Project new Østfold hospital

Project Director Dag Bøhler

Content

• Project charter and project objectives• Conceptual solutions• Project Execution Strategy• Project delivery achievements• Lessons learned

South-Eastern Norway Regional Health Authority

• Norwegian secondary health services• State owned public funded health trusts• Four regional health authorities controls 26 hospital trusts

• South-Eastern Norway Regional Health Authority (Helse Sør-Øst HSØ):• Providing specialist health services for 2.8 Mill. inhabitants

(56% of the Norwegian population)• Budget: 8 Billion EUR• 11 Hospital trusts, plus 5 private non commercial hospitals• 2,6 Mill. m2 floor area (excl. private hospitals)• 70.000 employees

South-Eastern Norway RHA

Central Norway RHA

Northern Norway RHA

Western Norway RHA

• Conceptual report approved in June 2009• Preliminary project approved in December 2010• Total of 89.680 gross square meters

– 416 standard beds (only single rooms)– 108 beds in psychriatic health care– 9 0peration theaters (inpatients)– Out patient facilities: 165 rooms– 3 CT– 2 MR– 1 PET/CT

New hospital facts

Steering model

HSØ •The Board in RHA approve the project•Project charter issued by the Board.

PNØ •Project board (steering committee)•Chairman from RHA•Internal and external professional members.

PNØ•Project organization with authorization to manage the project

within project framework.•Internal HSØ resources and consultants

Project objectives

Budget• Budget 3.650 MNOK (2010) ex VAT,comparable to P50 estimate.• In addition equipment; 425 MNOK ex. VAT.

Quality• Quality as defined in preliminary procjet• Modest standards• Life Cycle Cost• Well known technology• Energy class B

Time schedule• Start civil work autum 2011• Start early clinical operation from 2015• Full clinical operation from spring 2016

Safety • H-value less than 2 H-value measures the number of absence from work due to injury the day after the injury occured per million labor hour.

Completition • No errors or deficiencies with impact on

clinical operation.• Planning of startup face and training of

hospital employees in collaboration with the local hospital administration.

Project objectives

Project optimalisation in 2010

Service area

Treatment buildings

Ward buildings

Psychriatic facility

Main entrance

New hospital Campus

Ward layout with 36 single rooms

Procurement strategy/Contract structure• Standard requirements for all contractors • Follows EU laws and regulations for public procurement• Parallel contractors administrated by Construction client • “Standard” building and civil engineering contract• Contract for Design and Building in the technical discipline• Standard contract structures for Equipment and ICT

We use an combination of different contract structures in the different disciplines to achieve the project objectives. Important factors to consider are the competition in the local market, possible international suppliers, flexibility to modify strategy on the flight, how to keep control of cost, time schedule and product quality.

Private Public Partenership not common for hospital projects in Norway

Contract structure

Site clearance, excavation, filling, earth moving

General require-ments

Public roads

Foundations incl. installations

Interior works incl fixed furniture

Design build contracts for mechanical, electrical, ICT and specialised systems (many contracts)

Piping

Outdoor finishes (atrium gardens, green roofs)

Furniture, user equipment (many contracts)

Structure

Building envelope

Outdoor infrastructure - Roads, utilities, water, sewage

StructureBuilding envelope

StructureBuilding envelope

Interior works incl fixed furniture

Interior works incl fixed furniture

PipingPipingPiping

TREATMENT BUILDING30.200 m2

BEDWARD BUILDING38.400 m2

PSYCHIATRY13.100 m2

SERVICES3.600 m2

Status reports - Earned Value

• The Project Board reports status to the RHA board every 4th month. • The project managment reports to the Project board on mothly basis, based

on Earned vaule.• All contractors have to report on Earned value (hours) on all activities to the

project managment on mothly basis.• The project managment do all time schedule coordination between parallel

contractors on the construction site.

Building Information Model (BIM)

ICT implementation strategy

Existing hospital

New hospital

Freeze period

No new systems allowed

Phase 1• Implemententing all ICT

solutions in the old hospital

Phase 2

• Establish ICT infrastructure in new hospital

• Migrate solutions to the new hospital

Phase 3

• Implementing new functionality according to development plan.

4. Kvartal 2014

4. Kvartal 2016

New electronic chart

New patient logistic system

Laboratory suit

Clinisal Chemistry

Micro-biology

Pathology Blood Bank

OUS Flexlab Swisslab DocuLivePatologi

Prosang

Swisslab

Unilab Unilab

C5LIMS

AHUS Analytix Analytix DocuLive Patologi

LabCraft

VVHF Flexlab Miclis Sympathy LabCraft

Analytix Analytix Prosang

SIHF Analytix Analytix Sympathy LabCraft

SØHF Netlab Miclis Sympathy Prosang

SIV HF Unilab Miclis DocuLivePatologi

Prosang

STHF Flexlab Flexlab Sympathy LabCraft

SSHF Unilab Miclis Sympathy Prosang

Clinisal Chemistry

Micro-biology

Pathology

Blood Bank

Flexlab DocuLivePatologi

Prosang

Swisslab Swisslab

Unilab Unilab

C5LIMS

Analytix Analytix DocuLive Patologi

LabCraft

Flexlab Miclis Sympathy LabCraft

Analytix Analytix Prosang

Analytix Analytix Sympathy LabCraft

Netlab Miclis Sympathy Prosang

Unilab Miclis DocuLivePatologi

Prosang

Flexlab Sympathy LabCraft

Unilab Miclis Sympathy Prosang

One common medical laboratory suit

Did we meet the objectivces?

• Cost at completition meet budget. • Project finished 6 months before initial plan

– Initial clinical operation from 4th of May 2015– Starting full operation from 2nd of November 2015

• High quality throughout- according to prelimary project • Implemented new clinical ICT solutions to improve patient treatment.• H - value = 1,77 (best ever in Norway)• No errors that have disturbed clinical opertaion • The local hospital employees are very satisfied

Lessons learned

• We have very good experience taking the responibility to do time schedule coordination between parallel contractors.

• It is very important to involve the local hospital administration in an early face to settle functional requirements. This give ownership to solutions and reduses the number of change orders!

• Planning of clinical startup and transfering of the hospital must start early in collaboration with the local hospital administration.

Construction client: Must take responsibility and be the leading part !

Next project – improvements ?

We will copy the steering model in next project and reuse as much as possible from the project material and solutions. Some solutions will of course be modified, but no big issues.

– Some adjustments in the contracts- things can never bee expressed clear enough

– Extended use of BIM in engineering and construction– Most important: ICT projects should bee a part of the construction project

from preliminary project. The construction client is the only part with full responsibility for time schedule and the ability to overlook the totality.

New hospital in Drammen-Buskerud