Founded 110 years ago, CHRISTUS Spohn Health System is in the middle of the largest expansion plan in its history. Juggling new construction, numerous renovations, and demolition across two campuses in Corpus Christi, Texas - on a very aggressive schedule - requires Architect Perkins+Will of Dallas, Program Manager CBRE Healthcare Services of Dallas, and General Contractor McCarthy Building Companies, Inc., of Houston to collaborate closely with the owner, from preconstruction decisions through construction phasing that needs constant monitoring and frequent adjustments to maintain the best patient care. To make the $335 million project even more interesting, Hurricane Harvey threatened, but McCarthy and its team worked together to weather the storm and return to work quickly. The five-year project remains on schedule for completion in 2020.

Phasing Across Two Campuses

CHRISTUS Spohn offers the largest hospital system in South Texas, with six campuses and numerous clinics. In order to provide patient-centered care with the most appropriate and efficient resources, their new master facility plan combines two hospital campuses - the Shoreline campus bordering Corpus Christi Bay and the Memorial campus less than two miles away.

McCarthy joined preconstruction efforts in 2015. "We were able to work collaboratively through budget, schedule, and constructability as they designed this complex, large project so we could help accelerate the process," said Preston Cope, McCarthy's Senior Project Manager.  

McCarthy began construction of the 43,000-square-foot Dr. Hector P. Garcia Memorial Family Health Center in December 2015 and finished in December 2016. That facility incorporates a walk-in clinic, primary care, labs, and other services. As part of the master facility plan project, crews will demolish the old 500,000-square-foot hospital on the Memorial campus.

Work on the Shoreline campus includes a tower addition with 200 new patient beds, an expanded Emergency Department, a variety of other health services, and a new chapel; renovations in multiple buildings; site work, including a ground-based helipad to provide better access to the new Level II Trauma Center; an 18,000-square-foot, two-level central utility plant; and removal of 320,000 square feet of aging buildings. 

The variety and quantity of work creates challenges in phasing, Cope said. "Often we can't start renovations until a department is vacated, but that department can't move until we build out another space. Phasing has been one of the more complicated aspects of the project since the beginning, but we have a great team between McCarthy, P+W, CBRE, and CHRISTUS Spohn. We meet at least once a month to talk about the overall phasing and once a week to fine-tune the details of where we're working and what we're doing."

Weathering the Storm

McCarthy is currently constructing the 10-story, 395,000 square-foot tower on the Shoreline campus. As part of their site-specific safety efforts, they developed a hurricane preparedness plan. When Hurricane Harvey first headed their way as a tropical storm forecasted to reach hurricane levels, "We shut down all construction production work and stopped all deliveries," Cope said. "Our subcontractor trade partners worked to secure the building and their materials, load up debris, and get any excess materials and equipment off-site. At that time, the weather forecasters thought we'd get more rain than high winds."

However, the storm escalated to a Category 3 hurricane by the next morning. Before the storm intensified, "Our crane subcontractor [P&J Arcomet Services of Manassas, Virginia] was taking some additional precautions and safety measures, but no significant changes to the crane equipment would be required; the crane jibs would be allowed to weathervane in the wind, as per standard operating procedure," Cope said. "Once the hurricane moved to a Category 3, though, we had to do something different. Because it escalated quickly, there wasn't time to take the cranes down."

Instead, the team developed a plan to tie down the two Terex-Peiner SK 415-20 Tower Cranes. "P&J took four one-and-a-quarter-inch diameter cables and tied them to each corner of the turntable at the top of the crane tower just below the jib, which was still allowed to weathervane," Cope explained. "They then hooked the other end of two of the cables to 45,000-pound concrete ballast weights, which they trucked in overnight and set at the base of each crane. The ends of the remaining two cables were tied to the new tower's level eight concrete frame."

To accomplish that quickly, P&J pulled resources from all over Texas, including workers who drove through the night. "They started at 2 a.m. and by 2 p.m. that day, before the storm really hit, they had the cranes secured," Cope said.

During the storm, 14 McCarthy supervisors and hourly employees slept onsite in their office. "We're working so close to hospital operations, we didn't want something to blow off and cause damage," Cope said. "We also wanted to be sure no water entered the hospital through our construction areas."

Twenty people from McCarthy's trade partners - primarily The Brandt Companies of Dallas, the MEP subcontractor - also joined the ride-out team. "We really worked closely with the hospital to meet their needs," Cope said. "Since we had additional resources, we helped them hook up emergency generators and move patients to buildings with back-up power."

After weathering the storm on Friday night, August 25, construction crews returned to work on Monday. By Tuesday night the cranes were recertified and back in action.

Strategies to Save and Accelerate

To prevent damage from future hurricanes, the team invested significant efforts in finding the best products for the exterior of the patient tower. The architect partnered with a consultant to build a model and conduct a wind tunnel test that specified wind pressure design standards. "It's more specific and strenuous than what the code required," Cope said.

Because the Texas Department of Insurance must approve every product the wind touches, "We worked with the design team and our trade partners to ensure that the products they picked were already approved and didn't need to go through the lengthy testing process," Cope said. "That allowed us to meet our construction schedule." 

The accelerated timeline also prompted the design team to issue three separate packages for the tower - foundations, structural, and a finished-out package with the skin and interiors. In July 2016, McCarthy started foundation work while the design team and owner finalized revisions on the other packages. 

The design for the tower foundation incorporates a combination of 18-inch diameter auger cast piles and 66-inch diameter drilled shaft concrete piers. "The tower includes core areas where the shear walls extend down to the foundation," Cope explained. "During preconstruction, we conducted a cost analysis of how many auger cast piles would need to be added there because of the additional load of the shear walls. We found that the drilled shaft piers would actually be more cost-effective than the quantity and depth of auger cast piles needed."

Because of soil conditions, "The drilled piers extend down as tall as our building, about 160 feet below grade," Cope added. "Our typical auger cast piles extend 75 feet. Once the auger cast piles get over a certain length, the driller would need different equipment that costs significantly more."

Safety for All

To avoid disruptions to patient care, McCarthy works closely with CHRISTUS Spohn. "Because we're building the tower right up against the existing hospital, we have to handle noise and construction operations differently than a new hospital on a green site," Cope said. "We do a lot of preplanning with each trade so we can accurately inform the hospital and they can tell us if they have any concerns with the proposed work."

For instance, "If we think the noise involved in an upcoming construction activity will impact the hospital, we schedule a time to conduct that operation for a short while and situate their leadership team in the hospital next to it to hear the noise," Cope explained. "They can determine if it's an issue before we're scheduled to start. With a lot of the noise sampling we've done, we've been able to adjust the planned work time and duration." 

Throughout the project, McCarthy has focused on taking care of everyone involved. With more than 850,000 hours already worked at the Memorial campus, on the tower, and in various renovations at the Shoreline campus, the project hasn't experienced a single lost-time incident. On September 8, the team topped off the tower. They expect to complete tower construction in April 2019. Final Shoreline campus renovations and demolition will finish by the middle of 2020.