlier this week, we finally heard from the contractor on the DD pricing for TCMC, and we were pretty close to budget. Howie and I met with Akira from Avanta Health and several guys from the contracting company, whom I'll call Builditol Construction. Attending from Builditol was the project manager, who oversees budgets, schedules, and scope from start to finish; the main estimator, who sends out drawings and gathers bids on the work from various subcontractors; the MEP expert (for lack of a better phrase), who used to install mechanical and plumbing systems, so he knows a lot about MEP (mechanical, electrical, and plumbing) and can attest to what it takes to put those systems in a building as well as vet the prices that the subs send them; and a tech person who helped them navigate the various drawings and spreadsheets and so on that they pulled up on their laptops as we talked.

We were about 6% over construction budget, which could be accounted for partially through unforeseen issues with the project in general (like having to move a generator that we didn't think/know we'd have to move) and added scope from the owner (some extra sitework and retaining walls that they wanted in the side yard by the surgery department). It was also nice to see that Builditol included a fair amount of escalation and contingency in their original numbers from SD (which were just barely in budget) so that we had room for some additional problems that we didn't foresee and some other scope creep from the owner.

I should explain some terms here briefly, and I'll use the example of redoing a bathroom in your own home as a basis for these definitions. Let's say you decide that in 2010, you're going to remodel your master bathroom: new toilets and sinks and faucets and shower/tub and flooring and tile and even new lighting. Very cool, right? Well, let's say you decide you're going to do this yourself, so after you've drawn up plans and you know what you want where, you visit Home Depot and Lowe's and The Great Indoors, among other places, and you pick what fixtures you want and what tile you want and how much tile and so on. Then, you add up the costs of each of those items and that final number gives you your base budget. But let's think about this: if you're buying all these things in 2010 and not now, the costs may go up. Maybe when everyone starts shopping again, retailers will increase prices, or maybe the costs will go up because there won't be enough toilets to meet the demand of all the people buying them. The extra cost that contractors include to account for the price of things going up in the future is called escalation.

Now, you're looking at your bathroom, and you realize that the house is over fifty years old, and Lawd only knows what's in that wall when you tear off the tile, and Jesus, Mary, and Bob Vila help us if there's mold or evidence of a bad subfloor under there when you pull out that old tub insert. You'll need to fix those items--now you've got extra wall board or plywood subflooring to buy, maybe some sleepers to put under the existing floor joists, a little Kilz to mitigate any mild moldy funk. But uh-oh...did you account for all this extra spending? If you included contingency you did, at least to some extent. The other place that contingency gets eaten up in a project is scope creep: you decide that while you're doing the bathroom, you'll add a little wet bar in your bedroom on the other side of the bathroom wall where you're running a plumbing pipe anyway. Why not? you think. Well, at the very least, it's just adding more cost. At the worst, each bit of scope creep--adding something to the project that wasn't originally part of the project--begets new problems that require more contingency and/or scope creep. So adding that wet bar in the bedroom suddenly means that the pocket door no longer has a wall to tuck into, so now you need a new door, but because the house is so old it's settled and you have to redo the door frame and replumb it, but now you've cut a larger hole in the wall to get the new swinging door to fit so you have to redo the drywall in the bedroom, which means painting....

It's at the point when you realize that the budget is too small to do what you want that you may engage in value engineering, or VE, as we in Da Biz (un)affectionately call it. Value engineering is supposed to be a process in which the design and construction team brainstorms ways to get the project in budget but not sacrifice quality--is there a cheaper product that works just as well? Is there a supplier that can get us the product ( or a comparable one) faster or cheaper? Is there a subcontractor who can do just as good of a job for less? While this sounds fantastic, what it usually means is that we strip the building of nice finishes (say goodbye to the really cool carpet and interesting sheet vinyl patterns) and even some useful stuff ( looks like the heat and AC for the entire west portion of the admin wing gets controlled by one VAV box--good luck with that). In some VE efforts I've done, we really did get value: for example, a cabinetmaker suggested that we use regular rubber wall base as the base for some cabinets under contertops because the rubber would hold up better to being kicked than the plastic laminate would. That's a great idea! Not so great was when we superstripped the sheet vinyl brands and colors and patterns in Wheatlands--turns out we even eliminated the antistatic sheet vinyl that was required in the equipment room for the MRI. I haven't heard of anything arcing or blowing up out there, but it's only been a couple of years. So, let's say you decide you really want the wet bar, so you decide to keep the old tub and just replace the sink and toilet, and you decide to redo the walls with a less expensive tile--no glass accents like you planned previously. You'll replace the flooring, but not in this project, maybe later in 2010.

