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.

Good business or cutting off our nose to spite our face?

I discovered this week that Veronica was part of the layoff last week. I hadn't particularly noticed her absence because she does spend a lot of time meeting with the partners and sometimes keeps erratic hours, but I realized that she was gone as I was looking across the office while a colleague told me of her dismissal late on Friday afternoon. I suppose Veronica's layoff was obvious enough to do--she was likely well paid and the partners needed to cut costs. Before she arrived about 18 months to 2 years ago, they did their own marketing and wrote their own proposals, so they'd just have to go back to doing it again. But...people, you laid. off. the. head. of. marketing. Seriously?

Ingrid and Liz and I mulled over the decision this week. Liz evidently was never a fan, due to the fact that no work was coming in, and it's kinda her job to get work in the office. Plus, Veronica appeared to send out lots of emails about events coming up in the community and articles or slide shows relating to architecture and culture from the New York Times and other media sources. I countered with the fact that I felt she'd been behind the 8-ball to start with, having to try to get eight partners to talk to each other and agree on ANYTHING for the first time in 40 years. I mentioned that Bosley, under her advice, began taking chances with his interviews and proposals and was winning some small projects. Liz's rebuttal was, "Yeah, but we need some big work to keep up afloat, and we keep coming in second."

Fair enough, but the sendoff of Veronica leaves me feeling the same way when I see a sports team fire the manager or coach. The manager may be in charge of putting people in and out of the game or setting up training and practice and writing plays, but at some point the players have to go out there and play and win. I don't fully agree that it was Veronica's job to get work (though to be fair I may be misquoting Liz a bit on this). Her job was to help us make good, solid presentations and to convey ourselves in a way that appeals to potential clients and makes them take a second look. It's just that when they've taken a second look at us, after they toured our offices and saw our elaborate presentations and amazing models (real and digital) and we've built and heard all that we've had to say, they decided they liked another firm more. And ultimately, that's out of Veronica's--and perhaps everyone's--hands.

I emailed Veronica to see what was up, and she said that the decision to lay her off was not unanimous, so at least there was that. However, she seemed glad to be free of being set up for failure and having to repress aspects of her leadership and guidance methods, and I can certainly understand that. I'll be keeping in touch with her. I just hope DA hasn't cut off its nose to spite its face on this.

Sober with power

I mentioned that I'm now on two, about to be three projects. Presently, I'm working on the surgery and ICU renovation at FCH and on the surgery renovation at TCMC. For the first time in my 9+ year career, I also have staff. Staff is, in great part, good.

I have Intern Kimmy on FCH. This has become more and more a blessing, as she's been able to get stuff done with the drawings while I've been distracted on TCMC. The last two weeks of my life have been devoted mostly to TCMC, getting graphs and charts ready, taking and writing and distributing meeting notes, working out the schematic plan options for the department. I'd nearly forgotten about FCH until I received an email from the architect of record (we're the design architect--we're handing off the drawings to them midway through design development) looking for some drawings. I realized I hadn't checked in with Kimmy in a few days to see if she had enough to do--whoops. Turns out she was fine and had gotten a few marching order from Bosley while Howie and I had been doing as-builts at TCMC. Now, I make it a point to check with her almost every day, even if it's just a "how're things? you got what you need to keep moving forward?"

Meanwhile, Bosley gave me Intern Timmy--yes, the legendary Intern Timmy--for TCMC. This is a coup, I think, because the kid is sharp (and I'm not just saying that because he reads WAD). He listens and learns well, and he's about to sit for the ARE (no thanks to some nimrod at NCARB who could never seem to find the forms he sent in for seven months) at a younger age than almost everyone he works with. Timmy draws/builds the model of TCMC in Revit while I'm writing up notes, doing code research, assembling the aforementioned charts and graphs, and so on. I also make sure to check with him once a day to make sure he has what he needs to move forward. I've told both Kimmy and Timmy that if they ever have any question, no matter how dumb they may think it is, ASK. You'd be surprised how few dumb questions there are in healthcare architecture.

