Skanska, the eighth-largest construction company in the world, has set its sights on building a world-class heart and vascular hospital on the Rex University of North Carolina (UNC) Healthcare campus in Raleigh, N.C. The new facility will provide treatment, rehabilitation, education and preventive care in one facility.

Rex UNC Healthcare is located in Wake County, North Carolina’s most populous county, which adds thousands of new residents every year. It has been the hospital of choice in the area for 120 years, always focused on investing in new technologies and construction that could elevate the quality of healthcare it provides. 

Since 2011, however, the hospital has noticed a dramatic increase in heart and vascular referrals after it partnered with the largest cardiology practice in the county. This greatly stressed the facilities’ current capacity. Additionally, all of its heart and vascular services were scattered throughout its campus, making it hard for staff to coordinate care. Therefore, Rex UNC Healthcare needed more space to adequately serve the new influx of patients, all in one, centralized location.

Senior Project Manager Samuel Holbrook has been with Skanska since 2007 and in charge of the $235 million Rex UNC Healthcare North Carolina Heart and Vascular Hospital project since 2011. Skanska broke ground in fall 2014 and expects the project to be completed in January 2017.

The new 373,000-square-foot hospital will be eight stories tall and include 114 private patient rooms, 20 diagnostic testing rooms and 60 private patient prep and recovery rooms. Working with Skanska to bring this project to fruition are WHR Architects and BBH Design. 

“Everyone strives to work together out here,” Holbrook says. “We strive to make our vendors, designers part of the team. We really focused our team and got on the same page. They help us maintain the budget the hospital wanted.” He notes that the team has employed a “very innovative approach to the construction process, which has really helped our schedule.”

Ordered to Size

Skanska strives to bring innovative building techniques to the project, such as its prefabrication process. The company builds all the overhead mechanical, electrical and plumbing rough-ins offsite in a warehouse and brings all of it to the project site in unistrut racks ready to install. Prefabrication is relatively new to the industry and Skanska has used it on fewer than 10 projects in the United States so far.

With prefabrication, everything is ordered to size with very little waste generated. Instead of bringing all construction materials to the project site and making a mess with cutting the materials and hauling things from place to place, Skanska has localized this in one place. This project has installed over 300 of these prefabricated racks and shaved more than four months off of the current construction schedule. Holbrook says it also improves quality and safety and lowers the overall cost of the project. 

 “We’ve seen how well it’s worked out for us, not only schedule-wise but from a cost and safety standpoint,” he says. “Once you get it out here, you can really see all the added benefits.”

To further accelerate the schedule and save costs, Skanska utilized a concrete additive called Vapor Lock in its concrete slab and deck pours. This additive stops vapor emission from the concrete within days and eliminates all moisture issues that typically plague the flooring installation in a new building. This allows Skanska to install flooring without performing any moisture mitigation, and the additive is half the cost of typical topical floor prep.   

Additionally, Skanska does everything with the environment in mind. The Rex UNC Healthcare project has gone completely paperless with all contract documents. Instead of documenting everything on paper, Skanska utilizes a virtual plan room to track the project’s progress and all updates; communications and quality control are done via iPad. “It really keeps everyone up to date,” Holbrook says. “Same day we get it, it goes out to everyone else on the team.”

Smartphone applications help Skanska take the guesswork out of crucial construction aspects. Punchlists are generated and distributed to all subcontractors using an app. A quality control app simplifies checking for leaks and air barrier issues on the exterior of the new building, while another app detects potential environmental issues inside of the existing hospital. Sensors set up throughout the site send an automatic notification whenever vibration or noise is detected so Skanska can resolve the issue before the hospital even has to call. 

“Skanska is very innovative overall,” Holbrook says. “We encourage all of our teams and employees to bring anything innovative to the table. We even offer internal grants to develop new technologies. People can apply for a grant to Skanska and the company will give you funds to develop and study for a new way to do something.”

Working with Rex

Because the new hospital is located directly adjacent to the existing, fully operational Rex UNC Healthcare facility, logistics have been a challenge for Skanska. The company strives not to interrupt any day-to-day activities during the construction process. To ensure this, Skanska has rerouted the pedestrian and vehicular traffic flow, created a new patient drop-off location and even had to reroute power feeds without interrupting power to the hospital. 

“We’ve had to do a lot of electrical workarounds,” Holbrook explains. “We’ve done about 15 different phases of work to reroute all the utilities and roadways. Plus, we really stress out here that safety is everyone’s responsibility. We haven’t had any lost-time injuries in four years. We spend a lot of time training all employees on site.  The philosophy is if the whole pool is full of lifeguards, no one will drown.”

When the project finishes in 2017, Rex UNC Healthcare’s new hospital will have many new amenities for patients, staff and visitors. The crown jewel of amenities will be the hospital’s Center for Innovation and Learning. Rex Healthcare envisions becoming the world-class destination for heart and vascular-related teaching and healthcare services. 

Skanska has worked closely with Rex UNC Healthcare, designers, vendors and many more to execute this project. The project has taken all of Rex UNC Healthcare’s wishes into consideration, along with aesthetic design considerations such as arched ceiling accents, outdoor fountains and gardens and wood paneling to make the hospital a calming space for patients and visitors and a motivating space for staff to spend so much of their time.

“I’m most proud of the innovation on this project and the relationships we’ve developed with our construction team, client team and design team,” Holbrook explains. “We may be on different sides of the table, but in the end, we all understand why we’re out here and that’s to deliver a world-class healthcare facility the best we can. This is one of the projects and teams where I am going to look back on in 10 years and wish I could do it all over again.” 

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