So, we got some really good news today. We're pretty close to being on budget, so next week we'll present these numbers to TCMC and ask them if they're good with us proceeding. We have our fingers crossed--Lawd knows we'd all like some work to do.

Are my ears ringing or is it just quiet?

It occurred to me this afternoon that I haven't been really unbusy for a long time, for most of 2009 in fact. This is a good thing, really. For the vast majority of the year, I've been either just busy enough, decently busy, or almost crazy busy. And suddenly, I find myself barely busy enough. And it feels weird.

Last week I wrapped up two deadlines in the same week: TCMC and FCH. On TCMC, we finished the DD drawings, so we're not working on the project at all until the contractor has priced the drawings and Avanta Health has approved of the design, all of which should be completed by early November. The day after the TCMC deadline, Intern Kimmy and I wrapped up the partial DDs and handed them off to Contigo Architects, who will be the architect of record on FCH. They'll complete the DDs and CDs and then oversee construction of the project. Hence, we won't be working on that project at all after last week. The deadlines, as you may recall, came at a great time, as the day after FCH went out the door, my sister flew into town and I was able to take off two full weekdays with her--epic squee! But after the quiet few days I've had, I'm wishing I'd taken three days with her--I ran out of stuff to do today.

Architecture, as I've commented many times here on WAD, is a cyclical bidnazz. Sometimes we're crazy busy, other times we're mostly or partially idle. I was able to help Prudence, the head of interiors, with a small project that needed to go out the door--a two-page permit set to move a door in a clinic--but that ran out this afternoon, and I suddenly realized that the volume of work that had allowed me to bill between 36 and 40 hours for nine months was suddenly gone. What this also means is that the cash flow problem that has been plaguing many of my colleagues has not been a problem for me until now. I know, I've been pretty lucky.

I always get a little freaked out when I'm idle, but I'm sure it won't last. Sven will eventually have something for me, Prudence will need a little help over here, and TCMC will come back and need finishing. Meanwhile, I just have to take a deep breath and be patient. Which is not my strong suit.

Meanwhile, back in Architectureland...

...the board of directors for TCMC have approved a couple extra hundred grand to allow for an addition as well as the renovation of their existing surgery suite. Bosley and Howie went to the meeting and presented the pros and cons, the contractors were there to answer some questions about those pros and cons and give their two cents' worth, and Akira from Avanta was there for...some reason, I'm not sure what. Wes evidently couldn't be bothered to go, or maybe he figured there was no reason to show up if increasing the budget was a foregone conclusion. Apparently, during the two weeks between our last meeting with TCMC and their board meeting, there had been more talk amongst the hospital staff and the community, and more support had been garnered for approving the extra cabbage roll if it was at all available.

I'm surprised, but I guess I shouldn't be, really. I'm surprised because it's rare that architecture projects in general and healthcare projects in particular can get extra funds approved, especially here lately in the Land of Ever-Decreasing Funding that is construction finance. However, I've noticed that if a project involves a department that makes money--like imaging or surgery, or in some facilities OB/GYN or physical therapy--boards and CFOs are more likely to go digging through the sofa cushions for change if the project needs more to make it right. No one wants to underfund the improvements of a service line that actually pads the coffers of the facility. (I've heard mixed reviews on renovations of EDs [emergency departments], as they frequently lose money but you can't not have them, or if you do have them they have to be good or you could get sued if someone dies in your ED.) So, in that light, it makes sense that TCMC's surgery suite would get the extra cashola to rock-n-rolla.

Meanwhile, Intern Kimmy and I just sent out the SDs for FCH's surgery and ICU renovations, and it actually kinda exhausted me. It was a normal workweek, no overtime involved, but Bosley had been out of the office for six straight workdays and suddenly had to put his hands on the drawings. It was nothing too big, just some exterior roof system details, but it was just enough to frustrate me. Here's the deal: SD, or schematic design, is usually a pretty thin set of drawings. I do a few plans and exterior elevations, and then the engineers do a narrative or two that explain what's going on in the project and what will need to be done, and then the contractor (if you have one on board) will use those few documents to do some early cost-per-square-foot pricing. Peeps, I'm here to tell you that Kimmy and I put out a 28-page SD set. Seriously, it was ridiculous. The architect from the firm-of-record that will inherit our drawings in a month called me all surprised, but for the opposite reason that I thought. "Pixie," he said almost breathlessly, "I just heard that the engineers aren't doing any drawings...?"