I was describing my workload to someone recently, and I realized while I was occasionally crazy busy because of a deadline, I was never truly truly truly outrageously busy. Perhaps it was because of the projects' sizes, but something else hit me. The difference between these projects and Wheatlands is...I have help. I had to do about 90+% of the work on Wheatlands myself, which meant I worked no less than 7 eight-hour days a week for eight months straight. I really needed someone to get drawings done while I typed this and researched that and looked for the other, but I didn't.

"I remember that," Intern Timmy chuckled on Friday. "Howie lent me to you one morning, and after I spent, like, two hours checking an equipment list for you, he pulled me off to help someone else do something. But you know in his mind he gave me to you for a day!" I too had a good chuckle--that was back in the day when we were hiring people after 9/11 and life was wine and roses. Nowadays it's Spam and mac & cheese, and we're all thankful for it.

But it's an interesting thing, this being in charge of people's workload. I have to make sure that a) folks have something to do, and b) that they understand what they're doing. Kimmy knows a fair amount about buildings and putting out a set of drawings, but she doesn't know much about hospitals. I sometimes have to stop myself and think about if I'm talking down to her or giving her info that she really needs. Timmy asked if he could bug me more often about how healthcare planning works, and I'm glad to answer anything he's wondering. Hell, I'm glad people are asking any questions. GUy has said that if an intern isn't asking questions, that usually means trouble: they're banging their heads against a wall trying to solve a problem that you could solve in ten seconds, or worse, they're just warming a seat and doing rote redlines. Fortunately, my interns are better than that. I totally got lucky.

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.

Am I in a war zone? Because I just dodged yet another bullet.

Design Associates had another round of layoffs today. We've gotten a few smallish and mediumish projects recently, but it wasn't enough to sustain us. And for the first time since we started letting people go last year, finally in this fourth or fifth round of layoffs, they finally let go of two senior staff members.

They laid off two interns, two architects, two landscape architects, an interior designer who was an associate, and an architect who was a senior associate. I was okay with the interior designer going--I did my best to get along with her, but she was a tough one, and many of our clients complained about her (and how she stayed so long is beyond me). The only person y'all would know is Dash, the landscape architect who worked on Wheatlands with me. He's a good dude, and I (and many others) hated to see him go.

We all breathed a little after the final email went out about who was let go. It's a bit of a guilty feeling for going "okay, thank God it wasn't me, I'm safe for a few more months", but it's natural, I suppose. Norman, Intern Krissy, and I then surmised who might be next. This layoff was truly a cash dump--half were staff members from Vincent's team (he's gone after a lot of work lately, but we keep just missing the cut), and the other half were older folks with lots of experience and a high salary to boot. Healthcare has been pulling in a few jobs over the past few months, but will it be enough to protect us for the rest of 2009? Would they dump some more senior folks? After all, if you dump any more at our levels, who will be left to do the drawings? And which senior staff members do you send home? The really old guys? The guy with terminal cancer? Would they dare?

The contractors have also started the bloodshed. I got a call from Billy Ray (my superintendent on MHRC) saying that he and about 40 others had been let go from his company. I gave him a few leads and asked him to stay in touch. This is the beginning for the contractors; they're about six to twelve months behind us. We design the project, then they build it, so while our work dries up they're still building stuff. Eventually, they get to where we are. That eventually appears to be now.

I got home tonight, ate dinner, and then walked over to the grocery store to pick up meds for my cat. Despite her dire diagnosis, she's still alive and doing okay. She felt poorly the last couple of days my Mom was here, but she perked up last night and asked, nay demanded that I give her mooshy treats NOW, and the vet reupped her meds for two more months. So as I paid for her meds for the tenth month in a row, I did breathe a prayer of thanks that she's still around and that I have the resources to buy cancer medication for an 11-year-old cat. And I still have those resources.

Dress-O-Rama 2009

When Mom showed up seven days ago, she had a decent sized suitcase full of fabric and dresses in various stages of completion. By the time she left today, here's what she had to show for it (and I had to wear). (Yes, I airbrushed my face out where necessary. I actually do have facial features.)