Hospital construction offers its own set of challenges including the difficulty of scheduling tasks in a facility that never closes, working in and around people who shouldn’t be disturbed and keeping facility disruptions to a minimum. In earthquake-prone California, the state legislature enacted strict building codes, making hospital work especially challenging for electrical contractors who are asked to seismically upgrade and bring existing facilities into compliance. Sasco Electric, Cerritos, Calif., worked on construction of Kaiser Permanente’s new hospital tower for its West Los Angeles Medical Center, which adjoined an existing tower. Woods Electric, Santa Fe Springs, Calif., was challenged to do the occupancy separation between the new building and the existing one. The buildings have different occupancies and must comply with different California Building Codes.
After California’s 1971 Sylmar earthquake, the California legislature mandated, through the Hospital Facilities Seismic Safety Act (HFSSA), that hospitals in California be built to a higher standard. The California Electrical Code is the National Electrical Code (NEC) with California state amendments. Then came the 1994 Northridge earthquake, which caused 23 hospitals to suspend their services and resulted in more than $3 billion in hospital-related damages. In response, the legislature passed California State Senate Bill 1953 (SB-1953), an amendment to the HFSSA that called for even more stringent standards, making California’s standards some of the strictest in the country. The California Office of Statewide Health Planning and Development (OSHPD) enforces those standards.
While existing buildings often are razed to make room for new ones, hospitals just as often are expanded by the adjoining new buildings. The latter occurred in the expansion of Kaiser Permanente’s West Los Angeles Medical Center. A new state-of-the-art hospital tower was connected to the south tower of its existing facility.
The facility is one of 13 hospitals in California being replaced or upgraded by Kaiser Permanente, a nonprofit integrated health plan founded in 1945 that serves more than 8 million members in nine states and the District of Columbia.
Groundbreaking for Kaiser Permanente’s new tower, which opened in June 2007, took place on May 7, 2004. Sasco Electric was awarded the $10 million contract as the primary electrical contractor working under general contractor McCarthy Building Companies Inc., on the $170 million, 184,000-square-foot, five-story wing.
Another electrical contractor, Woods Electric, Santa Fe Springs, Calif., was awarded the contract for the multiphase occupancy separation project and worked with Kaiser’s internal general contractor, Kaiser Construction Services. While Woods Electric’s $1.5 million project doesn’t compare in size or scope to the work done by Sasco, yet the company’s work is an example of the specialized service done and skills needed by many electrical contractors who are engaged in hospital construction projects in California.
Central to Woods Electric’s work on the Kaiser Permanente construction project was the linking of the existing five-floor center tower of the facility, one that had been solely used as a hospital, but was converted to mixed-use, nonacute care services—outpatient medical offices, outpatient surgery and business offices—to the new tower.
The new tower now houses acute care services, including an expanded emergency department, radiology and lab services, three medical surgical units, five inpatient operating rooms, a central facility for sterilizing equipment and instruments, an inpatient pharmacy, labor and delivery suites, three 26-bed medical surgical units, a nursery focused on family care, and an intensive care unit.
Since the center, older tower and the new tower offer different services or occupancies, they are held to different standards. According to OSHPD, when adjoining buildings have different occupancies, an “occupancy separation” must be constructed between the two. The older tower, because of its occupancy of nonacute care services, does not have to comply with the seismic safety goals outlined in SB-1953, while the new tower, because of the occupancy of acute care services, must be in compliance.
Woods Electric began its work by doing surveys of the older building using circuit tracers to identify the paths of conduits in the ceiling. During the 14-month project, workers separated the compliant occupancy areas (in the new tower) from the noncompliant occupancy areas. Woods Electric then brought into compliance any noncompliant areas that fed into the new tower.
The project called for a high degree of specificity because the panels that feed the new tower are located in the older building.
“Everything that was coming to the new tower had to be upgraded to be compliant to the current code, since any system that serves a compliant area, be it lighting, fire alarm or others, had to be fed from a compliant area,” said Keith Pengilley, superintendent, Woods Electric.
According to OSHPD standards, new construction in an existing building must comply with the code in effect at the time the project is submitted and is referred to as “compliant” because it meets the current code as opposed to a previous edition of the building codes.
Any new conduit installed in the older building had to be anchored in accordance with current code requirements, whereas the existing adjacent conduit did not have to be brought into compliance.
That made the job labor intensive for Woods Electric. It was required to upgrade the supports for existing systems to comply with OSHPD standards. This was in addition to supporting new systems and working around everything that already was in place and didn’t have to be brought into compliance.