"No," I responded. "SD is usually a couple of plans and exterior elevations, maybe a schematic spec to help the contractor understand what systems and finishes I'm using, and the engineers do the same thing, but with narratives." I saw Kimmy's shocked and slightly-offended face pop up over the cubicle partition in my direction. We made eye contact and I continued. "To be fair, we did the SD plan for this project during the master planning effort for FCH, so these drawings are really ahead of what we usually do."

After I hung up with the architect, Kimmy said, "Pix! He just called me and asked me that very question about the engineers not doing drawings! Did he think I was lying or something?!"

I shook my head. "I don't think he does a lot of hospitals, and maybe SD is different for the kinds of projects he usually does. Go figure."

After all, Akira is using a couple of floor plans from DA as well as the engineers' pricing/scope narratives that we did three weeks ago to take to the Avanta headquarters in California to get SD approval from the bigwigs. If a couple of plans are good enough for healthcare management poobahs, it ought to be good enough for everyone else.

Playing devil's advocate is a helluva job

Part of being an architect (one of the many parts they don't tell you about in college) is that you have to occasionally save your client from themselves. This is not always easy, and rarely is it fun. We've had to do that recently with Tumbleweed County Medical Center (TCMC), and it made for a momentarily tense meeting.

TCMC is remodeling their surgery department, a project which I first spoke about here, and we wrapped up our initial space planning and pricing assessments last week and presented them to TCMC's executive staff (CEO, CFO, and CNO [Chief Nursing Officer]) and staff (facility manager, infection control staff, IT and security, and actual surgery nurses and an occasional physician who can take a break from surgery and drop by). Well, what happened is we came up with two plans: one that involved them just renovating in place and taking over a couple of nearby rooms in the hospital in order to renovate their department and make it useable as well as code-compliant, and another that invovled adding onto the outside wall of the existing surgery department and locating some program (i.e., rooms that you need in a department) there. We then listed pros and cons of the two plans, and it was pretty clear to us that the expansion+ renovation plan was better for TCMC than the renovation-only plan. Problem is, we knew it was likely going to cost more.

We have a contractor already on board, and the cost estimator from the contractor took our plans and figured out the costs associated with them. And I mean he really figured them out: because we gave him a 3D model instead of just some flat paper (or 2D CAD) drawings, he was able to see how much drywall and how many studs are in the drawings we made, what area of bricks, about how much ductwork, and so on. The contractor's construction estimate showed that the renovation + addition option cost about 20% more than the renovation-only option. We winced a bit, but we also felt like the estimates were good ones that the contractor could stand behind for a reasonable amount of time and had included proper escalation (i.e., inflation over the coming months that would make the construction costs go up) and contingency (the money you use to cover the stuff you didn't know was in the walls or suddenly go 'oh shit!' over during the course of construction).

So, we presented the plans to TCMC's executives and the users (facilities, surgery staff, and IT) and revealed our numbers. Wes, the project executive for Avanta, was there with Akira, his new Avanta project manager who handles a lot of Wes' projects. (So far I like Akira fine, but my jury is out on Wes. He's a hard dude to read.) Akira took the contractor's construction costs numbers and put them into a larger spreadsheet that Avanta uses to calculate total project costs. For example, the contractor's numbers don't include costs for medical equipment purchase and installation, nor does it include furniture or IT cabling and hook-up or asbestos removal. Avanta also included some slightly higher-than-average escalation and contingency upon contingency. When Avanta was done, their project costs had nearly doubled the contractor's construction costs. That felt kinda right but kinda weird at the same time. When all was said and done, the renovation-only project costs were just under the total project budget, and the renovation + addition project costs were about 14% over the total project budget. Everyone sat for a few seconds and let it sink in.

Then, Wes slightly shrugged and sat back in his seat and said, "Well, looks like we have to renovate only."

