When battling cancer, time is obviously of the essence. Early detection and treatment are among the keys to survival. But when Meadville Medical Center was planning its Oncology Wellness Institute in Vernon Township, Pa., cancer patients weren't the only ones hoping that the project could be completed quickly.
The 19,000-square-foot, $6.2 million building was set to become western Pennsylvania's first diagnostic and cancer-care facility - but only if the design-build team acted fast. A competitor planned a similar building nearby, making it vital that the project be done quickly without sacrificing quality.
Astorino, a construction firm with offices in Pittsburgh and southern Florida, used design-build project delivery to complete the institute just 13 months after contracts were signed. The quick completion dissuaded Meadville Medical Center's rival from opening up shop nearby and allowed institute staff to focus only on the most important aspect of their jobs - helping patients heal.
Tim Powers, senior vice president of Astorino's health-care design studio, maintains that design-build delivery was essential to getting this project completed on time and on budget. It's a method Astorino uses whenever possible. "The only thing that could have made this happen so quickly was design-build," Powers says. "We were able to guarantee a number early on and work with the contractor side to make sure we stayed on budget.
"Usually, the relationship between architects and the contractors is adversarial. The architect is trying to validate his work, and the contractor is trying to look for change orders. In design-build, all of that controversy goes away, and it's truly a collaborative effort to get the job done and meet the owner's expectations. In the non-design-build world, everyone's just in it for their own benefit, but [at Astorino] we're all in it for each other."
Louis P. Astorino, son of CEO Louis D. Astorino and leader the firm's design-build division, said initial plans for the institute came in several thousand dollars over budget. The firm quickly organized a project team meeting so that the architectural and construction sides could find ways to cut costs while maintaining the architectural integrity of the design. Such rapid response wouldn't have been possible if his firm had to work around the schedules of various contractors and other stakeholders.
"We were able to value-engineer the project within days," Astorino said. "We were able to get our team together immediately to come up with strategies to reduce the costs while making sure we maintained our level of quality.
"Value engineering can be a cumbersome process, and a lot of times, you're not sure if you're getting 50 cents or 20 cents back on the dollar. That's really how the industry works. The contractor can come back with some material substitutions that don't necessarily meet our quality requirements. But ours is a team approach that's very open, and the owners of the building are part of that. The owners get real-time information."
Astorino said the ability to react quickly is especially important when constructing medical buildings. Technological advances in medical equipment can easily translate into last- minute changes in design or construction. The day before a huge concrete pour at the institute, plans for the location of electrical conduits were changed due to issues with the linear accelerator, which was purchased by the hospital after construction began. The electrical conduits for this machinery had a very specific location and had to be placed at a certain angle to meet the requirements of the hospital's radiation test performed by the hospital physicist. Astorino says design-builders handle such changes easily.
"We were able to adhere to the budget," Astorino said. "There were no construction change orders. They were all owner-driven change orders, and we upheld the schedule even with those changes. We were able to react, keep the budget the same and keep the schedule the same."
Citing an article in The Economist, Astorino said there is a 30 percent waste factor across the construction industry due to "interoperability and inefficient use of resources," that cost the industry about $15.8 billion annually. Design-build creates a more streamlined process and Astorino suspects that increased use of design-build by the design and construction industry could lower that figure, saving jobs, time and headaches.
"We control the process in house," he said. "Instead of just contractors and architects looking out for their own hides, we're concentrating on making it more seamless for the building's owner and giving the owner the best value. When you're truly one team, you solve problems as a team."
The institute, recently renamed the Yolanda G. Barko Oncology Institute, seeks to reduce patients' stress levels in order to provide the best chance of recovery. The building sits in a peaceful stretch of woods and provides therapeutic activities such as art and music.
An outdoor area with gardens, walkways and access to walking trails was completed shortly after construction. Despite the natural feel, the building remains decidedly high-tech. It has a computerized medical library where patients and families can find the latest information related to their diagnosis.
"They received a great building for the money they spent," Powers said. "When people walk through the building, they're amazed. It's truly a value. We were able to build this high-tech cancer center in the middle of the woods. I think that placing people in an environment that's natural and interesting is part of the healing process. Most of the cancer centers are in urban areas that aren't very attractive. This is in a very attractive location, and that affects outcomes."
"With design-build, we talk together throughout the process. If it's done right, I think it's beneficial for everyone involved. I think architect-led design-build is the way to do it. If the architect is leading the design-build process, you can be assured that the design integrity of the building will be maintained throughout the construction process and that shortcuts won't be used that may step on some of the design principles. I want to do more projects like this."