Completed ahead of schedule and on budget, McCarthy Building Companies' $50 million expansion of the Erlanger East Hospital in Chattanooga, Tennessee, will provide patients with a "lifestyle" experience.

"They tried to make this hospital more hospitable," says Will Gaither, Project Manager with McCarthy in Atlanta, Georgia. "The design is more warm and comforting."

Erlanger's main campus facility is an academic medical center. The East suburban hospital can handle elective surgeries and normal deliveries nearer to people's homes, explains Bruce Komiske, Project Executive for Erlanger.

The 90,000-square-foot hospital addition is a three-story, steel structure. Three corridors and the operating room connect with the former hospital. Additionally, McCarthy completed about 25,000 square feet of renovations.

"We finished ahead of schedule and under budget, while taking on a number of challenges," Gaither says. "And we did it with few hiccups."

The project includes four new operating rooms; expansion of the post-anesthesia care unit; 10 pre- and post-op beds; a new cardiovascular interventional radiology suite; renovations to the reception and administrative areas; and construction of a new 58-bed patient tower with large rooms; six intensive care beds; a 1-mile, campus-wide walking trail; putting green and playground. 

"They want people from the community to come, eat in the cafeteria or take a walk," Gaither explains.

Erlanger held a photography contest, soliciting local photographers to submit photos to decorate the hospital. More than 1,400 images were submitted. The Photographic Society of Chattanooga ran the contest. Erlanger staff selected the 100 best images, enlarged and framed the photos and hung them from the walls of the lobby to the upper levels. Erlanger paid the photographers. Most of the images are of nature scenes. "It came out incredibly well," Komiske says.

Design and Construction with Resident Opinions

Erlanger selected HKS Architects of Atlanta and McCarthy in October 2014, to build a children's hospital after an extensive national search that included 25 firms to design and construct this hospital and its new Children's and Women's Hospital. The process included asking the final two architects and two contractors to indicate what other firm they would like to work with.

Erlanger spent three weeks working with both teams as they developed seven renderings. Then, the health system invited the city to watch as the two teams presented their vision for the renovated main campus with residents.

"The interaction was very positive and that led to the success of the project," Komiske says.

Once HKS and McCarthy were selected, they began planning the project.

"We heavily contributed our construction knowledge and experience in the design and provided feedback to the architect along the way," Gaither recalls. "It was close to a design-build atmosphere."

The company broke the project into four packages to get started faster and finish before Erlanger's certificate of need from the state expired. It treated the north and south end additions as separate projects. The six recovery beds and operating rooms opened in January and March 2016, respectively.

McCarthy broke ground six months after receiving the job in April 2015 with partial drawings. The company broke up the shop drawings by floors or half of a floor to get the work started as quickly as possible. It utilized building information moduling to mitigate clashes in the field.  

"This was a challenging project from the standpoint of a fast design," Gaither says. "The schedule was the driving factor of the design."

The addition sits on 80 caissons at a depth of up to 20 feet, with a grid of grade beams tying the pier caps together. This foundation was chosen because of the soil and rock conditions.

"The foundation was engineered to mitigate those issues, and the hospital is sitting on sound rock," Gaither says.

Subcontractors used a total station with GPS for layout work. McCarthy used laser scanning for structural as builts, and ground penetrating radar to locate utility lines in the slab before cutting to install plumbing and electrical lines. 

At each tie-in with the existing hospital, McCarthy competed an infection control risk and an interim life safety plan, with exit paths and smoke detectors.

"Infection control was almost a job in itself to maintain, monitor and repair daily," Gaither says. McCarthy erected temporary barricades to keep dust in the construction space and install negative pressure machines to ensure dust did not enter the hospital if a small crack developed. "We used a lot of new tools," Gaither recalls.

Sixty-seven percent of the money spent on construction stayed in the local community, with minority, veteran and women business participation, Komiske reports. Additionally, there were no injuries.

"In every category you could evaluate a construction manager firm, they exceeded expectations," Komiske says. "McCarthy could not have done a better job."

Part of a Larger Health System Update

The Erlanger East Hospital expansion and renovation is one part of a campus-wide upgrade. The same architecture and construction team will design and build the Erlanger Children's and Women's Hospital.          

"Instead of losing the team at the end of the project, we are gearing up for a bigger project, which will take place for years," Komiske says.

The magazine Modern Healthcare ranks employee-owned, 150-year-old McCarthy as its number one health care contractor, with $3.3 billion in annual billings. McCarthy showed its appreciation to the community by completing a Heart Hats project at the Oncology Center at the Erlanger Baroness campus. For two days, McCarthy employees, Erlanger Health System volunteers and patients brought new life to the Oncology Center's Healing Garden with new landscaping, added seating, a water fountain and the addition of a small bridge to help patients undergoing therapy and treatment relax.  

Komiske indicates that giving back is a hallmark of McCarthy's commitment to the communities in which it works and was a factor in the success. The company also contributed to fund-raising efforts.

"They became part of the hospital team," Komiske says. So much so, he adds, that Gaither's two children were born at Erlanger and his wife now works as a nurse in the neonatal intensive care unit.

"Everybody is excited about the finished product," Gaither says. "Everyone from the owner to the subs is pleased with the end result."