There was another small silence, and the CEO, a lovely woman in her mid-40s who looks like she'd be more at home in a PTA meeting than a boardroom, suddenly spoke up and showed everyone just why she belonged in that boardroom. "There's no question that the renovation-and-addition is the best bet for us," she began. "It gives us flexibility to grow in the future. We have two questions now: how can we reduce the gap between what it costs and what we have, and can we ask the TCMC board for a little more if we narrow that gap?"

Howie and I exchanged a quick look. Did TCMC's board have enough money? Wait--was all the budget money Avanta's money or TCMC's? Turns out, it was TCMC's board that allocated these funds 18 months ago, not Avanta. So why did Wes suddenly look so startled across the room when the CEO spoke up? Isn't his job to make the hospital's facility work well with regard to its physical appearance and operation?

A scrub nurse stood up at the back of the room. "Look," he said urgently as he readjusted his head rag made of flame-print scrub material, "I know budgets are important and they're made to be stuck to. But what does it say to our patients if they walk into this renovation only department and see that all the post-op bays open onto each other and thre's really not a lot of privacy? What if they see that we've outgrown the space as soon as we move in? They're gonna go elswhere. They're gonna go to Hepsburg...or Wheatlands." (Note for newcomers to WAD: Howie and I did the replacement hospital at Wheatlands, and their new building is forcing a lot of other nearby facilities to upgrade their stuff or risk losing patients to them. Some people in western Kansas say "Wheatlands" as if they're about to spit.)

Wes was clearly outnumbered here, and so we began picking through Akira's numbers and discovered about $150,000 in unnecessary costs (for example, he accounted for two new anesthesia machines when TCMC only needs one, which is a savings of about $53,000). The CFO then informed us that she would call for a special session of TCMC's board to meet in a couple of weeks so that we could present both options to them, describe the pros and cons, and then have TCMC explain to their board why they need a few extra hundred thousand bucks to really give themselves the surgery department they need.

When they planned for this project 18-24 months ago, TCMC and Avanta planned on a simple in-place renovation. Even Avanta's healthcare planner in California drew up a plan that just involved renovating in place. But when Howie and I took one look at Avanta CA's plan, we could tell right away wihtout putting a scale on it that it didn't meet code--not 2006 IBC and 2006 NFPA, not AIA Healthcare Guidelines, and not ADA and ANSI. You couldn't possibly do what that guy or gal drew up and not get thumped on the head by Colorado's state health board. Their inspectors smell blood, and if they walked into a surgery department where the pre-op and post-op bays had full walls and were only 9'-6" wide, things would get real ig'nant real fast. So we at Design Associates realized that what they really needed to do is expand their space, and adding onto the building was the best way to do it. Doing so would allow them to be right sized now and in the next twenty to thirty years, which is about the most you can even kinda predict.

As we drove back from Tumbleweedville, Howie, Bosley, and I mused on the nature of the meeting that day. Bosley actually seemed a tiny bit unnerved. "I'm not trying to step on Wes' toes," he said, "but I cannot in good conscience give a client a hospital what they think they want when it's not what they really need, what would really serve their needs now and later."

"Well, yeah," Howie echoed. "Part of our job as the experts is to tell them if they're off track or expecting too much for their budget or whatever. Sometimes, that involves a reality check on scope."

"So, if this is TCMC's money," I asked Howie and Bosley, "then why was Wes doing that frozen-eye thing? Why was he instantly jumping to the 'guess-we're-renovating' bit?

Bosley shook his head. "I'm not sure about him, what his deal is. Maybe...maybe it's part of his job to keep things in line and on track and he...alluva sudden felt like we were taking a detour..." Bosley's voice trailed off as he negotiated his car around a semi on the highway. "...not sure what We's deal is...."

I nestled back into the passenger seat in Bosley's car while Howie checked his messages on his phone. I really hope we can assure Wes we're trying to help, but being the bearer of the news that we sometimes bear can be...hard to bear.

The agony of renovations (or, one of the reasons for this blog's name) part 2

So it gets better--this week I went with Bosley to an FCH meeting with the engineers and the architect of record for FCH. I may have explained this before, but here it is again: sometimes, two architects will join together as a joint venture or one will hire the other to work on a project. One firm will do the initial design, and the other one will take the design over and finish the construction documents and oversee construction. The first architect is the design architect, and the second is the architect of record. On FCH, we're working with Contigo Architects, whose office is only 45 minutes from FCH (while ours is about 4 hours away), and we have more experience in laying out hospitals than Contigo does. Hence, our roles are what they are.

