The continuing need for healthcare facilities is consistently spurring new medical developments. Everything from urgent care, medical clinics to hospital complexes are under construction across the country. One such project is the SSM/St. Louis University Hospital and Ambulatory Care Center. This site will replace an existing hospital with a state of the art facility with greater capacity. This $550 million facility represents the beginning of the official partnership between SSM Health and St. Louis University. It is the culmination of decades of relationship between SSM Health and SLUCare. Projects of this magnitude have extremely detailed and aggressive schedules. The civil components require incredible teamwork and attention to detail. Another requirement is flexibility. This has all been present on this project, which is slated to open September 2020.

Alberici Constructors of St. Louis, Missouri, is the general contractor on site. Known for high quality, large project performance, Alberici needed to contract a team that was reliable and brought Bloomsdale Excavating on board. Bloomsdale has established a reputation as being professional and detail oriented. The company has a significant equipment fleet, which would be required on this project. Large-scale sites such as this need to be managed effectively or schedules could be drastically affected. Variations to original scopes need to be evaluated and adjusted in a timely, precise fashion. These are all elements that any team member would need, but especially the contractor performing the civil package.

The civil package required site clearing and demolition (pavement, surface items, and utility) prior to diving into the installation of site utilities in relation to storm water sanitary and water flow services. The complexity of these items was magnified by the placement in an urban environment. 

Alberici team members Austin Davis, Project Manager; Jim McGuirk, Project Superintendent; and Brian Crawford, Project Director; handled the project supervision and management requirements by working closely with Bloomsdale team members Brandon Zehr, Project Manager; and Craig Rose, Project Superintendent. By keeping strong communication lines open, the team was able to meet the nuances of all the above-mentioned tasks flawlessly.

Safety in a Tight Area

A unique excavating aspect of this project was the development of area for underground storage. This required incorporating the proper equipment that could be manipulated in a small area to create the space to exact specifications. Once again, attention to detail made this area develop effectively. Magnifying the challenge to perform all of these tasks was the project’s close proximity to a very busy and active Grand Avenue at Rutger Street. A beam and plate shoring system was placed adjacent to the Grand Avenue section with a rock and soil nail shoring system on Rutger Street. 

This increased the safety aspect and eliminated disruption of traffic flow. By attending daily and weekly safety meetings, Bloomsdale was able to communicate what safety procedures would be incorporated in relation to their project responsibilities. Alberici was extremely safety-conscious, and this transcended to all trades. With the movement of large dozers, excavators and dump trucks for hauling, safety in relation to vehicular traffic flow was critical. Being respectful of pedestrian foot traffic was a safety concern as well. 

Massive Earthmoving

The earthwork requirement was substantial. Over 170,000 cubic yards of dirt was moved combined with more than 42,000 cubic yards of rock. This required several pieces of large-capacity excavating equipment and hauling trucks. A permanent stockpile of over 43,000 cubic yards was created for SSM Health’s future use. The backfill for the building alone required 40,000 cubic yards. This mass of material requiring removal, placement and storage created an intricate plan in relation to both the site flow and equipment timing. Excavating windows were often narrow with other trades following Bloomsdale’s work. Project management was critical and daily attention to detail was standard procedure. 

On-site equipment maintenance was necessary. Selecting the best, most efficient types of equipment to perform the work on the front of the project avoided unnecessary delays. With the nature of the site logistics, needlessly moving equipment in and out, either for repair or misallocation, was completely unacceptable. Having reliable, well-maintained equipment was the only option. Equipment was not an area in which to cut corners.

A Successful Workflow

Often, projects of this magnitude can be logistical nightmares. The key to success is having a well thought out plan and contractors that fully buy into that plan. Add in a general contractor that keeps all parties accountable to the logistical plan and you have a recipe for efficiency.

To facilitate work flow, a working pad need to be created at the bottom of all building excavations. This required 29,000 tons of imported minus rock. That’s a significant amount of material that needed to be transported, spread and graded all while maintaining the aggressive project schedule. These challenges were met with efficient project management and a high work ethic by the labor force. The cooperation between the various trades on site underscored the team mentality set forth by the general contractor. 

