Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, March 6, 1994 TAG: 9403040148
SECTION: ROANOKE MEMORIAL HOSPITALS PAGE: RMH-10 EDITION: METRO
SOURCE: By JOANNE ANDERSON
DATELINE: LENGTH: Long
THE COMPANY
With $70 million to spend - $55 million for the building and $15 million for equipment - Roanoke Memorial commenced with planners, architects and contractors to create a state-of-the-art medical facility that will serve the medical needs of the community well into the 21st century.
Early in the program, in 1990, falling interest rates were used advantageously to refinance an existing mortgage, saving $4 million. Working with its investment banker, the hospital conserved another $300,000 with a special financing technique.
The concepts and practices of value engineering and cost containment were employed all along the way.
Value engineering, explained I.B. Heinemann, executive vice president for Carilion Health Systems, is a process of "making choices that represent the best value for accomplishing objectives. There are very specific steps, for example, in determining types of systems, the shape of the building, materials to use and so on."
All the alternatives have a value associated with cost, in terms of longevity, efficiency and other parameters. Making careful value judgments during the design phase can conserve money, if done properly and thoroughly.
Cost containment on a program of this magnitude, Heinemann continued, "addresses how the project is financed, what money costs, how the people working the building are managed and similar financial concerns.
The project started in the spring of 1991, a low point in the construction industry. Thus, materials pricing was favorable for buyers and builders.
Construction Management (CM) of Negotiated General Contract is another example of how Carilion Health System practiced sound financial control for the new South Pavilion project. Initially used by the military and NASA, CM gives the general contractor, or construction firm, the role of owner advocate, as well as that of prime contractor - Beers Construction of Atlanta, in this case.
Beers acts on behalf of the owner, competitively bidding all material and subcontract work on an open basis and holding all contracts. The owner benefits from a guaranteed price, money refunded for a lower bid and retaining input on all components.
Other advantages of CM include an accurate prediction and control of schedule, fair competition among trade contractors with the bidding process, bid management, single source of professional construction knowledge and responsibility and the opportunity to overlap construction with design.
CM also dictates that if any subcontractor bids come in less than Beers' guaranteed maximum, the difference is returned to the hospital.
In this case, the difference amounted to $6 million, and another story was added to the original design plans. The new floor allowed the surgery functions in the old part of the building to be relocated and some new equipment installed in 14 modern operating rooms, now called surgical suites.
A large savings was realized by the building's design and construction method. Dubbed "fast-track construction," the technique entails beginning construction on a building prior to completing the design.
The new South Pavilion was a four-phase program, so while phase one of the building was in process, architects were designing phase two. A primary advantage to this is the tie savings in accomplishing two tasks at once. The well-worn adage, "time is money," is also true.
THE PATIENT
Roanoke Memorial has responded to today's pressure on the health care industry to reduce costs to the patient by planning patient-focused benefits and operational efficiency in its new South Pavilion. The architectural design makes a bold statement, visually, as well as in terms of recuperation.
Since patient recovery is related to daylight and nature scenes, the extensive use of glass in the surgery post-op area and all the intensive care units (ICU) may truly reduce a patient's stay in the hospital.
The new pre-op section on the surgery floor allows some procedures to be started before a patient enters the surgical suite. Since operating room time is billed in 15-minute segments, the amount of time in surgery can be reduced.
"Nursing care is enhanced with mini-nurse stations at bedside in all the ICUs, new monitoring equipment networked throughout the pavilion and fewer nurse steps throughout their station areas," said Phyllis Wertz, director of patient care services. Increased efficiency in staff operations contributes to better care and quicker patient recovery.
Dr. Robert Keeley, pulmonary medicine specialist, says he believes that while there will be an improved efficiency of care because of the new building's physical layout, "there will be no change in the excellent quality of care."
The helicopter touchpad on the roof eliminates the need for and cost of an ambulance ride between helicopter landing and emergency department arrival. New technology, equipment and procedures in all areas of the South Pavilion will reduce patient waiting and recovery times.
Money matters, indeed. And Roanoke Memorial Hospitals has embarked on a course on cost-controlled, advanced health care technology and management, where the patient is first, recovery is faster, and efficiency is the modus operandi.
by CNB