I finally get to meet the architects I've only known as voices over the phone for four months, and we sit down to bidnazz. Part of the reason that we're meeting is to figure out how to get air into the newly-renovated surgery suite. We thought we could run some new ducts from a new small roof top unit (RTU), but the space between the underside of the structure and the top of the ceiling is too tight. From the floor of the building to the top of the roof deck is about 12 feet, and the structure is a 2.5" deep roof slab on 14" deep structure (cast in place concrete joists 24" o.c., for those of you keeping score at home). Plus, the roof structure is at different heights all over the roof, which is how they used to get a "flat" roof to slope so that you could shed water off of it to roof drains. Meanwhile, the ceiling in an operating room is ideally 10' high, but in order to get lights plus ducts in the ceiling space, we had to lower the OR ceilings to 9'-6". Furthermore, the structural engineer, who was present at the meeting helps us understand that at the lowest points in the roof structure, we would only have 6" between the ceiling and the bottom of structure, even with a 9'-6" ceiling. Really? Let's just send gnomes with fans up there to keep the place cool. Magic fairy dust will give us 25 air changes per hour! Ooh! And unicorns will keep the humidity between 40% and 60%--perfect conditions for doing a total hip replacement!

But that's not even the drinking-bingeworthy news. We had all decided earlier that we needed to create a mechanical penthouse thingy on the roof--this would hide and protect the ducts coming right out of the new mechanical unit, and they would go straight through the roof and into the ORs, no running long expanses of ducts underneath the supersnug structure. So we're all sitting around and working out how to do what and how to make it work and does this enclosure-thingy need to be rated or just insulated and if it's an attic then the IECC says it needs to be insulated to R-30 but ASHRAE says it needs to be R-38 (typical houses are about R-7 to R-13 in most places in the lower 48 states) when suddenly one of the engineers looks at a schematic plan Intern Kimmy and I drew of there the new RTU was going to go and said--

"Um, did you know there's already an RTU there?"

No. No, we did not know that. Do you have drawings that we don't have?

Oh. You do. You have drawings we don't have. Why is that? How come you have an entire set of drawings of a remodel that took place three years ago and we don't? Are we not cool enough to have a copy of said drawings? The most recent drawings we have of this building involve a remodel from 1999. And we have some crappy-ass CAD plans from Alphabet Design, who did that remodeling job in 1999 and who also evidently did the remodeling job from three years ago. And you have those drawings. And we don't. In ther words of Dr. Evil, throw us a frickin' bone here.

As we all look at the drawings showing the existing RTU, it turns out that this unit was installed about a year ago, and it was undersized from the day it went in. Thing is, Alphabet Design's in-house engineers supposedly sized the unit to provide air for two of the three floors of FCH, including the surgery suite, whenever they were going to remodel it. Which is weird, because if you ran the calculations even back then, even Ronnie Milsap could have seen that the unit was going to be too small to provide air for half the hospital, part of which included two 600-square-foot operating rooms that require megahuge amounts of fresh, HEPA-filtered air. So now, we have to figure out if we should try to fit two small units on this already-crowded roof, or if we should remove the pretty-much-new RTU, sell it on Mechanical Subcontractor eBay, and buy a new unit that is truly sized correctly to provide air to the half of the hospital that it's supposed to serve.

Either way, we're fixing a mistake we inherited, which as I understand it has pretty much been our experience with Alphabet Design. They produce crappy CAD drawings that aren't even remotely accurate (both on TCMC and FCH), they didn't even read ADAAG correctly and gave us crappy plans when we were their architect of record on another hospital (with Avanta, no less), and now they've undersized this RTU for this poor li'l hospital out in the boonies. Really, Alphabet Design? Really?

Forget the wine glass; just leave the bottle.

The agony of renovations (or, one of the reasons for this blog's name)

I remembered recently why I hate renovations. Well, hate might be a strong word. I intermittently loathe renovations, especially renovations on really old buildings. Nothing old enough to be on the National Register of Historic Places, the renovation of which would probably make you walk around with a vodka-and-cranberry-juice IV drip, but just really old stuff. I've blogged before about how it's hard to reuse old hospitals and bring them up to today's space and HVAC/electrical standards as well as building, accessibility, and healthcare codes, and I'm revisiting some of those old pains again on my two surgery renovation projects. Pour a fresh glass of cabernet, kids, and gather 'round.

