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PDF SB1953HospitalConstructionIB PDF
PDF SB1953HospitalConstructionIB PDF
ISSUE BRIEF
do so properly, they must be well designed,
The third phase covers bidding, construction,
safe, and efficient. Recent hospital construction
licensing, and evaluation. Licensing is provided
planning in response to the seismic safety
by the U.S. Department of Health Services
mandates of SB 1953 will require many hospital
and the California Health and Human Services
boards of directors to oversee major building
Agency. Only with their approval can the
projects. Because such projects are relatively
hospital operate and be eligible for Medicare
infrequent, board members and leaders may
and Medical reimbursement.
have only limited experience with the many
complexities and challenges involved in the Implementation of the hospital planning,
planning, design, and construction of a hospital design, and construction process is depicted on
facility. This issue brief is intended to acquaint the flow chart on page 2. The chart is based
non-experts with the way in which hospital upon major projects or extensive re-builds which
construction projects are developed and typically take seven or eight years to complete.
delivered. Smaller projects, such as interior remodeling,
use the same process but may not require the
Background land use approval activities.
The hospital planning, design, and construction
process takes the form of three distinct phases. Phase 1: Project Definition and
Planning
The first is the definition and planning for the
Project Request: All hospitals should have a
hospital project itself, including the project
process to identify construction projects and
request, strategic plan, facilities needs assess-
requests. Smaller projects are often a part of the
ment, specific program, and concept design.
routine planning and budgeting process; larger
Second is the preparation of schematic projects typically require focused attention and
design, design development, construction consideration within the context of the hospitals
documentation, and securing a building permit. longer range strategic and capital planning
This phase involves two public agencies: the processes.
city or county for land use approval, and
Strategic Plan: Most hospital construction
the Office of Statewide Health Planning and
projects are the result of either changes in
F EBRUARY
2007
Figure 1: Elements of a Hospital Building Project
Land Use Approval Planning, Design, and Construction Building Permit Approval
PHASE 1
Project Request
Strategic Plan
Needs Assessment
Specific Program
Concept Design
PHASE 2
Schematic Development
Building Permit
PHASE 3
Bidding/Construction Inspection
Licensing/Occupancy
Evaluation
the numbers of patients served, new treatments, patients, physicians, and the board of directors. The
or technologies, or strategic initiatives that further plan should address the patient care and community
the hospitals mission. All hospitals should have a service goals for a period of at least five years. The
strategic plan that has been developed with the partic- proposed building projects encompassed within the
ipation of hospitals administration, professional staff, strategic plan should both allow the hospital to grow
a conditional use permit are obtained, the building tals select a construction manager at the same time
permit will be issued. A final detailed cost estimate they select the architect/engineer. The construction
will also be prepared during this period. manager becomes part of the project delivery team
and advises the hospital on construction systems and
Phase 3: Bidding, Licensing, and techniques that may by incorporated in the design.
Evaluation They may also provide each of the cost estimates
The bidding and construction of a hospital project prior to the start of construction as well as manage
can take several forms. The first is to have pre-quali- the project delivery schedule.
fied general contractors bid competitively based
In some instances the construction manager is
on the permitted construction documents. This is
directly involved in the construction process by
the traditional way to select a contractor, and most
managing all the major sub-contractors and guaran-
publicly funded projects use it. However, some hospi-
teeing a maximum price. This more sophisticated
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