Construction Management of Healthcare Projects

As expected.

Great, Thanks

Great for who design or manage hospital project.

This book provides a very good summary of the complexities involved in healthcare construction as stated in the previous reviews. As a construction project manager and licensed architect looking to break into the health care construction field, I found this book to be a good starting point but only a starting point. Continued research into the AHCA, Joint Commission and NFPA99 are necessary to even begin to become versed in this complex topic.

The book by itself is good the content is not what i needed/expected

• Chapter1: What’s Different About Hospitals. I thought the chapter was a good overview, but missed the opportunity to highlight and address the intense political, emotional and reality drama that surrounds the healthcare facility environment. We in the industry often joke about hospitals being the first settings for television soap operas (and there are reasons for that) but in all seriousness the healthcare construction manager needs to be acutely aware of the dynamics that are embedded in the hospital environment that simply don’t exist in other facility settings.• Chapter 2: Codes and Regulations. The discussion on accreditation organizations should perhaps mention other orgs that have “deemed status” from CMS. These include AOA and more recently DNV, which has been gaining on TJC in terms of numbers of facilities accredited. While the purpose of these various accreditation orgs is generally the same, the codes/standards as well as the survey processes they use vary widely, and the construction manager should be aware which org any particular healthcare system is using, and the various impact on project delivery.• Chapter 5: Healthcare Facility Justification and Capacity: The conclusions drawn at the end of this chapter are , I believe, debatable. The degree to which the health care industry has “evolved over time to a highly refined process” may have been true up to a point some years ago, but I would submit that healthcare reform (both organic and legislatively driven) has unwound some of the processes built up over the decades. Changing demographics, uncertain and varied reimbursement pictures and the velocity of change in both have unseated some standard planning processes. While I don’t disagree with the pretext that the most effective management of project cost is done in the early planning stages, I would caution against any characterization of the planning process as mature.• Chapter 7: Project Delivery Methods for Healthcare Projects: While this chapter gives a good overview of a difficult-to-capture subject, I believe the description of the A/E team selection, as well as of the deliverables that can be expected from those professionals, are drastically oversimplified and may give the construction manager the impression that both are rote processes with very little variation. The opposite is actually true: we are seeing more variation in both selection processes and the nature and detail of deliverables than ever before.• Chapter 8: Modern Project Delivery Methods for Healthcare Projects:o Page 161 discusses BIM, but I believe way understates the impact of BIM technology and usage on the entire planning, design and construction process. The construction management student should be led to believe that BIM is changing the entire process from the inside out, which I believe it is.o Pages 162 and 163 discuss the impact of prefabrication on a typical project, and that discussion could benefit from adding some perspective of the impact of prefabrication on the design phase, where elements of the design process many times must be pulled out of sequence in order to facilitate an effective prefabrication program.• Chapter 9: Challenge of Additions and Renovations: A good overview of the challenges. Consider making the reader aware of the need to verify existing utility distribution before consideration of demolition of portions of an existing campus or building that was built in multiple phases. Often utilities feed from the “oldest to the newest” in terms of progression of construction, and demolition of the oldest buildings first can present major challenges as utilities feeding through those buildings might feed other buildings that are to remain.• Chapter 10: Mechanical and Electrical Systems in Hospitals: The chapter could benefit by some awareness of the potential impact on Hospital Acquired Infections by the HVAC systems, particularly with respect to airflow and pressure relationships. HAI issues are discussed well in Chapter 12, but the direct connection to HVAC systems isn’t highlighted. Also, Chapter 10 provides some general discussion on project delivery methodologies that seems to overlap (and contradict to some degree) the discussion in earlier chapters• Chapter 11: Medical Technology and Information Systems. Chapter provided good definitions of medical equipment and function, but didn’t speak to the critical process of planning, specifying, purchasing and coordinating utilities and space requirements for medical equipment. This could almost justify a paragraph of it’s own, with the potential impact to overall project budget, planning, design, coordination and installation. While there is some discussion of planning for IT systems, I could see little provided for equipment.• I may have missed this, but didn’t see any discussion on exterior skin, and the necessary planning and design required. Envelopes now touch many disciplines from structure to architecture to HVAC, and must be evaluated carefully. Where to place vapor barriers is but one subtle but potentially impactful detail.

Healthcare projects have many unique elements making them among the most complex of capital projects. Construction Management of Healthcare Projects successfully identifies the differences and focuses on the special skills needed from planning through turnover. Construction Management of Healthcare Projects is a great resource to understand the whole process as well as the pieces and parts.Wayne A. Crew, Director, Construction Industry Institute