Building in a hospital? Shhhh ... patients need their rest

Construction of the Wilbur D. May Pediatric Intensive Care Unit on the fourth floor of Renown Regional Medical Center's Sierra Tower required careful coordination and planning between hospital staff and construction crews to keep hospital operations flowing smoothly.

Jarrett Rosenau, senior project manager for Clark and Sullivan Construction, says the biggest challenge his company faces is completing work in a fully functional hospital. Although the fourth floor is completely vacant, construction schedules often have to be juggled to accommodate patients and staff on upper or lower floors.

Clark and Sullivan is remodeling about 24,000 square feet of space into the only pediatric intensive care unit in northern Nevada. Currently, very sick children have to travel to pediatric facilities Salt Lake City or Sacramento for specialized care. Work started in April on the $5.2 million renovation and is expected to be completed near the end of December.

"The biggest challenge, which mirrors the challenge on a lot of projects, is that we are in a full construction situation in an occupied hospital," Rosenau says. "We are in an occupied construction setting trying to do the work of construction, and sometimes it makes the situation a little challenging."

Noise from jackhammers, rotohammers and the associated banging and pounding of demolition has been the biggest complaint from patients and staff. Patty Evans, process and projects administrator, says hospital and construction staff work hand-in-hand to schedule what type and when work occurs.

Nursing managers are provided with 72-hour notice for work that potentially could be disruptive to patients. Sometimes, work must stop for the good of the patients.

"There have been a number of occasions where they are working and directly below is the existing pediatric care unit and patients couldn't tolerate it," Evans says. "We have to get creative we may change the location of a patient. Those are the kinds of things that go on pretty much continually in these projects."

Adds Rosenau: "We just try to work together to do our job but not compromise their ability to provide care for their patients."

In some instances, workers have been re-deployed to other, less disruptive tasks. Weekly construction meetings help keep the hospital construction team and staff abreast of the contractor's construction schedules.

"We know exactly what is going on and what is going to happen," Evans says. "It really speaks to the coordination of the contractors and subcontractor on they job; they are very acutely aware of where they are working and are very sensitive to that."

It also takes a great deal of coordination before construction crews can shut down operating mechanical systems in order to tie in new systems for the new pediatric intensive care unit. Tearing into the walls and ceiling of the older Sierra Tower also exposes a maze of old and sometimes abandoned mechanical, electrical and other systems. The old systems often must be removed in order to make way for new operating systems.

"The biggest challenge is sorting everything out," Rosenau says. "In the existing ceiling you have a lot of wiring and different components up there that are dead. You have to research and trace what is there to decide what to take out or leave."

The Wilbur D. May Pediatric Intensive Care Unit is completely donor funded, Evans says. Supporters of the project include the Nell J. Redfield Foundation, The Wilbur D. May Foundation, the Marshall R. Matley Foundation and the Ronald McDonald House Charities.

"We had some really great support from the community," Evans says.

Special amenities for the children's hospital include therapeutic playrooms with activities and hard-wired gaming stations in each room. Marie Wikoff of Wikoff Design Studio LLC designed the facility with kid-friendly decor.

Wikoff says she had to strike a delicate balance when designing for a children's hospital that also will be used by adults. However, she had already gained experience by working on the hospital's children's emergency room and the John & Sue Dermody Children's Healing Garden.

"You have to take into consideration the size of children, what they need versus adults," Wikoff says. "But you can't over-design for little children because they will have teenagers in there too."