Errors in the base civil work in a multi-story, high-profile facility can have major consequences as the building rises from the ground. The project is still on schedule, and the initial base work has proved effective. Though much of that work will go unseen, it’s importance is not diminished. Other facilities that were either rushed or not as strategically developed have encountered significant problems as the construction moved out of the civil phase. Alberici and Bloomsdale were determined to not make a simple error, so it was no surprise that this aspect of the project went smoothly. 

This doesn’t mean changes didn’t occur. It’s impossible to build a structure of this magnitude and not have them. The SSM/St. Louis University Hospital and Ambulatory Care Center experienced 100-plus changes (mixture of design and field). How those changes were handled was what was truly important. This is where unity between general and civil contractor is imperative. By using this relationship, changes were handled effectively and quickly with no contention. 

A “let’s get it done” attitude drove the quest to solve these issues in the best way possible. Many times, this can cause contention and project delays as resolutions are negotiated. This was not evident on this project. There just simply wasn’t time or space for situations to linger. Weekly schedule and coordination meetings were a big reason this process went so smoothly. These were regular checkups to make sure everyone was on task and provide constructive input. Placing high importance on these meetings brought a greater degree of team unity on the project. Linking these meetings with the aforementioned daily and weekly safety meetings created a climate of collaboration very few projects achieve. Credit goes to Alberici’s team members for cultivating this procedural technique.

A High Profile Project

The high profile of the SSM/St. Louis University Hospital and Ambulatory Care Center means many eyes are on the project contractors. Due to the high level of interest in the project citywide, appearance of equipment, material storage and contractor manpower is on stage. Making sure each aspect is meeting safety standards had to be apparent. Equipment had to be in working order. There’s nothing worse than a broken-down piece of equipment either disrupting traffic flow or sitting off to the side. These scenarios would not be acceptable on an urban project such as this. 

Having equipment functioning at peak performance helped move the project along effectively. A lack of downtime when fighting one of the wettest periods of St. Louis weather history was a challenge. Record-breaking rainfall, and a higher than usual snow season, could have drastically delayed the earthwork schedule, even with weather delays calculated into the schedule. Most project schedules are adjusted for normal, seasonal precipitation. When that number is greatly exceeded, it’s rare for a project to maintain its schedule. Solid contractors and reliable equipment can overcome those odds.

The project completion date is May 2020, and construction is right on target to hit that date. Bloomsdale’s role is winding down at this point. Equipment used on the project will gradually be returned to the Bloomsdale yard and shop for maintenance and repairs. By following a diligent preventive maintenance schedule, the expectation is little will need to be done. Alberici Constructors has done a masterful job coordinating many different trades and partnering effectively with each. This will continue through the completion, opening and occupancy of the facility. 

A Benefit to the Community

The innovations the hospital will provide will truly benefit the St. Louis community and beyond. With an aging population, longer life expectancies, advancement of treatments and the innovation of facilities, the healthcare industry is expected to grow significantly in the upcoming years. This bodes well for the building of both hospitals and specialized healthcare facilities. Contractors developing expertise in this type of work will find abundant opportunity. This is especially true of those that perform efficiently and have a significant knowledge of equipment, as well as its most effective usage. Project managers that are experienced in healthcare construction will be in high demand. 

New technologies in both equipment and project management reduce construction time and unexpected extras. The field of earthwork is one of the trades that strives to reduce unforeseen issues. Considering the fact that highest percentage of their work is underground, this is quite a challenge. The more research and design commitment equipment manufacturers give to developing superior products, the easier project efficiency is for the contractor.

Healthcare Innovations

The healthcare industry looks to innovation as a mainstay in its processes. Presenting innovation as a construction platform when approaching healthcare opportunities can be a significant negotiating point for contractors. Both Alberici and Bloomsdale understood this on this project. They each used current technology for project communication, reporting and analysis. Being on the forefront of available methods alleviated many of the issues common with a project of this magnitude. 

The end result of the construction of the SSM/St. Louis University Hospital and Ambulatory Care Center will be a facility with state-of-the art-technology and a patient-friendly environment. It will be a new landmark in the local healthcare community and make a construction and design statement nationally. 

Many times contractors are not given the proper credit for their motivation to go above and beyond in building a project. It’s very easy to see the passion for building a premium facility in this particular facility. Building a large hospital complex in an urban space is anything but run of the mill. The completion of this site will stand as a testimony to the unified effort these contractors put forth, all in the name of providing the highest quality healthcare possible. This construction partnership is achieving that end.