Heart of the Matter

Only eight weeks after having undergone heart surgery, comedian Robin Williams was a guest on “The Late Show with David Letterman” in May 2009. Chatting with Letterman about his surgery, he pulled a piece of paper out of his coat pocket, and said, “A lot of people have thanked people for the Academy Awards... . I also want to thank my doctors.” The list included cardiothoracic surgeon Dr. Marc Gillinov, who performed his surgery at the Cleveland Clinic. “I had this done in Cleveland,” Williams said, “and if you ever can, have it done there.”

Why Cleveland? In the latest America’s Best Hospitals rankings, U.S. News & World Report ranked the Cleveland Clinic’s hospital No. 1 in cardiac care. And now the clinic’s Heart and Vascular Institute has a new state-of-the-art home: The Sydell and Arnold Miller Family Pavilion. The nearly 1-million-square-foot building includes 128 exam rooms, 155 physician offices, 278 private patient rooms, 16 operating rooms, 10 catheterization labs and several specialized intensive-care units. Adjoining it, and built simultaneously, was the Glickman Urological and Kidney Institute, which includes a 330,000-square-foot building with a rooftop helipad, a 21-bed dialysis unit, 74 exam rooms, 16 procedure rooms and 77 physician offices.

Patients and visitors from across the United States and the world now enter the glassy, C-shaped Miller Pavilion by passing reflecting pools and rows of tulip trees. It was nothing more than a hole in the ground next to the existing hospital campus when electrical contractor WagnerSmith/ESI Electrical Contractors, Dayton, Ohio, began work on the $350 million project. Other electrical contractors (ECs) included Cleveland’s Lake Erie Electric Inc., a primary contractor, and Work Best Electric, also of Cleveland, a subcontractor to another contractor.

WagnerSmith/ESI was awarded a $20 million contract to provide the temporary power and power distribution for the Miller Pavilion, a four-year project completed in late 2008, and an $8 million contract for power distribution, branch circuits, lighting and telecommunications on the adjoining Glickman Tower, completed in 2009.

The challenges were the project schedule, interfacing with the existing hospital facilities and dealing with changes the owner made, said Gary Laidman, chief operations officer, WagnerSmith/ESI. And, did he mention the weather?

During the summer of 2004, the site—shoehorned into the existing hospital campus—was cleared when an existing building was torn down. Working with construction contractor Whiting-Turner, a company headquartered in Baltimore, with offices in Cleveland and around the United States, WagnerSmith/ESI assisted with the design of the temporary power for the new facility: routes for power up and down the complete building to run a power feed to tower cranes and to four double buck hoists. The design also included a power run to a dewatering system that circled the site. Due to the site’s proximity to Lake Erie, power was required to run pumps to lower the water table so that excavation could be done for the basement and foundation of the building.

“We needed to have a floor on the site and to have the power in place before winter set in so that the area wouldn’t get wet,” said Murray Hestley, senior MEP project manager, Whiting-Turner Contracting Co.
As it was, rain prompted constant pumping of the area, but any winter weather would have stopped construction.

This was not a desirable outcome. By the fall of 2004, the 125,000-square-feet base floor was in place. Above it was a 3-foot interstitial space, to catch any water that would accumulate, which was topped by the building’s basement floor.

“When we were working on the interstitial floors there wasn’t a building there. It was nothing but a wide open concrete mat,” Laidman said.

WagnerSmith/ESI installed the medium-voltage distribution duct banks in the interstitial space according to schedule, which then ran into winter weather. As a result, the company’s crew had to deal with shoveling snow to proceed with their work.

As part of the temporary power contract, WagnerSmith/ESI set up two temporary high-voltage substations, 1,500 and 2,000 kilovolt-amperes, in enclosures. From those substations, the workers ran feeder conduits into the building’s basement where they set up temporary 480-volt distribution panels.

WagnerSmith/ESI then ran the incoming power from there to the different risers that ran up the building, providing 480 volts to every floor. On each floor, mini power distribution centers, consisting of a transformer with a 480/277-voltage panel on one side and a 120/208-volt panel on the other side, were built.

