Vanderbilt University Medical Center

Finding space for healthy growth┬áVanderbilt University Medical CenterÔÇÖs rising profile has put pressure on its central campus. Keith Regan learns about its creative solutions, including building around existing structures and reusing a suburban shopping mall for outpatient care. Founded in 1875, Vanderbilt University Medical Center has recently seen its national profile grow dramatically. US News & World Report recently ranked the center among the top 15 hospitals in the nation.   The Nashville, Tennessee, medical center, which features a world-renowned cancer center among its many specialty care facilities, also ranked 10th in the nation in terms of National Institutes of Health research grant funding secured in 2007. The centerÔÇÖs higher profile has meant growth pressures on the medical center campus, which is headquartered on 52 acres in the central part of the city, with everyone from researchers to patients requiring more space, says Warren Goodwin, vice president of facilities planning and development at VUMC, which is associated with nearby Vanderbilt University. Goodwin joined the campus in March 2008 after spending two decades building healthcare facilities in various public and private sector positions and is now overseeing some $1.2 billion worth of construction work at Vanderbilt. That work includes not only expansion on the central campusÔÇöoften a challenge given the fact that the space is nearly built out alreadyÔÇöbut also the centerÔÇÖs first expansion into the surrounding suburbs. The center recently leased 56 acres that host what was the Nashville areaÔÇÖs first indoor shopping mall when it opened in 1967. As newer malls went up in the area, the shopping center, known as 100 Oaks Mall, went into decline and is now poised to become the centerpiece of the medical centerÔÇÖs efforts to boost its ability to deliver both outpatient and inpatient care while continuing to expand its research capacity. The satellite campus will add some 450,000 square feet of new space to the medical center when it opens in February 2009, with outpatient clinics and offices located on the second and third floors of the mall and in an adjacent office tower. The move, which comes with a $99 million price tag for renovation and relocation expenses, enables the center to relocate dozens of employees, creating much needed space on the core campus and making it easier for outpatients to get to and from appointments, thanks to easy access and ample parking at the mall site. The site will also contain a wellness center and some support functions for the medical center. ÔÇ£WeÔÇÖre at the point where weÔÇÖre stressing the infrastructure on the main campus,ÔÇØ he adds. ÔÇ£ThereÔÇÖs a limit to how much we can pile up in one spot.ÔÇØ Already, new buildings are being added by building over and above existing structures. For instance, a facility known as Medical Research Building #4 was recently completed and fit into the campus by bridging it over lower buildings. Design is already under way for a fifth research building. ÔÇ£We were in the top 10 in the nation for NIH funding in 2007 and expect that to go even higher this year. We need to find space for those researchers so they can keep growing their work.ÔÇØAlso new on the main campus is a Critical Care Tower, being constructed at a cost of $169 million. Slated to open in November 2009, the facility will house more than 300,000 square feet of space and was also built over and adjacent to an existing patient tower on campus. Still in the preliminary design stage is the Life Sciences Engineering/Clinical Research Center, a joint venture between the medical center and VanderbiltÔÇÖs School of Engineering. The university hopes to have that center, which will create 300,000 square feet of multidisciplinary research space when it opens in 2012, as a centerpiece of its efforts to develop synergistic relationships between engineers and medical researchers. Also in the planning stage is a major expansion to the centerÔÇÖs Monroe Carroll Jr. ChildrenÔÇÖs Hospital, a $244 million project that recently got a boost to its fundraising efforts thanks to a $20 million donation from the estate of Monroe Carroll Jr. All new construction on the campus is being designed with sustainability in mind, with all the projects being planned to achieve LEED certification from the US Green Building Council. The ChildrenÔÇÖs Hospital project will be built in conjunction with a 1,100-car parking deck built underneath it, which helps address long-term efforts to manage traffic and parking on the densely built campus. With so much work under way, Goodwin says the university takes great pride in its safety record during the building boom, which also includes a multitude of smaller fit-out and upgrade projects scattered across campus. The school has clocked 15 million man-hours of construction with no lives lost and 12.6 million man-hours with no lost-time accidents, and it has an incident rate that is 70 percent below the national average. ÔÇ£WeÔÇÖre at the top of just about any category you might want to look at in terms of safety,ÔÇØ he notes. Under GoodwinÔÇÖs guidance, work now in the pipeline is being handled mainly through an integrated project delivery model, an approach he has used before to deliver some 300 healthcare-related construction projects during his career, and one that involves bringing architects, designers and contractors together as early as possible in the process. The approach can also help combat rising prices by enabling a search for alternative construction methods early on in the design process. ÔÇ£ItÔÇÖs more of an interactive team environment that enables us to get the benefit of the knowledge of the entire group brought to bear on the projects,ÔÇØ he says. ÔÇ£Architects understand design and contractors understand construction, and when you get them working together in an environment that facilitates cooperation and communication, you can create synergies that can be important to the success of a project. The bottom line is to get good ideas to the table regardless of how they get there.ÔÇØThe centerÔÇÖs project management capabilities are also being expanded to enable project managers to hand off more day-to-day management to contractors so they can focus on the bigger picture. ÔÇ£Construction is one line item in the budget; there are maybe 40 others, and we want the project managers to have the skill sets to be able to look at other things, like technology, infrastructure and communications. Those aspects of a project can add up to significant dollars, and thatÔÇÖs where we want their attention to be focused.ÔÇØ┬á