A few weeks ago, Intern Timmy and I went to the site for TCMC and did some as-builting. We brought a print (to 1/8" scale) of the CAD plan for TCMC and measured just about everything, just to make sure our CAD plan was up to date. Some of the existing walls in the building were going to be used for temporary walls that will separate the surgery suite as we remodel it in phases, and we have one option for remodeling that involves expanding the surgery suite outside the existing building and adding on, so we have to make sure that the exterior doors and walls and whatnot really are where the plan says they are. So, Intern Timmy and I bring along a 25' measuring tape (the one 100' tape our office has was checked out) and measured. every. single. wall. and. door. and. thing. inside. and. out.

Or so we thought. When I went back again for a second visit, I made a few more measurements. With those fnial measurements, Timmy was ready to properly build the model in Revit, which is a 3D software that's replacing CAD as the gold standard for drawing and documenting projects. As he built the model, he brought to my attention that our as-builts showed that the building was 10' shorter than the old drawings from 1965 said. "We match architectural," he said, "but not structural." We mused on this, compared the architectural plans to the structural plans, and then I proclaimed that something was amiss and we would just have to tell Howie about it sometime soon when he'd finished everything else in the model. We were damn sure of those as-built measurements, so we know we didn't make a mistake there.

There was an obvious solution to the problem, but Intern Timmy and I hadn't figured it out yet. It wasn't until a few hours before a meeting with the contractor that we a) told Howie the problem and b) realized the obvious solution. We were meeting with the contractor to show them what we had built in the Revit model and ask them about what they need to make the model useful to them. Contractors can use Revit models to help them figure out scheduling as well as pricing--the model can tell you exactly how many square feet of drywall it has in it, how many feet of wall (divided by 16" and you find out how many studs you need to buy), how many yards of concrete, etc. So, Howie's looking at the plans, looking at our 10" bust in dimensions, gets appalled and offended by how we took our as-built dimensions (Timmy told him that someone had the 100' tape checked out, but it was cold comfort to him), and by the time he suggested the obvious solution, he was beside himself with annoyance that approached anger and was inconsolable.

He said, "Did you check your math when you added up all these dimensions along the outside wall?"

Wow, um...no. No, we didn't. And Intern Timmy and I shared a glance that was something between why didn't we think of that? and do you have a sharp object I can stick in my eye right now?

So he made us take almost an hour to check our math on the dimensions, and then he returned to check our math once again with us (and at this point, Timmy and I were annoyed beyond belief, thinking "Let it go, already.") and lo and behold, we were only 1.25" off from the drawings, which is pretty good for as-builting in the field. We then had to locate a line of columns in the surgery suite (which of course, when located properly, ended up right in every main hall we had in the frickin' suite) and then save the Revit files onto a jump drive to take to the contractor's office.

By the time we got to their office, Howie had calmed down, and the meeting went well. He appears to have gotten over it, but for a while there we thought we were going to have to clean out our desks. And Timmy and I realized that we still need to go confirm some more dimensions, because we're getting yet another dimension bust at one of the walls that we're going to use to separate the two construction phases, and we really need to know where that wall is. And that news reminded me of why renovations make me drink. Heavily.

Measure twice, cut once: an intro to Tumbleweed County Medical Center

So I haven't really been discussing what I've been doing lately, and it's not because I've been unbusy. Rather, I've been busy and trying to formulate in my head how best to a) explain what I'm doing such that I don't bore you all into hoping I'll post a YouTube video of a turtle riding a skateboard and b) disguise certain elements of my projects so that I don't out myself. (In really good but completely unrelated news, Guy scored us an amazing deal on a 17" laptop, so as I type this, I'm outside in my Extreme Balcony Garden with Maddy laying in a sunbeam and Hazel walking laps and looking for the house finches that have lately taken up roost in a high corner of the balcony. Me love wireless internets.)