Since the project schedule was tight, it was important that all the feeders went into place and were commissioned and energized reliably—all in a certain order. To streamline the process, Laidman explored the use of color-coded cable—which previously had not been widely used in the area—instead of using black cable with a piece of colored tape on the end. He visited the wiring manufacturer, Encore Wire Corp., in Texas; discussed the conditions and terms of the project; was sold on the idea; and ordered the cable: grey or white for neutrals, green for grounds. For circuit colors, he ordered black, red and blue for the 120/208V circuits and brown, orange and yellow for the 277/480v circuits. The result? No phasing problems occurred with more than 1,000 points.

The goal was to have the facility running—i.e., power distribution to more than 1,000 separate distribution panels in the building—as quickly as possible on the permanent service. That called for tying into the Cleveland Clinic’s high-voltage (11,400 volt) loop system, one with live circuits of 15,000V. At the time, another contractor was rearranging some of it. The two companies had to coordinate so that WagnerSmith/ESI had power available when the workers needed it and to ensure switchgear was being energized without putting the hospital at risk.

“There’s a manhole conduit system that runs around the campus, and we took conduits out of those manholes into each of those buildings and then pulled that high-voltage cable into the new high-voltage switchgear supplied by Eaton/Cutler-Hammer and GE. Our efforts required a lot of coordination and strict adherence to safety regulations,” Laidman said.

WagnerSmith/ESI also tied the new building into five separate existing campus buildings without shutting down the existing and without any failures.

On the Glickman Tower, WagnerSmith/ESI again used Encore’s color-coded cabling for the power distribution. One detail of the branch-circuit work on the Glickman Tower that required attention was that the thousands of circuits—each receptacle plate, switch plate, etc.—had to be engraved with the number of the panel where it originated and with the circuit number. WagnerSmith/ESI held off ordering the engravings until late in the project to minimize the number that would have to be redone due to project changes.

Work Best Electric Inc., Cleveland, also worked on the project as a subcontractor to Gorman-Lavelle Corp., a plumbing and HVAC contractor in Cleveland. Work Best Electric was awarded the $200,000 contract for the installation of the plumbing and the medical gas systems for the Miller Pavilion, a contract that involved installation of the low-voltage interconnecting wiring for the medical gas alarm panels. Seven separate medical gas systems, including oxygen, nitrogen, vacuum and compressed air, were involved. The gases are piped to the operating rooms, patient rooms, treatment rooms, ICUs and various outlets throughout the facility.

“When there’s a loss of pressure, a sensor sends a signal back to a panel,” said Tim Lavelle, president, Gorman-Lavelle Corp.

“The complexity of a medical gas system required maximum organization. With a large crew of electricians on a tight schedule, it was a challenge to get the information about the location of the points, equipment and tank rooms to the men in the field when they needed it,” said Susan Salontay, president of Work Best Electric. “It was not a tremendously complicated system but it encompassed so much territory.”

How much? “This project was the biggest single-use medical facility to ever be under construction,” said Jerry Salontay, project manager, Work Best Electric. “One of the challenges was that you would work one area, but then it might be a year before you could go back to that same area to do the next stage or finish because you had to wait for other installations.”

Work Best Electric rose to that challenge.

“It was a very fast-moving project in terms of schedule and entailed a lot of design changes. The medical gas systems underwent a lot of changes that affected Work Best Electric and they stayed up with it. They did well and were a participant in a sophisticated project team and a world-class design. I thought they did very well,” Lavelle said.

Robin Williams probably didn’t know about the sophisticated work done by the people on the job site that made it possible for his surgery to be done successfully. Their work makes his suggestion to anyone facing heart surgery all the more pertinent: “Where do you want to go? Cleveland!”

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 scbooks@aol.com and www.susancaseybooks.com.

About the Author

Susan Casey

Freelance Writer
Susan Casey, author of "Women Heroes of the American Revolution," "Kids Inventing! A Handbook for Young Inventors," and "Women Invent! Two Centuries of Discoveries that have Changed Our World," can be reached at scbooks@aol.com or www.susancaseybooks...

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