Medical Construction & Design (MCD) is the industry's leading source for news and information and reaches all disciplines involved in the healthcare construction and design process.
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A typical Fanwall Technology array. AHU replacement. This information helps determine the utility requirements and the best time of year for each replacement. Consultations with hospital directors are important to refine the plan based on hospital priorities and other facility and patient care considerations. Brasfield & Gorrie uses a modified version of pull planning to understand the logistics of the project, including the number of workers that can work safely in each space, the necessary tasks, the order of the tasks and the relationships between them. The pull-planning process — in which the entire project team meets and works backward from the desired placement and functionality of the AHUs at the end of the project to define the necessary steps of the process — addresses all aspects of each task in painstaking detail, assessing potential risks and planning for contingencies. The three guiding principles are first and foremost, 1) to ensure patient care and safety, 2) to provide optimal functionality and optimal conditions for long-term maintenance and 3) to make certain hospital operations are never down during the replacements. This process determines and defines each customization necessary to overcome site constraints and brings technical questions and collaboration issues to light. Other significant issues such as safety, clearances with old equipment, weight limits and rigging considerations are also addressed. The pull-planning process results in strong working relationships and schedule buy-in from the entire team, with each subcontractor taking responsibility for accurately assessing the scope of work and time requirements. Using the pull-planning process, the project team creates a round-the-clock hourly schedule for each AHU replacement. Each schedule details pre-shutdown and shutdown tasks, including the duration for each task, start and finish times, the contractor for each task and important notes such as the expected noise level or noise restrictions. In addition, the team considers each hospital department's peak service hours, replac- www.mcdmag.com ing units during the department's least busy hours. At Moses Cone, units serving administrative offices were replaced during weekend hours when use was low, but the unit serving the emergency department was replaced from 6 a.m. Tuesday to 6 a.m. Thursday, the department's least busy hours. Often the replacement process begins at 5 p.m. Friday and finishes at 5 p.m. Sunday. Each replacement is followed by airflow verification and testing of the electrical connections, control circuits, waterlines and fire alarm system to ensure that all components are functioning properly. To keep the hospital fully functional during each replacement, temporary ducts to one or two units adjacent to the affected area are used to provide air to the area while the unit that serves it is being replaced. The team gives special consideration to air change requirements in procedure/operating rooms and the number of rooms required to meet patient care demands in off hours. By keeping a portion of procedure/operating MCD MEDICAL CONSTRUCTION & DESIGN Full issues of MCD are now available online! Read them at mcdmag.com January/February 2013 | Medical Construction & Design 57