So, you'll recall over the July 4th weekend that we got a job that we interviewed for. That job is a surgery renovation gig at a li'l hospital called Tumbleweed County Medical Center, about 45 minutes northeast of Wheatlands. Nice enough little place--most small hospitals are full of good people doing the best they can with what they have, saving lives and comforting the unsaveable and their families. TCMC is a small hospital with one medical office building (MOB, as we call them in da biz) on its campus, hence it can call itself a "medical center" instead of just a "hospital". "Medical center" sounds more upscale than "hospital", just like "loft" sounds more upscale than "apartment." Anyway, TCMC is managed but not owned by a larger healthcare company we'll call Avanta Health. Avanta will give them some money and help them be profitable, but I'm still not sure how much of a say Avanta gets in TCMC's desicions.

The reason I bring up Avanta is twofold. One, early on in Howie's (my main boss) career with Design Associates, he worked on a hospital remodel and expansion with Avanta and ended up rubbing the Avanta Colorado project manager the wrong way. Howie was trying to build consensus and not impose a my-way-or-the-highway healthcare design on the users of that reno/expansion project, but the Avanta PM, named Wes, took Howie's constant questions to the staff ("How do patients come through your department?") as a sign of being green and ordered that Bosely remove Howie from the project. Well, ten years later, here we are, and Howie is a half-partner in DA. Ooh, look who's all growed up, Mr. PM! Ah, but that cranky PM, who later attributed some flaws in the project to DA (inaccurately so, in my opinion, but I'll spare you the details), is now the Avanta Colorado project executive. Somebody's movin' on up like George and Weezy. We've gone after work with Avanta before and didn't get it, we think in some part due to Wes' earlier prejudice/bad taste in his mouth regarding DA. So now that we finally got an Avanta job, we know we have to work at least twice or three times as hard, because a) this is a shitty economy, and b) we have to impress Wes enough to give him a better taste in his mouth regarding DA.

The second reason I bring up Avanta is because a health system changes the dynamic of design and construction projects. They provide a great deal of funding to facilities that might not otherwise be able to afford a new MRI or remodeled surgery suite or updated physical therapy department, but these systems have their own set of rules that might not work for a smaller facility at best or might not really make sense functionally at all at worst. Health systems often have templates and standards for how big different typical rooms are (an OR, an exam room, a trauma room in an ED) and what's on each wall (sharps container, paper towel dispenser, sphygmomanometer, etc.) and how those rooms are shaped (9'x11', 8'x12', etc.). When fitting those templates into an existing space built in 1960, they might not always work, and getting the health system to buy off on a variation of their template can be a reasonable process or one that makes you want to gouge your eye out with a spoon.

At any rate, Bosley, Howie, and I have gone out to Tumbleweedville to do a couple of kickoff and programming meetings with them. Part of what we do is assess utilization statistics and population and patient growth figures. For example, with a surgery department, utilization statistics are what we produce when we find out from the facility how many procedures of what kind do they do every month and how long those procedures last. We can then show a facility how much their ORs and minor procedure rooms get used. We then compare those numbers to real life. At Wheatlands, their utilization stats could only justify having one operating room, but because they could only schedule their specialty surgeons to come out at certain times of the month, they really needed two ORs for scheduling. So it goes with TCMC.

We also run utilization stats of surgery prep and recovery beds. TCMC was originally planning for only four or five of those beds total in their surgery department, but when Bosley sat down and scheduled out two surgeries and an endoscope procedure happening on the same day, he showed them that they really need at least six prep and recovery beds. Furthermore, we had to show them that maybe they could get by with their one anesthesiologist and five prep/recovery beds, but if we cap them at that in this renovation, we've screwed them (and they screw themselves) for the future. What if they start doing C-sections, or if they bring on another surgeon trying to escape the hustle and bustle of Denver, and he brings along his own second nurse anesthetist? Guess who suddenly doesn't have the room to expand in place?

So, what we've been doing these first few weeks of the project is getting the foundation right. In terms of drawings, we've been getting as-built dimensions of the existing facility (which is exhausting, and you still never get all the dimensions you thought you needed) and building a model of the existing facility in Revit (which requires looking at a CAD drawing they had from 1999, looking at the existing drawings from 1960, and checking all of these against the as-built dimensions we took). We've also been checking their needs once more against reality with the utilization stats and looking at what rooms are required by code (for example, the actual sterile/restricted area where the ORs are requires a separate housekeeping/janitor closet from the rest of the department). Plus, we've been developing a couple of different schemes we showed them in our interview that will allow them to think about different ways to do their department: what if we just renovate? What if we add on and renovate?

While all this is going on, I'm still working on FCH's surgery and ICU renovation, which is good. Busy is good.