BOSTON, MA – Two top national healthcare construction trends—building to support expanded healthcare services for regional communities, and the repurposing of existing facilities to optimize the efficiency of urban medical center campuses—have come to life in Consigli’s recent work for clients at Milford Regional Medical Center (MRMC), and Beth Israel Deaconess Medical Center (BIDMC).

This fall’s grand-opening of the expanded MRMC in Milford, Mass. celebrated the fact that for this community-focused medical center “great care is going to get even better,” as one MRMC nurse summed up the benefits of the 78,000-square-foot addition. This expansion reflects the national healthcare trend of keeping the best possible care close-to-home. The new wing increases the emergency department’s capacity three-fold and adds much-needed intensive care and surgical facilities. Lean approaches, including the work of Consigli’s pioneering Pre-Fab Lab, were instrumental in reaching opening day on time.

And in Boston, Consigli’s on-going work at BIDMC is helping the facilities team take the best care of their extensive medical campus, and build the renovations that support leading-edge healthcare in Boston’s Longwood Medical Area. For the recent expansion of the BIDMC’s East Campus’ Interventional Radiology Suite, some of the project’s most important work was done before construction began. To assure the smooth integration of the new suite’s upgraded mechanical, electrical and plumbing (M/E/P) systems, the team used laser scans of the existing infrastructure to understand what was hidden above the 7,000-square-foot space’s ceiling.

Pre-Fabrication Brings Patient-Centered Expansion On-Line, On-Target:
MRMC’s New Emergency Department and ICU Wing, Milford, Mass.

A four-year effort of true community collaboration, the expansion of Milford Regional Medical Center (MRMC) opened to great fanfare this month, within just three days of the original schedule, developed back in 2010.  A labor of community pride, Consigli, a Milford-based company, was both the project’s construction manager and part of the hometown spirit dedicated to building the new wing as well, and as speedily, as possible.

The new Meehan Family Pavilion adds nearly 78,000 square feet of direct patient care to the medical center. To meet the growing demand for Milford Regional’s emergency services—from 38,000 patients in 2000 to 56,000 last year, the emergency department has increased from 30 to 52 beds and doubled in size to nearly 30,000 square feet. The intensive care unit also expanded—in this case from 4,600 to 13,000 square feet—to accommodate today’s advanced life-saving technologies.

What kept this medical center expansion on track? A range of construction management strategies, most notably, Consigli’s pioneering Pre-Fab Lab, developed at the company’s headquarters in Milford. Used as the manufacturing center for the project’s collaborative team of M/E/P sub-contractors, the Lab made the pre-fabrication of the project’s M/E/P piping racks possible, which in turn allowed Consigli to hasten the project, while creating an even-more consistent project quality, and a safer work environment.

While the use of pre-fabrication is not new in construction, Consigli is always looking for new ways to incorporate it, especially on projects for which it might not seem an obvious choice initially. Traditionally pre-fabrication is implemented primarily on projects of more than 100,000-square-feet, where the schedule and cost benefits of mass produced components is clear.

Consigli’s team, led by Project Executive Brian Hamilton, asked the question “How can we adapt pre-fabrication to smaller scale projects, so they can still reap its schedule, cost and safety benefits?” Hamilton and his team determined two keys to the success of a scaled-to-fit pre-fabrication program. First, when construction managers partner with subcontractors who do not have their own pre-fabrication facility, the question of where the work will be done, is an important one. Consigli answered this question by transforming a warehouse at the company’s headquarters into a manufacturing facility, aptly named the “Pre-Fab Lab.” The Lab could then be shared by the multi-disciplinary trade teams—in this case the project’s mechanical and plumbing sub-contractors. And this leads to the second key—to partner with sub-contractor companies who are willing to work collaboratively, with other trades.  In the case of the MRMC expansion, the subs were eager to make this work.

With more than 50 miles of mechanical piping in the new wing, Consigli was able to prepare many miles of this in the Pre-Fab Lab. Once fabricated, the racks were delivered to the site on the day scheduled for their installation, eliminating the need to store them on site, and simplifying material delivery. With this ultra-efficient M/E/P rack installation, the team was able to move to the next step in the construction process readily.

With the Center now ready to help so many more, the community-based support that made this all possible can be seen through the finished building: the 50-plus donor plaques that double as exam room signage represent the varied community members that came together to make this expansion possible.

“Every person involved with this project, and every decision made about it, had one goal in mind, that being: to create a facility that would help us improve the health and well-being of our patients. It is quite literally a dream come true,” said Francis Saba, MRMC’s CEO, at the ribbon-cutting.

Laser Sharp Exploration for an On Trend Renovation:
BIDMC’s East Campus Interventional Radiology Suite, Boston, Mass.

Before the work to transform an existing BIDMC East Campus space into the new home for the Interventional Radiology suite, Consigli’s team completed a proactive investigation of the 7,100-square-foot area’s existing conditions, assuring an efficient construction phase for the new suite.

“Before construction began, we captured the question marks,” explained Consigli’s Project Manager, Sean O’Keefe.

Using 3D laser scans of the area’s above-ceiling M/E/P systems, the team determined exactly where the existing systems were and could plan both the needed demolition and confirm the spatial layout for the new suite. With this accurate existing building data, Consigli was able to create a building information model to coordinate the integration of the M/E/P system upgrades seamlessly.

With the work to build the new Interventional Radiology Suite divided into three phases, the team first built the area’s new reading room and office, then the interventional radiology procedure areas, finishing this fall with the construction of the new suite’s support areas. Each phase has been managed with strict adherence to Infection Control Risk Assessment (ICRA) procedures, including the use of temporary partitions, indoor air quality monitoring and daily site cleaning. The team’s construction schedule was also developed to mitigate the effect of construction on BIDMC’s patients and staff.

Each phase began with interior demolition and included upgrades to the space’s HVAC, electrical, plumbing and fire protection systems, the construction of new partitions, doors, ceilings, flooring and millwork and the installation of the unit’s new imaging equipment.

One in a series of projects with BIDMC over the last several years, Consigli is also completing a sequence of exploratory and enabling projects for the future reconstruction of BIDMC’s main plaza.