Granger Construction undertook a $3.1 million project to substantially renovate the 5 Foster Pediatric Unit of Sparrow Hospital in Lansing, Michigan. In addition to the complexity of working within a functioning hospital, the looming threat of RSV season (respiratory syncytial virus, which commonly spreads in the colder months and poses a high risk to young children) added urgency to the completion deadline. Work began in mid-September of 2016, and the project was slated to finish in early February of 2017.
Conventional wisdom dictated that renovations within a working hospital can’t be completed in fewer than three to four months, and if patient rooms and wall movement are included in the scope, in fewer than six months. That timeline created a dilemma for Sparrow Hospital, which needed its pediatric unit back at full capacity sooner than that.
Further complicating the situation, all of the work needed to be done in tight, occupied space on the fifth floor of the hospital, taking care not to disturb the floors above or below. The floor below houses a cardiac recovery ward, and at one point valves on that floor had to be shut off in order to isolate the fifth floor. This required extensive coordination with the nursing staff, hospital management and the owner’s representative to ensure that no operations were disrupted. Walls couldn’t be closed off until the valves and pipes had been replaced, so the timing of every step of the project needed to be accurately predicted and adhered to.
While the work was in progress, the pediatrics unit had to be relocated to other areas of the hospital, putting pressure on the operations of those units. Additionally, the project’s scope increased as it progressed, which required stringent change management on the part of the project team to ensure that the pediatric ward could continue to operate.
In the face of these complexities, the project team, under the guidance of Lean consultant Hal Macomber, decided to implement Touchplan to make sure they could still meet their deadlines.
High-Stakes Planning
The project’s anticipated scope consisted of removing all of the drywall and completing an architectural finish of the walls, floors and ceilings. However, the scope increased when it became clear that more work including valve replacements, plumbing work, the removal of galvanized piping, and servicing of med-gas outlets would also be necessary. Since the hospital was still fully operational, careful management was required to ensure that none of the work interfered with patient care.
To accommodate the increasing scope of an already challenging project, the team knew that they would have to work very strategically. Under Macomber’s guidance, they implemented Touchplan and were the first team to combine it with takt planning. The takt planning approach centered on four flow units (the unit used to measure the completion of work); the twenty-six patient rooms, the nursing core, the pediatric rehab area and the corridor and support space. The teams adjusted their takt planning process depending on the function of the space in which they were working. For example, work on the nursing core was more focused on systems due to the complexities of the plumbing and HVAC infrastructure than the work on the patient rooms. The patient room planning was primarily based around space constraints.
A key motivating factor for every team involved, from the Granger staff to the building inspectors, was the ultimate purpose behind the work. According to Project Manager Bill Bofysil, “The inspection process, with the HFES, the Health Department, and Bureau of Higher Services, went off without a hitch. Same with local inspectors. They [were] very accommodating to the workflow that we established, because they had to come out multiple times for inspection to allow us to keep progress…Everybody bought into the idea [that]…it’s for the kids.”
A Healthy Result
The combination of ambitious implementation of new strategies and the motivating purpose behind the project combined to yield a very successful result. The project was completed six weeks ahead of schedule; rather than finishing the renovations in early to mid-February as originally forecast, the work was completed before Christmas.
The accelerated completion was a double boon to the hospital, which was not only able to operate at full capacity during the onset of the RSV-intensive winter season, but also relieve pressure on the other wards that pediatric services had been occupying.
Because the project finished with time and money left over, the team was able to expand upon some of the renovations to deliver some of the hospital’s wish-list items, such as an upgraded corridor finish outside of the pediatric unit.
According to Bofysil, the communication Touchplan enabled was also critical to the project’s success. “The best part of the collaboration/communication is that you get to find the variation as far as the roadblocks that are there through the communication and you’re able to plan around those, which you typically don’t do on a traditional setup.” The communication also facilitated the coordination required to maintain a predictable workflow, which was vitally important to minimizing disruption to the pediatric ward and the adjacent floors.
As is often the case, success on one project quickly spreads. The productivity metrics from the Sparrow Hospital project are so persuasive that Granger has already won new work on the strength of that project’s results, embodying their commitment to continuous learning and improvement.
Project Highlights
- Finished six weeks ahead of schedule
- Completion was accelerated through better communication and planning
- Cost savings enabled upgrades and wish-list items
- Sparrow Hospital was able to open in time for its high season
- Successful first-time use of Touchplan and takt time planning
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