St. Francis Health System

Growing in a building boomKeith Regan details how St. Francis Health System has used close project management and oversight to keep its projects on track even as contractors are being tempted by other work. About five years ago, St. Francis Health System developed a long-range facilities master plan that would address the institutionÔÇÖs growing role in delivering healthcare in the city of Tulsa, Oklahoma, and the surrounding suburbs.  According to Robert Butler, senior vice president for facilities management, of the top ten priorities raised in the plan, eight have already been addressed or completed. In that time frame, St. Francis has converted a suburban hospital that was targeted to become a heart hospitalÔÇöa joint venture with a team of cardiologists envisioned in the┬á master plan did not come to fruitionÔÇöinto a medical surgical building, a $35 million renovation and conversion project. ÔÇ£Things havenÔÇÖt unfolded exactly the way we thought they would five years ago. ItÔÇÖs a dynamic market and weÔÇÖve had to remain flexible,ÔÇØ Butler notes. St. Francis also spent $80 million to create a childrenÔÇÖs hospital facility with 104 new beds and is in the midst of a multiphase project that will create a specialty heart hospital within the main Yale Hospital. Instead of a standalone facility, the new heart hospital will be built as a hospital-within-a-hospital and will be located in space currently used in part for intensive care units inside the systemÔÇÖs Yale Hospital. This requires that those facilities be moved; theyÔÇÖll also be expanded at the same time. That in turn requires moving an orthopedics unit. ÔÇ£ItÔÇÖs been a real domino effect, with a lot of moving parts that require a lot of coordination and cooperation to happen smoothly,ÔÇØ Butler says. In addition to the coordination required, the other major challenge lies in keeping projects moving forward on schedule. ÔÇ£Time is money, not just for us but for the contractors as well,ÔÇØ Butler notes. ÔÇ£When you focus on that common goal, it makes it easier to get cooperation.ÔÇØ An in-house team of engineers and architects that Butler heads up serves as project managers on the work, and Butler himself keeps a close eye on progress with weekly update meetings on all projects. ÔÇ£It enables us to keep track of whatÔÇÖs staying on schedule and whatÔÇÖs falling behind and then to quickly address those situations.ÔÇØ That has become an issue because Tulsa is enjoying a robust economic time in the construction segment, thanks to the recent surge in oil prices and publicly funded construction endeavors such as a convention center that took three years and significant manpower to complete. ÔÇ£There was a lot of competition for contractors and labor,ÔÇØ Butler says. ÔÇ£It hasnÔÇÖt been hard to get contractors, but it has been hard to keep them on the job and get them to devote the resources instead of diverting them to the squeaky wheel all the time.ÔÇØ┬á┬á┬á In all, the hospital system has 2 million square feet of space and some 800 beds, plus an 80-bed psychiatric facility on campus. As the shifting of resources takes place, gains are being made and modernizations taking place inside the 1960s-era hospital. For instance, one relocated ICU unit will expand the hospitalÔÇÖs number of ICU beds from 30 to 36, in two 18-bed units that are set up more as private rooms than in the original ward-style configuration. ÔÇ£WeÔÇÖve been getting good feedback from doctors about the new setup of the ICU units and the way itÔÇÖs all laid out,ÔÇØ Butler says. A future project now in the drawing-board stage is an expanded emergency room and trauma facility, one that reflects the hospitalÔÇÖs role as a major trauma center for the area. ÔÇ£The emergency room is designed to treat walk-in patients and that sort of thing, but the reality is that we get a lot of ambulance traffic and helicopters flying in,ÔÇØ Butler says. The emergency room now cares for 85,000 patients a year, far above the original expected capacity of the facility. ÔÇ£ItÔÇÖs a big operation, and it needs space and amenities that match the work being done there.ÔÇØAnother major project at the facility is a joint venture with the W.K. Warren Foundation, which founded the St. Francis system in 1960 and today directly owns most of the medical office facilities in the system. All the main campus facilities are run from a central physical plant that provides electrical, heating and cooling services. There, an ice vault will be installed that will enable the facility to use off-peak electricity capacity to chill water, which will then be stored in the vault until it is needed during the day. The $30 million project has an expected payback period of seven years, based largely on the differential in electric power rates between daytime peak hours and evening rates. The project is feasible, Butler says, because of the size of the system and because the warm climate requires cooling services year-round. That effort is the biggest part of a larger push to increase energy savings through activities such as installing thousands of more efficient light fixtures and better regulating motors that operate around the clock. That project and others emphasize the importance of facilities management and improvements to the operation of the system. ÔÇ£I spent a long time on the operations side, so I know what theyÔÇÖre trying to achieve in terms of reducing costs and delivering more services even as revenues go down. IÔÇÖm a firm believer that facilities can be a part of the answer for the future of healthcare. Everyone here understands how important it is to have the right facilities at the right time in the right place, whether itÔÇÖs anything from parking garages to a big enough emergency room.ÔÇØ