“When we ran a new system through the noncompliant area, we had to have our system in compliance with
OSHPD standards. However, the 50 other conduits around ours didn’t have to be in compliance with the same standards or be anchored or supported in the way ours did,” said Richard Orozco, foreman, Woods Electric.
OSHPD standards are very specific about those supports, including requirements for anchorage and bracing of electrical equipment, switchgear, conduit, etc., that are listed in the seismic building codes for hospitals. So, while most electrical contractors might substitute materials listed on drawings or in plans for equivalent ones, it is not an option on this and other California hospital projects. Plans for the Kaiser facility by architects and engineers had been submitted to the state for approval and listed the required materials.
According to the plans, Woods Electric had to drop wedge anchors for support instead of wires that typically would hold pipe. And while Woods’ crew usually could use a pole gun to reach into ceiling areas to shoot pins, because of having to put in the wedge anchors, the crew had to physically get up into small spaces and drill with a rotary hammer and drop in anchors with threaded rod suspended from them, making it a longer process than the simple conduit supports normally acceptable.
“If a certain anchor was on the drawing, we had to have that,” Orozco said. “Let’s say we mounted boxes or straps and used a type of screw that wasn’t in the plans. For example, the specs called for a No. 10 screw, and we, as electricians, usually use a No. 8. If we used an 8, though, a compliance officer would say, ‘Do you have an engineering report for that type of screw to show that you can use it?’ And there were lots of examples of those sorts of specifications. We were required to upgrade the size of our wire from No. 12 AWG to No. 10 AWG for electrical home runs over 70 feet in length. If we didn’t use it, the inspector would cite us for it.”
And the workers were closely watched. The state, not the city, had jurisdiction, so a site inspector of record visited daily, looked at the work, then reported directly to the state area compliance officer.
“Hospitals are a lot more complicated than other buildings because of the number of systems and the strict enforcement of code requirements. It requires a higher than normal competency of the electrical contractor. Woods handled the job well,” said David Rose, associate, HMC Architects.
Rerouting conduit was another part of the process, with a firewall thrown in.
“We had these existing conduits going right through where they needed to build a firewall, and we had to completely take them out and reroute them,” Orozco said.
While on four of the five floors, the areas linking the existing building and the new tower previously had been areas of patient beds, on one floor, the area to be linked had been an intensive care unit (ICU). Since planners decided to retain the area as an ICU, the entire area had to be upgraded. Woods’ crew of 12 took all electrical systems off the walls, disconnected and made them safe and then identified all the existing systems, to prepare for the rebuild and to make it a compliant area.
“In one spot there was a wall. And our boxes were anchored to the wall, and they took the wall out to make a pathway to the new tower,” Pengilley said. “When the carpenters got done with demolition, there were all these conduits hanging out in dead air. We had to go back and remount and support them.”
Since the ICU also was to be used as a link between the two buildings, with the nurse station at its center, it also was designated as a fire corridor.
“Normally, in a nurse station you wouldn’t have that,” Pengilley said. “But because it became a path of egress, it had to be brought up to a specific fire rating and rebuilt so that it could be closed off in case of fire.”
The fire alarm system that Woods installed included several devices that worked together but were not connected with the existing panels. It now is a stand-alone system—an interim solution approved through an alternate method of compliance until the fire alarm system for the building can be upgraded to fully meet the code—that serves and monitors just the ICU and the points of connection to the new tower. The vendor, Johnson Controls, programmed and commissioned it.
But the required attention to detail affected staffing.
“You can’t just bring anyone to work in here,” Orozco said. “We had to train each of the guys that come in because of the specifications. We had to fine-tune their training. I had to be on top of everyone, making sure that they worked according to the drawings.”
In addition, simply working in a hospital setting provided a set of challenges. Woods Electric had to work quietly to avoid disturbing patients. Workers also had to control the dust and comply with infection control. And because the area under construction was near occupied areas, they couldn’t all do their work in an area at the same time. They had to move around.
“If we were working an area, maybe drilling for anchors, and we were making too much noise, they’d come by and stop us. If a patient was being disturbed, we had to stop,” Pengilley said. “That is what made it a very challenging situation and part of what makes hospital work more difficult than other work. It was super-sophisticated tenant improvement because of all the systems that are involved and was complicated because of the proximity of compliant and noncompliant areas,” he said.
“Their work involved a lot of detail,” said Ron Carnahan, construction manager, Kaiser Permanente. “And they’ve done an excellent job.”
CASEY, author of “Kids Inventing! A Handbook for Young Inventors” and “Women Invent! Two Centuries of Discoveries that have Changed Our World,” can be reached at firstname.lastname@example.org or www.susancaseybooks.com.